Whistleblower

This Sunday night, RTE will broadcast ‘Whistleblower‘ the first of a 2-part drama series based on the true events outlined in the enquiry into irregular obstetric practices at Our Lady of Lourdes Hospital, Drogheda. The Lourdes Hospital Inquiry Report by Judge Maureen Harding Clark was published two and a half years ago and highlighted the plight of 129 women whose lives were blighted forever by unnecessary caesarian-hysterectomies carried out by obstetrician, Dr. Michael Neary. The investigation described the number of peripartum hysterectomies performed at Drogheda as “truly shocking”. It’s probably the worst case of systems failure in Irish medical history. It took the tremendous bravery of a midwife to blow the whistle in 1998, to put a stop to the wrong doing.

Dr Michael Neary has never explained the failure in his duty of care to his patients nor has he ever apologised. What he did was tantamount to abuse over a period of 30 years, he ruined people’s lives. How did this happen? How could 129 women lose their wombs unnecessarily? The vast majority of these women were young, 25 of them were first-time mothers. The report praised the management of the hospital and the health board for dealing promptly and appropriately in setting up the investigation to take-on the consultant. However, opinions still vary on the reasons why Dr. Neary did what he did and nobody, except Dr. Neary, knows the real answer.

Click here to see a promotional video of the programme.

Anyone affected by the events depicted in this programme or by similar events can contact Patient Focus for support.
Website: www.patientfocus.ie
Phone: 018851611/ 17 /33/ 58.
Email: support@patientfocus.ie

A Better Place

I knew the moment I walked into the dementia unit at the nursing home that something had changed. My mother was up and dressed and sitting in her wheelchair beside the window. I settled down beside her to chat and it was only then that I realised what was different… one of the long term residents was missing and her possessions were all neatly piled on top of her bed. Poor Hannah* had died during the night.

The other residents of the unit were all sitting staring into space as per normal and while they appeared oblivious to the fact that one of their own was no more, a sombre mood was palpable. Looking at them sitting in silence, I found it hard not to ponder over who’s turn it will be next… for that is the reality of this unit.

Alzheimer patients slowly fade away, it’s like a living death as bit by bit they withdraw from the world. The staff of this unit are very supportive of the families. We are like one big family who are on a difficult journey together and everyone supports one another. When a bereavement occurs, it affects everyone in the unit.

When Hannah’s family arrived to collect her belongings this afternoon, the sense of togetherness was powerful. We all hugged and shed a few tears and remembered the good times together. We’ve come to know each other well over the years and today’s farewell was a reminder that one day my turn will also come, to say goodbye.

My mother is one of the few residents in this unit that can still hold a conversation although she has great difficulty processing her thoughts. She loves to listen to the staff chatting as they work and will occasionally chip in with her penny’s worth.

Today, when I was discussing Hannah’s demise with the staff, my mother suddenly joined in and asked “well, is she better yet“?

I looked at her and smiled. “Hannah’s in a better place now, Mum, don’t you worry” and she smiled back at me happily.

Rest in Peace, Hannah.

* denotes a name change.

Some Day…

Do you have health insurance or is this something you’ve put off until another day? If you’re young, fit and healthy, the chances are you’ve never really given your health much thought. Why would you worry when you haven’t had to face huge medical bills? With the rapid privatisation of our health service, health care in Ireland is becoming more like the 2-tier system in the States. Those with insurance will get top dollar care while those without, will suffer.

About five years ago, my GP sent me urgently to the A&E department of our local public hospital as I had developed acute abdominal pain. I was processed by the triage nurse and allocated a trolley in a cubicle so that the doctors could assess my condition. Once my blood tests had come back from the lab, the decision was made to admit me overnight in case I needed to go to theatre. I was put on a drip (nil by mouth) and lined up on a trolley in the centre of the department along with scores of others, in a queue for a bed. I hit lucky on that particular occasion and was transferred to a ward in the middle of the night. By the following day, my abdominal pain was severe (my intestine was blocked by an abscess) and it was decided that a CT scan should be performed to ascertain if surgery should be performed. I was started on intravenous antibiotics while I awaited the scan but kept fasting in case surgery was required. This was bearable until a harassed looking junior doctor appeared at my bedside to announce that the CT scanner had broken down and was awaiting repair. By the following morning (day 3), the scanner was still out of action and my situation was beginning to look very bleak. Around lunchtime, the same doctor rushed in and asked me to confirm that I had private health insurance. I did, thankfully, so the decision was made to transfer me to the private hospital, to avail of their scanner. The scan confirmed a diagnosis of acute diverticulitis with obstruction of the bowel but it was seen to be resolving so I could finally be taken off the emergency list. Had I not had health insurance, I hate to think that I may have ended up having investigative surgery as no scanner was available to make the diagnosis. Please don’t get me wrong here, I received excellent medical care during my 10-day stay in this public hospital and was very grateful for it. However, the system was clearly in overload and patients were suffering as a result. My insurance was worth every penny to get the care I needed when I needed it most.

Health insurance is a complicated business. It’s designed this way so that the insurers are protected against excessive charges by private doctors and also to restrict patient benefits. There are three main insurance groups in Ireland and they each purposely have slightly different health plans so that it’s almost impossible to compare like with like. I have spent vast amounts of time over the years, trying to work out which plan offers the best deal for my family. It was years before I realised that each member of the family can hold a different policy to meet their individual needs but don’t expect your insurance company to tell you stuff like this, ‘cos they won’t. I review our policies every year to see how we can reduce costs yet still retain adequate cover for both emergencies and day to day care. There are all sorts of clauses to catch you out, so be careful what you change. And remember, it’s too late to look for insurance when you’ve already become ill because penalties will abound. You have to put in the work yourself if you want to see improved benefits. I long ago gave up hoping that an apple a day would keep the doctor away.

Salmonella Agony

The latest figures for the recent outbreak of salmonella agona show that some 132 people have now been infected with the bug and it’s already spread to 5 countries within the European Union. The genetic fingerprint of the microbe has been linked to a particular production line at Dawn Farm Foods in Naas, Co. Kildare. The company has decided to close the entire plant for a week and has contracted the expertise of Limerick company OMC Scientific, to decontaminate the entire production facility. How times have changed.

Many years ago when holidaying in Connemara, our holiday plans came to an abrupt end when the friends who’d been staying with us, had to return home following the sudden death of a relative. Our little holiday cottage felt very empty with just my husband, myself and our young son rattling around in it so to cheer ourselves up, we decided to treat ourselves to lunch in a local hotel. Later that evening, I became violently ill with nausea, vomiting and diarrhoea which continued relentlessly all night. I still felt very unwell the following day so we decided to give up on the holiday and return home. I shall never forget that 6-hour car journey with awful nausea, every mile was agony. My husband and son luckily were unaffected and sang songs together all the way home to help pass the time. As far as I can remember, I recovered within a few days but a week or so later, I again became increasingly nauseated until the whole unpleasant episode started all over again.  I consulted my doctor who prescribed medication to ease the symptoms. This pattern repeated itself every few weeks until eventually about two months later and two stone lighter, I was admitted to hospital for investigation and treatment. This is when it emerged that I had a dangerous form of infective diarrhoea and the bacteria was linked back to the piece of chicken I’d eaten for lunch on that fateful day in Connemara. My infection was officially notified to the Food Safety Authority and that was the last I ever heard of the sorry tale. I’ve often wondered since how many other poor souls suffered the same fate after eating food from that kitchen and I have to admit, I still to this day shudder whenever I pass by the doors of that hotel.

The HSE is presently in talks with OMC Scientific to consider using it’s technology in Irish hospitals, to reduce the incidence of hospital-acquired infections (HCAI’s) such as MRSA and clostridium difficile. OMC’s bio-decontamination service is already used in a number of British, French and American hospitals. A study published in the Journal of Hospital Infection found that this technology is 66 times more effective than manual cleaning in removing hospitals superbugs. It’s estimated it would cost the HSE about €14 million a year to cover all 52 acute hospitals in the country but this would lead to a reduction in the prevalence of superbugs which is thought to cost the HSE about €200 million a year. Now there’s a cutback worth considering!

Phew!

I didn’t sleep well last night. I tossed and turned and looked at the clock repeatedly waiting for 6am to arrive. Time crawled… 1.15am… 3.45am…5.20am… until finally, 7.15am… “aagh! Quick! Turn on the computer”. For anyone hoping to go to college, today marks the day when future careers are decided through the courses offered by the Central Applications Office (CAO). It’s sure been a testing process.

Anyone would think I’d just done the Leaving Cert by the excitement generated but in fact it’s my daughter, Poppy who’s put in all the hard work. Last week, she made her Mum and Dad really proud by receiving excellent exam results. However, despite gaining enough points for a multitude of college places, it was still not certain she’d be allocated the place in college that she really wanted. For those who don’t know how the Irish system works, the points for college courses are dictated by the demand for places. It’s a lottery based on the number of places available for each course and on how many people apply in any given year. Students select their courses in order of preference, not according to the points required and the CAO does the rest.

Unfortunately for Poppy, she experienced a very unsettling hiccup with her college application. She’d carefully selected her courses and submitted her online application but when the postal confirmation arrived, it was incorrect. The courses she’d chosen were all visible but the order of preference was completely wrong. Poppy was away on holiday after her exams when I spotted this error and so armed with her exam number, email address, password etc., I rang CAO on her behalf to get her choice of courses corrected. Blow me, if this didn’t happen a second time, on the very day that applications closed. I was now in no doubt that someone was making malicious changes to Poppy’s CAO application and insisted that CAO carry out a thorough investigation. A few days later they came back to me with an IP address which had been identified as different to the ones we’d used whenever we’d contacted CAO online. Following some clever detective work, we were able to exactly match this IP address to someone known to Poppy who for some unknown reason, had decided to interfere with her career choices. This guy had her email address and had somehow got her email password. He was watching her emails and this is how he gained access to her CAO application. He then used the ‘forget your password’ facility at CAO to change her password and proceeded to change her courses around not once, but twice! He also covered his tracks by deleting the confirmation emails which were automatically generated. All highly illegal actions and all potentially damaging to Poppy’s future. Thankfully, we caught him out at his game and once challenged, he fully admitted to the crime. He has apologised profusely for the hurt he’s caused. He was an ex-boyfriend of Poppy’s, he’s now an ex-friend as well.

The first round offers from the CAO became available online from 6am this morning. Poppy was awarded the exact course she’d set her heart on. Had her abuser got his wishes, she would have been allocated a different course. She really deserves this outcome after studying so hard and I’m really proud of her for the way she’s coped with the CAO debacle. So today is a double cause for celebration.

Sod the computer, I’m off to celebrate.

Hey Presto!

I took my elderly father for a walk outdoors today to enjoy the first bit of sunshine we’ve seen in a very long time. With arms linked, we stepped out the door of his nursing home unit only to heard the familiar *bleep* *bleep* as his wrist band activated an alarm at the nurses station. My father suffers from severe short term memory loss and this tagging system alerts the staff as to his whereabouts. What my father didn’t know was that I too was ‘tagged’ today and it made a world of a difference. I just wish I’d done it sooner.

Am I the only person to think it strange that illicit drugs are now being advertised in a large multinational supermarket? On walking through the shop last week, I spotted a leaflet advertising an eTrip. “Mmmm… interesting” I thought … until on closer inspection, I realised that it was a flyer to advertise the latest in electronic tolls. eTrip.ie is the only electronic tag company providing tolling and parking on a single tag. No cash! No ticket! No hassle! Just call and go! I did, and today I crossed the toll bridge for the first time without any need to fumble for coins. I drove up to a cash booth fully expecting that the little electronic tag in my car would fail to activate the barrier but like magic, it worked!

I think I’m hooked as I’m already looking forward to my next trip!

One size fits all?

Have you ever been a medical mystery? I’m talking about those patients whose symptoms fail to fall neatly into the diagnostic criteria for a particular illness. You go to your doctor feeling really ill, your doctor listens carefully to your woes and recommends a battery of tests to help with the diagnosis. Several days later, your doctor rings to tell you that all your tests have come back normal. You’re still feeling lousy and you’re meant to be pleased with this news?

I’ve found an interesting new blog written by A Country Doctor (based in the USA) which provides a refreshing look at illness. Today he discusses how the labelling of a patient can affect a patient’s response to an illness.

“Labels are good if they help you understand what’s going on, and bad if they lock you into some sort of fixed category where you either don’t believe you can get out or, perhaps worse, start to feel comfortable and liberated from your own responsibility for your life and health.”

Receiving a diagnosis is never any fun but sometimes it’s almost preferable to not knowing what’s wrong. There’s little to recommend about being a medical mystery. The patient is suffering from very real symptoms yet nobody seems to be able to explain why and it’s not unusual for them to get to a stage where they begin to doubt their own sanity. Doctors these days have a large array of tests available to them to assist with a diagnosis. It seems that the days are gone when doctors rely on their own diagnostic skills to make a judgement. Today, tests are often ordered before an opinion is given. If the tests fail to show any abnormality, doctors generally take great pride in reassuring the patient that all is normal. However, from the patient’s perspective all is not normal if they continue to suffer from the original symptoms and are no closer to receiving help with the problem.

As the Country Doctor says “Somehow in the last generation of doctors, we seem to have lost our ability, or perhaps our perceived right, to give patients advice about their health; only if we diagnose them with a disease, or pre-disease, do we have something to tell them.”

Having been a medical puzzle myself for many years, I can assure you that it was a huge relief to finally receive a diagnosis. The missing piece of the jigsaw was found and suddenly my medical history made sense. My ‘label’ has not caused me to become fixated with illness, rather it has helped me to understand my condition more fully and to take responsibility for my own health. When I consult a medical doctor, it’s because I want to find out what it is wrong and receive advice on how best to deal with the symptoms. I think that doctors would do well to remember that not all patients have symptoms that fit the label and very often, these are the patients who most need their help.

Going It Alone

Do you have private health insurance? If you’re young, fit and healthy, the chances are you’ve never even considered taking out cover. Maybe you are relying on tax relief to ease the blow of medical bills? This is fine although if you develop a serious illness or require prolonged hospital treatment, you could end up in financial trouble.

In Ireland, everyone is entitled to free hospital care, subject to certain daily bed charges or casualty (A&E) fees but thanks to our 2-tier health service, waiting times in the public system tend to be much longer than in private health care. Over a million Irish people, with incomes below a certain level, are covered by the state General Medical Service scheme, for totally free hospital care. However, if you develop a long-term health problem but do not qualify for a medical card or hold private health insurance, you could find yourself in trouble with medical expenses.The more serious your illness, the more costly your treatment. Those on a lower rate of tax, can only claim back 20 percent of their medical costs. If you plan to rely on tax relief to make your medical expenses more affordable, you need to make sure that the treatment or care you receive qualifies for tax relief. The hospitals, doctors, dentists and therapists you see must be approved by the Revenue Commissioners – otherwise, you may not be eligible for relief. Some of the things that qualify for relief include doctors’ and consultants’ fees, prescriptions from a doctor or consultant, treatment in a hospital or approved nursing home, routine maternity care, in-vitro fertilisation, wheelchairs prescribed by a doctor, orthodontic treatment, and surgical extraction of impacted wisdom teeth.

If you have private health insurance, you can still claim tax relief on your medical expenses but only on those expenses which have or will not be reimbursed by your insurer. And remember, if you do not have any health insurance cover whether by choice or because you simply cannot afford it, there is always the National Treatment Purchase Fund (NTPF) if you end up needing hospital treatment. If you are a public patient on a public hospital waiting list and have been waiting over three months for an operation or procedure, you may get your treatment free of charge if you qualify for this scheme.

Private health insurance is not an automatic guarantee of financial security – cover can be refused on a technicality or expenses may be only partially covered – but it does offer peace of mind in case of serious illness. The fact that over 50 percent of the population choose to have health insurance cover, says a great deal. While you may be happy to wait, sometimes your health cannot afford the delay.

Cancer is…

I wrote a post the other day to highlight a book which aims to help people let go of their fears following a diagnosis of cancer. The comments I received in response were notable for their honesty and also for the understanding shown about serious illness. I believe that cancer has been a taboo subject for far too long and that people would really like to talk about it more. Here is a link to a very powerful statement on living with leukaemia, which started me thinking.

Practically everyone knows somebody affected by cancer so I thought it might be an idea to ask the readers of this blog to stop and think about cancer for a moment. What does the word ‘cancer’ mean to you? Are you a survivor? Does the very word fill you with dread? Did cancer change your life? Please feel free to voice your thoughts here in as many or as few words as you like. You are welcome to remain anonymous, it’s your choice. I’ll start the ball rolling with the first comment below.

UPDATE: This is your space to say what you feel about cancer.  I will not comment on your contribution unless you specifically request me to do so. Thanks 😀

Facing the Facts

When someone receives a diagnosis of cancer it is the beginning of a long, lonely journey. Demystifying cancer is crucial, according to oncologist Dr. Robert Buckman, and leads to a greater ability to cope. Buckman is the author of a new book called Cancer is a Word, Not a Sentence, in which he gives readers clear, calm and concise explanations of a range of cancers from diagnosis to treatment. His aim is to help people recently diagnosed with cancer, to get over the initial shock and cope better with the facts of their situation.

In the book, Buckman gives clear advice on the do’s and don’ts following diagnosis.

DO try to a get a reasonable, general overview of your type of cancer.

DO get a small amount of trustworthy current information from a few reputable cancer websites.

DO accept, which means admit and acknowledge to yourself any uncertainty about the diagnosis and/or treatment. Uncertainty is always unpleasant but easier to cope with if you acknowledge that fact.

DO ask your medical team a few specific questions once you understand the general overview of your situation.

DO get a second opinion if you really think you need it.

DO talk to your friends and family.

DO breathe. Do spend a little bit of time every day doing something you really enjoy and thus look forward to it.

DON’T respond simply to the word cancer as a universal and total signal of doom and gloom.

DON’T go to the internet and collect hundreds of different views, opinions, home remedies and fringe medications.

DON’T think that things won’t change after you hear the first view of the diagnosis and treatment. Plans may well change as time goes on, so try to stay as flexible as possible.

DON’T or try not to ask the same questions too often. Asking over and over again usually means that it’s difficult for you to accept the answers.

DON’T get a third opinion if the second opinion is the same as the first.

DON’T feel you have to hold all your concerns and worries in until you know all the answers.

DON’T panic. There is plenty of time to get informed and make decisions.

Adapted from Cancer is a Word, Not a Sentence by Dr. Robert Buckman (Collins UK £9.99)

Cancer threatens fundamental assumptions about our lives. People’s personalities, coping styles, expectations, and past experiences all influence the impact of a cancer diagnosis. This book aims to help those with cancer understand better every aspect of their disease so that they can let go some of their fears and face the facts. Sound advice indeed.