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Observations from last week

Yesterday I described the events of last week and how they made for a less than pleasant experience.

Today I present some observations I made, in respect to the performance of our health system -- especially emergency care.

Firstly, it does seem to be rather under-staffed.

I rolled up at 6:20am on Saturday morning and it took several minutes before someone attended. Throughout the whole process, which lasted until almost noon, I saw just three people: the nurse on the front counter, another nurse and a couple of fleeting visits by a doctor.

To the best of my knowledge, I was the only one in A&E during that period.

I'm pretty sure that in a small hospital like Tokoroa, there's no dedicated ER staff and so the nurse was likely called away from ward-duties to see to me. She was very professional and efficient, I could have absolutely no complaints in regards to her performance.

However, I did spend inordinately long periods of time (up to almost two hours) sitting in a room (in pain) simply waiting to find out what was happening. Not the end of the world but rather disconcerting.

Perhaps the most worrying aspect of the whole event was that on three separate occasions I was asked if I had any alergic reactions to any specific antibiotics. The front-counter nurse asked, the attending nurse asked and the doctor asked.

In each case I said that I had a bad reaction to amoxicillin. This antibiotic does not agree with my gastric tract and results in violent liquid motions as well as quite significant "discomfort". With that in mind I clearly told them "no amoxicillin" and it was noted down.

However, the nurse returned and gave me a couple of pills part way into the morning -- being some pain relief and an oral antibiotic that would begin to stabilise my situation while they waited for the lab results of the blood and urine tests that had been taken.

Once the tests were in I was placed on an IV because apparently my kidneys were under significant stress due to the infection so I lay quietly for an hour while the bag emptied itself into my arm.

Eventually I was released with a prescription for some "strong" antibiotics and sent home to suffer in silence for the following four or five days.

At the time of my release I was completely "out of it". My brain was fogged up due to the CV19 and the effects of the bacterial infection so I wasn't paying much attention to anything. Fortunately my wife took care of everything that needed taking care of, including getting the presecription filled.

It was she who noticed the problem.

Despite telling the nurses and doctor on three separate occasions that I had a bad reaction to amoxicillin, I had been prescribed a 7 day course of augmentin.

"So what?" I hear you ask?

Well augmentin is the name for a mixture of amoxicillin and clavulanic acid, the acid serving to increase the effectiveness of the antibiotic itself.

Yep, that's right, despite being told three times that amoxicillin was not good for me, they prescribed it anyway.

At this point it was "take it or leave it" and I was prepared to put up with anything to get rid of the pain caused by the UTI so I started the course of augmentin. What followed was a week of constant diarrhea and even more abdominal discomfort than the infection itself was causing. I had to work very hard to avoid dehydration due to the amount of fluid I was losing and I felt so very, very bad.

Fortunately, my reaction to amoxicillin is not a fatal one but it is a really debilitating and painful one. Imagine however, if I suffered a more anaphalactic response to this antibiotic. What would the outcome have been?

Surely the nurses or at least the doctor would be aware that augmentin is 65% amoxicillin and therefore perhaps ought not be prescribed to someone who suffers a bad reaction to that particular drug?

The phrase "medical misadventure" springs to mind.

Ultimately, I'm feeling a truck-load better now but I think that if they'd simply prescribed a different antibiotic I might have avoided a lot of suffering over the past week. Even now my gut is still wrecked and it'll likely take weeks or months for my regular biome to re-establish itself.

I am very grateful to the staff of the hospital who rescued me from purgatory but I do feel a deep concern that the system under which they operate allows for such inefficiencies and potentially life-threatening mistakes to be made.

Carpe Diem folks!

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