Rx the Casbah
Most Canadians spend December 26th, or "Boxing Day", at their local shopping mall returning all of the sweaters they got the day before. I spent mine doing firsthand research into the differences between the Canadian and American health care systems.
At around 8 pm on Christmas day, I noticed that I suddenly couldn't move my shoulder without experiencing a very sharp pain. I figured it had to do with sitting awkwardly in an airplane or sleeping funny on that side, and took an advil.
The next morning, I still couldn't move my arm properly. After trying more advil, a heating pad, and a nice long soak in my sister's tub, we decided that maybe a trip to the doctor wasn't such a bad idea. Luckily, I have insurance coverage for when I am out of the country, so I wasn't too worried about the cost. I had heard horror stories, after all. I called my insurance company, and told them what I planned on doing to make sure I was covered, and we were away to the races. And by races I mean Evergreen Medical Centre.
We got to the Emergency room, I checked in with the triage nurse, and waited for my name to be called. We (Heather and Babygirl were with me) passed the time reading Time (Heather and I) and dropping binkies on the floor (Babygirl). After about an hour, the triage nurse called my name. So far, the experience was not unlike waiting in the Ottawa General emergency room with my sprained ankle. But things were about to get very, very different.
The triage nurse started taking my history and vitals. When she asked me what brought me there today, I told her my shoulder was hurting and that I couldn't move my arm very well, particularly that I couldn't abduct it or elevate it or flex it forward.
Image: American Academy of Family Physicians, 1998
She commented on my fancy terminology and said that I would be the next to go. Her exact words were "We'll take you and the girl with the swollen lip. We made need you some day, you could do my job." I highly doubted that, but I was glad to be moved out of the waiting room and down the hall to... another waiting room?
This is where the similarities between the two systems ended. I waited in the secondary, secured I might add, waiting room for about another 45 minutes before being escorted to the a curtained-off bed. Things started to really pick up after that. I changed into a gown, and waited for the Dr. A women from Registry came by to take my insurance card and ask for a billing address. I asked her to call my company to make sure they were billed directly, and she said it wouldn't be a problem.
Dr. Gross (that was his real name, and he was really very pleasant) came in shortly after and asked about my injury. I told him that I hadn't really been lifting anything with my left arm, but did mention the plane trip. He became concerned that what I was experiencing might not be my shoulder at all, but referred pain from a blood clot in my lungs, as a result of "Coach Class Syndrome", or pulmonary thrombosis. I hadn't even thought of that. Dang. He ordered an ultrasoud of both legs and a chest CT to check for clots, as well as a set of routine blood tests. The nurse came in and hooked me up with a canula for the blood tests and in case I needed an IV later on, and I asked if Heather and Babygirl could come in, since this was obviously going to take a while.
While waiting for my tests, we listened into the other curtains to see what sorts of things brought people to emergency rooms on Boxing day. Most involved muscle or back pain. One woman tried to convince the Dr. that her spine was swelling. He couldn't reassure her that it really wasn't. Her moans of agony only seemed to be elicited by him or a nurse being in the vicinity of her curtain, so I'm thinking she was probably after some morphine.
After about aother 45 minutes, I was escorted down to the ultrasound room, and they scanned my legs from top to toe. I then went into the CT room, and had two chest scans, one without contrast, and one with contrast. They injected me with an iodine dye like I'd had before for my brain CT in February. This time, the familiar metallic taste was accompanied by intense itching in my ears, throat, and on my skin. I was having an allergic reaction. They shot me up with Benadryl, and I dozily waited for the results of my tests.
You'll be happy and relieved to know that all tests came back normal. I didn't have a blood clot. The pain in my shoulder was likely the result of sitting awkwardly in an airplane or sleeping funny on that side. The Dr. sent me home with a prescription for pain medication. Vicodin to be exact. They don't mess around with paltry Tylenol 3 down here, b'y. This is the real deal.
Overall, the total amount of time spent in the ER (approxiamtely 5 hours) was about the same as I've spent in Canada for a similar injury. However, in Canada, only about 5 minutes of that time was spent with an actual Dr., and that was after demanding that someone look at my x-ray so that I could go home and get some rest if nothing was broken. Also, on the way out the door, I noticed a number of patients still waiting in the primary waiting room who looked to be in about similar shape as I had been. Which to me says that maybe their insurance converage wasn't quite as flexible as mine was, since I really don't think that my quality of care rested quite so much on my vocabulary.
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