How I rated things

Appendectomy

I had an appendectomy on New Years Eve 1962. I would have died without it, true. But, I also awoke, and sat up, during the operation, causing panic stations about the theatre. I was sewn up very badly, and suffered through decades of pain from adhesions, making distance running (my passion at the time) impossibly painful. That pain abated only in my fifties, meaning it took 30 years to heal. I have to score it as a part-botch.

Gout

I have taken care to claim my drinking as the likeliest cause of my gout. That may or may not be true. My paternal grandfather neither smoked nor drank, yet his death notice cites complications from obesity as cause of death. I think I did at least partly inherit a tendency to gout from him, just as my son has from me.

The first doctor to treat my gout began well. Later though, he claimed that the standard gout treatment, allopurenol, was affecting my heart, and advised me to go off it. The alternatives were too expensive for me, so I sufffered from near constand gout attacks for years until a Bloemfontein doctor disputed the heart story. He put me back on allopurenol, and over around six years, all the “gout bumps” (bursitis) on various joints have receded. I very rarely feel even a twinge.

A public health doctor tweaked the treatment strength, to protect my kidneys.

Kidney Health

Kidney dialysis reared a very ugly head, but had that (private) doctor prescribed an ECG, he would have found that my heart was not a problem, and saved me a mountain of sturm und drang.

I was counselled, told it was not the end of the world, going to get new blood every few weeks. I found that news dreadful and stressful.

Wrong hypertension medicine, prescribed previously by a private practice, was the problem. I don’t think blame really applies. The treatment succeeds with 95% of patients. It just happened to half kill me. Given time, I like to think that doctor would have realised, and prescribed something better, but someone who knew the prescribing doctor thought he would never have picked it up. We will never know. He has retired, and I moved to Egoli.

There, in a private medical clinic, the catastrophic misdiagnosis of Congestive Cardiac Failure nearly had me beat. The problem was picked up by a different doctor in the same clinic, who had treated me for pneumonia. He recalled that my kidney function was “better than his own” when successfully treating my pneumonia. I have to rate pneumonia as a partial botch by private health, because two successive doctors were sure that I had suffered from it for years, yet no previous doctors had picked it up.

Back to the high blood pressure/heart problem. My ankles were swollen. Congestive Cardiac Failure, given that I was being treated for high blood pressure, was a fairly good guess, but an ECG would have revealed that guess as completely wrong. The swellikng was a known side-effect of the blood pressure medicine i was on. Instead of changing that I was given something on top of ti, and between the two medicines, I was close to death within weeks.

I returned in some distress. Fortunately the prescribing doctor was not in that day, and my case fell to a doctor who had treated me previously. He was visibly affected by my condition. Blood was taken, and he phoned me early the next morning to come in again. I was close to renal failure. My meds were changed, I was told to drink as much water as possible. My poor kidneys, from a low eFGR of 16, are now back in the 60s. Maybe I will return to the excellent 88 that I enjoyed only six months before I was being counselled about dialysis. Time will tell.

The Cold Light of Day

In the ‘quality of care’ debate, It is only fair to point out that clinic scale public health would not have likely picked up my renal failure even. I asked for a blood test at Touwsranten, because it was not routine, whereas it is one of the first things that private doctors do. After being asked to wait to the following week to phone for results, I was told “there was no test - they say there is no more money for pathology”. Well, that is a dismal fail. Other than that Touwsranten was a delight. Most of the clinics think that we know and understand the problem, which they sum up in a single word: *government. Apparently, nothing surprises them any more. I wonder if they would even express surprise if ‘government’ told them on arrival:

CLOSED UNTIL FURTHER NOTICE

I think they would be shocked but not surprised.

Elderly seniors like me are not a common sight in public health care clinics. I was often the only paleface in the daily departmental throngs at Helen Joseph Hospital, and for two weeks there I was the only whitey in any of the wards. Like most SA seniors ‘down on our luck’, I saw public clinics and hospitals as ‘black only’. One person even said to me (about Helen Joseph)

“Going in there is a death sentence”.

I don’t know if anyone keeps statistics on public-private health care success rates. I doubt it, and they will be fudged anyway.

I do know that one’s life can change and even be over, in minutes. If we are alone, with nobody near, we will surely die from a mamba bite or from choking on food. Other than, one expects to be in safe hands once admitted to a hospital or other special care place, but Murphy lurks everywhere. In HJH, I was brought medicine for a ‘Mrs L——’. That medicine, had I taken it, could have killed me.

Physio was the toughest love at HJH. After nearly three weeks post-surgery bed-rest, a beautiful, slender, unsmiling girl in white stood five paces away from 78 year old, post-op me, and held her hands out. She said nothing. A passing nurse said “She wants you to walk to her”.

I summoned up all my strength and balance and barely made the five paces, and she caught me before I fell. The next day, she did not come. The third day it became 10 paces, then she tricked me by backing away. I followed her, slower than a tortoise, and 10 shuffling paces became 22. The beautiful, slender, unsmiling girl promised to come the next day, but I was discharged next morning. I didn’t feel ready, and said so to the ward sister. The friendly sister said “She said to discharge you. She says you can walk”.

I wished I had the confidence in me that my physio had! It was actually months before I progressed from a walker to walking sticks. Maybe it was not all bad to be pushed, though. There was a time when it was thought I would never walk again, yet here I am these days, three years on, strolling two blocks from time to time to visit my granddaughter. Best of all, and this is the focus (pun intended) of the article, I once again have two good eyes. It was a hell of a job getting public health to remove my cataracts, enough to devote a whole chapter to, but I got there in the end.

It took six years. But, there is nothing quite like the thrill of sitting at Zwartvlei Beach, watching dolpins stitching in and out of the breakers. For nearly ten years, I could not have seen them.