Paul

We saw a patient at the clinic last week. He had dysphagia – a fancy word for difficulty swallowing. He was unable to keep any food down, was losing weight, and had a history of diabetes and high cholesterol. It was his first time at the clinic. He reported not taking his medications for about two weeks due to not being able to keep them down. He was living on fluids, at least the ones that he could keep down.

The PA who saw him was concerned that he might have cancer. I marvel at their instincts and knowledge – with the little we have to go on here.

So, he ordered an x-ray and an EGD or an esophagogastroduodenoscopy, which is a common procedure used to screen the upper digestive tract for growths or foreign bodies. It is performed by inserting a bendable tube that acts like a camera into the throat to look at the esophagus, stomach, and small intestine. Upper digestive tract problems that can be found through this procedure include gastro-esophageal reflux disease, peptic ulcers, and abnormal growths.

This is not a test that is typical of services provided by a free clinic. Fortunately for us, one of the local doctors agreed to do this test for this gentleman. And, they found cancer.

He was admitted to the hospital because he was not able to keep any fluids down after the procedure. From there, he was transferred to a larger hospital for treatment. The plan is for him to have surgery after he goes through some radiation therapy. Currently, he is on a feeding tube to provide some nutrients.

Remember – he has no insurance. He should qualify for Medicaid – hopefully soon. He will be sent home on tube feedings, with home care coming in to assist him. At this point, it has been set up as “private pay.” He has a part-time job working 24 hours a week for $8/hour. And, when he doesn’t work, he doesn’t get paid.

He has no family in the area. He had difficulty getting transportation to the hospital for his EGD last week. In a rural area like this, transportation is a real challenge for people.

It overwhelms me to think about what he is facing – and I would have the resources to deal with these issues. He doesn’t, and, he is sick – really sick.

This is just another of a million reasons why people need health insurance. It would be one less thing for him to worry about…