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Wednesday, December 18, 2013

From Dragonfly: Sick Call

I have a recurring small health issue that I haven't had an issue with since I have been here for the past four months. The inner eye/edge of where the nose meets the eye gets red, inflamed, dry, scaly, itchy, and has slight pain. I don't worry about it, but when it first showed, just over a year ago, my doctor told me that I should always take care of it and prescribed me a gel-like steroid topical that is safe for eyes. I would goop it on mornings and nights, and the problem would mostly go away. In the year, I had three small flair ups of this slight irritation. Well, it started again about a week ago. Anyone who looked at me would ask what was wrong with my eye. I knew that it meant that I needed the steroid creme, but I dreaded the infamous sick call. I had made it four months at Carswell without having to go to sick-call and I was happy with that fact.

Sick call is only available Mondays, Tuesdays, Thursdays and Fridays. Any inmate with any medical problem, who needs a prescription refill, or has a medical issue of any type has to start with sick-call. Our sick call is in the clinic on the second floor of the main building and serves the entire inmate population. First, we each need to fill out a document before arrival that states why we are going to sick-call. We need to bring that document with us. At 6am, we have to be walking to the clinic (as soon as the housing units open for breakfast). We cannot go to eat first, as we must sign in by a certain time or we lose out on sick-call for the day. So, at 6am, I walk into the clinic, my book and my filled out sheet of paper in hand, and sign my name on "group 3." We are put into one of four groups based on the last two digits of our first five digits in our inmate i.d. number. The PA's that see the sick-call inmates rotate every quarter, so most people do not have a medical professional that sees them regularly.

Anyway, I have a seat and read my book, waiting for my name to be called. About 6:15am, a nurse walks around in an order selected by her, and picks up all the sick-call sheets. The first time my name is called is at 6:30am. A line of us are called to the vitals room, where my blood pressure is taken. I thought they would weigh me too, but they said that it takes too much time to do blood pressure and weight. As usual, my blood pressure is low - but seems quite low on the second number - 110 over 52. No one says anything about it, so neither do I. I am told to go back out to the waiting room, and the blue uncomfortable benches, and wait to be called by my Physician's Assistant. From what I could tell, the P.A.'s started to call people in about 7:30 or 8am. By 8am, the clinic waiting room is packed. The wheelchair/walker area does not serve everyone...

(Okay - I'm finishing this a day later... as I was writing the above, Lola came in and told me that Freckles would eat the ice cream that Nurse had saved for me... so I needed to save and come back - which is now on the next day... I got 3 spoonfuls of real vanilla ice cream. It was wonderful.)

Back to the clinic waiting room: So there are wheelchairs and people stacked everywhere - going out into the hallway, some people are sitting on the floor, others leaning up against the receptionist's booth. You have to say, "excuse me" about 15 times to walk across the room. Since I was there for sick-call at 6am, I had found my bench space and never moved from it.

If you've ever "waited" to see a medical provider, which everyone has, you know that people get impatient. Well, by 10am, I had heard the PA that I had to wait to see call back maybe 3 people... there were at least 20 of us assigned to her and there seemed no order to her decision on whom to call next. It certainly wasn't by the order we arrived and signed in, nor was it by the order that they collected our sick-call sheets.

At 10:20, someone waiting to be seen had a massive seizure right in front of me. If she is not supposed to be in stressful situations, then not being able to sit for hours in the clinic waiting room would surely bring on the seizure. There's no way of knowing who "needs" to sit and who doesn't. The most able body people tend to take up the benches and care not if someone elderly or really ill is standing for hours. Luckily, most of the elderly have wheelchairs and walkers - not so much because they need the help walking, but because they can sit during the long waits at pill line, the chow hall, clinic, and just about everywhere else. The seizure lasted several minutes. Even with it occurring in the clinic, it took a bit for a medical professional to head over to her. Of course, they needed to make sure people stepped back, so the seizure could end. They did not stick anything in the mouth.

(... another break from this writing... Freckles came into the email room and we went to breakfast... it's 6:40, so the going "bananas" crowd had already eaten...)

Anyway, finally a stretcher was brought out and the woman seizing was taken into an observation room. A lot of seizures happen here. I see one - or hear about on - almost daily. Before coming here, I had only seen one in my life. A lot of the people having seizures are diabetic. The other day, a woman in my unit went into a diabetic coma. Hours later, she was right back in our unit on her top bunk. How can they put people with seizure issues on a top bunk??

At 11am, I am still sitting in sick-call, waiting. I'm getting hungry (I hadn't eaten dinner the night before or breakfast that day, so I'm feeling the emptiness). There is still no sign of getting called by my P.A. and we cannot ask when we will be seen. Our duty is just to sit and wait. It's been 5 hours. I look to my right, and a woman next to me is reading her book... not sure the title, but the chapter she is reading is called, "If it ain't one ting, it's another." I couldn't agree more!!! We hear that food service is open and several people ask for permission to go eat... not granted.

I am fortunate to have thought to bring my own book. It is called, "A House in the Sky" and tells the story of the more than 460 days Amanda Lindhout spent as a captive in Somalia. It is a memoir, co-written by a well published journalist, and it is a great book. I will not say that it's a happy book (but since we know it's a first-person memoir, it's always good to know that she somehow survives this experience). I highly recommend the book - especially for people who love to travel to new places and have that adventure bug in them. However, be prepared for some very depressing and frightening moments as you read through - as being a captive in a terrorist country can never be a good thing. I read more than 200 pages while I am sitting at the clinic.

At 11:20, with my stomach gurgling, I hear my name. Finally. I walk back with the PA, who tells me that based on what I wrote, she believes I have something (I couldn't understand). She did not give me a more than a quick look, and told me that she will order me what she can, but most things are not allowed or in the pharmacy. I tell her my history with this issue, although she doesn't ask. She asks nothing about my general health. When you go to sick-call, you can ONLY discuss one thing. If you have more than one thing to discuss, you have to go that many days... wait that many hours... to be seen.

She says she will try to order what I need. She goes into the computer, and then says, the DOP won't approve the medicine I've taken in the past. She says, "I don't know why... It's really cheap." Even the medical providers are in disbelief of the limits of DOP health care. So, she says she will try to find something and that I can go. I ask, "how will I know if you are able to order a medication?" She says, go to the pharmacy (another long line) and see if I was successful. Otherwise, come back for another sick-call and we'll see what I can do..." Really!?!?!?

Well, at 3:30pm, I went to the pharmacy line and they did have something for me. It's an eye drop and meant for the eyes, but it says from her, to place the drop "outside my eye." It's the best she could do. Instead of having the cream, I have something that will run down my face the minute it is applied. The cream stays in place and I would sleep with it. That is Carswell health care - we'll see if the eye drops (they do have steroids in them) help.

Around the same time as I was getting the medication, I heard tragic news. A woman in the unit next to me was found hanging, and unresponsive. Luckily, she was found in time and is breathing. That means that she has to go to suicide watch now. She will spend days naked, except for an apron, with someone watching her 24/7. For someone who was obviously depressed, having to be watched by a stranger while you are naked can't help. They say that this time of the year is hard for many people in prison. We are away from our loved ones at a time when we would normally be surrounded by them. I'm glad she survived, but afraid for what's next for her. Will she get the real help she needs? Will they just move her to the mental health floor, where she will be surrounded by people with severe mental impairments? I don't know.

I know this place is listed as a health care facility, but I fail to understand the concept of just keeping us alive, but not an attempt to help us actually thrive. Sick-call is just one example of a bureaucratic block to actually getting the health care we need. People avoid going, because they don't want to wait so long, they can't sit that long, or they don't trust what the medical providers will say. There are just too many stories of problems. Inmate.com wasn't wrong, though, that the sick-call experience should be avoided if at all possible.

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