Thoughts

Healthcare in Romania

 

There are two options for the person requiring care: the public healthcare system, financed by the government, where one is supposed to be cared for without cost if they hold medical insurance, and the private healthcare system, which is not really a system but is made up of different, unrelated private clinics or hospitals, where one must pay all expenses out of pocket. Let’s look at each system in more detail.

Public healthcare

I believe there are three main problems plaguing public healthcare in Romania:

  1. Widespread corruption at all levels of care. Bribes must be paid to hospital directors, managers, doctors and nurses, and sometimes even to hospital guards, if you are to get any competent care other than a daily temperature and blood pressure check until you check out or expire, whichever comes first.
  2. Incompetent personnel, due to:
    1. An inefficient medical education system, staffed with teachers and professors who care more about furthering their own careers, brown-nosing and getting bribes than teaching students how to be proper nurses and doctors.
    2. An unwillingness on the part of most students and medical personnel to put in the effort to acquire the knowledge they need to do their jobs right.
  3. Old facilities and equipment. Hospitals and clinics lack the funds to maintain the infrastructure properly, so all of them are run-down, cold in winter, hot in the summers, with drafty rooms and hallways where you’re likely to catch pneumonia, with bathrooms that have leaky faucets and leaky toilets, mostly left uncleaned, smelly, wet and old, with metal beds that date way back from the 1st or 2nd world war (I’m not kidding about this), and with mattresses that have seen more than their fair share of human bodies and bodily fluids. When it comes to equipment, it’s mostly non-existent, other than basic X-ray machines.

Sure, there are exceptions. There are some doctors and nurses who don’t ask for bribes. And there are some medical personnel who are competent at their jobs — they know how to do them and take the time and effort to put their knowledge to good use. But if you think the two groups contain the same people, you are probably mistaken. It’s usually the doctors who are the most competent that demand the bigger bribes, though it could be that a really good doctor or nurse may also be the one who doesn’t ask for or accept bribes. There’s no way to tell, really. It’s like taking a potshot in the dark. You’ll go to get some care and may end up with a butcher or a blundering fool who only makes things worse, and you may also end up paying him or her plenty of money for the shoddy treatment.

On some level, I understand why the corruption exists. Salaries for government-paid doctors and nurses are very low — janitors at profitable private businesses usually make more money than doctors in government hospitals — but that’s still no excuse for the endemic corruption. While salaries are low, medical personnel have also gotten used to asking for money from each and every patient, to the point where they expect it for the littlest thing and won’t help you if you don’t pay. There’s a ridiculous, infuriating sense of entitlement among most, if not all of them. Somehow they’ve gotten to think you owe them money simply for looking at you. That’s not right.

If only they’d take the time to study more, to get better at their craft, I, along with the millions of Romanians who visit hospitals, would feel better about paying extra to get care, but most are ignorant of any new developments in their fields. They only know enough to get by on routine matters. As soon as there are complications, they’ll take your money for a consultation, then tell you to go see this other doctor, who’ll ask for his share, then send you along to another, and so on and so forth until you’ve seen seven, eight, nine, ten doctors, have spent a month’s or two months’ salary on bribes, and you’re still no closer to getting treated right or cured. They’ll all nod their head, promise to help, take your money, run their tests, then scratch their heads and say they’re not sure what’s going on, that you’ll need to come see them again in a little while, etc., while happily fleecing you.

When it comes to government nurses, they won’t administer the injections or infusions or obey the doctors’ orders if you don’t slip them a bill, or some coffee, or chocolate, or whatever. It has to be something a little more expensive than just some candy or a trinket, and let me tell, when you’re being seen by four or five nurses and you need to make sure each of them gets something, it gets expensive. It’s so sad to visit hospitals and see all the old people on small pensions walk about with sad looks on their faces, mostly ignored by the nurses who are supposed to care for them, simply because they can’t afford to bribe them.

Private healthcare

There is hope when it comes to Romanian healthcare, and as is usual in a free enterprise system, it’s found in the private arena, where there are financial incentives for those willing to take some risks and make some investments in buildings, medical equipment and qualified personnel.

There are private clinics and hospitals, completely separate and unrelated to the government, where you can get competent care if you have the money to pay for it. Truth be told, it may end up costing you less than government healthcare if you add up all the extra costs involved with bribing government personnel.

Only the best doctors and nurses get hired in the private clinics and hospitals, are paid good salaries, are forbidden from taking bribes, and these facilities are equipped with the latest devices needed for proper patient care. There are entire hospitals and sanatoriums placed in beautiful locations in the mountains, where you can go to spend a few weeks to relax and get allopathic or natural, holistic treatments. There’s an entire gamut of options available to those willing to pay out of pocket.

For example, let’s say you need to run a whole battery of tests to see how your body is doing. You can go to the local government hospital, see and bribe a doctor to get some tests, then go to five or six different labs inside the hospital to run those tests, bribe your way through each place, then come back to the doctor in a few days to give him or her more money to look at the test results and tell you what’s going on. Or you can check into a private clinic, where for a fixed cost, you will spend a few days in a clean, private room with proper heating and cooling, pick your food from a menu, have your meals served to you, be able to take showers in a clean bathroom, be seen by caring, competent doctors and nurses, and get accurate test results interpreted properly. That’s the difference.

I should mention that private doctors’ offices aren’t the same thing as privately-run clinics and hospitals. Many government doctors also keep private offices, and will actually force people who come to see them in hospitals to go to their private offices and pay out of pocket to get the same care they could get for free in hospitals, but the care patients get there is just as bad as inside hospitals, and the facilities are usually just as unhygienic and inefficient. No, you must seek out professional private clinics and hospitals if you want to get the serious care I mentioned above.

Possible solutions

I think you know by now which option I would pick if I were to get sick in Romania, and for good reason. That’s not to say public healthcare can’t be fixed. In recent years, there’s been a serious push against corruption in Romania, at all levels of government, not just in healthcare, driven by the EU, but they haven’t made much headway other than talking about it and putting up posters in government agencies. Much more needs to be done, and it needs to start first with better salaries for medical personnel, probably double or triple what they are now.

Corruption in Romania is a very serious problem, one that requires an organization with teeth, one that can and does take immediate action against infractors, and where the identity of the person reporting incidents of corruption is kept top secret. Sadly, the system is still stacked against those willing to report it. Think for a moment what happens to someone who wishes to report a doctor who asks for money. First, they won’t get the treatment they need, and they may have an urgent medical problem, and then, if their identity is leaked, word about them spreads like wildfire, and no medical personnel at that hospital will want to treat them — and it may be the only government hospital or clinic in town. So people usually shut up and pay up, because they want to get on with their lives, not cause problems for themselves and for others.

Until the problems of corruption and salaries and public healthcare infrastructure get resolved, I would encourage people to use private healthcare options, if they can afford it. The more people use private healthcare, the more affordable and accessible it will get over time, and the more incentive there will be for the government to fix public healthcare.

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Places

Peruvian vampire bats carry silent strain of rabies

Courtesy of the Greenhall's Trust - WI

Courtesy of the Greenhall's Trust - WI

In Peru, vampire bats are increasingly biting people, and death is often the result of their normally innocuous bites. Researchers are exploring the possibility that the bats are carrying a strain of rabies known as paralytic or dumb rabies, which causes disorientation, muscle weakness, then death.

The vampire bats normally stick to biting wildlife or livestock, but as more people infringe on their habitat, through deforestation and agriculture, the growing bat population turns to them as another food source.

Research is focusing on how the disease persists in the bat population, and also on where it is located, so that health authorities may know where people will need to be vaccinated against this particular strain of rabies.

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Thoughts

Don’t play with Tussionex

Late last night, I kept coughing due to a passing cold. After taking several doses of other cough syrups during the evening, which had obviously not done their job, I decided to take some Tussionex — my ultimate weapon against coughing. I try to use it only when I absolutely need it, because it’s fairly expensive and it’s also hard to get (it can only be prescribed by a doctor). But after three days of coughing through the night and keeping my wife and myself awake, I figured the time had come. I took a teaspoon, waited a half hour, and nothing happened. I took another, waited another half hour, and still the coughing continued. I began to worry: had the syrup expired? Was my coughing so bad that I needed to take more? I took another teaspoon. Bad idea!

Tussionex

Soon after that, I started to feel the effects. Tussionex contains a codeine derivative, which means that, along with stopping my cough, it usually gives me a warm and fuzzy feeling that wears off in a couple of hours or so. This time, because I’d unwittingly (and stupidly) overdosed, the effect was very pronounced, and it was mixed with a sensation of nausea. I found it hard to sit up or stand up and went to bed, where I fell asleep immediately.

Here’s the full list of side effects for Tussionex, from the PDR (Physician’s Desk Reference):

“Anxiety, constipation, decreased mental and physical performance, difficulty breathing, difficulty urinating, dizziness, drowsiness, dry throat, emotional dependence, exaggerated feeling of depression, extreme calm (sedation), exaggerated sense of well-being, fear, itching, mental clouding, mood changes, nausea, rash, restlessness, sluggishness, tightness in chest, vomiting.”

I guess I should be thankful the only side effect I’d experienced before this was the “exaggerated sense of well-being”, along with a slight headache which occurred a few hours after taking the medication. Things were going to be very different now.

I woke up early in the morning, around 6 am, feeling rested and alert. I figured the effects of the overdose had worn off. They hadn’t. I got up to go about my business, and shortly after that, a general, overpowering feeling of nausea swept over me. I could not stand up. I couldn’t keep my balance at all. I felt sick, wasn’t seeing straight, I couldn’t control my movements and had trouble putting words together. It didn’t take long after that for me to experience a fuller spectrum of the side effects: decreased mental and physical performance, dizziness, drowsiness, mental clouding, nausea and finally, vomiting. That’s right, I did it again… I vomited more often in these past few months than in the past several years, and I don’t like it.

I’m still in bed as I write this. The moment I stand or sit upright, the nausea comes back, my face turns white, etc. I’ll be in bed for a while, hopefully not the whole day. All this fun gave me a chance to think about the situation. It’s clear that this wouldn’t have occurred if I hadn’t overdosed. The recommended dosage is one teaspoon every 12 hours. The PDR says: “The usual dose is 1 teaspoonful (5 milliliters) every 12 hours. Do not take more than 2 teaspoonfuls in 24 hours.”

I took three teaspoons within 1 ½ hours. That was incredibly stupid and irresponsible of me, and truthfully, I should be thankful I’m still alive. Here’s what one should expect from a Tussionex overdose:

“Blue skin color due to lack of oxygen, cardiac arrest, cold and clammy skin, decreased or difficult breathing, extreme sleepiness leading to stupor or coma, low blood pressure, muscle flabbiness, slow heartbeat, temporary cessation of breathing”

There it is, in black and white: cardiac arrest, stupor or coma. Instead of getting up from my bed last night and doing a quick search for this info last night, I overdosed like a dummy. My wife could have woken up next to my corpse. Thank God that didn’t happen!

I found out this morning that the FDA, since 2008, is also cautioning healthcare providers, pharmacists and patients, to guard against Tussionex overdose. After my own accidental brush with death, I agree with them.

Recommended Site: Many have become so addicted to certain cough medicine brands that prescription drug abuse treatment has become necessary for them. 

Still, I’m not sorry I took Tussionex. I’m definitely sorry I overdosed though. I’ve used many cough syrups over the years, and none stops my coughing like Tussionex. Here’s a sample of the stuff I tried in only the past few months:

Ketof

Coughend Sirop

Stodal

Ketof is the only other cough syrup that helps me marginally. The rest are garbage, particularly that Coughend Sirop. I also used a syrup called Prospan (not pictured here) in the last few days, which I found did a good job at clearing my throat. It tastes great, but still, it doesn’t stop my coughing. And of course I tried plenty of American cough syrups over the years, none of which helped.

Don’t think I cough all the time, either. But I’m stubborn like a mule, and will often go outside when it’s cold and I’m not dressed adequately. So naturally, I catch colds, and when I do, I cough a lot.

This experience also got me thinking about drugs and their effects on the body. Our bodies, you see, are endowed with the capability to heal themselves. That capability works better or worse in people, depending on how well they take care of themselves (diet, exercise, regular sleep, etc.) Drugs will usually only mask the symptoms of a disease, not cure it. Even though I’m not coughing now, that doesn’t mean Tussionex cured my cough and sore throat. It only stopped my coughing. Here’s what the PDR says about it:

“Tussionex Extended-Release Suspension is a cough-suppressant/antihistamine combination used to relieve coughs and the upper respiratory symptoms of colds and allergies. Hydrocodone, a mild narcotic similar to codeine, is believed to work directly on the cough center. Chlorpheniramine, an antihistamine, reduces itching and swelling and dries up secretions from the eyes, nose, and throat.”

You see, it’s used to “relieve” coughs and other symptoms, not “cure” them. They’re not even sure how it works. They “believe” the codeine derivative in it works directly on the cough center. The human body’s internal chemistry is so complex that I don’t know if we’ll ever figure it out properly. Right now, we’re still just stabbing in the dark when it comes to medicating people. We give them a drug and then, oops, we realize the effect isn’t the desired one, or that it interacts with other drugs and causes undesirable side effects. The PDR says about Tussionex that its “side effects cannot be anticipated”. And there’s also a section dedicated to its possible food and drug interactions. Here’s what that says:

“Tussionex may increase the effects of alcohol. Do not drink alcohol while taking this medication. If Tussionex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Tussionex with the following:

  • Antispasmodic medications such as Bentyl and Cogentin
  • Major tranquilizers such as Thorazine and Compazine
  • MAO inhibitor drugs (antidepressant drugs such as Nardil and Parnate)
  • Medications for anxiety such as Xanax and Valium
  • Medications for depression such as Elavil and Prozac
  • Other antihistamines such as Benadryl
  • Other narcotics such as Percocet and Demerol”

You see, this is what medicine has become these days: the chemistry of drug interactions. Every physician that works in a field where they prescribe lots of medications has to know drug interactions perfectly, or they will put their patients’ lives at risk. Sadly, most do not know all they need to know, because the interactions are so complex.

My dad is a psychiatrist. He made it a point to know all the psychiatric drug interactions and those of common drugs administered by other doctors, such as primary care providers or internal medicine specialists. He studies them all the time and keeps up to date with all the latest medications. He meets plenty of other doctors who aren’t as well prepared as he is, and he’s told me often how shocked he is to find these people are prescribing drugs that readily conflict with others, creating undesired and potentially lethal side effects. The sad part is that when he tries to let them know about it, they usually brush him off. And then we wonder why so many patients do poorly in hospitals… Isn’t it to be expected when most doctors are ill-prepared to prescribe medications for their patients?

I think the takeaway lesson from all this is that prescription drugs can be very dangerous. They are not to be treated lightly, like I treated Tussionex — even though its nature is supposedly benign — it is, after all, “only” a cough syrup, right? A drug’s side effects and its interactions with other drugs need to be known not only by the doctor but also by the patient, so that each of us is aware of what we are putting inside our bodies. The consequences — if we don’t do this — can be fatal at times. I may not realize it fully right now, but I might not have been around today, and it was all because I self-medicated carelessly.

Updated 1/11/10: I’ve gotten a number of rude comments since I wrote this article, none of which were published, where dorm room heroes and couch potato experts called me all sorts of names, all because the dosage that I took was too low by their standards. They’d have been satisfied if I drank a whole bottle of Tussionex and woken up a month later out of a coma, or if I hadn’t woken up at all. What can I say, other than your mileage may vary. People react differently to different dosages. I suppose if my body had been addled by years of alcohol and prescription drug abuse, my tolerance level for the drug would have been higher, and three teaspoons wouldn’t have done much for me. However, when you lead a clean life and are in full possession of your senses, you tend to be much more sensitive to these situations. So please stop criticizing the article. I wrote it not to draw attention to myself, but to put up a warning sign about prescription drug abuse.

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Reviews

One way to get food poisoning

I held off writing about this because I couldn’t even look at photos of the stuff that gave me food poisoning and kept me in bed and feeling miserable for two days, but the embargo is finally lifted. Here’s the culprit behind a nasty bout of food poisoning back in January: 7 Days Bake Rolls.

7 Days Bake Rolls - Pizza Flavor

The company that makes these things stuffs them full of chemicals and preservatives and flavors to make the taste hard to resist. I ate about three quarters of a bag one evening, as we were watching a movie. Then, during the night and early morning, the “fun” began. A general feeling of malaise grew until I hugged the porcelain throne and went through several private and painful “confessions” that purged the “sins” out of me. I was weak, could barely get out of bed, and if I ate anything I only hurled more. Even though I could move around and eat smaller portions for the rest of the week, I was still sick and couldn’t do what I needed.

I don’t know what in the world they put in those things, whether it was a bad batch, or whether I’d have the same reaction if I ate any more, but I do know one thing. I never want to see or touch them or smell them again. It’ll turn my stomach inside out. It’s one bad product, which exemplifies what I wrote recently about packaged foods versus fresh foods. The next time I want some toasted bread, I’ll make it myself, without preservatives and other artificial crap.

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Thoughts

Pork's dirty secret: It's one of America's worst polluters

Pork’s Dirty Secret: The nation’s top hog producer is also one of America’s worst polluters : Rolling Stone.

I’m shocked beyond belief by what I read in Rolling Stone magazine today, in the article pointed about above. Let me quote a few excerpts to draw your attention to the crimes that have gone unpunished for the last couple of decades, done right here in the US, under our eyes and noses, and with the approval of smarmy politicians all too happy to oblige deep-pocketed campaign contributors.

This is how pig farms function:

“Taken together, the immobility, poisonous air and terror of confinement badly damage the pigs’ immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds — oxytetracycline, draxxin, ceftiofur, tiamulin — diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they’re slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.

The drugs Smithfield administers to its pigs, of course, exit its hog houses in pig shit. Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.

Smithfield’s holding ponds — the company calls them lagoons — cover as much as 120,000 square feet. The area around a single slaughterhouse can contain hundreds of lagoons, some of which run thirty feet deep. The liquid in them is not brown. The interactions between the bacteria and blood and afterbirths and stillborn piglets and urine and excrement and chemicals and drugs turn the lagoons pink.”

This is the man in charge of the largest pig producer in the US:

“The chairman of Smithfield Foods, Joseph Luter III, is a funny, jowly, canny, barbarous guy who lives in a multimillion-dollar condo on Park Avenue in Manhattan and conveys himself about the planet in a corporate jet and a private yacht. At sixty-seven, he is unrepentant in the face of criticism. He describes himself as a “tough man in a tough business” and his factories as wholly legitimate products of the American free market. He can be sardonic; he likes to mock his critics and rivals.”

This is how the journalist describes his encounter with the smell from one of the pig shit lagoons:

“Concentrated manure is my first thought, but I am fighting an impulse to vomit even as I am thinking it. I’ve probably smelled stronger odors in my life, but nothing so insidiously and instantaneously nauseating. It takes my mind a second or two to get through the odor’s first coat. The smell at its core has a frightening, uniquely enriched putridity, both deep-sweet and high-sour. I back away from it and walk back to the car but I remain sick — it’s a shivery, retchy kind of nausea — for a good five minutes. That’s apparently characteristic of industrial pig shit: It keeps making you sick for a good while after you’ve stopped smelling it. It’s an unduly invasive, adhesive smell. Your whole body reacts to it. It’s as if something has physically entered your stomach. A little later I am driving and I catch a crosswind stench — it must have been from a stirred-up lagoon — and from the moment it hit me a timer in my body started ticking: You can only function for so long in that smell. The memory of it makes you gag.”

And this is what happens to the people who live near the pig shit lagoons:

“Epidemiological studies show that those who live near hog lagoons suffer from abnormally high levels of depression, tension, anger, fatigue and confusion. “We are used to farm odors,” says one local farmer. “These are not farm odors.” Sometimes the stink literally knocks people down: They walk out of the house to get something in the yard and become so nauseous they collapse. When they retain consciousness, they crawl back into the house.”

And this is what happens when the lagoons spill their vile contents into the environment, which happens all too often:

“The biggest spill in the history of corporate hog farming happened in 1995. The dike of a 120,000-square-foot lagoon owned by a Smithfield competitor ruptured, releasing 25.8 million gallons of effluvium into the headwaters of the New River in North Carolina. It was the biggest environmental spill in United States history, more than twice as big as the Exxon Valdez oil spill six years earlier. The sludge was so toxic it burned your skin if you touched it, and so dense it took almost two months to make its way sixteen miles downstream to the ocean. From the headwaters to the sea, every creature living in the river was killed. Fish died by the millions.”

As if those sorts of unmitigated environmental disasters aren’t enough, it gets worse:

“… Corporate hog farming contributes to another form of environmental havoc: Pfiesteria piscicida, a microbe that, in its toxic form, has killed a billion fish and injured dozens of people. Nutrient-rich waste like pig shit creates the ideal environment for Pfiesteria to bloom: The microbe eats fish attracted to algae nourished by the waste. Pfiesteria is invisible and odorless — you know it by the trail of dead. The microbe degrades a fish’s skin, laying bare tissue and blood cells; it then eats its way into the fish’s body. After the 1995 spill, millions of fish developed large bleeding sores on their sides and quickly died. Fishermen found that at least one of Pfiesteria’s toxins could take flight: Breathing the air above the bloom caused severe respiratory difficulty, headaches, blurry vision and logical impairment. Some fishermen forgot how to get home; laboratory workers exposed to Pfiesteria lost the ability to solve simple math problems and dial phones; they forgot their own names. It could take weeks or months for the brain and lungs to recover.”

And now the bastard that runs Smithfield, Joseph Luter, wants to expand into Europe, particularly into Poland and Romania:

“When Joseph Luter entered Poland, he announced that he planned to turn the country into the “Iowa of Europe.” Iowa has always been America’s biggest hog producer and remains the nation’s chief icon of hog farming. Having subdued Poland, Luter announced this summer that all of Eastern Europe — “particularly Romania” — should become the “Iowa of Europe.” Seventy-five percent of Romania’s hogs currently come from household farms. Over the next five years, Smithfield plans to spend $800 million in Romania to change that.”

You want to see a real terrorist? One that’s irreversibly damaged the environment, killed millions of fish and other aquatic life, and ruined the lives of tens of thousands of people? Look no farther than Joseph Luter. The evidence is overwhelming. And yet he’s not in prison. No, he’s out, enjoying his life while ruining the lives of others. I say we put him not in jail, but in a prison which contains one of his very own pig shit lagoons, where he’s to spend the remainder of his criminal life.

Luter has made pig farming profitable, but at what expense? The environmental disasters he’s directly responsible for equal the ones perpetrated on mankind by the industrial revolution — only we outgrew those abuses, and didn’t expect to find such flagrantly illegal and morally corrupt behavior in the businesses of today.

Don’t think Luter is the only one. You look at cows, at sheep, at chicken and other farm animals, and you’ll find incredible, criminal abuses of animal life and the environment in all those industries. Seemingly everywhere, our food supply has been hijacked by companies hell-bent on making profits at the expense of health, safety, the environment and even life.

Quotes used courtesy of Rolling Stone magazine. If the magazine feels that the quotes are too extensive, please contact me and I will abbreviate them.

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