Friday, October 23, 2009

One Week After Emergency Abdominal Surgery Maggie Jochild Is Still In Intensive Care

Donations Desperately Urgently Needed or
Maggie May Be Sent Home and Tough Luck
Instead Of To Surgical Rehab As Needed

Bottom Line: Maggie Desperately Needs YOUR Donations Now
For Reals, No Kidding, This One's for All The Marbles

The alternative is Maggie may literally be kicked out of the hospital with a big surgical incision in her stomach which isn't anywhere near healed, unable to walk (even to the kitchen or the bathroom) and sent home. If this happens her surgical wound WILL split back open, become infected, and if we're really really lucky, the worst that will happen is Maggie will get sent back to the hospital where it will all get fixed.

Those of you whom remember Steve Gilliard remember that he was out of heart surgery, was talking and recovering, and then the hospital pushed his fat black poor ass out of its expensive ICU bed because he had no insurance, threw him to a non-monitored cheap-ass ward bed...where Gil promptly got a major infection which killed him, even after they returned him to the ICU and did surgery to try and save him again.

If the hospital had only kept Steve in the ICU for another week he'd likely have lived. If he'd had insurance -- if someone would have PAID for that expensive medical shit -- then Gil would for sure have been left on the ICU no problem. And in the ICU a) he likely wouldn't have caught the damn infection to start with, but if he had, b) they'd have been all over the damn thing within 3-6 hours of it starting and BOOM, knocked it on its ass right away. 'Cause that's what they do in ICU, catch 'em small and knock 'em down. Instead, Gilly was on the ward, they missed it for days, and by the time they caught it it'd spread all over his body, thus he died.

We talk (more or less privately) how Gilly's death was partially caused by racism. Let's be even more blunt. It was caused by classism. If Steve had been a black man with money, a fat black man with good health insurance and a decent job, he'd likely have lived. He died because the hospital was not being PAID to give a shit.

We are facing down the very same problem with Maggie.
It's the money, stupid.

Maggie is alive.
And dead broke.
We need your help, for reals.

Maggie is in totally wonderfully amazingly health (with respect to her recovery that is; I'm not comparing her to an Olympic champion) in one of the best major surgical recoveries I've ever seen.

If you'd asked me two weeks ago if what has just happened could happen with Maggie would happen with Maggie, I'd have told you not only no but hell no, and listed 20 major problems which no doubt would go wrong during any major hospitalization/surgery time frame for Maggie. Yet here we are.

Two ways it all can go:

1. Get Maggie into a good Long Term Acute Care / Rehab facility.

a) This will require both a charity bed from the facility and/or donations from various sources in Austin. We have LOTS of sources working to make that happen. If any of you have high-level contacts in Austin who might be willing to help, please email me directly.

b) We'll also need SUBSCRIPTIONS & DONATIONS from y'all. Thousands and thousands of dollars both in ongoing monthly subscriptions and current immediate donations. Both are needed. If you need to choose, I'd prefer you choose to subscribe for a monthly lessor amount. How much you subscribe for monthly is your business.  The current highest monthly subscription Maggie receives is $200 month; two people currently subscribe to Maggie at that level. Furthermore, both of those people sometimes donate additional sums when money is short. Money goes to the very basic needs of life: food; Maggie's food budget is $160 per month. Rent. Water and electricity, Internet, cat food, medicines (prescription and OTC), clothing. The pure basics.

2. The bad route: Maggie gets sent home alone to heal.

a) In rehab yesterday (Thursday) it was a triumph when Maggie stood for ten minutes immediately next to her bed WITH TWO PEOPLE HELPING HER. She is unable to walk to the bathroom ten feet from her bed. (She uses a rolling toilet next to her bed with two attendants and a nurse with her at all times as she's backing out a big one. The attendant rolls away and cleans up the toilet afterward. As for peeing, she still has in a Foley cath.

Question: At home, when she can't get out of bed without help, how is she to crap, pee, cook food (when she can't stand), wipe her bum, keep her incision clean (no attendent is going to come to her home for a home health care visit; she has no insurance and no financial aid or support to get a home health aid.) And so on and on. She's recovering wonderfully but she will need massive support and assistance around the clock for the next 3-8 weeks depending. (I'm not yet clear myself, nor are the doctors. The best numbers I've been able to get are, three weeks to two months of FULL-TIME care depending on how she does, part-time support for several months afterward.

Bottom line: She either gets #1 above, the Charity Bed or she'll become a lying in her own sickness infection case and the only question will be, will she become to infected to quickly to dial 911 in time? As part of #1 above we'll need enough donations from y'all to keep her home handled, lights on, cat taken care of, all the basics. If we can manage the basics for her then we're good.

Moving on...

Even though it is way early, because there's such a concern about money, her surgical team is removing her surgical staples TODAY (Friday) while she's still in the ICU Stepdown with ICU Nurses 24/7, Internists and Surgeons doing rounds twice a day, the entire intensive care setup but with the focus on rehabilitation, not purely on critical care.

Maggie has a history of her abdominal surgical wound breaking wide-the-frack open -- technical term: dehiscence -- and taking months, infected, pain-filled, pus-dripping agonizing months to heal. *shudders* Throughout the last two weeks, much much more than dying, dehiscence and cancer have been Maggie's major fears.

The good news is Maggie had Cancer. Because she was accidentally taken to the rich people's hospital in Austin -- the indigent people's hospital was on ER bypass when she called 911 -- she got the best surgical, anesthesiology & OR Team in Austin in what is without question the best hospital in Austin. And the #1 surgical etc. team (as I just said) decided her case was interesting enough to take it on themselves.

Came the day before her surgery when her surgeon asked her if she wanted a "surgical weave" to hold the abdominal organs in place afterward or not. The benefit would be it would allow him to do an appendectomy as well; the problem is, it would cost an extra twenty-thousand dollars. Maggie told me "I looked him dead in the face and said, 'Use the surgical weave and do the appendectomy. That's one less possible emergency abdominal surgery I'll never have to have. As for the $20 grand, it's fine. I'm dead broke and am never going to be able to pay for any of this anyway.'"

"The surgeon blinked for a moment, then started laughing, caught himself -- it was as if he admired my guts -- and said, 'Alright, we'll use the weave and do the appendectomy.' And walked out of the room."

The surgery happened. Along with all the stuff which saved her life, an utterly routine appendectomy took place. In addition, an utterly routine D&C took place, as Maggie's had long-lasting issues with cervical cysts rupturing. The question for 20 years has been, should she get a total hysterectomy to avoid the substantial risk of cervical cancer. One of the major questions considered in this surgery was, 'Should we do a full hysterectomy?' A GYN/Oncologist was brought in on the case precisely to answer that question. After doing a full work-up on Maggie, talking with the primary surgeon about the seriousness of the primary surgery -- it was a MAJOR threat to her life and time-of-surgery, e.g.: how long she was under anesthesia, as well as length-of-incision, e.g.: if a total hysterectomy had been done the surgical incision required would have been triple its current size, the dehiscence Maggie is worried about (which has not yet happened) would have been flat-out unavoidable, infection would have set in, rehab would have been measured in six months to a year... and that is if she had lived to get off the table, given the longer OR time and the additional insult to her already badly damaged system.

Maggie and I decided against it. Her surgeon, and her GYN/Oncologist recommended against it. What they did suggest instead was a full D&C during the surgery along with a biopsy, as well as an examination of the uterus and other reproductive organs, visually (if possible), by touch, and through biopsy.

What you need to understand is Maggie has had cervical cysts rupturing every few weeks/months for decades. The pain is a 9 out of 10 with 10 being screaming then dropping to the floor writhing banging your head trying to knock yourself out. Nine is just short of that, all you can do NOT to totally lose it.

I speak as someone who has gone all the way to 10 more than once. Dropping to the floor, first screaming, then sobbing in agony. Almost everyone around me getting away from me. One good friend came over and helped me to my car; I drove myself, somehow, to my doctor's office where I stumbled in (without an appointment; ha!) and they instantly took me back where I was seen within 90-120 seconds. Hours later I was in the hospital being admitted by a neurosurgeon for the next four days, emergency neurosurgery two-three times, morphine drip, unable to form words of more than two syllables or speak past a four-year old level...for four days due to the pain.

THAT is a 10 (in case you're ever asked how bad it hurts 1-10.) If you can talk about the pain while you're in the pain, it ain't no 10. *smiles*

Maggie's been living with a 9 for 2 to 3 days every few weeks to a month for the last 10-20 years. Plus the fear of cervical cancer. With no health insurance, she's had NO way to find out; she's simply had to ride out the pain with Advil, and ride out her fears alone.

The physical examination during surgery was unremarkable. Which is good. Of course, it's the biopsy that tells the story. Two days ago (Wednesday) the biopsy of Maggie's D&C came back. Nada. Nothing. Clean. Her GYN/Oncologist came by and explained... as Maggie told me, he said this means because Maggie is in menopause, she in no longer a cervical cancer risk. She made it through the danger zone and out the other side. Done, complete, fini.

The biopsy results also came back Wednesday from the appendectomy. Remember, the routine appendectomy that almost didn't get done and only happened because Maggie insisted they spend an extra $20,000.00? Cancer. Malignant cancer. The Oncologist came by... as Maggie told me, he said you got lucky. The margins on the cancer were clean. That means we got ALL of the cancer. It didn't spread anywhere. It was just growing there in your appendix. Because we took out your appendix, the cancer is all gone. You don't need any special treatment, any checkups, nothing. It's handled.

Maggie told me, "I pushed for being treated like a rich person. 'Twenty-thousand dollar weave & an appendectomy.' That's the price-tag on my life. Well, one of them."

Had Maggie NOT had this surgery, she would have died, three different ways that I am SURE of, and that's just so far. My guess is, by the time this all gets sorted out, between her doctors, nurses, rehab team and myself (as a retired paramedic) we'll come up with six to seven certain issues which would have killed Maggie for sure over the next five years, another five to ten which might have killed her over the next five years, plus another ten ranging from would have for sure to probably to would have/might have got around to killing her 5-25 years if the other shit didn't get her first. *smiles sweetly*

Shorter me: Rich people live longer than poor people. Maggie Jochild is a brutal demonstration. She would have been DEAD RIGHT NOW (within a week of when she called 911) in an ugly, ugly way... from gangrene/peritonitis of the bowel/abdomen. Followed by lots of other crap shortly thereafter, ranging from heart to appendix to cancer of the appendix to other abdominal organs being strangled to hernia's rupturing to the stomach literally exploding to intestines dying to kidneys dying.

Maggie was a dead woman who could barely even walk. Now she's going to a Nursing Rehab facility IF someone gives her CHARITY, if y'all can cover her personal expenses so she still has a home and a cat to come home to afterwards.

They treated Maggie like a Rich Person (she says; I say, like someone in the middle to upper class), someone like me or Sara or Evan or Jen, someone with INSURANCE.

If they'd treated Maggie like someone with no insurance she'd be dead right now. If she'd waited one more day (maybe), two more days (for sure) to dial 911, she'd be dead.

If she had insurance she'd have been seeing her doctor all along and ALL this crap would have been caught 8-10 months ago and NONE of this would have happened. Or to the extent that it did happen at all it would have been caught early on, the surgeries would have been done early, and Maggie's life would never have been at risk. As it was when they put her under last week, there was a VERY real chance she was not going to wake up. I placed the odds at 80% survival which means there was a 1 out of 5 chance of on-the-table mortality. If she'd not been in a Rich People's hospital -- simply because the poor people's hospital by the grace of the Gods was on ER diversion that night -- I'd have given her 60/40 maybe even 40/60 odds depending on who was operating and who was doing anesthesia. As it was, instead of a 60% chance (3 out of 5) of dying on the table, it was 4 out of 5 of her making it in the Rich Person's hospital, and she wouldn't have even had that risk, not anywhere close, perhaps 1-100, if she'd had health insurance all along and had been being treated properly from the jump.

But Maggie's dirt poor. So she's screwed. What she needs now, desperately, is money. Her food budget for an entire MONTH is $160. Seriously. Her entire MONTHLY budget, rent, medicine, cat foot, electric, phone, water, everything...comes to $1200 bucks per month -- and she doesn't always hit that. When she misses and me and her other close friends can't make it up, she goes hungry. Yes, you know someone who goes without food on a routine basis because she has no money. And yes, she almost just died because she didn't have the money to see a doctor.

About half of her monthly income comes from GNB/Meta Watershed donations, the rest from her work as a Medical Transcriptionist. Due to her many disabilities, working from home very part time is all she's been able to do for quite some time. (And yes, I am working on the design of a company in which Maggie would be able to be able to make a real living, have insurance... but starting a start-up is tough anytime; it's especially hard at the moment when I'm wiped out physically myself. *sighs*) For the next 4-10 weeks here, she won't have any income from her work. We need to raise roughly $2-3K (obviously more would be better) to fill in the gap; the extra goes for extra medicines she must have, plus additional medical supplies, and healthier foods during the healing process.

Any donations or monthly PayPal subscriptions anyone is willing to make to help us support Maggie Jochild, are most gratefully appreciated. (None of the donations go for administrative expenses with the exception of PayPal transfer fees and the like. All of us supporting Maggie are donating our time and efforts completely, our phone costs and so on. We're not recovering costs.) Like many of the completely poor Maggie has no one else whom to turn; we are her insurance, we are her support system.

Please help as much as you can. The hospital has saved her life. Now let us help her financially so that she still has an apartment to return to when she gets out of rehab, so that her cat has food to eat, so that her electricity is still on and the water still flows. The doctors and nurses have taken care of Maggie's internal organs. It is up to us to finance her voice.

Study links 45,000 U.S. deaths to lack of insurance

Not Being Insured Will Probably Kill You

1. A post from Maggie will go up by Saturday morning.

2. Here's a poem Maggie "wrote" days ago, working on passing gas:

Forgive me
For not eating the plums
That were in the refrigerator

They looked so cold
And delicious

But if I had
My stomach would have exploded.

     Apologies to
     William Carlos Williams

Go to Meta Watershed and SUBSCRIBE or DONATE for Maggie.
Do this now.

Cross-posted at Meta Watershed and Group News Blog.