Private Vs Public Medical System in QLD, Australia

Wednesday, 25 May 2005

Following months of problems, I finally "bit the bullet" and saw a specialist about my haemorrhoid problem which had become worse having returned to my job as a courier - driving and being on the road up to 10 hours a day.

I saw the specialist on Wednesday morning, 23rd March before work and following and examination in his rooms, it was decided I would have an endoscopy (I had a history of reflux and stomach ulcer) and colonoscopy to check my bowel and what was going on down in that area of my body. The doctor said he would treat the rhoids whilst doing these procedures.

A booking was subsequently made for the procedures to take place on 8th April and following my appointment I went back on the road to work. The cost for this was $120.00 plus $15.00 for the preparation materials. Of the $120.00, I got back about $61.00 from Medicare.

On Thursday, 24th March I was driving and half way through the day felt ill. I phoned my base manager and told him I was not feeling well and needed to take the afternoon off. Within an hour
of getting home I was violently physically ill. I didn't know if this was related to my rhoid problem or not but phoned the doctor's rooms and told them I had been sick and asked to see if I could bring my procedure date forward. This was done and my new date was now Tuesday, 29 March.

Over the long weekend (it was Easter) I managed to cope with the pain in my lower region much as I had been over the previous few months. On the Tuesday, I presented to the private hospital the specialist operated out of at 4.00pm. A nurse weighed me and checked blood pressure etc. and took down various details then I went back to the waiting room where there were 3 patients waiting ahead of me for their treatment by my doctor and 5 other patients waiting for treatment from their doctor - most of them had been waiting since 1.00pm.

At around 5.00pm I was seen by the anaethetist who went through a check list with me and took down details and then about 20 minutes late I was led into the procedure room and had my endoscopy and colonoscopy. This was all done under light sedation - whatever that means - and around 6.30pm I was taken into the recovery lounge where I was given a tea and biscuit. My wife joined me there and shortly after I was discharged and my wife drove me home.

I did not recall talking to the doctor after the procedures but was later told that I had in fact had a conversation with the doctor and that I probably did not recall it due to the sedation. My wife when picking me asked and was told that I had had two haemorrhoids banded

I had pain that night which was to be expected and took panadeine forte as instructed. The following morning, a nurse from the hospital phoned to see how I was which I thought was nice. Over the next few days the pain did not subside much and I was living on panadeine fortes. By Saturday I was still in so much pain that my wife phoned the hospital and spoke to a nurse who it turns out was present when I was treated. He confirmed that I could have pain for a number of days.

By Monday, 4th April the pain was still bad. I phoned the doctor's rooms and an appointment was made for me to come in the next day for a check up. I did this on Tuesday, 5th April. The doctor said that it could take a bit of time to heal and for the pain to go away and also commented that I had "a tight muscle" (tight arse I guess) in that area and that probably the cause of the pain was due to my being constipated from the panadeine and my having motions (a crap) straining and causing the muscle spasm which in turn caused the pain.

He gave me script for rectogesic to use after going to the toilet to help relax the muscle and also a script for valium to also help my body relax. This visit cost $66.00 - a bit less than half I got back from Medicare. I got the rectogesic script filled at a cost of $39.75 from the pharmacy located in the same building as the doctor's rooms and later found out I could have bought the same item for around $10.00 less from our local pharmacy. I did not get the valium script filled as I really did not want to go onto valium.

For the next 5 days I did as the doctor suggested - applying the rectogesic but the pain did not go away nor did it seem to be easing and a few days later I gave in and got the valium. I wasn't happy taking the valium as it was sending me to "la la land" each time I took it, even though I was only taking half of a 5mg tablet. After a couple of days of this I stopped taking the valium and by the end of the weekend (Sunday, 9th April) I was still very much in pain - the pain would start within 15 minutes of my going to the toilet and would last 6, 7 and more hours - all I could do was pace up and down our living room, I could not sit and only when the pain had subsided enough, could I lie down on the couch.

I phoned the doctor's rooms again after the weekend and had another appointment on Wednesday, 13th April which again revealed nothing as the source of the pain other than being told about my tight muscle causing pain from the spasm. Again the visit cost me $66.00 less the refund from Medicare.

Another week went by and there was no improvement - I was still having serious pain, I was still taking panadeine fortes - sometimes up to 8 a day - was using the rectogesic, and from time to time was taking the valium when I simply could not bear it anymore and at least it helped me sleep - some nights I didn't even go to bed due to the pain. This would happen if I went to the loo in the evening and the pain would set in and last for up to 6-8 hours and even more.

To counter the element of constipation from the panadeines I was taking Agarol daily, eating prunes, drinking lots of water and having at least once a day a large bowl of Sultana Bran with All Bran. If nothing else I was now the most regular I had ever been, going to the loo virtually within 30 minutes of getting up each morning and then suffering the pain till mid-late afternoon. On the odd day that I didn't go in the morning, I would go at night which resulted in me being in pain throughout the night. My wife would get up in the morning to find me pacing and sweating from the pain.

On Monday, 18th April another appointment was made with the doctor for Wednesday, 20th April, again at a cost of $66.00. This time he suggested that maybe I had an infection and gave me scripts for two "strong" antibiotics which set me back another $26.00. This is in addition to the panadeine fortes which I was now going through at an average of a box every 5-6 days at a cost of $11.50 a box.

Another week and no improvement so I again saw the doctor on Tuesday, 26 April (another $66.00) and he suggested I have another procedure. This was scheduled for Friday, 29th April at 3.00pm. The hospital insisted that I would need to pay $225.00 before being admitted as I was not covered for private hospital care (which I thought I was). I had already received a bill from pathology for nearly $200.00 and shortly after received a bill from the hospital asking for $491.00 - what I owed for the first treatment which I thought I was covered for.

On Friday, 29th April at 3.00pm I turned up for my appointment. I paid my $225.00, was taken in to the waiting area at around 3.30pm, interviewed by the nurse and then sat around in the waiting room with one other patient who was to be seen before me by the same doctor. There was no-one else in the room apart from the two of us. At around 4.00pm, the other patient was taken in and about 15 minutes later the anaethetist called me in to go over my chart and explain again what was going to happen (different anaethetist to the previous occasion).

In his room, he inserted a canyula in the back of my hand and then I returned to the waiting room. It was now around 4.30pm. About 20 minutes later I was taken into the treatment room and placed on the operating table. Being my normal nervous self, I tried to crack a few jokes while someone was fiddling with the canyula and the next thing I felt was a very hot burning sensation all over the back of my hand. I did my best not to look and then I was asleep. My guess is there was a stuff-up with the placement of the canyula or the anaesthetic fluid was going into the wrong part of my hand or both - I don't really know, but this certainly did not happen during the first surgery. The time would have been around 5.00pm.

The next thing I knew, I was being roused by a nurse and helped to walk to the recovery/waiting lounge room where the other patient was also seated. Again I was given a coffee and biscuits and some cheese. The time would have been around 6.30pm and soon after my wife arrived. She asked to speak to the doctor but was told he had already left. She wanted to know what had been done and what I should do if I have any problems over the long weekend. The nurse on duty told my wife to phone the doctor's room after the weekend and she told my wife they had found another small haemorrhoid and had banded this as well as "stretching" my rear end muscle to try and "loosen" it to avoid the muscle spasms. She also found out all this had been done under a general anaesthetic.

The patient next to me who was also in discomfort/pain following his procedure was asked if he wanted morphine for his pain. His name was Ian, so my wife reminded me, and he took up the offer. I was also asked if I wanted morphine for my pain to which I said "no" - I might have been in pain but I was not interested in taking morphine.

Ian was asked who was picking him up as it was now getting on to 7.00pm and I think he said his wife was on her way. I was then told to go and get dressed (change out of the gown and back into my own clothes). My wife had to help me as I was very drousy - she had been told by the nurse that they close at 7.00pm. I did not see the doctor after my procedure as I was still sedated - my wife was told he had gone home. Both my wife (who has some medical background) and I found it strange that I was being discharged so quickly after a procedure that involved a general anaesthetic.

As was to be expected, I was woozy and drousy when we got home around 7.30pm and was like this for a few hours after this. I had pain later in the evening and took panadeine forte for this and managed to sleep through the night. Saturday, however, was another story and the pain was now worse than before the second treatment. I was taking panadeine fortes every couple of hours and also the valium. Sunday was no better especially after I managed to go to the loo on the Sunday evening and I spent the night pacing the living room. Monday was a public holiday so I couldn't phone the doctor. Interestingly, this time there was no follow-up phone call from the hospital on the Saturday to see how I was going.

On Tuesday, 3rd May I phoned the doctor's rooms to advise them that the pain was actually worse and the response was that I could/should expect some pain and to contact him later in the week if things did not improve.

I was now rapidly losing confidence in this doctor and the pain was now worse than before the second procedure. I had now been in pain for over a month and not been able to work during this period and things were only worse, not better. On Thursday, I saw my local GP as I needed a script for more Panadeine forte and wanted a blood test (I am diabetic and had my thyroid burnt out a number of years ago and I was due for a blood test to check these levels). I also wanted another doctor to get a second opinion.

On Wednesday, 11th May I saw a second specialist (another $120.00 - got back $61-00 from medicare) and he examined me and could see I was in pain when he prodded the area and therefore could not do full examination in my state. He suggested an MRI which would cost me $250.00 and also said that it may not show anything but should be first option before having another procedure. He said the surgery would be a similar cost in the private hospital he operates in as what I had paid previously.

I simply lost it and told him I can not afford this and that we were already out of pocket hundreds of dollars to date. He gave me a script for an antibiotic just in case there was an infection (another $11.00). He could see the pain I was in and was good enough to suggest my seeing him across the road as a public patient in the public hospital's clinic at which time he would be able to organise the MRI which would not cost me anything.

On Monday, 16th May I had my appointment with the second specialist at the public hospital (I only had to wait 15 minutes to see him). An appointment was made for me to have the MRI on Thursday, 19th May and in the follow-up appointment with the doctor on Monday, 23rd May he reported to me that the MRI was clear and that all he could now suggest was another procedure to further investigate the area under a general anaesthetic at the hospital (again I only had to wait 15 minutes to see the doctor). He also told me had spoken to two of his colleagues about my situation and felt the only choice left was another procedure with a view to looking for an abscess and or doing a sphincterotomy or something like that.

He advised me that he was fully booked for the next two weeks but one of his colleagues could do the procedure on Thursday, 26th May. I accepted this readily - I have simply had enough of suffering pain every day after going to the loo for 6+ hours a day as has been the case for the past two months.

From his rooms, I went to admissions to book my operation and then went home. I was told to come back the next day to complete the pre-admission procedure. On Tuesday, 24th May I returned to the hospital for the pre-admission check-up. I only had to wait 10 minutes and I saw the attending doctor who went through my medical history - all this took about 15 minutes. Being a diabetic and with my thryoid condition as well as being a smoker, the doctor wanted me to do a full blood test and have an chest X-ray.

From the doctor I went back to the pre-admission waiting room and 10 minutes later was taken in by the nurse. She went through the preparations I would need to take for the operation and also checked my blood pressure and heart rate and also did an ECG all of which were normal. This again took about 20 minutes and then I downstairs for the X-ray (waited only 15 minutes) and then up to pathology for the blood test - the wait here was a little longer, around 30 minutes.

It would seem to me based on my two experiences in a private hospital when compared so far to what I have been through in a public hospital, that the latter tends to be more thorough in preparing patients for surgery than the private hospital system. It is also worth noting that I have been told that following tomorrow's surgery I will be staying overnight and will only be discharged after the doctor has checked me on Friday - a far cry from the way I was treated in the private hospital after having a procedure under a general anaesthetic.

Hopefully, everything tomorrow will go well and the problem will be found and resolved.

Thursday, 26 May 2005

Had a phone call this morning at 9.00am from the hospital just as I was about to shower and get ready to go in for my operation. They called to tell my operation today needs to be postponed - the doctor is sick and another doctor will ring me later today to reschedule.

By late afternoon, did not hear from the hospital so called to find out what was happening. Was told I had now been rescheduled for next Thursday, 2nd June again for afternoon surgery.

Because of the severe pain I was still suffering, my wife spoke to the registrar at the hospital whom she was told would be carrying out the operation and he gave her the name of some different pain killers including Tramal and one which is morphine based. The doctor said our local GP would be able to give her a script for these.

My wife tried to make a booking to see our GP but he was booked out so she made an appointment for Friday afternoon after she had finished work.

Friday, 27 May 2005

My wife saw our GP on Friday and got a script for Tramal which is stronger than Panadeine Forte but not as strong as the morphine based tablets. The chemist gave her a generic brand for Tramal called Zydol which is made up of 50mg Tramadol Hydrochloride.

Monday, 30 May 2005

Took the Zydol on Friday and over the weekend and found they made very little difference to the pain level I was suffering - which would still last 6-8+ hours after going to the loo and leave me pacing around the house for that amount of time and sweating profusely from the pain (infection???).

Late this morning, the hospital phoned again to advise that my operation was now being put back another week "due to a lack of OT time" this Thursday and also due to their being a couple of emergency (cancer) cases that needed to be done this week.

I was told I was now scheduled for Thursday morning, 9th June and a note had been put in the computer to not change my time again.

I was not happy about this nor was my wife when I phoned her with the news. When my wife got home from work she phoned the hospital to see if anything could be done but was told there was no option. As I had had particularly bad pain on Sunday and Monday, she tried to speak to the registrar who did not return her phone call. She tried to see our GP to get a stronger tablet for me, but he was booked out so she made an appointment to see him on Tuesday.

Thursday, 02 June 2005

On Tuesday, our GP gave me a script for Tramal SR 100mg (stronger than the previous script for Tramal 50mg) and gave me a sample of 4 tablets to take until I got the script filled - one in the morning and one in the evening.

So far I have found these tablets make little difference to the pain level but will persevere with them. Have found it necessary to also take valium a couple of times this week if for no other reason to try and help me relax.

One week to go until the operation and hopefully a resolution of the problem which is causing me so much pain.

Wednesday, 08 June 2005

Just spoke to the hospital to confirm the time I need to be there - told 6.45am and nothing to eat or drink after 2.00am tomorrow morning.

Yesterday, the hospital phoned to check that I did not have a temperature or the flu or anything like that - they confirmed my surgery time for Thursday (tomorrow) and told me to phone the next day (today) to get the time I need to come in (which I have just done).

Yesterday afternoon went back to the hospital to pick up the preparation kit I need to take before the surgery. Didn't have to wait - all was ready in a bag with my name on it wating for me to pick it up - no cost.

Last Friday and Saturday, I had shocking days pain wise with it lasting well over 7 hours on both days. Ran out of the Tramadol 100mg samples our GP gave me so went back to the weaker Tramadol.

On Sunday, my wife got the script filled for the stronger Tramadol and they appeared to help a little and on Monday (my birthday) the pain was a lot more bearable - maybe the tablets helped.

Yesterday, however, was a different story. Went to the loo in the morning and had pain for most of the day then had to go again around 7.00pm which again left me with severe pain until 12.30am when I finally went to bed. Took two valiums during the day so I guess they helped me get off to sleep.

Sleep these past days has been bad. Haven't had a decent nights sleep without waking up for weeks.

Today, so far has not been too bad, but that I guess is mainly due to the fact that I haven't been or needed to go the loo so far today. That will change later in the day when I have to take the preparation to clear my system out for tomorrow's surgery. Anticipate this will happen late this afternoon or early in the evening which means I will have another night of pain to contend with.

Will update this when I get home after the surgery tomorrow.

Thursday evening, 09 June 2005

Talk about feeling "woozy"!!!

It's around 7.30pm and I am sore, tired, uncomfortable and have this sterile sanity pad type thing stuck on my behind. My head is "light" and I have been dozing on and off most of the day.

Yesterday afternoon at around 3.00pm I had my main meal for the day and then took the two durolax tablets given to me by the hospital as part of the preparation to clean my insides out before having surgery.

I was a little hungry at 6.00pm so had a finger bun then out of the blue at around 7.30pm got this almighty stomach ache and went to the loo - those tablets sure worked fast. And then the pain set in and didn't go away for hours. I had a shower at 11.00pm using the special pre-operative body sponge given to me by the hospital.

(When I had surgery twice at the private hospital all they gave me by way of preparation was the two tablets to take the night before and an anema to take a couple of hours before coming in for the procedure.)

I was still in deep pain at 2.00am so decided not to go to bed as I needed to be up by 5.00am to take an anema and go to the loo and take a shower before leaving for the hospital by 6.15am.

As it was, at 5.00am, I got the urge to go to the loo which again left me in pain. About half an hour later I used the anema which resulted in me having to go to the loo another 3 times in the space of less than half an hour. The pain after each of these "excursions" was incredible and as time was running out I had my second shower using a second body-sponge at 6.00am and left for the hospital at 6.30am.

I will continue this tomorrow when I am feeling a bit better (hopefully).

Saturday afternoon, 11 June, 2005

Well. The rest of Thursday night and Friday were virtually a write-off.

Feeling drowsy and nauseas after the operation and dozing on and off most of Thursday afternoon after returning home from the hospital, I elected to sleep on the couch that night. I was feeling uncomfortable, had pain and did not really feel like trying to sleep in bed opting instead to lie on the couch with the TV going and let myself drift in and out of sleep.

Having arrived at the hospital the previous morning on time at 6.45am, my wife completed the required forms on my behalf and I signed where needed - I was in severe pain from visits to the loo only a matter of an hour or so before - I could not sit down in the waiting room, was sweating profusely and was just wishing the whole thing was over - I felt absolutely "shit-house".

About 20 minutes later, a pre-operation nurse called us in - she had to check my pulse, blood pressure, weight etc. and go through a series of questions - this took about 20 minutes. I couldn't sit, was trying to crack jokes and the nurse could see I was not feeling all that great.

From here she took me to change into a hospital gown complete with stockings (didn't get this at the private hospital) and booties plus a pair of "bloomer" disposable underpants and dressing-gown. I was then taken to another waiting area closer to the operating rooms.

It was now around 7.45am when the anaethetist called me to go through his check list and ask if I had any allergies etc. This took about 10 minutes. After this my wife and I went back to the waiting room and about 15-20 minutes later the anaethetist's assistant came to get me. I said my goodbyes to my wife and went off with the assistant to get ready for "La La Land".

Things went pretty quickly from there. Once I got on the gurney, I was taken into the operating room where the anaethetist was plus the assistant that wheeled me plus another assistant plus a another person (nurse) who placed what I was told were ECG probes on my chest and legs so my hear could be monitored during the procedure (the private hospital didn't do this).

I remember the doctor coming in and my talking to him while the anaethetist was doing his thing on my arm and then I was gone - all in the space of a couple of minutes.

The next thing I remember was waking up with an oxygen mask on my face - I was drowsy, my throat and mouth were dry and I was in pain. I remember I could see two nurses and I mumbled something about the pain and feeling thirsty. I can recall the nurse saying something about giving me something for the pain and at some stage being given a sip of water.

I remember waking and dozing a number of times and then the mask being taken off my face and my being wheeled into another room where my wife joined me shortly after. I think the time was around 11.00am.

A couple of nurses attended me and gave me water to drink and some tablets for the pain. One of the nurses asked if I wanted a sandwich and a tea or coffee. I felt this strong urge to have a "pee". I was offered a bottle by the nurse but declined this option. They wouldn't let me walk to the toilets so I was put in a wheelchair and pushed down the corridor.

I was wobbly on my feet so my wife came in with me to hold me steady - I guess the choice was either her or the nurse and since my wife was with me I really couldn't choose the nurse, now could I???

I stood there for what seemed like hours trying to pee but it wouldn't come. We went back to the recovery room where the nurse sat me down in an easy chair and I finished my sandwich and tea. The nurse joined us and went through a check-list of things I needed to do. She was great - Barbara was her name.

She told both of us what had been done - another haemorrhoid was "attacked", a fissure was found and attended to and I had had a lateral sphincterotomy. Barabar said I could expect to have pain and/or some bleeding for up to 3 weeks and she had made an appointment for me to see the doctor in 3 weeks time. She said I would not be ablet to work (courier) until after I had seen the doctor and been given clearance by him.

It was now going around 12.00pm and I asked about going home. Barbara said it really depended on how I felt and as long as there was someone at home for the rest of the day, she saw no problem with my going home. My wife cancelled her work for the afternoon to make sure she would be around at home.

Having been wheelchaired to my wife's car, we got home around 1.00pm. I was groggy, and in some pain and feeling a bit nauseas. All I remember was my spending the rest of the afternoon and early evening lying on the couch dozing and waking in front of the TV and this is how I spent the rest of the night apart from about ten minutes when I added to this story. I had virtually nothing to eat - I didn't want to eat as I didn't want to have to go the loo as I still associated strong pain following a visit to the loo.

I had been given strong pain killers and a script for more Tramadol 100 and was taking these plus Tramadol 50's to help manage the pain.

Friday, was much the same. I spent the day and evening on the couch in front of the TV. Again I ate very little during the day - I had a yoghurt and cups of tea and a cheese on toast - nothing heavy still having that fear of going to the loo. Around 10.00pm, I did go to bed and apart from having to get up to take a pee once or twice, managed to stay in bed despite the discomfort and pain. The pain-killers were doing their job.

This morning both my wife and I got up at 4.30am. We couldn't sleep so we both got up early. I watched TV while my wife went on the computer. I had coffee and toast - still hadn't been to the loo since before the procedure, and was not in a hurry to do so. Later in the morning my wife made me scrambled eggs with mushrooms. I had a shower this morning - took off the pad I still had on from the hospital and put on a new one.

The rest of the day was pretty uneventful - was still feeling drowsy, probably due to the heavy dose pain killers I was taking so again spent most of the day on the couch in front of the TV.

My wife made a lovely roast chicken dinner. I seem to have lost my appetite lately and only managed to eat about half of what I used to eat. Nonetheless, it was great having a cooked meal for a change.

I still had not been to the loo but felt that this was going to happen within the next 24 hours so had some agarol tonight before going to bed - might as well try and make what was going to be an unpleasant experience a little bit less painful if possible. It is going on 11.00pm and I am off to bed.

Sunday evening, 12 June 2005

What a horrible day today has been. Got up around 8.30am after a restless night's sleep - pain and going for a pee. After a coffee and toast I finally got the urge and it was off to the loo - it was now after 10.00am and whilst I had no difficulty in going to the loo, a new and searing pain had set in - recovery pain I was told by the hospital when I was being discharged.

I had a shower a while after going to the loo and put on a new pad. Couldn't help but notice there was some bleeding which I had been warned could happen for up to 3 weeks after the operation. Not having a bath-tub in our house, my wife made up a salt-bath in a plastic tub for me to sit in - this had been suggested by the hospital to help assist the healing process.

I had been warned that the first couple of visits to the loo after the work I had done on me was going to be painful - they were not kidding. I have been popping my pain killers - Tramadol 100 in the morning and eveing - and taking Tramadol 50 every 4 hours in between, but feel these are doing precious little to alleviate the pain. I have again been on my feet pacing most of today and it wasn't until after 7.00pm tonight that the pain subsided enough to let me lie down on the couch.

The pain had completely drained me and all I could manage to do tonight was lie on the couch - I couldn't sit, it was too painful - and writing this is being done whilst standing in front of the computer desk.

I am exhausted and it is going on midnight so I am off to bed.

Monday, 13 June, 2005

Last night was better but not great. Was pretty tired and slept through most of the night except for getting up for a "pee". Pain at night seems to have improved a little and woke this morning feeling not to bad - not so drowsy and pain was quite bearable.

Had a coffee and shortly after a bowl of cereal and around 11.00am got the urge and went off to the loo. Again the pain was bad - again the tablets did not appear to be doing much. Again I was pacing - was not able to sit and too uncomfortable to lie down.

Ate lightly for the rest of the day - toast and yoghurt - was going to try and avoid the loo again today and/or tomorrow - I can only take so much of this bloody pain.

Around 2.00pm the pain started to subside and I was finally able to lie down on the couch where I spent the rest of the afternoon.