Tuesday, December 7, 2010

What he brought home from Vietnam

Working in ICU, I seem to always be seeing and learning new things. Who would have thought I would ever take care of a patient with Tetanus (Lock-Jaw), a disease that has been pretty much eradicated in our country? Now I have cared for another patient with something I never thought I would see in my lifetime: Hansen's Disease (Leprosy). I did not even know what Hansen's Disease was, so I asked the nurse giving me report, "What the heck is that?". He had cared for the patient 12 hours without even asking that question. We googled it on our iPhones (management has taken away our internet use and we don't have any "books" on the units), and were amazed to find that Leprosy is now called Hansen's disease because so dude discovered the bactrium rods that prove the diagnosis.

Hansen's disease can be treated, but not really cured. It is simular to Tuberculosis and the medications are almost the same. Apparently there are thousands of cases here in the United States every year. The Armadillo is a carrier of the bacteria (another good reason to run from the scaly armored digging machine). Usually Leprosy is contracted in another country, a 3rd world country, where the sanitation is not good and the water is not clean. In this man's case he contracted the disease in Vietnam while serving in the military, judging from his age, it was probably his 3rd or 4th tour of duty. The article I downloaded stated that the incubation period could be up to 30 years.

This man had documented treatment at least 3 years ago. Apparently he was not following up with the VA or his family physician. He had gotten neuropathy to the point that he could no longer walk. He lived alone, his family all lived far away, and no body took care of him. No one, at all....apparently even knew what his diagnosis was or how sick he actually was....no one. With the stigma that this bibical disease has, I would venture to guess he didn't talk about it much.

Finally one of his children traveled to see him, and seeing the condition he was in decided to stay to take care of him, but his father refused to let him take him to the doctor (maybe a little dementia setting in here). The son, who had no medical training, tried to care for his father to the best of his abilities, but he was already so debilitated and covered in decubitus ulcers (bedsores) that the care he needed was beyond his skills. His father began having difficulty breathing and was brought to the hospital by ambulance.

Now he is recieving end of life care and will probably go home with hospice. I am puzzled that any ex-military, who should have been recieving military benifits and medical care, could have gotten to be in such poor condition...in this country with all the medical advances we have. I would think that there would be a Social Worker who would follow up when patient's with chronic conditions just stopped showing up for their appointments. I would think they would at least contact them by phone to be sure they were still alive. I know that patients are in part responsible for their own health, but sometimes, just one person going out of their way can make a big difference.

The physical manisfastations of this disease was horrible, the neglect of someone who served our country so nobely....criminal.


Aleta said...

This is so incredibly sad. You're right - for someone who served our country - this never should have happened to him.

I didn't know it was called Hansen's Disease either...

And didn't know that about Armadillos - ok, Learn something new every day.

GingerJar said...

Really a sad situation. I think sometimes they rename stuff to make it more politically correct: like "swine flue" "H2N1".