Wrecked Valve

[Guest]

I had a call from a doc today about 23 year old gang banger that I have known since he was 14. (That was the age when he beat up his mother and left home.) Just before that he had his mitral valve replaced. He has claimed the he hates needles but I have seen him with cigarette burns on his arms from contests to see who could go the longest without screaming. He has probably missed 10 appointments for every one that he kept. Sometimes he comes in after a 6 month absence and has an INR of >8 because he wanted to prove that he was taking warfarin, so he would take a handful the night before his appointment. I kept telling him that he was going to wreck his valve or be paralyzed from a stroke. But I guess when you are 15 and about 6'4" and weight about 400 pounds and are the meanest (fill in your own adjectives) you figure that it can't happen to you. So the doc confirmed what I told him; a teensy, weensy little clot on his valve has caused it to bend and now the taxpayers are going to foot the bill for a second valve replacement. The young guys always think that I don't know what I am talking about.

 

[dkapuscik]

I guess that the invincibility of youth will never change. The sad thing is that todays youth are more violent and seem to have no hope. It is a disappointing vision of our future. And yes we will continue to pay the price through the failed programs that prove throwing money at a problem wont fix things. Worst, you are forced into a position that leaves few options.

 

[geebee]

Al,
They know you know what you are talking about - they just don't care. They know there will always be government agencies that will take care of them and even bury them once they blow it completely. It is certainly sad that money is wasted on people who do not understand or appreciate how great life is.

 

[Kate]

Al,
Having worked with low-income people for most of my career, I know how frustrating it can be to see an individual repeatedly making bad choices. However, in my experience, this young man is the exception rather than the rule. Most poor people - even young men - are just trying to get by like the rest of us, but with the added burden of inadequate schools, poorly-paid jobs and substandard medical care. For all the Christian sentiments expressed on this website, I'm a little disappointed to hear such a blanket condemnation of the poor. But, as Jesus so accurately put it, it's easier to pass a camel through the eye of a needle... Kate

 

[Guest]

I lived six years on the Navajo Reservation so I have not only worked with but lived among the poorest of the poor.

I am always reminded of the words of Ross Swimmer, a former Principal Chief of The Cherokee Nation who said, it is not in our best short-term interest to do well.

He was saying that it it is easier to get grant money than to find a sustainable way of making a living.

 

[Dennis S]

Huh?

Huh?

Al,
Having worked with low-income people for most of my career, I know how frustrating it can be to see an individual repeatedly making bad choices. However, in my experience, this young man is the exception rather than the rule. Most poor people - even young men - are just trying to get by like the rest of us, but with the added burden of inadequate schools, poorly-paid jobs and substandard medical care. For all the Christian sentiments expressed on this website, I'm a little disappointed to hear such a blanket condemnation of the poor. But, as Jesus so accurately put it, it's easier to pass a camel through the eye of a needle... Kate

Maybe you should review the posts that preceeded yours. I think the folly referred to in these posts is the folly of youth. I think you have taken offense where none exists. In my opinion it is people who care (about the poor and others) who are the most frustrated when they see an individual toss away something so precious as life.

 

[Lynlw]

I lived six years on the Navajo Reservation so I have not only worked with but lived among the poorest of the poor.

I am always reminded of the words of Ross Swimmer, a former Principal Chief of The Cherokee Nation who said, it is not in our best short-term interest to do well.

He was saying that it it is easier to get grant money than to find a sustainable way of making a living.

I was just curious if they thought about replacing it w/ a tissue, i know it will wear out faster in the long run, but if he won't take his meds or show up for coum clinic, a new mech probably won't last that long either.
It is very sad and i feel bad for his mother, Lyn

 

[geebee]

I see no condemnation of the poor in this thread only comments on the money that is wasted on people that just don't care.

 

[Nan]

So sad, I hope that at least he does get a biological valve if he isn't going to take the coumadin as needed. Sad for him, his family and our society.

I have to add my 2 cents here having been a social worker in the "system" for most of my adult life. A kid like that is most likely (but not always!) the product of a terribly dysfunctional family and unless he gets hold of himself, will most likely end up in jail or worse. It's all complicated by that adolescent "it can't /won't happen to me" thinking. Several studies have shown that the adolescent brain is not yet physically developed and in boys in particular emotional and possibly violent reaction to events is not out of the question.

With any luck this need for a repeat surgery will be a life changing event for him. We can hope.

But for every kid like him, there are so many more that are involved with 4-h, scouting, clubs, working,and helping others in their community that are not usually even known about. Kids from all backgrounds, ethnicities and "classes" both wealthy and not so wealthy.

They are our future and will do well!

 

[Guest]

Just got word of a different 25-year-old male who had to have his valve replaced because he didn't believe me. Due to be discharged from the hospital tomorrow.

The first guy we saw this morning wrecked his first one nine years ago. He was telling my student about it today. "Better to take the pills than get cut open or shocked."

 

[Marty]

At the same time I hear all these horror stories about our youth I see every day a generation of medical students and premeds who are the hardest working, most altruistic group I have ever seen. They are so much better than my generation that came up in the 30's, 40's, and 50's. All is not lost. They will take care of( probably gratis) and pay the taxes for Al's patients.

 

[Guest]

I agree Marty. The people are much better trained today than we were.

Our hospital's largest budget expense item is bad debts. We write off more care than we take in from private insurance.

We take in more from Medicaid than we do from private insurance.