This Crazy Whirlwind of Life

Honestly, those of you with kids in public school, I don’t know how you manage.  My son made the basketball team, so I have had to drive him to the school for either practices or games every day.  Then I have to go back and pick him up.  If there’s a game, I stay and watch.  It is exhausting to arrange my schedule around someone else’s — I’m accustomed to setting my own schedule.  And this is only for basketball season; I can’t imagine doing it all year long.

This has been going on since mid-November, and I’m beat.  The only day they don’t practice/play is Sunday (oh, they also got Thanksgiving, Christmas, and New Year’s off).  The season is almost over, but there’s no rest for the weary.  Now that the high-school aged son is nearly done with basketball, the youngest son has begun to play.  I had to quit teaching swimming lessons so that I can transport my basketball players.  Now that I think about it, cessation of swimming probably contributed to the return of my shoulder and hip issues.

Even knitting has become painful.  I drag my knitting bag along to all the basketball games.  All that time I would have wasted, just sitting there waiting for the game to start, has added up to two pair of socks, three hats, and a pair of mittens.  It’s nice to have something to show for all that sitting-around time.  Unfortunately, for the past few days, my shoulders have hurt even while resting my elbows at my sides — that’s worse than usual.

Wouldn’t it be nice to treat ourselves sometimes?  When my animals are sick, I can go to the feed store to buy medicine. Just today I gave a cow two shots s of LA-200.  In the spring I give vaccines to our horses. When they’re injured, I can clean them up and apply bandages. We have a stomach tube for calves that won’t eat.  Yet for some reason, there is no way for me to say, “Look, I’ve had this problem with my shoulders and hips off-and-on for six years.  Can’t I just cut out the middle man and treat it the same way it’s been treated every other time?”  No.  Instead, I have to phone my doctor’s office, make an appointment, spend two hours on the road for a short visit with the doctor who will do the same exam he always does and recommend the same treatment as usual.  Wouldn’t it be nice if I could go online, do the point-and-click thing, and a few days later have a bottle of kenalog show up in my mailbox?  No travelling. No time lost.  Not that I don’t like my doctor.  I do.  It’s just so overwhelming to think about going to see him yet again, that it’s easier to just stay home and deal with the pain.

This is why I haven’t been blogging.  Life has been even busier than usual, and the bursitis & tendonitis have been waging war.  My computer is upstairs, and I’ve been mostly staying downstairs.  I’ve even been sleeping in a recliner in the living room since November (instead of climbing the stairs to torture my hips and shoulders by squishing them against a mattress).  Something needs to change.

Miscellaneous other stuff, since I haven’t posted in ages:

Last month I finally took dear daughter to see her rheumy in Seattle.  The doctor saw why I’d been phoning and pestering her to treat this more aggressively. DD is now on a DMARD instead of just NSAIDs.  She’s also getting some pretty intense physical therapy.  More about that another time.

Both my college kids came home for Christmas break.  It was great to see them and hug their necks.  Our son is planning a service-project trip for spring break, and is applying for an internship over the summer, so I guess that means he’s all grown up and on his own, and we’ll see him again next Christmas unless we go to visit him in Texas (which we are considering).  Our daughter, however, plans to be home both for spring break and over the summer; we are thrilled.  My husband and I are both the oldest child in our families, and really had no idea how hard it is on the younger kids when older siblings grow up and move away.

In other news, totally unrelated to RA (but I could make a case following the RA/food allergy thread), my ducks molted.  Molting means that their feathers fall out and they quit laying eggs.  Not good, since the people in this house without a Y chromosome do not tolerate chicken eggs.  We eat duck eggs.  I finally threatened the ducks, and said that if they didn’t produce, they’d go in the soup pot.  Two started laying.  I should’ve threatened them sooner.  1-2 eggs a day isn’t really enough, so I increased my flock.  Unfortunately, the new ducks are all white, which means that they are much easier than brown ducks for owls to see in the dark.  It’s been most frustrating, but I started shutting the ducks inside at night and haven’t lost any more heads.

AND… if you just skimmed:  IFAA is doing some great chats with blog leaders on the Facebook page.  I am signed up, but don’t even have a date scheduled yet — because, seriously, nobody wants to do a chat at midnight, and I feel like I’ve been running from first thing in the morning until the rest of the household is asleep at night.  That seems to be the only time I’m not committed to doing stuff.  Basketball won’t last forever, though.  Meanwhile, please check out the Facebook page and participate in the chats!

Wishing you painless days!

More Problems With EHRs

My fourteen year old son had a sports physical yesterday.  At the end of the visit we were handed a sheaf of papers summarizing everything that had occurred.  We headed toward the lab for a blood draw, then drove home.  Finally, two hours after the appointment was over, I sat down to review the paperwork I’d received.  There it was:

EHR Problem

There are a few problems with this.  First, obviously, is that the information is wrong.  My son did not have his first menstrual period at age 13.

Second, poor programming permitted this error to occur.  When the patient is a male, it should not be possible to enter data in a “females only” section of the chart.  Either the entire section should be greyed-out, or selecting “male” in the gender field should generate an “N/A” entry in all female-only fields.  Worse, even for female patients, it should not be possible to enter any data in the second and third fields when the first question received a “no.”  This is incredibly sloppy programming.  If this is an example of the quality of work that’s gone into writing EHR software, it’s no wonder that it took an act of Congress to coerce physicians into purchasing this garbage.

After laughing at the typo, I checked the rest of the paperwork to make sure there weren’t any other surprises, then phoned our doctor’s office to request that they make the appropriate correction.  The receptionist was very nice, laughed with me, and promised to have the error fixed.

Problem:  at 5:30 our doctor phoned. The error can’t be fixed.  Once information is in an electronic chart, it can’t be changed.  What kind of numskull programmer doesn’t recognize the need for fallible humans to make corrections to typos?

Image getting a statement from your financial institution and finding that a decimal was in the wrong place —  that the check you wrote for $50 went through as $500.  Nobody would accept the bank saying, “Sorry, but once something is in the computer, it can’t be changed.”  Or what if your deposit was credited to another person’s account?  This happened to us once – fortunately my spouse keeps all deposit slips and checks them against the bank statement; it was relatively easy to resolve the problem because banks can make corrections to bad data.

It is possible to leave a trail showing that a correction was made: when, why, by whom, etc. The programming should then make it impossible for the old “bad” data to be copied and carried forward into future notes and communications.

In fact, the same programming would directly address misdiagnoses. Once a diagnosis is determined to be inaccurate and the true problem is discovered, it would not be difficult for a small addendum to appear throughout the chart whenever that misdiagnosis occurs, noting that on such-and-such a date, it was determined that the dx in question was more accurately replaced with a diagnosis of ___. The programming needs to ensure that the correct information, not the erroneous data, is what carries forward.

Electronic Health Records – a great idea in theory, but an abysmal failure in practice – have been inflicted on this country by the lawyers in DC who wrote the “Affordable” Care Act thinking that it’s appropriate for politicians to tell doctors how to do their jobs.  There are too many problems, from poor design, to bad programming, to the tendency to perpetuate inaccurate data.

All computer software need to be well-designed.  It needs to be tested and idiot-proofed.  Electronic health records are no different.  EHR software needs to acknowledge that fallible humans have a need to correct errors.  It’s true at the bank, and it’s even more true when people’s lives are at stake.