Discussion in 'The Watercooler' started by janebrain, Jul 8, 2008.
just wondering how dtr is, please update when you can.
Whew, spent all day getting in touch with darned doctor and then waiting at pharmacy for - too long- cuz docs office took so long to call in RX for phenergan.. Dr still is not moving follow up appointment any closer....still mid july.....easy child is still not even holding even sips of water.docs office told her to not bother with anything except water now? one tablespoon every five mins....<sigh>
This morning she was at it so long so many times, so hard, now her throat is bleeding, and she feels like she has a lump in her throat. GRRRRR.
Ironically, in the midst of all the cold people who are being less than helpful at all--- well, um, first, one RX was filled in pharm at clinic for immediacy when we WERE at docs office...2nd RX filled at 24 hr pharmacy cuz nothing else open when we needed it (the Rx from first ER visit) 3rd RX filled where easy child works, cuz it seeemed that would be easier, to fill it here she already goes....and where I go (grocery store) but darned docs office, not sure why, wanted to pick where to have this one filled- and it is yet another pharm! and the furthest from home, but still technically our town. Well, LOL- I got there and the pharm looked confused, said he did not remember that name...nope, no Rx ready.so he called docs..they left him hang ON HOLD over an hour! He kept apologizing to me....over and over, he looked more distressed than me! He must have had my name in his records connected to easy child from previous Rxs, other years etc, cuz then he used MY name, apologized more..told he he hoped easy child was OK.....I thought he was gonna get in his car and DRIVE around corner to docs office and grab someone there physically.
I shrugged and said I understood he could not have esp and just KNOW we needed a rx and to have it ready if he got no call or anything.....then he said he wished he could, LOL.I said me, too, with 3 kids, I sure do wish I had a magic wand. He said yeah, with 3 kids, I am sure.......
As soon as docs office told him what to give, he had that Rx filled in a flash.....and sending message to easy child that he hoped she would feel bettter fast.....
So I JUST got home with it and she just now took it.....and we have fingers crossed.
Last nite a wicked storm blew in and took out elect all over town......and she is so overheated......and the medication she just got increases risk of overheating. :-( So I told her to climb in a bath. <sigh> doctor did NOT give her a note for work....did give an alternative location/company to do ultrasound where they can handle if she cannot drink the required fluids.....
Oh, her doctor was not in office at all today, and the one that was in office was out for hours, doing a delivery? But but but, hey there are supposed FOUR docs there all the patients are supposed to have to rotate thru? How could there have been NO doctor there? (exhale dreamer)
I dunno, it is not me preg, not me so ill, and trying to handle things is overwhelming ME big time.and I do not even work outside our home anymore. She is just 18, so ill, UG grrrrrr...... as if she could handle trying to do all this by herself???? Give me a break. She DID however feel good enough for a short time this morning to pull out her durable power of attorney-medical she signed just a bit over a week ago AT THIS DOCS OFFICE......appointing ME......and the HIPPAA paperwork and she said MOM! What good was it for me to SIGN this?
The first bill came in today for her first ER visit when she got rehydrated? It does NOT include the DOCs bill on it, nor the lab or pharmacy.it is just the room fees for being in a room at ER.....$1,800
the phergan? um..now she has a bright red face, spiked a high temp and is crying her head off ----I begged husband or easy child boyfriend to take her to er this time, cuz I am exhausted and thought maybe if someone ELSE took her in, maybe someone might listen? but..no go? boyfriend is? Im not sure what and husband, well he is useless, helpless, hopeless and now HE just disassociated on me. <sigh>
This is horrible.
I have had a lot of experience with out of control nausea because of recurring kidney stones and I know Phenegrin makes me insane. Literally, off out my mind. Some doctor told me one time there is a chemical reason why - don't remember now - but I would take her off ASAP.
Zofran is the only thing I can take for nausea. Did that work for her?
Has she tried Pedialyte or sips of Gatorade and nibbling some corners of saltines while she sits in cold bath water?
We are here for you. This will get better.
well, that might happen with the phenrgan, BUT we have been at er twice in less than a week for dehydration, possible arythmia....she has tied every single thing listed on internet, folk remedies etc.......she got one type zofran at docs office, to start, did not help AT ALL......got disolving zofran, higher dose at ER and IV zofran as well, did not help AT ALL.......
then they added prevacid, pepcid and tums.....she nibbled a quarter of a cracker this morning a quarter of one tiny saltine, and vomited at least 30 times after, ALL yellow bile, and nothing else. Now her throat is messed up, too......now she cannot talk.....cannot swallow at all. not even a miniscule ice chip.
The air cond is broken, the temp here is 90 and humidity is 90%.
The doctor won't see her.the ER is angry and said this is chronic and needs a doctor not an ER.
and the docs here all belong to the same um corporation? as do the hospitals? and I cannot handle her myself to get her anywhere else, and doubt she can tolerate being in car to leave the area......
on top of whichher insurance and her Medicaide are not widely accepted anywhere in the general vicinity either.
I am beyond frustrated, flummoxed. I have now lost all objectivity..in addition have a couple crisises brewing with difficult child......(one medical and 2 not, but all semi intense) and still the day to day minute to minute demands of any mother and home are all piling up, now, too, beyond belief. Nope, husband will not handle any of it, none of it, not the lawn, not dinner, not dishes, not letting dog in and out to do dog duty.......no difficult child at the moment is beyond rationale.....and son is starting to fall into whatever it is 13 yr old boys fall into when they have given their sister their bedroom, complete with computer and tv and 2 sisters are disrupting EVERYTHING at home......
I have lost all objectivity, I am so hot, so exhausted......so frustrated, out of ideas, and beginning to flare myself with my darned illness.
Tried to wothdraw her from university she was enrolled in for fall, but no- they demand SHE do it..I said well, she is far too ill, and I wanted to open slots for others..nope. She was supposed to register at comm college last week, rescheduled to this week, and now??????? she has major scholarships etc riding on it. she was supposed to go to her wic, but, too ill......is supposed to have ultrasound, too ill......since she is now 18, noone wants to talk with me.....
One of my friends suffered with the same thing. She had to be in bed and on an IV drip for both of her pregnancies.....for the entire preganancy. She was told after thesecond one not to have any more children because it would get worse each time. The second preg., she was hospitalized and on an IV drip the last three months.
She needs to call the doctor and tell him she wants immediate care or she needs a referral to a high risk pregnancy center. PERIOd.
I should have said, I do understand noone wants to talk with me, becuz she IS 18....I get that part, I do. So- like the 2 colleges, I understand....but, literally, seriously, she is half conscious. and I thought her univ would want to know they DO now have an open dorm spot and an open spot in the classes easy child was registered for. But, I understand, and I am not so frustrated with any of them. BUT the doctor? and ER? easy child did the required paperwork, easy child discussed with her doctor about being able to talk to me, and then...who could have known easy child would get THIS ill, like this....how else can we get word to her doctor? whether she has signed anything or not, the fact is, she needs care and she is beyond ability to get that care herself... and ER keeps referring her back to the doctor. I checked phone book, the docs do not seem to put in phone book if they do "high risk"- so I am not sure who to call. I was high risk and this was my doctor. It is like "pass the buck" ER sends her to doctor, doctor sends her to er and neither really is very willing to SEE her. Meanwhile she gets more and more ill. It started 2 weeks ago. The ONLY intake she has had that did not come back up on its way down was LAST thurs she ate 3-4 bites of plain roast turkey and a teaspoon of plain mashed potatos, and held it for 2 hours. Freezer pops, gatorade, ice chips, lukewarm weak tea, flat gingr ale in sips, saltines, plain baked potato, plain boiled white rice, sherbert, jello- it ALL comes right back before it even goes down. she has on motion sickness bracelts on both wrists. When she can sit, she sits in a lukewrm-tepid tub.....she tried mint, lemon drops, watermelon, dry toast, ginger snaps, fresh ginger tea, some weird something in a bottle, ? from bfs dads girlfriend, some ? homeopathic something to smell......
The ER was getting mean on her last time, demanding since she IS 18, that she be alone in her room while just laying there waiting for doctor......becuz "after all she IS 18" which freaked easy child out and I pointed to sign on wall that said max 2 visitors per patient and said HEY! wait! and they keep saying they are not for long term care, we need to see our doctor, and I keep telling them doctor sent us there....doctor does not DO rehydration in office.....doctor does not DO ekg in office.....and I also keep saying doctor is not even permitting an exam, just keeps sending us here......
and docs office just keeps telling me easy child is 18 and she HAS to call herself....and I keep saying, she has signed HIPPAAA and MPOA and she is far far too ill.....
Well, now her throat thing is worse. she cannot even whisper, cannot swallow even saliva in her mouth.....I was wrong, she did not take the phenrgan, couldn't..she tried, it would not go down.
Loks like maybe I will call an ambulance? or take her on a road trip out of this area, to the city, or something......I'm not sure what.
The ER may not be for long term care, but they can admit her to the hospital which is for longer term care. If her throat is that raw from vomitting she needs to go back now. And keep going back until somebody does something.
This is beyond ridiculous.
GEEZ- can you just start calling every dr and urgent care facility listed in the phone book? She is going to be so seriously dehydrated- if not already. Somehow, there has to be a way to go about this so that the doctors feel liable. (Not that liability if something goes wrong is the answer you are looking for- but if they feel liable, it appears that they might be more willing to take some action.)
I'm trying to think of who else you might call who could make some things start happening. Ok, what if you just walked into a local clinic with her and let them see what kind of shape she is in? What if they said that she should be in a hospital and called an ambulance? Can you take her to her dr's office every day until he does something? Did she have a regular dr before this that you could get involved to help?
I wish I had an answer...
gees poor thing, prayers of healing coming her way, poor babe
Dreamer, this is beyond belief! How can all of them keep avoiding responsibility? She needs to be in a hospital for God's sake! And what the h is wrong with your husband that he can do nothing to help? I want to come there and give a swift kick to as many behinds as I can find!
I don't know how you are managing to retain any semblance of sanity and I don't know how poor difficult child can manage either. I know how frightened and upset I am when I feel that sick, she is beyond anything I have ever experienced! She must be dehydrated--please get her back to the ER or to another hospital or clinic or something.
Please let us know what is going on--I know you must be exhausted but I am so worried so please just a quick update when you are able!
Dreamer, are there any Holistic care centers or Whole Care Health centers near your area at all? Nutritionists? Naturopaths? Even accupunturists may possibly be able to help with this.
I think I would go above the ER's head and possibly call the administration office asking how to lodge a complaint against the ER. It doesn't make sense that they would continually turn her down for care when it's so obvious that she's listeless and hasn't had any real intake of protien in over a week, and she's pregnant, etc. I mean, what are they waiting for? Her to collapse completely? Yeesh.
I'm so sorry you're going through this and so sorry for easy child.
As to H and his non-compliance, if I were you, I think I'd go on strike and let the you know what hit the fan on him. Ugh, bonehead. Hugs~let us know how it goes today if you get anywhere.
Good morning, SHe did fall asleep and slept for several hours without upchucking, so I let her rest. I just kept peeking in on her. MAYBE the phenergan is helping? SHe did manage to get it in her finally.
Yes, she has been treated at our ER twice now in this past week for dehydration, with bags of IV fluids. The doctor did see her on an emergency basis not the Monday that just passed but LAST Monday- per my urgent call, and the doctor sent us to ER for rehydration, if the first zofran did not help. easy child and her boyfriend did not understand how serious dehydration can be, and at first it did seem the first rx of zofran might help. But by that Wed I got her to ER for first visit. I posted about ERs paperwork after that visit. Even with zofran in her rehydration IV at hospital, she was still throwing up. BUT, of course, the IV did help bring her vital signs back into normal range. So they discharged her, with a Rx for dissolving zofran at a higher dose. Her ob gyne decided NOT to move her previously (pre-illness) appointment any closer. We had been to doctor for the first prenatal appointment I think JUne 17. At THAT appointment we did not see doctor after all, turnns out, you sit with nurse and do history etc. AT that time easy child was not ill, feeling good, aside from fact of just adjusting to the changes to plans her preg created. BUT her, her boyfriend, and our family were happy - easy child and boyfriend were starting to make their new plans, adjustments, rearrangements etc. Nurse at that time said doctor does not see the women till like 16 weeks? THat surprised me, and I think I posted about that, too. But at that time, things were going fine.
When easy child first began to get sick....we both assumed it was just normal type morning sickness. I never had morning sickness, and neither did PCs friends who have been preg. I was not alarmed, not then. Of course consulting with others who have had morning sickness we found all the typical "remedies" and nothing helped. I called doctor when it became apparent it was not just "regular" morning sickness. doctor did get us in that same day... But that was now 2 ER visits ago. and more than 1 new medication ago.
I am thinking becuz immediately post IV her vital signs go within normal range, ER does not admit her. They clearly say in person and paperwork they only stabilize and to call your doctor. Problem is docs office does not want to take the call from ME in spite of easy child haveing signed paperwork. easy child signed the paperwork becuz she was nervous, and is so young. I donot get past the nurse, nurse will not hear or listen, so I have no idea if the doctor even knows. I did call ER and tell them to fax reports back to docs office for both ER visits, in theory they do this automatically, but....
Docs office called in the phenergan, but it was not orderedby the doctor easy child saw.
I am now nervous- is it the type of insurance? easy child gets coverage thru military due to husband being 100% permanant total service connected military bens as long as she is a college student. She is enrolled so- she has it. Then the state has a program for "moms and babies" thru Medicaide. BUT her Medicaide card says "no inpatient" We have had a lot of weirdness with the ChampVA coverage and we have always had difficulty with the Medicaide of any type around this area.
Is it her age? She just turned 18. Yes, she is young and not married. It was a "surprise" - she was due to go away to university in August. (on full scholarships) Are the medical personnel behaving this way due to the high publicity of young teen mothers all in the media right now? I know my own mother was 16 when I was born....and I know she said she was not treated well at that time, nor when my brother was born 2 years later.... (or for that matter when my last brother was born 27 years after me- altho the twins she birthed when I was around 15 they treated her good, LOL) I do not have experience with how a teen mother might be treated, I was not a mother until age 30----
Nearly every docs office here is associated with one of 2 major corporations and every hospital around is all from one major corporation. Approx 10-15 years ago, a very very large number of OB gynes (among other specialists) left the area, many left the state itself, due to extremely high malpratice premiums.
As for husband, I knew better than to expect him to step up to the plate re ANYTHING. I was desperate. His own diagnosis list is long and complicated, a large mix of both physical and mental illnesses....and a long history of literal helplessness. The kids call him The Chair. When my mom died, my kids were quite upset he did not go to the wake or funeral at all - when son had his surgeries, husband was absolutely useless, easy child ran the house, and I was gone with son.
Son is perfectly stable and fine these days, altho a typical 13 yr old boy (minus the vision of course, and homeschooled) difficult child had been holding her own - not independant, very clingy, very agoraphobic, but no new dramas etc. Had been trying to get and hold a job with no success but, nothing "big" BUT she did recently come to a couple crisis issues....that came to a head over the weekend, and one of those triggered off a mini medical crisis (of all things, wicked bug bites, - goofy brat DID leave the house, DID go without me, which I had hoped might be a good thing....but she came back literally covered in thousands of mosquito bites- chiggers? rash, poison ivy? VERY extreme)
The good thing is that I am doing great able to walk, etc, but, in back of my mind I get nervous being at docs and hospital etc, becuz of my medications, immunosuppressants etc. If this had been a "non eventful" preg, I would not be going to the doctor vists much....not the routine ones. I would be sending easy child and boyfriend on their own. Mostly just to avoid exposure to me.
While I myself have had 14 miscarraiges, I did not have this level of illness. When I miscarried it was fast. Hit hard happened fast, the end.
When my mom had twins, things went fine, LOL actually doctor did not know there were twins until after delivering the first one, yeesh.
Becuz of the violence in the city recently, I had stopped taking my son to his eye surgeons. I simply could not handle to fears- and also could not cope with survivor guilt when staying at RMH.
I am not a city girl, to begin with.....but being with such parents as all the ones with dying children, it got so hard. Yes, I was a Hospice Nurse....and an Alzhiemers nurse.....but being at the RMH at the trauma center hospital tops everything. THe weekend this spring when chicago had 40 shootings, we were supposed to be on our way there, and .......I. just. could. not get. us. there. And I have not been able to go back.
Yes easy child has a doctor, well, no, not really. Um, we have been at this docs office all my kids lives. Its really the only one for miles around, sounds like we are VERY rural, but we are not really. When difficult child was turning 18, a month shy or so, she got ill, and the pediatrician there got weird at us, said she is ALMOST 18, I am not gonna see her. HUH? But she's NOT 18 YET. easy child saw pediatrician maybe 2 months before her 18th birthday....mind you same all their lives. BUT she just turned 18 and now the pediatrician likely will get weird......and bummer but me and the GP had a nasty run in last time I was in GPs office (and the time befre, as well) BUT until now, the ob gyne usually would accept all the women for most health issues.
THank you so much for all your well wishes, ideas, support, and prayers. It is truly appreciated.....
I will update when things change etc....
JoG you posted while I was typing, LOL.
H is um....well, he has been um, noncompliant since 1990. In and out of catatonic fugue states etc....early alzhiemers, early onset...lots of things, emphysema, schizoaffective abcdefg......in and out of phosps, and VA hospital etc. Striking is of no use, everything simply WAITS for me. WHen I was at RMH the betetr part of 18 months, I got home and am STILL unburying our poor home from that.....(quite a job) He literally does not do anything, sometimes not even feed himself.....dependant and often combative.
The ER did give the IV fluid to rehydrate. BUT they say that anything above that, the doctor has to handle. easy child IS near collapsed, listless, lethargic, too weak to walk, speak etc. They HAVE seen her, twice. The 2nd ER visit they did an ekg becuz of chest pain added on - and fear was cardiac issues related to dehydration, but.....again, they stabilize, but thats all. if her treating doctor does not order inpatient, it does not happen. and docs nurses are not accepting the info from me to get thru to doctor. Yeah, I have been removed from our local ER and hospital by security on other occasions when they were discharging my family. (and once when they were dischargeing me) I have lodged complaints a couple times...LOL- once when I lodged a complaint for same for my husband, they erased the bill. Big deal---I took him elsewhere (to VA hospital) and he WAS admitted- to ICU for 3 weeks. I mean big deal becuz that did nnnot get him what he needed..the bill is always a big deal, LOL, grrrrrr. Our hospital is not good......but this doctor, had always been good for me all these 20 years....well, her and her mom, but her mom now is retired. This doctor was new when she delivered my son. BUT at first these docs were NOT part of this big corporation.....
Im not sure just what I am doing next. Got thru the nite OK.....better than the last 2 weeks. But yes, I am now very concerned with this 2 weeks of no food intake, constant dehydration and now all these medications on board.
All hospitals...unless completely private...have to take Medicaid. Even private hospitals have to see a patient in the ER if it is an emergency. Then they can transfer to a hospital that takes any government funding at all.
You are on the outskirts of Chicago I think. Or someplace close. Get her in the car or have boyfriend get her in the car...and take her elsewhere. This is senseless. Once she gets seen by someone at a decent ER they can refer her to a high risk OB if she needs one and they will take her medicaid. It just has to go through back channels.
Sorry dreamer - should have read your by-line!
Yes I am outskirts (far outskirts) of chicago. Yes, have been dealing with the problems of Medicaide/Medicare for 20 years here.....it is not asecret, the politicians acknowledge it, the media acknowledges it....no, hosps do not openly refuse to accept it, they just do not give the proper level of care, and sicharge without doing things, in my husband case, he was brought by ambulance post motorcycle accident to our ER. Head injury (no helmet)bleeding, lacerated liver, dislocated shoulder, extensive road rash ambulance crew was even shocked, er accepted him to an exam bed, and then discharged him, NO xrays, no physical exam, nothing, and hehad altered consciousness.
That was not the first time similar has occured, and not just me or my family. My best friends nephew died.....and more, so many more stories, horror stories.
There is a neonatal level 1 trauma hospital less than 3 hours east, I am gonna check into going there.
with my preg history of 14 miscarraiges, and my husband moms hx of traumatic births and conjoined twins.....and husband agent orange exposure----and now this problem....<sigh> This ob gyne is a high risk one but.......
Anyway, LOL.she did sleep several hours last nite, first time since this began. She is in sons room at one end of house. all windows are open in house cuz ac is broken....and, kitchen is at opposite end of house. I just decided to have a cup of coffee, brewed a pot and heard this weak mewling-----mo om mo om.......it was easy child, I went to her, she said mom, did you make coffee? wretch wretch. She could smell it, it woke her up......UG! BUT she IS more alert, much more than she has been.....she even stood up for a few mins....walked to BR.
ANd now her boyfriend just arrived, he had not been here in 2 days cuz he was working overtime and catching up his laundry.
I am goonna give them a few and then go in and "reassess" I also got some sleep and made a tuna casserole in the nite and had a bite myself.....I feel a lil less frantic this morning.more angry, but less frantic. Maybe the phenergan IS helping a little? I think sleeping was good for her.
Oh my.....boyfriend just left, looking ssad? dejected?
easy child said he was too active, too wiggly, jiggling the bed on her, spilled her pills all over floor...I think she told him to go? <sigh> she is too ill, and he feels so useless and helpless.....I had been planning on giving him some "jobs" to do-- to make him busy and useful- clean THEIR rabbits cage.....FEED their rabbit......maybe go get her some fresh gatorade at store for her to try to drink.....hand HIM phone book, or interneet to check out docs.....while I did some of the other things around the house here. <sigh>
In chicago itself, we had no problems with the Medicaide or Medicare. Not with docs and not with hosps. If we go south into rural central IL we have no problems. BUT we are 3-5 hours outside chicago. If there was an emergency, that is a long distance to go. Yes, difficult child had her psychiatrist in the city, and her neuro as well as sons neuro and sons eye care docs. My rheumy is in city. while my son was haveing his 2 eye suregries and followup for them, me and him lived at a Ronald McDonald house most of the 18 months. BUT that left difficult child and ill husband home untended and alone with just easy child to oversee them. It also cost a LOT for gas etc......that wound up on credit cards.
In late June, our state - I read something- they contacted providers? and said not to bother submitting either Medicare or Medicaide bills at the time- one or both, I do not remember, becuz they would not be paying any anyway, so not to bother billing.
The suburbs are laregly affluent. They are also judgemental and critical. You are hard pressed to find a lot of servies not becuz they cannot affod them so much as the mindset is "not in my backyard" and also "if I do not see it it does not exist" Use WIC at grocery store and cashier groans as does anyone in line behind you....and yes, you get nasty snide comments at you. If your child gets the free or reduced school lunch, people treat you not so nice. Not all so many years ago, I used Medicaide to pick up a Rx at pharmacy for ?? difficult child? and pharmacist was abnosixious and rude.
easy child was in a school basketball game and hit bleachers face first. went to ER and ER refused to sether broken arm. They said they no longer cast breaks, you have to call an ortho yourself to get it done. across hall from us was another kid, LOL at the private school who also got hurt at THEIR school basketball game and I SAW the ortho go into his room, and saw them prepping to cast his arm.....I KNEW from previous experience that once no longer IN the ER the ortho would not see easy child with Medicaide. NOT in his office. SO I watched the goings on, and then when the ortho came out of that exam area, I walked up to him and demanded he set my childs arm. He balked, he argued, security came to remove me.......and it was awful.....he tried to tell me no, he does not set bones at ER, as we were standing outside curtains of the arm he just finished casting.
Well, he DID set her arm.....BUT a few hours later we were at a different ER getting THAT cast removed, it was far too tight, and swelling had created a circulation problem and bruising. The other ER had to cut that cast off and put on a different one. BUT while in first ER noone was going to do anything for easy child. Their logic? broken bone is NOT life threatening, therefore not an ER issue.
The reality? They do not want to be bothered becuz reimbursement from Medicaide and Medicare is slow and low.
Is it illegal? Sure. But who enforces and how do they enforce? Even if authorities did do something, it takes years and if it is just fines? It still works out for them to pay those fines, costs them less overall than to take care of these patients.
My son was in this ER when he first hurt his eye. hey said nothing was wong with it......it would be fine. 3 days later it was so clearly not fine. Went back. they shrugged. went to another facility, they sent us to university......scar tissue built and internal bleeding into the eye- caused the retina to detach and the macula to detach and the scar tissue and bleeding was very extensive. By then the damage was so great, 2 9 hour surgeries could not repair it.
To sue this hospital would require the next docs to testify......and to say the damage was due to time delay.which they would say informally, but not formally in court.
why did I take easy child to this ER? cuz it was simple IV rehydration. we knew what was needed.....and we got that. same with 2nd time, I knew an ekg was needed and rehydration, we got that.
Why is ob gyne nurse acting this way? becuz per HIPPAA and confidentiality laws etc.....she CAN. and while I DO have signed paperwork, nurse CA defend herself saying....."yeah thats what they all say"
Experience with leaving home area to seek medical help elsewhre gets complicated, partly due to my illness, partly due to costs etc .lots of things, but, also when we do go elsewhere, we do run into facilities etc that really do not want us..they say things like we are too far away to be helpful in an emergency.......or they say "you are outside our general service area" and not always will the places between us and the city take us on. Often they will claim they are not accepting new patients.
and there is some truth....in an emergency, it would be a problem to be 3-5 hours away.
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