Home Again

July 28, 2008

My good friend Bendy Girl, who is also an EDS‘er, asked me to bring back some photos of my holiday. Thankfully, she didn’t specify that I had to take the pictures myself. I didn’t. All credit is due to my husband, Jaimie, who has me spoilt with his beautiful, professional photographs. We have just spent three fantastic days together in Connemara in the West of Ireland. I hope you enjoy these shots.

This was the view from my ‘hotel’ last night.

And the lovely view from my bedroom window.

My hotel for the night, with broadband connection.

A salmon jumping on the river at Ballynahinch Castle.

Galway hooker in Roundstone Bay.

Herbaceous border in restored Victorian gardens at Kylemore Abbey.

Cut turf drying out on Roundstone Bog.

Sea Holly growing on a Connemara beach.

We’ve had some very good times over the years camping in this location, especially when our children were young. On this occasion however, we only spent the last night of our holiday in a tent. The rest of the time we ‘cheated’ by staying in the luxury of the Ardagh Hotel, just outside Clifden on the Ballyconneely Road. This is a place we’ve also come to love in recent years as our bones grow older and wearier. Our two night stay this weekend included a 5-course gourmet dinner plus two superb breakfasts and the price was €149 per person sharing. To put this into perspective, it costs me at least €150 each time I have to see a specialist. I’ll leave you to guess which one leaves me feeling better.

I hope these pictures are enough to make Bendy Girl happy too!

I’m not here

July 25, 2008

I’m away. I’m off to the wilds of Connemara this morning for a few days of fresh air, walking the white beaches, eating seafood and drinking lots of Guinness. I may even dip my toes into the sea and while it’s pure agony to get into the cold, clear water of the Atlantic, the healthy feeling afterwards is magic!

Before I go, I want to wish a speedy recovery to the Distant Rambler who is stuck in hospital at the moment, following surgery. GET WELL SOON, LAURA! I’ll raise a pint to you.

Please feel free to leave me a comment as I shall check my blog while away. I couldn’t possibly leave my friends behind!

How Great Thou Art

July 24, 2008

Last night, I listened to RTE radio’s ‘Documentary on One‘ and was completely blown away by ‘The Long Goodbye’, a hugely moving documentary on Alzheimer’s disease. It was first broadcast in January 2007 and has since won a silver medal at this year’s New York Media Festival. The documentary follows the daily routine of a couple who have been married for 44 years but who’s lives have been changed dramatically in recent years, due to Alzheimer’s disease.

“Seven years ago May started mislaying her handbag and amounts of money and her husband Matt noticed that she would start to cry during the day. She was diagnosed with depression but after a year and a half, it finally emerged that May had Alzheimer’s disease.

On the verge of his retirement, Matt was now facing a new journey with his wife May, as her carer. The couple moved from their home in London back to her hometown in the midlands.

As May’s illness has progressed, the couple have swapped roles. Matt has taken over all domestic tasks, a world he never inhabited during the first few decades of their marriage. As her carer and husband, Matt acts as May’s voice and is her rock.

This documentary looks at the relationship between Matt and May, as May’s ability to communicate decreases with progression of the illness while Matt’s responsibilities for her care continue.”

Compiled and presented by Sarah Neville
Production Supervision Liam O’Brien

Click here to listen to the documentary.

RealPlayer is required to open. Fast forward to 2.23 minutes and prepare to be blown away by the power of love. And as Matt would say “play every day as it comes.” Who knows what the future holds?

With thanks to RTE Radio One.

Aychessee Sinking?

July 21, 2008

What’s that about? It took me a while before the penny dropped.

The “Aychessee” is a sinking ship according to Prof John Crown. “A suitable alternative needs to be launched before it sucks our health service and our economy down with it into Davy Jones’ Locker.”

You can read all about it here.

If you’re still confused as to what this is all about, it may be because you pronounce “H” as “Haych” in keeping with Irish ways.

Aychessee = HSE. Geddit?

It remains to be seen if Captain Harney and First Mate Drumm, will stay with the sinking ship.

Risk Equalisation

July 18, 2008

Does that affect me? The answer could be ‘”Yes”. ‘If you are old/suffering from a long-term medical condition then this week’s ruling in the Supreme Court could well end up costing you a great deal more for health insurance cover.

Risk equalisation is a scheme to ensure that community rating is implemented whereby everyone, young and old, sick or healthy, pays the same premium. It is a scheme that provides for insurance companies with fewer elderly subscribers to compensate other companies who have higher numbers of medically vulnerable subscribers. This week, the Supreme Court struck down legislation which our government had in place to ensure that risk equalisation was enforced. Up until now, this legislation placed restrictions on other insurers thereby restricting competition within the private health insurance market. The VHI is the longest serving health insurance provider and carries the largest number of elderly customers. It currently holds a monopoly with 70 percent of the health insurance market and as the state insurer, was protected up until now by risk equalisation. This week’s decision is without doubt, an embarrassment for the government and it may have serious consequences for the VHI and it’s subscribers. A more detailed explanation of the situation can be found here in this week’s online edition of The Irish Medical Times.

Competition is good but a balance has to be found whereby those most vulnerable in our society are not squeezed out of the private health insurance market. This latest development potentially represents a big upset to our Minister for Health’s plans to privatise the health service. Her future in the Department of Health, is looking more than a little bleak.

An Itchy Business

July 16, 2008

I have a problem that has me scratching my head big time. Ever heard of psoriasis? It’s an unpleasant skin condition that people tend not to talk about. Why? Because there’s nothing sexy about it and yet it has the potential to have a serious impact on people’s lives. I’ve no problem talking about psoriasis, I’ve no reason to be ashamed of it and I’m dying to find someone else who’s been down the same road.

Last January, I started to develop what looked like dandruff on my scalp. I consulted my hairdresser who recommended a dandruff treatment shampoo which she promised would be highly effective. It was useless and the scaling on my scalp continued to gradually worsen. After I’d exhausted every avenue with over-the-counter treatment shampoos, I consulted my GP for advice. He prescribed several lotions and potions but none of them had any lasting effect. Soon afterwards, I noticed that I’d developed a rash in both armpits so I went back to the doctor and came away with yet more prescriptions. When these failed to halt the rapidly deteriorating condition of my skin, I was referred on to a dermatologist. She confirmed that the skin problem is an unusual form of psoriasis, called inverse psoriasis. My sore and flaking scalp is also a form of psoriasis. Apparently, I’m in the target age bracket and with a strong family history of psoriasis, I was a sitting duck waiting for this to happen. Psoriasis is thought to be an auto-immune condition and there is also a definite genetic link to it. Frankly, my medical history is already so long, I could have done without this bolt-on extra but having said that, I’m all too aware that things could be much, much worse.

I now follow a twice daily regime of baths, treatment ointments and moisturising creams. It’s terribly tedious and time-consuming but it’s effective and as long as I follow the regime, I can keep my skin under control. The scalp condition has been another story however. It has failed to respond to the multiple treatments prescribed and at this stage, I’m getting desperate to find a remedy. So far, the dermatologist has recommended the following shampoos: Nizoral, Capasal, Elave, T-Gel sensitive and Oilatum scalp. I’ve also been prescribed Cocoid (coal tar ointment), Bettamousse (steroid mousse), and Dovenex (calcium solution) treatments. My scalp initially responds positively to every new treatment and my hopes sore only to be dashed again when it relapses shortly afterwards, no matter how long I persist with the treatment. I’m nearly driven mad at this stage with the persistent itching, dryness, flaking and soreness of my scalp. I’ve tried rubbing pure coconut oil into my scalp but again, the relief is very short-lived. I recently found an over-the-counter scalp moisturiser called Exorex. It’s an expensive product but it has calmed my scalp more than anything else so far.

At this stage, the psoriasis is having a significant impact on my life and I need to get some control over it. You could say, I’m itching to find a solution! Do you know of anyone who has suffered from psoriasis of the scalp and can you recommend a treatment that has really worked? I’ve done everything within my power to reverse the process but at the moment I’m not winning the battle. I know that a holiday in the sunshine would probably work wonders but I think what I’d really appreciate more than anything, is a long holiday from doctors.

Saving the HSE

July 12, 2008

The Health Service Exexutive (HSE) was established on January 1st, 2005, a few months after Mary Harney took over as Minister for Health. At the time she promised that the HSE would bring about a more integrated, effective and accountable health service. Three and a half years have passed and none of the promised reforms have happened. Harney is now setting out to save the HSE, from itself, by doing an about turn with it’s organisational structure. For an excellent overview of the whole situation, I highly recommend that you read this article courtesy of The Irish Times online.

With thanks to Sara Burke, journalist and health policy analyst for her superb analysis of Mary Harney’s tenure in office. It’s the best explanation I’ve seen of the so-called reform of our health service. Hats off to Sara.

Knowledge of MRSA

July 12, 2008

Did you know that hand washing is an effective way to prevent MRSA contamination and infection? According to a recent survey, the main source of the public’s information about MRSA, is through the media. The results of the survey have shown that there is a clear need to further educate the public on how to prevent the spread of infection. You can find a report here in The Irish Times online. Ever since my own brush with MRSA, I’ve tried to make it my business to become better informed about infection control and to spread the word.

MRSA is a subject close to the heart of The Biopsy Report. Consistently, the top posts on this blog are the ones which contain information on MRSA. The most frequently used search engine terms all refer to queries about MRSA. Terms such as “boils on butt”, “do you have mrsa forever”, “antibiotic resistance”, “chances of mrsa recurrence”, “superbug news”, “what is difference between mrsa and C Diff” and “mrsa nasal swab”, appear regularly and show that there is a huge hunger out there for more information on MRSA. Two funny search terms which appeared recently were “mrsa bed and breakfast” and “steph and staph infection together.” The mind boggles to think what was going through the minds of those people?

There is no doubt that infection control would benefit from greater public awareness. The media coverage of MRSA is far from an ideal source of information because of a tendency towards a sensationalist approach. We need a well-orchestrated campaign to combat the spread of MRSA and where better to start than online. Spread the word, not the germs.

Tighten your Belt

July 8, 2008

Well, it’s finally happened. The economic downturn is upon us, our public finances are under severe pressure and major cutbacks in healthcare spending are anticipated. Our already ailing health service is set to suffer even further and it almost goes without saying that patient care will be compromised.

Brendan Drumm, the HSE chief, believes that in the present economic environment, the health service could face five years without any extra funding. He also believes that there is no reason why the standard of health service provision should suffer as a consequence. Our Minister for Health, Mary Harney has warned that hospitals must operate within budget and must do so without impacting on patient care. We’re told that the way our hospitals are being run is both ineffective and inefficient. I turned on the news last night to hear that hospitals across the country are facing a scaling back of services with staff cuts and ward closures. One hospital has already accused the HSE of gross neglect of patients and claims that the cutbacks are being done at the expense of patients. A spokesperson for the HSE insisted that patient care will not be compromised by the cutbacks. Who do they think they’re fooling?

My biggest fear is that patient’s lives will be put at risk by these further cutbacks in spending. There is already a serious problem in our hospitals with the level of healthcare associated infections (HCAI’s) such as MRSA and Clostridium difficile. Poor cleaning, overcrowding, inadequate facilities, lack of infection control staff, poor management and a lack of accountability have all contributed to unacceptable levels of infection and death within our health system. There is also growing public disquiet. We are constantly promised that improvements are “planned” or “under way” but how can this be so when cutbacks in basic front-line services are being simultaneously requested. This is not the time to talk about cutbacks and the necessity of hospitals staying within budgets. The HSE has lost sight of the needs of the patients. It increasingly prioritises bureaucracy and finance rather than health, with numbers and budgets taking precedence over real people and care.

We are once again being asked to tighten our belts. Brendan Drumm says that it is the duty of everybody, including the health service, to use taxpayers’ money more effectively. This is all very well and good but could someone please explain why this situation has arisen after a whole decade of unprecedented economic growth? Is there any Government accountability left in the area of healthcare?

UPDATE: In case anyone ever thinks I’m exaggerating about the state of our health service, have a look at this post which can also be found over at Irish Election. It details the experience of bringing a child to A&E and is a classic example of how the system is failing to provide emergency care. This post completely mirrors my thoughts.

Why, Oh Why?

July 2, 2008

I accompanied my elderly mother to a high-tech private hospital yesterday for a check-up with a specialist. While she received nothing but the best of care, I couldn’t help but feel very uncomfortable with the whole experience. The gap between the public service and the private sector seems to be ever widening and I really fear for the future of our health service if privatisation continues to be seen as the way forward.

My mother is a long-term resident in the dementia unit of a large public nursing home. She is severely physically disabled and suffers from an unusual form of dementia. When she was admitted to the nursing home some years ago, I was told that she would no longer require health insurance as all care is fully covered by the public health system. Knowing what I do about the state of our health service, I ignored this advice and opted to maintain my mother’s basic insurance cover. Every citizen in this state is entitled to a bed in a public hospital but the reality is, only the very sickest patients and accident victims succeed in getting a bed when they need it. Otherwise, the waiting lists for specialist appointments, out-patient services and elective admissions, are atrocious. I wanted to keep her insurance as a safety valve in case we ever needed to access specialist intervention for her.

As things turned out, my mother developed a nasty auto-immune condition recently and required urgent specialist attention. The nearest appointment we could get for her at the local public hospital involved a four-month wait. A private appointment was available at the Beacon Hospital for the following day so naturally I gave the go-ahead to proceed with this appointment. Her insurance policy covers out-patient expenses incurred for investigations carried out in a private hospital but it offers little or no help with appointment charges. Frankly, I didn’t care how much it all cost as long as my mother got the urgent help she needed. As it transpired, she required day surgery and her insurance thankfully covered this expense so the charges for her appointments pale into insignificance by comparison. She will have to be carefully monitored until her condition settles.

The Beacon Hospital is quite literally a beacon of the private healthcare market. It’s quiet and efficient but it’s also ‘over the top’ in luxury and exudes wealth out of every corner. The leather armchairs were so huge in the waiting area where we checked-in yesterday that it was almost impossible to manoeuvre a wheelchair. The sight of my poor mother slumped in her wheelchair could not have been more incongruous with the exclusive surroundings we found ourselves in. Her world in the nursing home is very far removed from this plush hospital environment and I felt sick just thinking about how inequitable the whole health system has become. Why are we forced to access care in ‘over the top’ facilities like this when all that’s needed is a basic health service that works efficiently? Why does there have to be such a contrast between public and private care? I hasten to add that my mother was treated with the utmost respect at the Beacon and I’m very grateful for the treatment she’s received there. However, she’s also treated with the utmost respect at the nursing home but her surroundings there leave a lot to be desired. Why does it have to be so different? Why can’t we have a public health service that treats all citizens and especially it’s oldest ones, with the dignity they deserve?

The Beacon Medical Group has won the tenders to build three of the co-located hospitals that are due to be built on public hospital sites (Beaumont Hospital, Cork University Hospital and Limerick Regional Hospital). If what I saw at the Beacon Hospital yesterday is what our Minister for Health envisages as the way forward for our health service, then I despair. When are people going to wake-up to what’s happening to healthcare in this country, and shout STOP?