Carrying On

I don’t know whether I should blow steam off on the world or count my blessings. I guess I should do the latter. Around me wonderful people die every day. Others live their entire lives with disabilities so great that it’s difficult to comprehend how they cope from day to day. Comparatively, I have nothing to complain about.
Until recently, my medical file consisted of maybe four pages and a few x-rays which served to prove that nothing was wrong with me. Now I’m faced with one physical crisis after another and feeling like my body is sabotaging me. Here, on the other side of the better half of 40, I’m faced with the prospect of living with a permanent disability. What I have learned in the last two years is that from the moment we are born we begin a journey of slow deterioration.
Some of us are lucky enough to live our entire lives having avoided the genetic pitfalls potentially inherited from our mothers and fathers, the follies of our youth, our poor habits as adults and every other mishap that could leave us relying on machines to communicate, to get around or even to live.
I’ve taught hundreds of children and raised one daughter (so far) with the hope of helping others avoid mistakes that might steal away their enjoyment of life as adults. Maybe I’m hypersensitive to the issue since I feel as though I’ve made so many unnecessary mistakes of my own. So many times I’ve been too stubborn to learn from others.
But not everything is avoidable or foreseeable. Even when a person lives the very best life style, there are no guarantees. We must simply persevere.

The Ever Changing World

It feels like an odd year for cold and snow. Here we are in mid March and we’re just coming off of a -30 C cold snap. It snowed in Victoria BC and at least as far south as Oregon. Maybe I’m just more intolerant of colder temperatures now that I’m middle aged.
I know that as humans we are having an unimaginable impact on the planet. One only has to look at night photos taken from space to see how much of the world we have managed to light up. And maybe the time of modern man will be one of the shorter periods of the earth’s history. We are consumers and we are consuming the planet.
Wisdom and action are two different things. Recent infusions of bailout money in the US make me wonder what kind of wisdom is at play here. What makes change necessary if there are no consequences for poor business practices – like…hmmm…I don’t know…bankruptcy? I imagine that in a year or less the auto companies and banks that have received this cash and survive will be vying for market share with unreasonable promises and easy credit all over again.
Just a jot.

More Challenges

I feel it was dumb luck that I survived my aneurism while I was visiting in the US, but the care I have received in my own province since I returned has been less than what I hoped for or expected. Now I face hospital bills that no insurance company will touch, though I carried all the insurance I should have needed.

After spending almost three weeks in the hospital – most of that time in intensive care – they released me and I eventually returned home to Vanderhoof British Columbia with instructions to get a follow-up CAT scan and see a neurosurgeon within two weeks. As soon as I got back I made an appointment with my family doctor who ordered another CAT scan and worked to get me a follow-up with a neurosurgeon. The report from the scan stated that I was recovering normally and everything inside my brain looked fine. My family doctor is a general practitioner and relies heavily on reports from specialists in situations like this one. We didn’t find out until much later how wrong the report had been. Doctors expected recovery to take a long time, so I chalked up my nausea and other symptoms to medication and the healing process.

The earliest appointment I could get with a neurosurgeon wasn’t until November 2008 – over eight months after my original emergency. In the meantime, the Oregon Health and Science University offered free follow-ups. I was still very sick so I took a copy of my CAT scan with me when my wife and I went to the US to discuss my health concerns with someone who was familiar with my case. The surgeon was immediately concerned when she viewed the scan. Even a layperson could see the large space of air inside my skull (approximately the size of two golf balls) caused by a hole somewhere in my sinuses that allowed air to be drawn inside. The doctor wanted to have another CAT scan done immediately, but when I explained that we were from Canada she suggested that I get another scan as soon as we got back to our own country. Again, she told me to see a neurosurgeon as soon as possible. The CAT scan was easy enough to take care of, but finding a neurosurgeon proved no easier than it had been before.

Meanwhile I was getting sicker and sicker. I required continuous care at home because I might need emergency care at any time. My wife stayed home with me as much as she could and my parents were especially helpful looking after me when my wife couldn’t. Every time I got nauseous and threw up, I ended up in the emergency room with an IV to combat my dehydration.

As a teacher I receive wages only during school year months and this made the summer very difficult to bear. We had little income and our expenses were beyond normal. As a result it’s going to take most of the year to rebound from the cost of the numerous trips south. Combine that with the expenses associated with sending an eighteen year old off to university and a newly adopted daughter, we are finding our situation quickly becoming unmanageable.

The second CAT scan revealed that my situation had not improved and my brain was becoming inflamed from the constant exposure to the outside world through the hole in my sinus cavity. My risk for meningitis was ever present as well. My family doctor was becoming more and more concerned and he increased his efforts to find help for me. Though he reminds me that he did very little for me during this time, I will always appreciate his efforts and concerns in light of the fact that even as a doctor, he does not have the authority to act on my behalf because he is not a neurosurgeon.

Yet again, I traveled again to the US for another appointment taking along the second scan which I gave to the doctor immediately upon my arrival. He left the office and when he returned, his first words were that he was scheduling another surgery for the following week. It was obvious that he considered my condition an emergency. Why couldn’t the medical system in BC see the same urgency? I asked about the list of questions we had brought with us but he said that everything I was experiencing was likely due to the air and that the surgery would alleviate all of the symptoms.

I accepted the appointment thinking that between my travel insurance, my BC medical insurance and my extended health insurance I’d find a way to be covered, or I would find a way to get help in BC before the surgery date. None of that came to pass.

I called my various health insurances and contacted our local MLA. All the insurance companies denied helping. My doctor managed to get the appointment with the BC neurosurgeon moved to late September, but my surgery was scheduled for August 4th. I thought that I might be able to hold on when suddenly I came down with some kind of flu and I ended up spending four days in the local ICU. The hospital released me just a few days before we were scheduled to be in the US again. We were out of options and I felt like I was out of time. Every day I was getting sicker and I knew that any unlucky turn for the worse could be my last.

The phone rang in my Vanderhoof home just three days before my scheduled surgery. I thought it might be good news at last. My doctor could put me on a life flight to Vancouver to see a neurosurgeon. I accepted the opportunity, packed and went to the hospital. Things were not as simple as he thought however. There were no beds available and if I went to Vancouver I would be seeing a surgeon for a consultation only. After hearing my case, the surgeon decided that he did not want to try and deal with the problem because according to him the original surgeon aught to do the second surgery. He suggested I borrow the deposit for the surgery and go to the US for care. To me, this was a least a statement that care could not be provided in BC and that if I might be able to have the surgery covered by my medical service plan after all.

I drove to the US. The surgery was a success and two months later I am beginning to feel more like my old self, but the loan and outstanding bills are now making it impossible to carry on my life normally.

Thanks to our local MLA, BC Medical has agreed to look at my case retroactively provided that a neurosurgeon from British Columbia fills out the appropriate forms and submits them. Unfortunately, no surgeon is willing to make a judgment on a case and surgery that they had nothing to do with - regardless of how compelling the evidence is. We are out the cost of the initial fee and are receiving new bills every day. We had just sold our properties and we were looking forward to purchasing a new home when this happened. Now we are ineligible for a home loan and we are currently staying with my parents who have been very gracious. They remind us that we can stay as long as we need to.

I am an insured BC resident who has lived in this province almost my whole life. I went to university here and became a teacher. I’ve been employed by school district #91 for almost twenty years and have maintained a healthy lifestyle along the way. I did nothing that would increase my odds of having an aneurism and I waited for as long as I could possibly wait for the care that I needed. Health insurance means nothing if when there is an emergency no help is available. I needed immediate help and my only option was to go where it was available. British Columbia effectively denied me care by the impossible bureaucratic expectations amidst an urgent situation that could wait no longer.

The Saga Continues.

The worst of the ordeal is over. The last surgery was a success. They opened my head up using the same scar and opened a hole in my forehead over my right eye. Inside there was a hole in my skull about the size of my small fingernail. Taking a piece of muscle from the side of my face, they filled the hole.
My problem was two fold. The shunt was working superbly and the hole in my sinus cavity created an endless supply of outside air. This combination created the airspace inside my brain, about the size of a golf ball and a half or two golf balls. My brain had become inflamed around the edge of the space. They removed the shunt and covered the hole with a small titanium plate.
Now the real fight is going to have to happen and I’m glad that I’m feeling stronger every day. The soap opera plays out like this. I had travel insurance, regular health insurance and extended health insurance. At this point BC Medical is refusing to pick up the bill because I’ve never seen a neurosurgeon in British Columbia. Extended medical won’t do their share unless BC Medical agrees that the procedure was imperative. Travel insurance won’t cover it because they claim that it was a pre-existing condition.
The kicker is that I’m on the mend and my first appointment in BC isn’t scheduled until the beginning of October. In all honesty, we did reschedule, but that was because the September appointment was scheduled a month after my final surgery in the US – six months after my original bleed.
My current plight is simple. I believe that my life was in imminent danger. The services and concern for my wellbeing were not available in British Columbia. I took our a loan to pay for the surgery at the suggestion of my family doctor who had been in contact with a couple of neurosurgeons – neither wanted to deal with my case. I’ve been paying into the healthcare system for years with no significant illnesses. Now, with everything on the line, there is no support. I feel betrayed by the system and am now carrying a debt I should never have had to endure in the first place.We need to do something about our medical system. Care is not available equally to those covered. Had I been living in the lower mainland, I would have had access to necessary services. Of this, I am certain. If you’ve had a similar problem or have any suggestions, drop me a line.

British Columbia Health Care

In British Columbia, we would like to believe that we live under a security blanket of insurance and medical professionals. Our insurance is affordable and under most circumstances care is just a phone call away. Sadly, that blanket is a thin sheet offering little warmth. Much of what our doctors come across is the mundane day-to-day ailments a small community produces. The question is, can a person living in the north survive a serious illness in our province? In my case, I’m not so sure.

On April 2nd 2008 my wife, Wendy and I were visiting my parents-in-law’s near Portland Oregon. I had just stepped out into the hallway after using the restroom when a strange painful sensation of moving fluid, started in my upper shoulders and rolled over the crown of my head, overcoming me. I had never felt anything like it before, but I knew immediately that it was bad. Awareness was slipping away and I wandered down the hall to find someone who could help. The first person I came across was my mother-in-law. “I need to go to the hospital right away,” I remember saying.

She asked me about what I was feeling and I remember saying that I was experiencing the worst headache of my life. That wasn’t entirely true, but I knew that I didn’t want anyone to waste time trying to help me. They called 911 immediately. My mother-in-law helped me to the sofa where I lay face down with my face resting over the edge. It seemed only moments had passed before the paramedics arrived. They moved me to the ambulance and rushed me to the nearest hospital. A neighbor and a retired surgeon, I was told, recognized my condition immediately. He phoned ahead to the McMinnville Medical Center to ensure the hospital was prepared.

My memories at this point are sketchy at best. I remember arriving in the McMinnville hospital, but very little other than that. Someone, I don’t remember who, told me that a helicopter arrived to Life Flight me to Oregon Health & Science University, but due to a malfunction, it never left the tarmac. Instead, the team and I boarded an ambulance and made the trip with sirens blaring.

During the weeks that followed I underwent numerous scans and tests. I spent weeks in the ICU and remember making a concerted effort to distinguish night from day. I tried to use my wife’s visits to help figure out the time of day, but since she spent as much time with me as she was allowed, her coming and going didn’t help with this particular problem.

After arriving at the hospital on April 2nd, I was surprised to learn that the major surgery to put a shunt in for the spinal fluid buildup did not take place until April 8th. After that, memories are clearer. I was able to spend one day on the regular ward and this was great. Visitors were no longer restricted to one or two. Unfortunately, I cannot say that I was a good host. I slept when I was tired and visited when I could. At least some family members, who do not have much of a chance to visit, did.

The following day nurses loaded me onto a stretcher and took me back to the ICU. Although I was one of the healthiest patients in the ward, my condition was not as stable as they would have liked.

I feel lucky to have had this emergency in the United States. Care was immediate. I shudder to think of the series of events that the Canadian system of health care creates. An ambulance would have been called and the distance from dispatch could have meant a half of an hour wait. I could have spent an hour or more waiting to be seen at the hospital - through no fault of any of the competent general practitioners. Once they recognized my condition I more than likely would have been sent to the next largest centre. Unfortunately, there they are not equipped to deal with brain trauma.

After having spent hours in the system I may have been transported to Vancouver British Columbia. If I was lucky enough to have survived the trip without suffering irreparable damage, my treatment would have begun then – possibly a full day after the initial bleed. I have little confidence that if this worse case scenario had been realized that I would have survived.

I spent another week in the US recuperating before traveling back to Canada.

When I arrived home I made an immediate appointment to see my doctor and he scheduled a follow-up CAT scan. I received a copy of that scan and one was sent to a specialist in Vancouver British Columbia as well as to the neurosurgeon in the United States. My wife scheduled an appointment in the US because the hospital offers free follow-up for three months. Upon seeing the scan, my doctor in the US was immediately concerned. I explained that we were from Canada and reluctantly she released me saying that she wanted us to get another scan right away when we returned. She hoped that the healing process would close whatever hole was allowing gas to enter my brain.

The next CAT scan didn’t occur until July. In the mean time my doctor advocates in Canada were working hard to get the specialists in Vancouver to understand my plight. They informed me that I had an appointment scheduled in November. In the mean time the gas in my head was causing me to be nauseated. Every time I got sick, I ended up in the hospital dehydrated. Toward the end of July I came down with some kind of virus and because the doctor was afraid that whatever it was might move to my brain, he admitted me into the hospital. More contact with the surgeon in Vancouver finally bumped my appointment up to September – a month away as I write this.

A second follow-up appointment in the United States showed that the space inside my head was not getting smaller. Some of the smaller spaces seemed to have disappeared, but the main space, that I figure was somewhere between 50 and 100 mL, was larger if anything. There was a white ring of inflammation along the edge of my brain. I was getting scared.

The doctor arrived after looking at the scan ignoring the list of questions I had written down. He said that the symptoms that I was experiencing were probably associated with the air pressing against my brain. He informed me that they were scheduling an operation immediately. When the appointment was over, the surgery was set for a week later. I left the office and went back to Canada.

My first order of business was to try to get one of my four insurances to cover the upcoming surgery. All declined.

The day before I was scheduled to return to the US I received a call from my family doctor. He said that there was a doctor available in Vancouver and they could life flight me there to see him. After discussing the issue with my wife, I agreed to take the flight, mostly because this route would be covered by my insurance. I quickly packed and was driven to the hospital. When I got there, my doctor was still discussing the issue with doctors in Vancouver. The final verdict was that I should go ahead and borrow the money and have the operation in the US, so the next day we loaded into the truck and began our trip south.

Where am I now? I am currently at my in-laws in the United States and recovering well. Yesterday was my first day without medication and most of the pain I am experiencing has to do with recovery. I am confident that the problems I’ve been facing since April are behind me. When I get home my priority will be to find some way to pay for this life saving procedure. In the meantime, I’m just happy to be alive.

My Meager Publishing Experiences/Wisdom

Publish America has received some very bad press and not all of it is justified. However, some of it is.
The good things:
I got my fist book published.
There was no cost to me.
I learned valuable lessons:
- The writer is the first and most important editor. Trust no one else with this task lightly.
It's so important it bears repeating.
- The writer is the first and most important editor. Trust no one else with this task lightly.
- It provided me with a real life publishing experience that I didn’t have to wait for years to have.
The book is available and does have good qualities.
They did do everything they said they would, unfortunately for some authors this has not been the case.

The not so good things:
It won’t be in bookstores no matter how hard you try (I believe). I was shocked to find out (because they never told me) that bookstores (at least in Canada) get a five percent discount on the books. This doesn’t cover shipping, so they can’t/won't bring the books in.
Authors outside of the US are at a disadvantage because Publish America won’t accept returns from other countries.
There is confusion about whether Publish America is a vanity press. It’s not in the sense that it doesn't charge fees, but it is POD.
Publish America does not have good author support.
There are many disgruntled Publish America authors because they feel they should have received more. This might be true.
Note: I did look this company up with the Better Business Bureau and what they said is that this new company has had no more startup problems than any other new company has. They have actively dealt with issues that have arisen. A further note: issues on the web tend to be written in stone, one disgruntled individual can seem to knock around forever, stirring things up. There are a half a dozen people who have been so angry and frustrated that they’ve posted on many different forums – and still do.
They should have two departments and don’t. They should have one department that accepts only serious manuscripts with a solid support staff for these authors. The second department should be for those people who have a very small audience – like family and friends – who never intend to be serious authors.
Further Note: If I ever publish with Publish America again, I would not bother with their editing department. They failed miserably at this task (spell check, and not even a good job at that). I should have never let them touch the manuscript.
As a Publish America author, you are a part of a very large group of writers, many of whom are mediocre at best. (I may be one of those, but you can decide that for yourself.) Because they do not have high standards for acceptance, it affects the reputation of all other authors published under their name.


How to decide:
If you’re a serious author and have high expectations, don’t choose Publish America for your book. There is little support, cover prices are set high, there is little respect from the writing community (though few of these critics form part of your readership), and there is no exposure in stores or promotions that you don’t organize yourself. However, this has been a good learning experience. I’m finished my second novel and working on the final draft. This is probably true only because I’ve been through the experience once and have learned some meaningful things about the publishing industry. I wouldn’t have any experience if my book was still a manuscript under the bed.
If you have a cookbook, a book of poems, a family heirloom, or anything that is not mainstream literature, this might be a good option that does not cost anything.

One other lesson:
Never before published authors don’t realize that a publishing or agent contract is a two way street. They might be eager to publish and any cost. Becoming a published author should not cost you your reputation or your bank account. There are many publishers and agents who have few scruples. Learn about the industry and what the standards should be and do not enter a contract that is not going to serve you well.

I got a lot from having been published. I AM an author - something I didn’t really believe I could do before. That by itself has been worth it.

Happy Birthday

Several days ago (prior to my birthday) I was kicked in the head by a nasty virus. Once it got me down it decided to bash me into the curb until every muscle in my body ached.

Then it was my birthday. :) I can tell you that it was quiet and relaxing during the times when I wasn't trying to choke up a lung.

Things progressed as you might expect. The nasty thing migrated from one sinus cavity to another, then to the throat where it used its heavy artillery and now it sits heavily in my chest where every cough threatens exit through the top of my skull.

Yesterday was an auspicious day (depending on your definition of luck). The morning was about to begin. I woke and made the call to work, letting them know I wouldn’t be there. It was then that my daughter came upstairs informing me that there was a flood in the basement.

Naturally, I went down there to assess the situation and since the lagoon has been a problem in the past, I started there. My brother came over with an ice auger and we crossed the fence onto the snow-covered surface of the sewage-filled hole. The snow was only few inches deep and it didn’t take long to scrape it down to the green tinted ice below.

We got to work immediately and before long, there was a growing pile of ice shavings. Even these gave off the same odor that you would expect from any open sewer line.

Fifteen minutes later and through eighteen inches of ice, we hit water. I satisfying, yet perplexing result. The problem was not at the lagoon.

I arrived in the house to discover the house had begun its normal routine. Maybe they thought I had solved the problem or possibly, it was a response similar to turning lights on during a power outage. My daughter was the unfortunate one for the second time that morning. While earlier she had gotten her socks wet, now with shoes on she expected to avoid any unpleasantness. She did not know that the water was now significantly higher and the shoes she chose were inadequate. She had some choice words and I doubt that I would have responded any differently.

I arrived in the house to chaos only a panic strickened household can create. The problem that had seemed a minor one was quickly getting out of hand and I did not have to suggest that everyone in the house should stop using water.

The next step was to go to town. I needed a wet/dry vacuum cleaner and an auger that I could run down the pipe to see if I could clear the blockage or figure out what it was. By the time I arrived home, it was after noon and the house was beginning to smell as badly as you might expect.

The first task was clean up some of the standing water, which had now begun to soak into furniture. That task took some time and by two o’clock, I was threading the snake into the cleanout.

By three, two things were obvious. The clog wasn’t in or near the house.

I’ve never made an insurance claim before, but this impossible mess got me thinking about that. Wendy got on the phone to our insurance provider, who immediately reprimanded her for not calling sooner.

After an afternoon of being on the phone, all the wheels were finally in motion. The insurance adjuster had arrived, a cleanup crew was on its way and the backhoe was pulling into the driveway. It looked like some kind of strange house party, but not one you want to be having.

It’s morning now and the basement is almost gutted. I’m at home... still sick. I’m going back to bed now.