http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x2923074Oh my.
The perpetually indignant Ms. Ed, the unappellated eohippus, the most underpaid nurse in America:
Horse with no Name (1000+ posts) Mon Feb-25-08 09:40 PM
Original message
Insured 50-year old man goes to the hospital with chest pains
Gets full cardiac workup and most likely admitted.
Insured 50-year old woman goes to the hospital with chest pains...gets Zantac and gets sent home.
This happened Friday to one of the clerks at a local business.
Her funeral was today. May she rest in peace.
xultar (1000+ posts) Mon Feb-25-08 09:42 PM
Response to Original message
2. Same thing happens with minorities. Makes me wonder if this place is really ready for a woman or a black president.
We have institutional sexism and racism. That shit don't change overnight.
Horse with no Name (1000+ posts) Mon Feb-25-08 09:44 PM
Response to Reply #2
6. She was black.
She was a black, middle-aged, slightly overweight woman with a history of high blood pressure.
Heart Disease is the #1 killer of women.
You would have thought her risk factors would have at least scored her an EKG or some lab work .
xultar (1000+ posts) Mon Feb-25-08 09:47 PM
Response to Reply #6
9. Nope. I've read many articles on the lack of equal healthcare for women and minorities.
It is basic shit like that occuring every day that makes me wonder about this ****ing place.
kikiek (1000+ posts) Mon Feb-25-08 09:55 PM
Response to Reply #6
16. Has it been determined there were no tests? That would be my 1st question.
There are problems with ER's downplaying cardiac symptoms in women. It is difficult to understand why the ER doesn't do its part. The campaign to women to not ignore the symptoms has been widespread and ongoing. What good is it if the MD's ignore them? I was trying to reserve judgment until I heard if any tests were run though.
Horse with no Name (1000+ posts) Mon Feb-25-08 10:03 PM
Response to Reply #16
20. Yes. We know her family.
They said "no tests were done. She was given a prescription and sent home". They still had the prescription because she died before she could have it filled.
liberalhistorian (1000+ posts) Tue Feb-26-08 03:03 AM
Response to Reply #16
69. I may be white, but as a woman, I can personally attest to the fact that women are often not taken as seriously as men when it comes to medical treatment. I'm not sure if it's unconcern and uncaring, or deeply entrenched sociocultural gender perceptions and stereotyping, or a combination of both. Women are often seen as more dramatic, more prone to hype and hysteria, etc.; just pat them on the head and send them off to bed with a pill permit and a glass of water and they'll be just fine. This used to especially be the case among gynecologists, before women became OB-GYN's in large numbers and women now prefer female GYN's, so that most men don't enter that specialty anymore (thank God-no offense, guys, but it really is preferable to have a woman as your gynecologist).
This is, unfortunately, especially true when it comes to the fact that women often will manifest different symptoms than men in many common health problems, especially heart attacks and heart disease. Yet, male symptoms are often the only ones considered and if she doesn't have them, well, tough luck, she's just a hypochondriac. I've personally both witnessed and experienced such differences in attitude among the health care profession. I think it's even worse with minority women, sad to say.
notadmblnd (1000+ posts) Mon Feb-25-08 10:47 PM
Response to Reply #2
41. Same thing happened to my husband and he had insurance he collapsed at work. They took him to the hospital and they told him it was gas. he was sent back to work. Luckily for him at the time he didn't listen, he came home and went to a cardiologist. He was immediately admitted to the hospital for triple bypass. Not listing to the quack in the ER is what gave him the 12 extra years he had.
on edit: BTW he was black
After which the primitives squibble squabble about possible legal retribution, and further on:
liberalhistorian (1000+ posts) Tue Feb-26-08 03:07 AM
Response to Reply #42
70. See, that's the thing. A lot of the time the ER staff doesn't want to be bothered with doing even fairly routine tests, and studies have actually shown that minorities and women are especially unlikely to get tests that are clearly needed and often fairly simple and routine. They just don't want to be bothered. Cultural, gender and racial perceptions and stereotypes still play a large role in medical care, especially ER care, whether the medical profession likes it or not or even recognizes it or not. Same can be said for the legal profession; I'm a paralegal, so I'm well aware of that.
mike_c (1000+ posts) Mon Feb-25-08 09:47 PM
Response to Original message
10. ok, that's a tricky issue and not nearly as clear cut as your OP...
...seems to want to make it. Chest pain is not a primary heart attack symptom for women-- only something on the order of 30 percent of women presenting for heart attack in the ER report any chest pain at all, and the excruciating chest pain typical of male infarction is rarely seen in women. Stated another way, most women presenting with bad chest pain really do have some other condition, including indigestion or acid reflux, hence the Zantac.
That said, it IS also true that female heart attacks slip through the cracks more frequently than male heart attacks, but again that is at least partly because the symptoms women present the most are fatique and sleeplessness if I'm not mistaken. In other words, an easy diagnosis of heart attack is MUCH more difficult in most women. It stands to reason that more difficult diagnosises will fail more frequently than easy ones, and a women presenting with fatique is simply not as clear cut a signal as a man clutching his chest and yelling "This is the big one!"
There probably is a gender issue in there somewhere, but as I said, the medical issue is just not as easy to resolve as your post seems to imply.
Oh my. The mike_c primitive's in trouble now.
Horse with no Name (1000+ posts) Mon Feb-25-08 09:50 PM
Response to Reply #10
13. Yet she was having classic chest pain
I have been a nurse for 20 years and I know the differences that CAN and most often DO occur in women.
However, her chest pain was CLASSIC. It was hard to miss.
A nurse, and allegedly makes only $24,000 per year.
mike_c (1000+ posts) Mon Feb-25-08 09:54 PM
Response to Reply #13
14. but it's not a classic symptom in women....
If I present with abdominal cramps no one is going to give me Midol (I'm male). Just because the symptoms are the same, men and women often express them for different reasons. As a nurse you're probably aware that this is a real ER concern most places-- I mean the significant differences in the way males and females present with heart attacks.
Horse with no Name (1000+ posts) Mon Feb-25-08 10:02 PM
Response to Reply #14
19. I have LITERALLY gone fist to fist (verbally) with a doctor
I had a patient (years ago before protocols were in place). She was admitted with chest pains.
However, had no pains after admitted. Her 3rd day in the hospital, I went in to do my assessment.
She was pale, sweaty, short of breath, and said she had enormous pressure in her chest.
She looked like a poster child for an MI.
It was a Sunday, I called the doc at home. He ordered Maalox.
I waited 1 min after giving it...no pain relief, called back and told him no relief.
He ordered Maalox with Xylocaine.
I told him that I didn't think he understood what I was telling him, I thought she was having a heart attack.
He said nonsense. I asked if I could get an EKG...he said yes...BUT not to bother him again because he was watching the Cowboys game.
Anyway...her EKG showed a lateral wall MI in progress.
So...one of the Internal Medicine docs was on the floor at the time--I asked him to please read it. He looked at the timestamp and called ICU for a bed and told me to get her up there fast.
He asked if I called the doctor and I told him "No, he gave me an order not to bother him"
Anyway...the lady was flown out and had angioplasty that night and recovered just fine.
But women are NOT treated the same way regardless how classic (or not) their symptoms are.
mike_c (1000+ posts) Mon Feb-25-08 10:14 PM
Response to Reply #19
27. good on ya' sister....
I totally agree that she should have been profiled (the OP). It's just that in a busy ER, people waiting, often for a LONG TIME, ER physicians sometimes HAVE to make quick judgements. This one was clearly wrong-- I'm not arguing otherwise, but I wasn't there and don't know the circumstances. But I do think it was an understandable call, given the statistics for female heart attack symptoms. More often than not (at least 70% vs 30%) that would likely have been the right diagnosis.
mike_c (1000+ posts) Mon Feb-25-08 10:06 PM
Response to Reply #18
24. absolutely-- I totally agree....
It's just that the judgement call wasn't NEARLY as egregious as most of the poorly informed outrage here is making it seem.
Horse with no Name (1000+ posts) Mon Feb-25-08 10:08 PM
Response to Reply #24
25. I am not "poorly informed" in the least. AND YES, it was EGREGIOUS
mike_c (1000+ posts) Mon Feb-25-08 10:20 PM
Response to Reply #25
28. I didn't say that you were....
I was talking about some of the replies up thread, which simply followed the lead you established in the OP because it sounds so horrible and unfair. I don't think you're uninformed-- just the opposite, which is why I'm having a hard time understanding why you seem to be trying to blow this case out of proportion. Diagnosing women's MIs from presentations simply IS more difficult than diagnosing mens'. It simply IS more likely to result in bad calls. Women don't usually present with as clear a syndrome as men do. That's not a matter of gender inequality-- which I'm NOT arguing was absent here-- it's just the physical truth.
Horse with no Name (1000+ posts) Mon Feb-25-08 10:25 PM
Response to Reply #28
32. I disagree with you 100%.
As long as there are people WILLING to buy into your argument and excuse it, then this will happen over and over.
Heart Disease is the #1 killer in women.
ANY TYPE of chest pain--TYPICAL OR ATYPICAL--should be investigated and assessed thoroughly.
It IS a matter of gender bias and buys into the argument that women have histrionic personalities.
mike_c (1000+ posts) Mon Feb-25-08 10:36 PM
Original message
no you don't....
You're WAY over stating my comments.
"ANY TYPE of chest pain--TYPICAL OR ATYPICAL--should be investigated and assessed thoroughly."
We agree 100 percent about that one.
I've never said anything about "histrionic personalities" nor is there any indication that such predjudice played a role in this instance. It might very well have, but that was never the issue I've been discussing.
You have never really replied to my comments about female MIs being genuinely harder to diagnose from presentations than mens' or about chest pain being a relatively poor indicator of MI in females. As a nurse I expect you know these things are true.
Horse with no Name (1000+ posts) Mon Feb-25-08 10:41 PM
Response to Original message
39. THIS is the case we were discussing
She had CLASSIC chest pains.
I'm not talking about some vague, generalized symptoms here or the symptoms in general. This woman WAS symptomatic. She should have been treated as such.
And on it goes.
It's difficult to take Ms. Ed seriously about her indignation, because as betrayed in postings by the unappellated eohippus during her entire career as the High Priestess of Moloch to the primitives on Skins's island, there's a lot of human victims Ms. Ed doesn't care about; she's pretty selective.
I already told this story over at the other place, about how on January 20,1993--a most unfortunate day in more ways than one--I destroyed my right elbow; utterly destroyed it. Because I am deaf, I don't quite talk the same way other people do, and in the emergency room was misconstrued to be too stupid to know what I was talking about. The shoulder (not the elbow) was x-rayed, nothing wrong was found, and I was sent home.
When I went to see my regular physician, who of course was intimately acquainted with me and my circumstances, and knew me to be no idiot, it was discovered there was no bone left in the elbow larger than one of those old-fashioned match-sticks.
Excresence happens. One accepts, adjusts, and moves on.
