Modern Medicine --- The Good

I recently posted a couple of entries detailing some medical mistakes and what we can do to protect ourselves from such things. Today's post is about the other side of our medical establishment and the care we receive.

We've all heard about the nefarious uses of chloroform and ether, but when I had my tonsils removed in the late forties, ether was the medical anesthetic of choice. The use of chloroform as anesthesia had pretty well ended by that time because of the number of accidental deaths. Ether had a reputation for safety so was used almost exclusively until the fifties. Now we have dozens of anesthetics ranging from inhaled to intravenous, short term to long term, local to general and combinations of various kinds. Some are quick acting, some maintain their effect over longer periods and some are designed to promote amnesia while allowing a person to be responsive to a doctor's orders.

Similar improvements have been made in diagnostic tools. When I went in for my first physical the doctor depended on a stethoscope, reflex hammer and his own senses. I donated a urine specimen which he smelled and eyeballed for color and cloudiness, matching those attributes to standard charts. I don't think he tasted mine but if a doctor suspected diabetes, he would taste the urine to determine its sweetness, a pretty good indicator of diabetes.

Doctors today have access to dozens of blood tests, MRI and CT or CAT scans, XRays with immediate results via digital methods, endoscopies (upper and lower), EKG and StressEKG tests and echo scans from fetus to old age and often concentrating on the heart. Speaking of the heart, there are tiny cameras and surgical instruments that can be inserted into an artery or vein thereby looking at and treating the heart from the inside. Then there are very sensitive microscopic tests and even DNA tests.

Surgical techniques also have changed for the better. The old "sawbones" has become a specialist equipped with a wide array of instruments to perform amazing medical feats. 

When my appendix was removed in 1960 I was left with a four inch scar. With today's laparoscopic surgery (sometimes called minimally invasive surgery) there would be only a small dimple. 

Prior to 1950, if you had an arthritic knee or hip, you learned to walk on crutches, operate a wheelchair or stay at home.  In 2009 there were 773,000 hip or knee replacement surgeries just for Americans. Of course, there also are replacements for ankles, elbows and wrists. Today's recipients of artificial knees and hips are often out of the hospital in just a couple days. What an amazing improvement.

Then there are the medical specialties. A hundred years ago there were only a few specialists, today the American Board of Medical Specialties lists Specialty and Subspecialty Certificates for which they can give certification. There are 26 specialties with up to 20 subspecialties under each specialty.

With this number of specialists and the many diagnostic options available, any patient worth his insurance can have up to a dozen specialty doctors and a huge file of diagnostic procedures. In my own case, I’m pretty healthy but at times I see my primary care provider, cardiologist, dermatologist, endocrinologist, gastroenterologist, neurologist, ophthalmologist and sports medicine specialist. If I need to go under, that calls for an anesthesiologist as well.

All these improvements lead to better medicine and longer lives. When I was born in 1939 my life expectancy was 62.1 years, if I had been born in 2010 my life expectancy would have been 76.5 years. That’s a remarkable improvement in 71 years.

Doctors are better trained, tests are better, anesthetics are safer and surgical procedures are more effective with better outcomes. Some doctors tend to over test and over prescribe. Over testing is often driven by the specter of malpractice lawsuits, justified or not, and over prescribing is driven, at least in part, by the ubiquitous advertising of Big Pharma urging watchers to “ask your doctor if this magical drug is right for you.”

There are some problems, as there must be with any system as large as our medical program. If I were in charge I would make a couple changes. I think people make better decisions when they have some skin in the game. Somehow we need to let people feel a little of the economic impact of medical decisions. When medical care is given at no cost to the individual we see cases of sniffles in the emergency room and sore backs in the doctor’s office with the owner asking for an operation.

Sometimes the best course of action is no action while letting the ailment cure itself, as ailments have done for thousands of years. Maybe with a little help for old wives and their time-tested remedies but without knives and operations with questionable results and certainly without wonder drugs that are rapidly losing their power to cure fast evolving microbes.

Overall I’m impressed with the progress of medicine and medical professionals during my lifetime. No system is perfect and medical professionals are human, but by and large the system is better, the doctors are more professional and people are living longer, healthier lives. It doesn’t get much better than that.

Tree Bones

Kuro and I usually walk in the evening. This time of year the sun has long set and, depending on her phase, we sometimes see the moon as she watches us walk.

Last Sunday, we had nice weather and knowing we wouldn't be able to walk at our usual hour because of a dinner date, we set out in the afternoon.

Our mountain was out, the sun was shining and Seattle wore its pretty face.

As we walked along, I was struck by the way the slanting afternoon sun highlighted the trunks and branches of the trees along our route. I remarked to Kuro that with the sun and the lack of leaves, we clearly could see the bones of the trees. 

Lichen and moss hitching a ride on this old tree.

The bones of an old Birch shining in the sun. 

This pine wears needles year round so needs sturdy bones to bear the extra
weight of our occasional snow falls.

Young Oak trees modestly wear their dead leaves all winter.

Mister Douglas Fir is a heavyweight among city trees. 

This old ornamental plum is gnarled and battered. The large burl at his
base would yield beautiful woodwork at some master's hands. 

This ornamental is healthy even though it has peeling bones.

In the spring these ornamental cherry trees will be umbrellas of white.

But their strong feet wreak havoc with city sidewalks.

The bones of this Japanese lace leaf maple will be invisible when she soon dons her red cloak.

This birch shows grotesque bones caused by botched surgery when she was young.

Whenever we pass, I admire the twisted old bones of Ms. Lilac. Her spring
finery is white and her perfume is a wonderful introduction to the season.

This young tree is just getting started in life. Her owner planted her in a poor location
so I'm afraid she won't make it to tree old age.

This old madrona still reaches for the sun.

This pine has a split personality.

During this walk we discovered some amazing shapes and colors most of which are hidden later in the year.

I decided it was a good walk.

Kuro says any walk is good.

Medical Mistakes Happen

You may have seen headlines in the past few weeks, “Medical mistakes cause 250,000 deaths annually,” “440,000 people in the US die annually from medical mistakes,” “Medical mistakes are the third highest cause of death in the USA.”

These headlines are scary but rather impersonal. I’d like to tell you about my first-hand experience with medical mistakes.

Almost three years ago, my favorite gastroenterologist retired. Finally, about a year ago, I went to see a new specialist in the field.

After introductions, he asked why I was there and I told him I was following up on GERD problems but with an eye toward reducing and eventually eliminating my use of Omeprazole. It was my goal because of the adverse publicity associated with the use of Proton Pump Inhibitors (PPI’s).

He said that before we could discuss Omeprazole usage he needed to do an upper endoscopy to look at the area. He said he was going to schedule one and wanted to know when I last had a colonoscopy. Told him a couple years previously and in response to his question about polyps, told him I didn’t remember but they may have found one or two. “Well,” he said, “we’ll do a colonoscopy at the same time.”

My HMO has digitized our medical records so a patient’s records are readily available. A provider can turn on the computer using his coded pass key, but this doctor never turned it on during the thirty minutes I was in the office, even though he easily could have checked the results of my previous colonoscopy.

When I got home, I looked through my paper records and found a record of the previous (25 months prior) colonoscopy with no polyps found and a follow-up recommended in ten years.

I called his office and cancelled the colonoscopy.

So far, no harm done. “But wait, there’s more,” as the TV pitchman says.

About six weeks later, I received a 90-day supply of a drug to treat gout, prescribed by this same doctor. I immediately called the pharmacy worried that this prescription was intended for someone else and they had shipped it to me in error. After checking, the clerk assured me that my doctor had ordered the drug for me. I called his office only to be told not to worry about it and to dispose of it.

This worried me. I didn’t remember any discussion about gout, I've never had gout, and why would a consultation about GERD result in a prescription for gout. Finally, if he prescribed for my nonexistent gout, I wondered what else this doctor might be doing.

I ordered a copy of my medical records including all entries by this doctor. In review, the record was innocuous. There was a brief review of my physical appearance and apparent health, and an order for an upper endoscopy and colonoscopy. He justified the order for colonoscopy by citing polyps. "The patient's colon cancer screening history is remarkable for a history of colonic polyps on previous colonoscopy. He has not had a colonoscopy for 2 to 3 years with the last colonoscopy showing the presence of adenomatous polyps with no atypia. He clearly will also need a colonoscopy." He may have been confused by my poor recall, but if he had simply checked my record he would have known the facts.

If that weren’t bad enough, on June 16, 2016, a prescription for Ursodiol written by the same doctor was filled and sent to me with instructions to take one 500 mg tablet three times per day.

I checked the internet drug sources and found that this drug is used mostly to dissolve gallstones or prevent them from building up. It should be prescribed and used with caution as it may cause liver problems.

Now worry turned to anger. I’ve never had gallstones and, again, there had been absolutely no discussion about gallstones with the doctor nor was there mention of that in my record.

Of course, there is a possibility that he wrote the prescription for a different patient and his staff confused that person with me. There may be other reasons for these mix-ups but the basic facts are clear. The drugs went to a person who didn't need them, with potential serious harm. 

I wondered about other patients who might receive such a prescription and take it thinking that it had been ordered by their doctor. Even if they checked the pharmacy, they’d find that the doctor did order it and so some of them might risk problems thinking they were doing the right thing. Perhaps the blame is mostly on the doctor but the patient who unquestioningly takes a drug in such circumstances is also partly to blame.

Of course, I didn’t take the drug. I also didn’t call either the pharmacy or the doctor’s office. This time I wrote a letter of complaint to my HMO.

In early December I received a call from an assistant in that same office saying that I needed to come in (“at absolutely no cost to you. Even parking will be paid”) for a repeat of the upper endoscopy because, “there had been discrepancies in the administration and interpretation of the original test.” Upon further questioning, he told me that the doctor in question, “No longer works here.”

I don't know if this was a bundle of medical mistakes or an example of a medical doctor on the take or with other problems, but the important lesson to remember, as I said in my last post is, MEDICAL PATIENT BEWARE.

I hope this doctor was the unwitting victim of mix-ups and incompetent staff. But even assuming the worst, that he was doing things in an unethical way for unethical purposes and got caught, it often results in only a hand slap. Assuming he was investigated and Washington State revoked his license in this state, he could move to another state and probably begin practice there.

An unnecessary colonoscopy or other invasive procedure can be dangerous. Erroneous drug prescriptions can be dangerous. No matter the reason, if I had taken those pills because he had prescribed them for me, I might be trying to post blog entries from the great beyond.

I like to think I'm savvy enough not to take questionable prescriptions like that, but what if I'd been overtired, or ill, or distracted, or what if it had been someone else similarly impaired? It's easy to see how death or severe illness from medical mistakes can happen.

As you can see from this example and as we’ve all heard from friends or family, doctors make mistakes. Just because a person has a piece of paper giving him authority to practice medicine, he is still a human being with human weaknesses.

Moreover, doctors are given (rightfully so) a lot of authority. They listen to a person’s symptoms, interpret tests, investigate the various drug (or surgery) options and devise a treatment plan. Typically, they don’t have a supervisor checking their decisions or reviewing their prescriptions or surgical procedures. They operate with a great deal of autonomy. BUT, they sometimes make mistakes! 

How do we protect ourselves from such mistakes?

First, take backup. Have another person with you to listen and watch but also to serve as your advocate. Another person's eyes and ears may catch things that you don't or ask questions that you don't think about. Take notes, your memory is never perfect and when stressed it's even less so.  Ask for a printed summary of the doctor's instructions. Since my HMO converted to computerized records a couple years ago, patients receive a printed summary of the visit. That's a great help but even if your provider doesn't use a computer, ask for a summary of the visit.

There is another reason for having another person present, especially if you are a patient in the hospital. If you are ill or tired or even unconscious, your advocate can influence the behavior of the doctors or other medical professionals simply by being there watching. They know that your friend or family member is on your side and that will influence them to take extra care they might not take without a dedicated observer.

If you can’t find backup, consider taking a recording device, ask for permission and make a recording of the doctor’s instructions, procedure review or other communications. This is especially important if you have been sedated. Even though you may appear normal, your memory is probably unreliable at that point. Also, the fact that you are recording will encourage medical personnel to be more accurate and cover all necessary facts and instructions.

Second, be vigilant. Always read the labels, make sure they know it's you. Check the name on any papers they hand you. Make sure you are taking the drugs specified on the label. There are several good sites on the internet that will help you identify the drug the doctor prescribed. Just because the label says it’s the right drug, doesn’t make it so. The color of the Omeprazole capsules I take has changed twice in the past two years. It only took me a couple minutes to double check to make sure I was taking what the label said.

Don't feel irritated when they ask your name and DOB again and again. Encourage them to ask more often by thanking them for asking. Medical professionals are human and they make mistakes. Try to help them make as few as possible.

Third, if he is prescribing drugs, check a doctor’s income from drug companies at this site: https://openpaymentsdata.cms.gov/ or this site: https://projects.propublica.org/docdollars  Some doctors make big bucks (some make over a million dollars a year) from drug company payola. I'm not saying it would make your doctor prescribe the wrong medicine, but it might influence his prescription decision.

Fourth, request copies of your records. As a patient, you are entitled to receive copies of your records, but you must ask. Review those records while the visit is fresh to make sure it agrees with what you and your backup remember. If there are mistakes, request correction.

Finally, remember it's your health and your body. Question a recommended course of treatment and ask why certain drugs are prescribed. Doctors are human and there is often disagreement among professionals about the best treatment. If you ask questions, the doctor may realize while answering that he made a mistake or can reassure you that there were good reasons for this particular drug or procedure. In serious or questionable cases ask for and get a second opinion.

Above all, take care of yourself. The doctor might have hundreds of patients to care for, you have only one, yourself. 

Medical Patient Beware

As I've gotten older I find myself observing and thinking more and "being entertained" less. Accordingly, this blog entry will depart from my usual. It will deal with the state of our medical system. I will relate some personal examples and question some common beliefs. In this part I will look at the impact of universal medical insurance and in the next part look at the deaths and other troubles caused by medical mistakes.

First, a disclaimer. I am not a doctor, nurse or medical technician and have no medical training other than basic lifesaving techniques that I received in the Army. I do read about a wide range of subjects. I also observe the popular media with the widening range of commercials for pharmaceuticals and medical appliances.

During my time serving in the US Army I had adequate medical care although I seldom needed to take advantage of what there was. After retiring from the Army and as a natural consequence of aging, I've found my body needing and using more medical care so I've been paying more attention to this situation.

I have never expected to receive medical care that compares to that received by upper level politicians, leaders of industry or the wealthy people in our society. I have expected, however, to receive adequate care that meets the standard of the old aphorism, "First, do no harm."

My medical care generally has been pretty good, but there have been a few exceptions, which prove to me, and I hope to you also, that it is incumbent on all of us to be vigilant. Double check prescriptions; request copies of your medical records and check them for accuracy and if you don't understand or aren't sure about prescribed treatments, question the doctor.

TOO MUCH INSURANCE?

In this part, I’d like to examine the hidden costs of “free” medical care. Nowadays many people think such cost-free (to the patient) coverage is a “right” and everyone should be entitled. Sometimes I wonder if complete medical insurance coverage is really a good thing.

About ten years ago, I was troubled by pain radiating back from behind the small toe of my left foot. I was referred to a podiatrist who X-Rayed, poked and prodded and gave me a cure.

"This bone," he said, tracing the bone that connects the joint of the small toe to the rest of the foot, "has spread out too far, causing the pain where your shoe pushes on it and we need to operate. I'll make a V-shaped cut in the bone, bring the front of the bone back where it belongs, wire it up and when everything heals you'll be as good as new."

I asked him how much would cost. Says he, "Oh, don't worry about that, your insurance will cover everything."

When I asked if there were any alternatives to operating, to his credit, he did say, "You could wear wider shoes." and gave me the names of a couple of manufacturers who still make shoes sized for width. I've been wearing wider shoes and haven't had the pain recur since. 

A similar situation occurred five or six years ago with another consulting doctor where I was referred for possible treatment for strabismus, commonly called crossed eyes. In my case, one eye tends to look up and the other, down. As I've gotten older, the problem has gotten worse so now when my eyes get tired, I see double. 

One solution for this problem is to prescribe prisms for a person's eye glasses. In my case, I was started with a prism of 2.5 up in one eye and 2.5 down in the other to compensate for their tendency to wander. As time went by, I progressed (or degressed) to 3 up and 3 down, and with the most recent prescription, it has gone to 3.5 up and 3.5 down. 

This is a practical and inexpensive treatment for the problem. The prisms don't cost more and their effectiveness in compensating for the pull of the eye muscles is relatively good. But the consulting ophthalmologist had an even better solution. In each eye, he would relocate one of the muscles that control where that eye looks, thus pulling the eye back into alignment and saving the need for prisms.

He made a very enthusiastic presentation of the benefits of the surgery and, again, came that reassurance that, "There was no need to worry about cost since it will all be covered by your insurance." I told him I wanted to think about it. I researched and found that it is very effective when used on babies and young children but with adults, especially older adults, the brain soon returns to its pattern of interpreting the data from the eyes and another operation is needed to move the muscles even further. Or, you again wear glasses with prisms. 

A few days later, the doctor himself called me early one evening and wanted to know when I would be in and if he could schedule the operation. When I questioned him about the efficacy of the operation, especially on older adults, he did moderate his enthusiasm but still wanted to schedule me in. Told him I would wait. He called back one more time, again wanting me to schedule an operation. This time I told him a flat, “No.” Later, I complained to my regular optometrist and she said that particular consulting ophthalmologist had been removed from the referral lists. 

I relate these two examples because, first, they actually happened to me and, second, they illustrate the problem of universal insurance, as I see it.

Many people, presented with this kind of situation, would say, first, “It’s free, so why not?” and second, “It might help,” and third, “The doctor recommended the operation so it must be good for me.”

But, not so fast. Anytime a doctor sticks a knife in your body there is danger of unwanted results.

It’s difficult to find good data, but the current best guess is that 1.14% of patients who go into the hospital for surgery don’t leave alive. Based on 50 million surgeries, that’s about 570,000 deaths per year.

Bacterial infections after surgery also cause problems. As the Johns Hopkins site says:

Your skin is a natural barrier against infection. Even with many precautions and protocols to prevent infection in place, any surgery that causes a break in the skin can lead to an infection. Doctors call these infections surgical site infections (SSIs) because they occur on the part of the body where the surgery took place. If you have surgery, the chances of developing an SSI are about 1% to 3%.

Taking a mid-range figure of 2%, that’s about 1 million infections per year. http://www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/surgical_site_infections_134,144/

If that’s not enough to make you carefully question a recommended surgery, there is also the increasing number of infections from bacteria that are resistant to antibiotics. US Center for Disease Control (CDC) estimates at least 2 million people become infected annually with bacteria that are resistant to antibiotics, and at least 23,000 people die as a direct result of infection. Of course, not all are a result of elective surgery, but many are.

And there are anesthesia complications (. . .anesthesia/anesthetics are reported as the underlying cause in approximately 34 deaths and contributing factors in another 281 deaths. . .) (from NCBI, The National Center for Biotechnology Information).

If they see equal outcomes between operating or not, doctors, even the most altruistic, might be swayed by the bottom line. Less altruistic doctors, as in the cases above, may put their thumb on the scale in favor of operating because they want the money. As we’ll see in the next post, the occasional doctor seems to be in the business only for the money.

Patients are motivated by money also. In many cases I think the “buffet lunch syndrome” comes into play. People think, “Well I’ve paid my deductible,” or “my insurance covers everything,” and like the diner at a buffet lunch or a passenger on a cruise ship, they want to get as much as they can because it’s “free.”

I also see this in the media where the commercials often say, “This battery driven wheelchair (or back brace, or whatever) is available at little or no cost to you,” playing on the desire many people have to get something for nothing, really needed or not.

So just because it’s “free,” “might help,” and “the doctor recommends it,” I recommend you think at least twice before having a doctor cut into your body. Think once about the possible problems and think once more about the pull of money, both on the doctor and also on your own motivation.

This post has grown as I’ve been writing. I will end this part here and in the next post take a look at medical mistakes. I’ll cite some personal examples and make some more recommendations.  

Kuro's First Snow

This morning was one of those rare mornings in Seattle when wet snow fell gently and stuck to all things available. Some areas got more than others. Here in Magnolia we managed to get enough to make life beautiful and miserable.

Beautiful for Kuro and me as we went out and enjoyed his first snow. Miserable for people who live on these hills and had to fight the slippery conditions to go about their business.

Kuro was a little puzzled but he enjoyed romping in his first snow.

Our black bamboo bends under the load but will recover as the snow melts and falls off.

Seen here from the west, my winter flag flies in all weather.

 My smaller flag (2'x3'), sometimes called "storm flag," flies during our rainy windy winter weather. Sometime around Easter I'll change it for the larger (3'x5') summer flag.

Same flag, seen from the east.

Our trees carried a load of snow but nothing like that being experienced further north in Whatcom County where they have been suffering from a "silver thaw." 

For those of you who don't know, a silver thaw is an adult's nightmare and a child's dream come true. Cold rain falls into a ground-level below freezing zone and freezes on everything. Trees and power lines fall, branches break and all surfaces freeze. 

In this case, my sister in rural Whatcom County reports almost an inch of ice on the roads. Great for kids to skate on but not so great for drivers and emergency vehicles.

This flowering cherry shivers now but will burst into flower in April.

 I prune our Chojuro Nashii (Asian pear) back to maintain an open and easy to pick shape. Now it's cold and bare but come the end of September we'll enjoy lots of its fruits fresh and I plan to make more of the pear-lime marmalade that I made last fall.

It's good to think about the coming warm weather on a cold morning like this.

This shot was taken from our kitchen table. Note the reflections
of the light fixtures, about the only color in the black and white scene.

The bird feeders saw lots of action this morning. If you look carefully, you can spot nine birds in this photo. We have a family of Northern Flickers (a kind of woodpecker) that likes the suet in the second feeder from the front. They flew away when I went out to take pictures, but they'll be back. Even though they are very cautious, they can't resist that tasty suet.

After his romp in the snow, Kuro was happy to come in and warm up. He's still a little damp around the edges but he keeps a careful eye on me just in case I decide to go back outside.


   

Seattle Museum of Flight

A couple weeks ago we visited the Museum of Flight at Boeing Field here in Seattle.

Greeting us as we arrived outside the entrance was this Lockheed 1049G Super Constellation. The "Connie" was the last of the piston-powered airliners introduced (1954-5) before the jets took over as the aircraft of choice for commercial airlines. This one has the wing tanks that almost doubled its flying range. 

The museum is an amazing place. To do it justice, two or three visits would be required. We went in not long after opening at 1015 and ended up leaving at 1630 not long before closing time. We did our best, and covered all the main exhibits but I'm going back again to spend more time.

There are forty-some volunteer docents who are very knowledgeable. We joined one for a twenty-minute initial tour and noticed other docents throughout the museum waiting to give mini-tours or answer questions. 

This replica of the Wright Brothers 1903 Flyer hangs near the entrance.

This is another replica but it is one of three very accurate and detailed reproductions of the original built by the Wright Experience in Virginia. It is has been tested in a NASA wind tunnel and has a fully operational 12 horsepower, water-cooled engine. 

I took the photograph from this angle to show the juxtaposition of the Flyer and the space hardware (Mercury Capsule reproduction and the Resurs 500 capsule recovered off our Washington coast in 1992) behind the blast curtains. Those items will soon be moved to the remodeled space exhibit, see below.

A thorough exploration of the T. A. Wilson Great Gallery could take most of one day. Here we see the Lockheed M-21 Blackbird (fastest plane) and the Gossamer Albatross (man powered & probably the slowest) among many others.  

This Boeing Model 40-B was one of the more successful early air mail delivery models. 

Another look at the Great Gallery, this time from the east end. Lots of planes. I could have spent one whole day just in this gallery.

Inside the NASA Full Fuselage Trainer (FFT). The FFT is a full-scale
 mockup of the space shuttle orbiter built and used at the Johnson Space
Center in the 1970's to train astronauts.

As you can see the FFT doesn't have wings. It was used to train astronauts for duties and procedures inside the orbiter. We will need to return to this area in the future to visit the new exhibit: The Space: Exploring the New Frontier, which have the rest of the Museum's space hardware on display.

Across East Marginal Way to the south is the newest addition to the museum, this covered but open-walled building houses a Boeing 747, a Concord, a B-29 and many other aircraft. Self-guided walk throughs are available for several of these aircraft.

This Huey was delivered to the Army in Vietnam in 1970 and was used in various other roles until retired in in 1994 and obtained by the Museum from King County.

Here a frustrated fighter pilot (son Glenn) tries out the cockpit.

Ikuko and I paused for a photo op just before heading over the sky bridge to the new
part of the museum.

As I've mentioned, we (at least I) could have spent much more time visiting this museum. The McCaw Personal Courage Wing has two floors, the upper floor features WWI aircraft and below are the exhibits of WWII planes. Another wing worthy of more time.

The Boeing Red Barn, original manufacturing facility, was barged up the Duwamish, restored in 1983 and became the first of the permanent exhibits. I could spend several more hours admiring the exposed wooden framing and static exhibits in this building. 

I'll keep an eye on the news for the opening of the remodeled Space Exhibit, then I'll schedule another visit. Meanwhile, if you haven't visited this museum, I heartily recommend you take the time to see some original history of Seattle in a grand venue.

Give Blood - Save a Life

When I first donated blood, it was not long after I enlisted in the Army in 1959. One day the Drill Sergeant said, "You men volunteered to give blood. Corporal, march them down to the Red Cross." And that was the first time I gave blood.

Since that first time "volunteering" I have given blood off and on, depending on where in the world I happened to be. While stationed overseas, there might be the occasional blood drive but there wasn't a regular program that encouraged giving such as there is at BloodWorksNW here in Seattle.

Even in the days before the prevalence of HIV and other blood-borne diseases, if I had been stationed or traveled through some tropical countries, no blood donations were allowed. There were other restrictions as well but even with those, I managed to donate over four gallons by the end of 1976.

In 1980, while stationed in Panama, I developed a duodenal ulcer. By the time I figured out there was something wrong and went to the hospital, I had lost enough blood that I immediately was given three units of platelets, getting a little back for a change.

After I retired from the Army in 1981, I regularly gave blood again but after a year or two, developed borderline anemia so was barred from donating for several years.Two or three years ago I wanted to resume donating but travel to Vietnam and Laos (see blog entries from June and july 2015) was disqualifying. Just last fall the mandatory waiting period elapsed so I could donate again. When I stopped in at BloodWorksNW one day and gave blood, I was surprised how much things had changed since the last time I donated in the early nineties.

Compared to how it used to work the new system is amazingly user friendly.

• You save time by making an appointment on line or by phone.
• The screening questionnaire is done quickly on a small electronic device.
• The hematocrit is a modern spun version so less blood is needed and it saves time.
• The reclining couch is more ergonomically designed and extremely comfortable.
• The actual blood draw is easier from beginning to end with modern crimping devices and even a covered needle extraction shroud.
• They have machinery on site to separate out various parts of blood such as platelets, plasma or coagulation factors and return the rest to your body.
• It seems the staffers and volunteers are friendlier and more efficient. Only the cookies, crackers and drinks are about the same. 

  

  Your blogger, hard at work, donating blood to save a life.

The appointment system is a real time saver for modern blood letting. Appointments are available on line or by phone and people with appointments receive faster service.  I was a walk-in last fall when I donated and fortunately they weren't busy so I didn't wait long. In November I made an appointment and I was in and out in about twenty-five minutes. Of course, I'm a fast bleeder so that also speeds things up.

Two weeks ago I had an appointment but changed it at the last minute so I could go in earlier. That was a mistake since I waited about 90 minutes after the screening to take my turn on the bleeding couch. While waiting I talked with the receptionist who let me in on a couple secrets: Mornings aren't as busy as afternoons. If you must drop by in the afternoon do it about an hour before scheduled closing time. Follow those suggestions and chances are you can just walk in without an appointment and still get fast service.

I understand that, for various reasons, many people can't donate blood. But if you can, follow my lead, stop by your friendly Blood Center and give a pint to save a life.