Saturday, October 11, 2014

Death, Warfarin, Famine, Pestilence

I have been collecting information about my condition and got segued looking into healthcare protocols and procedures. Can't help it - part of my work is assessing organisations.

First of all, there's an information gap. Serious gaps in information that I would need. These are not gaps in info the doctors need to treat patients, but simply the type of info I wish was there for me. It's a selfish thing.

For example, how many people have the same condition here in Malaysia? What is the mortality rate? How long do I have to live - a rough estimate is fine? How about morbidity - how do we determine what I can or cannot do? How long do I have to wait when given a number? I Googled and read up studies on every single drug they give me, but what if an old pakcik was prescribed a risky med and does not have Internet access to know that eating something together with the drug could cause a brain hemorrhage?

I haven't done much but what I encountered when I ask some questions or give some small suggestions is how defensive some people working in the medical industry are. This is understandable. Humans are defensive. And I should just shut up.

Especially when given the fact that I can't afford private hospitalisation. Being poor, I should just take it up the ass. And I'm not a Datuk or Tan Sri who can get in IJN. Even if I can, I don't have the money to pay for it. And I don't think my condition is special enough to warrant free healthcare at IJN, for research purposes. At least I hope it's not.

The thing is, I'm not even criticising individuals or even doctors. I just believe some of the system can be improved. It is an administration and management issue, which is not an ailment unique to just hospitals but is prevalent everywhere in Malaysia.

I would have been happy if the nurses told me, "You HAD an appointment at 11am, but you will only see the doctor after 4pm or so. Now go fuck yourself and come back at 4pm." AND if the doctors just told me, "hey, you know what? You lost a third of your heart. There are people who lost half their heart to whatever and they are unfortunately still alive 40 years later. Then again, there are people who died two weeks after their first heart attack. Badum-tish! The stats according to people who get treated here would be 546 of 1098 patients with similar conditions die within the first two years. Here's a chart. Good luck. Now fuck off."

Studies, stats and the rest are unavailable, unless conducted by pharmaceutical companies to prove or disprove the effectiveness of their or competitors' drugs. But there are independent studies.

For example, the drug I am on right now - Warfarin (formerly rat poison) - is used to treat severe heart conditions, DVT, etc, etc. A doctor friend only mentioned Warfarin as treatment for DVT - deep vein thrombosis - but further reading showed that it is used for severe cases of heart problems.

Warfarin also significantly increases the mortality risk of traumatic injuries in both elderly and younger patients.

These studies and stats, numbers and figures are unavailable in Malaysia - except through the internet - and it's not the doctors' fault. This thing can be made available with better management and administration.

However, it is impossible to expect this kind of coordination when you have to wait 5-6 hours to see a doctor, if you are not really, really dying.

Some systems work very well, even the non-emergency cases. The pharmacy at UMMC, for example, is reasonably fast on certain times of day.

Oh well. Just wanking.