How to Fake Wheezing and Avoid Going to Jail

First of all, you can’t fake wheezing.  Wheezing occurs deep in the small airways and alveoli.  it is a characteristic noise that cna be heard, even through screaming babies and mumbling old men.  It’s a sound that can’t be mistaken for gurgling, moaning, croup, stridor, coughing or purposely constricting your throat.

A wheeze is a wheeze is a wheeze,  and you can’t fake it.

So if you’re ever in the situation wher eyouare arrested, and you try to fake an upper respiratory illness and demand that you need to be admitted to the hospital until the doctors get your wheezing under control…don’t even try it…you can’t fake it.

But even more important to remember is that if you TRY to fake wheezing, it’s best to do some breathing…I mean, if no air is going in and out of your mouth, no wheeze will be produced, even if it’s real.

While it may seem logical to hold yoru breath and just move your chest in and out to try and fake a lung related illness…it will not keep you from going to jail.

So don’t waste the officer’s time dragging him to the ER…it’s just going to result in a big bill arriving in the mail.  (unless you live in massachusette’s…in which case the state will probably get the bill).

Maddog knows my Social Fears…

Maddog Medic is a blogger from way back in the day when there were just a handful of us ER types blogging. He’s still active and still tells the truth.

Here is a recent excerpt from a post about the awkwardness of knowing what it is that keeps people alive…

An earnest young student asks me a serious question:

“What’s the hardest part about being a paramedic?”

I look her right in the eye.

“Cocktail parties.”

I say this with all seriousness.

She leans back in her chair, blinking her disbelief.

It’s the social that’s the most difficult.

I could substitute “Cocktail Parties” with “Family Gatherings”. It’s awkward. I am not a Doctor. It’s just something that I do. It’s a skill that can be learned and practiced just like many other skills i’ve learned in almost 40 years…tuning a piano, picking a lock, climbing a 5.10, kayaking a Class IV rapid, planning a season of Iron Man Triathlon Training, swimming from Alcatraz…all just things I do or have done. I am not defined by them. They are just things that I do.

Read the whole post.

Massachusette’s Plan Gobbling up State Funds

Since instituting mandatory health insurance for all residents of Massachusette’s, a recent study finds that one of the plan’s goals of connecting more patients with PCPs has failed miserably.  Accordign to the Boston Globe,

Thousands of newly insured Massachusetts residents are relying on emergency rooms for routine medical care, an expensive habit that drives up healthcare costs and thwarts a major goal of the state’s first-in-the-nation health insurance law.

The law framers had hoped that instituting mandatory health insurance, would open the door to primary care offices for many previously unisnured patients.  But instead what they are finding is that these patients are still using ERs as their primary care, increasing the burden on overworked ERs.

People flock to ERs for primary care because they are accesible, convenient, don’t require upfront payment prior to evaluation and as a bonus, you can get a “free ride” by calling an ambulance.   It’s clear that the solution to these times of problems do not rely directly with health care insurance, but rather health care access.

Do these results surprise anyone?  Certainly no one who works on the front lines in the ER…

One reason I won’t vote for McCain

Is his healthcare advisor’s attitude toward’s Emergency Departments:

 In the Los Angeles Times‘s (8/28) Booster Shots Blog, Shari Roan wrote that this week, “John McCain campaign advisor” John Goodman “said, in effect, that as long as there are emergency [departments], no one in America is really uninsured.”

And…

Op-ed columnist Paul Krugman writes in the New York Times (8/29, A21) that according to Goodman, in America, “there’s no such thing as being uninsured. After all, you can always get treatment at an emergency [department].” Furthermore, Goodman “the president of the National Center for Policy Analysis, an important conservative think tank…wants the next president to issue an executive order prohibiting the Census Bureau from classifying anyone as uninsured.”

Understand that there are a few issues here:

1)  An unfunded government mandate that requires that anyone presenting to an ER requesting medical evaluation, or someone requests a medical evaluation on their behalf, must receive screening for an emergency medical condition regardless of ability to pay.

I have no issues with screening people for medical problems…but the government provides no compensation or liability coverage for hospitals or physicians following this mandate.

Why should this concern you?  When the ER is full of uninsured people demanding an evaluation for their chronic pain or made up medical conditions, or just because they are bored and it’s your hospital’s turn for their daily/weekly/monthly ER visit (yes, it happens…over and over and over again)…YOU or your LOVED ones, who are responsible users of the system will be a) waiting for an ambulance to return to service after transporting the “sprained ankle” who didn’t have money to call a cab or b) waiting in the waiting room because all rooms are full…

Problem #2

Going to the ER to be screened for an emergency medical condition is no substitute for primary preventative care.  People come to the ER only AFTER they are ill, or well advanced into a serious medical condition for which the might have sought treatment had they had insurance.  In addition, the ER is only required to screen for an emergency medical condition and provide stabilizing treatment.  In other words, if the patient does have a medical condition, but it is not an emergency (long term treatment of hypertension, for example), the ER is a horribly inadequate place to be seen and evaluated.

A patient like that will fall through the cracks, not follow up, not be treated for his ongoing medical problem until he shows up in an ER years later (if he can get in) with a heart attack, stroke or flash pulmonary edema.

The stance of the McCain advisors is flat out abuse of the existing Emergency Medical System, which will ultimately hinder your ability to receive appropriate and timely emergency medical care when you or your family needs it most.

If You’re Not a Cowboy…

I see a lot of Horse injuries up here in the rocky mountains.  Mostly tourist stables and stuff, but when there are horse shows in town, we seem to get a lot of hunter-jumper injuries…girls getting thrown headfirst from their horse.

Which is wierd, because during the rodeo, when guys are deliberately riding horses & bulls getting thrown off, we never see them in the ER.  Those cowboys are tough and refuse to go to the hospital, even if they can’t breath or walk.

So my new motto is, “If you’re not a Cowboy, don’t get on a horse.”