M.R.S.A. – a lonely journey

In writing this story about my own personal experience of MRSA infection, I am not looking for sympathy – simply understanding of where I’m coming from and of what has helped to form my views. I welcome comments.

Part 1: Medical History

MRSA – Multiple Reasons to Shout Aloud. They say you never forget ‘the day’ you were told you had cancer. Well, I’ll never forget the day I was told I had MRSA. The news came like a bolt out of the blue. It has had a major impact on my life and continues to this day to be an unknown entity.

I have a long history of chronic sinus infection with multiple admissions to hospital for surgery and intravenous antibiotic treatment over a period of 20 years. I also have an inherited genetic condition, Ehlers Danlos Syndrome (EDS), which is basically a connective tissue disorder that affects different people in different ways. In my case, it’s manifested itself in the connective tissue of my joints leaving me with a tendency to dislocate joints/to tear ligaments easily and in some instances, this has required surgical repair. It also caused me a lot of problems during pregnancy, both with pregnancy loss and as a result of two full-term deliveries (lucky old me!) with numerous admissions to hospital for gynaecological surgery. I’ve had at least 40 admissions to hospital so far with all the various medical problems over the years. Another side effect of EDS is a tendency to form abnormal scar tissue following injury/surgery. It took many years of failed surgery before my diagnosis of EDS was made but by then, it was too late. The damage had already been done. With my history of acute frontal sinus infection requiring repeat surgery to manage it, scar tissue now blocked the natural drainage channels and severe infection (abscess in the bone of the skull) had become a reality. My life was in real danger at times because of the possibility of rupture of the thin wall of bone between the abscess and my brain, and with an associated risk of developing septic meningitis.

Read Part 2 tomorrow.

Sick Waiting

What is about politicians – I don’t understand them? In the run up to the election Mary Harney was pushing private healthcare with unseemly haste. A solution to end the Nurses’ work-to-rule was found in double quick time just ahead of polling day. Even Bertie Ahern rushed off to dissolve the 29th Dail in the early hours of a Sunday morning. And yet, here we are post-election in ‘limbo land’ and nobody seems in any hurry to do anything. The country is ‘on-hold’ while the politicians try to decide who really won the election! Fianna Fail don’t know who to get into bed with next. Fine Gael seem to want to get into bed with anyone and everyone.

I’ll tell you who’s bed they should get into. I’d like to see them take Orla Tinsley’s place the next time she is hospitalised for treatment of her cystic fibrosis. Her life is quite literally in politicians’ hands. Two days before polling day she made an impassioned appeal (Irish Times 22/05/2007) to the government to allow her the best shot at life. Orla is 20. Each time she’s hospitalised she has to to endure appalling hospital conditions in order to get the treatment she needs to stay alive. The average life expectancy for a person with cystic fibrosis in Ireland is 21. In Northern Ireland, it’s 33 and in Britain and the US, it’s longer again. Ireland has the highest incidence of CF in the world and yet those suffering from the disease here have to fight to stay alive in the shambles that is our Health Service.

Orla is just one of many, many people who deserve a better shot at life. Get a move on Bertie – there’s no time to waste! It’s time for action. You’ve been given another chance at life – some people don’t have that choice you know.

Dem Bones – Dem ‘Surgeons’

The fourth and final episode of Surgeons lived up to expectation with a graphic insight into the world of orthopaedic surgery. This week we witnessed both hip and knee replacement surgery being carried out (with full sound effects included) by surgeon Sean Dudeney in Cappagh Hospital, whose other passion in life seems to be repairing old cars. Orthopaedic surgeons, we were told are the sort of people who “like fixing things”. That’s great, but I’m not completely convinced that I want to know exactly ‘how’ they go about fixing our bones and joints. It’s hugely impressive but pretty gorey stuff. Think ‘meat on a slab’ and you’re half way there. We were also introduced to the world of paediatric orthopaedics with complex spinal surgery being performed by surgeon Frank Dowling at Our Lady’s Hospital, Crumlin. His clear joy of working with children and helping to improve their quality of life was marred by the frustration he felt at the hands of HSE and the continuing Dickensian conditions at Crumlin. Frank Dowling told us that 15 years ago he spent two years on a committee having regular meetings with Health Board executives to plan out a much needed new out-patient’s department for Crumlin, right down to the nitty gritty of where the sockets would be. Just when they reached the final stages of negotiation news came through that the funding required was not available and Crumlin today remains in the same crummy condition with lack of privacy and space and it’s associated infection control risks. And our Taoiseach, Bertie Ahern continues to insist that our Health Service is not in crisis. It’s crumbling at it’s knees and even the best orthopaedic surgeons can’t fix it!

‘Surgeons’ was yet another fantastic series from Mint Productions. The skill of the surgeons was a wonder to behold. And the bravery of the patients portrayed throughout the series was thoroughly uplifting. It was an true insight into humanity. As we were told each week “surgery by it’s nature – must injure first in order to heal”. Bring on more please!

Wrong Diagnosis

See breaking news about a woman from Tipperary who was given a wrong diagnosis following a breast biopsy.  She was given the all-clear when in fact her biopsy was malignant and she subsequently required a mastectomy.  Cork University Hospital and HSE have apologised to the woman.  Wouldn’t give you a lot of confidence in the system if you’d just had a breast biopsy, would it?

Surviving Breast Cancer

Have a look at One Breast Less an everyday story of breast cancer to witness first hand the impact that breast cancer can have on family life. This blog was shortlisted for the 2007 Irish Blog Awards. It’s a wonderfully honest and candid insight into ‘living with cancer’ and ‘surviving’ the Irish health service.

Breast Cancer – Surgeons RTE 1

Wow! What a programme. If you’ve had breast cancer or know someone who’s had breast cancer (let’s face it – who doesn’t know someone) then this was the programme to watch last night. The third episode of ‘Surgeons‘ (a 4-part series) covered the whole topic of breast cancer from diagnosis, through surgery to recovery and finally, to reconstruction of the breast. It was graphic stuff (not for the recently diagnosed or faint-hearted) and was hugely insightful into the emotional roller coaster that follows a diagnosis of breast cancer. You could not but be moved by the experiences of the women portrayed in the programme. I take my hat off to them for taking part in such intimate filming at such a difficult time in their lives. I also salute the two breast surgeons featured in the programme – Arnie Hill at Beaumont Hospital and Margaret O’Donnell at St. Vincent’s Hospital. Again, this programme allowed us behind the scenes of a surgeon’s personal life and gave us an insight into the dedication required to achieve a high level of skills. As a television viewer, I felt as if I was actually in the consulting room with the patient when news was given that her breast biopsy was malignant. I agonised with her as to what lay ahead. We were told that it is important when bad news is given to a patient that there is some positive slant to it – ‘hope’ is what keeps everyone going. As Arnie Hill said, “it’s not just the patient that you’re breaking this news to but their husband/partner, children and extended family as well”. It was also interesting to witness how this same young patient’s mother gradually came to terms with her daughter’s diagnosis by avoiding the use of the ‘C’ (cancer) word. She simply told people that that her daughter had a ‘tumour’ in the breast. When asked if the tumour was ‘benign’ (innocent) she would just reply “no” in an effort to avoid using the term ‘malignant’.  She was so supportive of her daughter and it was very moving to watch them both receive good news following the surgery.

Anyone who would like further information and support can contact the Irish Cancer Society Action Breast Cancer. These services are free, confidential and accessible and include a national helpline, publications, one-to-one support, breast awareness talks, and advocacy.

(Co)-Location, (Co)-Location, (Co)-Location

I just don’t get it. As I understand this co-location policy, Fianna Fail wants to free-up more Public beds in Public hospitals for Public patients. They say that the quickest way to achieve this is by moving Private patients out of Public beds into co-located (cushy) Private hospitals on Public hospital sites. These Private hospitals are to be staffed by Consultants who agree to work in the Private system only. And in the long term, it’s hoped that Public hospital Consultants will agree to work only in the Public sector. In HSE speak, this policy will free-up approx 1,ooo Public beds for those patients without private health insurance. But let’s look at what else this policy will achieve.

Without doubt it’s going to cause an even wider divide between the Public and the Private systems. The Private health insurance market has gone mad and is set to get even worse with this government’s policies. Are the hospital Consultants happy with the HSE proposals? No. The HSE is interfering in doctor/patient relationships. Is it any wonder that the IHCA (Irish Hospital Consultants Association) is refusing to agree to new contracts. Private patients will always continue to need both elective and emergency care in Public hospitals as these are the centres of excellence for many complicated conditions. What is a Private consultant meant to do when his/her Private patient is re-admitted as an emergency to a Public hospital following surgery in the Private system. Are they expected to abandon their patients?
Could someone please explain to me why patients in Public hospitals are expected to put up with filthy, old-fashioned hospital conditions while Private patients are set to get all the nice new modern, clean facilities? And why is it that Public patients get lousy food when Private patients have á la carte menus? You’re either sick and in need of good hospital care or you’re not.

Surely it makes sense to concentrate resources on getting a decent Health Service that works for everyone. I say – one for all, and all for one! But it’s not about common sense is it?

A Way Forward – The Nurses’ Work to Rule

Yesterday the Minister for Health, Mary Harney, spoke to 400 members of the Irish Nurses Organisation (INO) at their special delegate conference in Dublin. She told the nurses that the Health Service Executive (HSE) was looking for a ‘way forward’ in this dispute – not a ‘victory’.  I’ve got a suggestion for you Minister.

It seems to me that the nurses have already achieved their goals with their ‘work to rule’ – with HSE picking up the tab. The nurses have reduced their working hours (while on the picket line) and they’ve stopped doing all non-nursing duties such as administrative work so that they can concentrate on their patients.

We’ve been repeatedly told by HSE that it’s costing €2 million per week extra (paid out of our taxes) to manage the Health Service throughout this dispute. In fact, this morning on the radio (Morning Ireland RTE 1) I heard HSE CEO, Prof. Drumm state that it’s costing €3 million per week. Has anyone heard HSE state ‘why’ it’s costing €3 million per week?

Surely, the way forward in this dispute is there for all to see?

Mary, Mary, quite contrary

So the talks between the INO, the PNA and the HSE continue at a painfully slow pace – at a painful cost of €2 million (of our hard-earned taxes) per week apparently to the HSE and of course also, at the expense of patient services across the country. And our Minister for Health continues to alienate all around her in the Health Service, her latest target being the VHI.

The Government announced proposals last week to reform VHI. Part of this plan is to be achieved by bringing forward the deadline for VHI to meet normal solvency requirements from 2012 to the end of 2008. As anticipated, VHI are unhappy and their trade union, Amicus, are looking to the State to provide the injection of funds required. As a member of VHI since age 18 (and I’m no spring chicken I can assure you) I feel entitled to ask the following questions:-

Why does VHI pay in full for all elective investigative in-patient stays? Surely when something is elective it means that it is by choice and therefore the patient should carry some responsibility. It strikes me that there are an awful lot of private patients choosing (perhaps with encouragement from their private consultant) to opt to have their investigations carried out as an in-patient because all expenses will be paid in full. Why trek around the place having out-patient tests which have to be paid for up front by the patient (and will only be partially re-imbursed at the end of the subscription year) when VHI is prepared to fully fund you as an in-patient in a private hospital with an á la carte menu to boot. And in the words of Garret FitzGerald, Irish Times 28/04/07, there is presently an “unseemly haste in pushing private healthcare”.

The same principle applies to out-patient scans such as MRI’s and CT’s. The VHI has a direct payment scheme in place with many of the new private hospitals settling the bill directly with VHI so that the private patient doesn’t even see the cost of the procedure. Why would a private patient opt to have a good old-fashioned x-ray which still costs good old-fashioned money when the option to have an MRI or CT is available to them free of charge. Surely this is madness and is ‘bleeding’ VHI to death?

So no surprise then that the annual subscription rates continue to rise and rise. I could go on and on.

Oh Mary, Mary, quite contrary – how does your VHI grow?