It was nearly 3 years ago and I blogged about it at the time. I had suffered from severe headaches for most of my adult life, but on the morning of Tuesday, March 27, 2007, I had a headache for the ages. It came on in the night and no amount of painkiller was enough to stop it. More alarmingly, my vision had become blurred and I was having trouble speaking clearly, although I had no trouble screaming in agony. There wasn't much that Mrs. D could do for me except to get the kids off to school and then get me to the doctor's office.
We'd been through the drill before but after I described the symptoms to the doctor at our clinic, he immediately ordered a CT scan. I'd had a CT scan about six years before but nothing came up. We drove from the clinic to St. Paul Radiology's location in Arden Hills, about a mile from my house. The scan was completed and sent back to the clinic. This time, the news was different. I can still hear his words now. We saw something on the CT scan. The good news is that you didn't have a stroke, but you may have a tumor. You need to get to United Hospital right away. We'll call over there and have you admitted. Can you go right away?
Well, yes, we could go right away. We got down there and I was admitted immediately. Shortly thereafter, I went to the radiology department and had an MRI done. At that point, the diagnosis was provided. Pituitary adenoma. The doctors were concerned about the tumor, which had grown to 2.5cm and was showing signs of bleeding, which would have required emergency surgery. I was admitted to United for 4 days while the medical team put me through a battery of tests. While the need for immediate surgery might not materialize, there was little time to waste.
One of the things that was most impressive about my initial stay at United was how doctors seemed to appear out of nowhere. In the course of the first day I met the neurosurgeon who would later perform the surgery. Then a neurologist arrived, and an endocrinologist and otylarynologist. Finally, I met an opthamologist. I later learned that a number of these doctors were regularly featured on the list of top doctors that runs in Minneapolis-St. Paul magazine each year.
What I learned was about my condition was troubling, especially from the opthamologist. I took a test of my formal visual fields, which measures peripheral vision, both left and right and up and down. While I hadn't realized it, I had lost almost 30% of my visual field, on the top and bottom. While I could see peripherally, the tumor was impinging on my optic nerve and I could not see things up and down. If the tumor were to grow much more, I would likely suffer permanent vision loss.
After consulting with the doctors, the surgery was scheduled for the following Wednesday. The surgery would be a six hour procedure. The otylarynologist (an ear, nose and throat surgeon) would clear a path through my nose that would allow the neurosurgeon to reach and remove the tumor.
The surgery was uneventful and successful. It helps to have some of the best doctors in Minnesota working on your behalf. I spent about a week in the hospital recovering. The timing wasn't the greatest, as it was Easter weekend and I wasn't able to spend time with my family except for a few short visits. But eventually I was able to go home and slowly recover. By the 4th of July, I was healthy.
Three years on, the change is nothing short of remarkable. I rarely have headaches anymore and my vision has returned to 100%. I have no limitations on my physical activities and while I have to take a lot of medications to maintain my hormonal levels, I can do whatever I want. I'm a lucky guy.
So why did I share this story now? I'm concerned. The primary basis of my good fortune is that I had immediate access to a team of specialists in a variety of medical disciplines, who were able to work together quickly to solve a serious medical problem. I did not have to wait for care -- if it had been necessary, I would have been on the operating table the same day as the initial diagnosis. Beyond the skilled and dedicated medical professionals who were available to help me, I also had the good fortune of living in a metropolitan area with a number of top-flight hospitals, all with state-of-the-art diagnostic equipment, including an available MRI machine. We did not have a "Cadillac" health insurance policy -- in fact, we weren't doing so well financially in early 2007. My wife had coverage through her employer, which was a good thing because I had been laid off from my job in 2006 when my employer moved its operations out of state. I had not been able to find a full-time job and my health had been complicating my job search. This diagnosis and the related medical bills could have been catastrophic, but we came out of it just fine. Although we had some good-sized deductibles, we were able to manage the expense. The insurance company paid the bills, which likely ran into six figures, and did not fight us in any way.
There are undeniable problems with the medical delivery system in this country, especially the reality that third parties end up paying for medical services. And it is true that millions of Americans do not have health insurance at any given time.
What we do have an incredible amount of capacity to deliver medical care in this country. I ended up having my surgery at United Hospital, but I could as easily have had the procedure performed at Methodist Hospital, or Regions, or Fairview Southdale, or any number of other hospitals in the Twin Cities. Or I could have gone to the Mayo Clinic, home to some of the best doctors in the world. If I lived just a few hundred miles to the north, I would have had to wait.
Why is that? In Canada, everyone waits. The average wait for an MRI in Ottawa, Ontario is anywhere from 52-173 days, according to this website. There would have been an alternative, which is to have an MRI done privately, but the cost would have been around $1,000, which would have been close to impossible for a guy who was unemployed at the time. I would have had to wait for an MRI and endure more headaches, with the potential that the adenoma would indeed start to bleed and cause other damage. And in any event, as the website notes, there isn't an endocrinologist who specializes in the pituitary in Ottawa, which happens to be the capital of Canada.
Meanwhile, in the capital of this nation, there are politicians who believe that our current medical system must be overhauled. These politicians are currently involved in some amazingly convoluted measures to fundamentally change the medical system that helped me. I'd be willing to stipulate that their intentions are good, even though I'm not really convinced of that. But do we really want to change the system we have now in unalterable, unknowable ways? I would hope that the next guy who wakes up on a sunny March morning with a horrifying headache, blurred vision and slurred speech can get the same level of care that I received in 2007. If we change nothing, chances are he will. If our politicians change our system, good luck to him.