January 31, 2008
I want you to be able to see some of the attitudes with which this Campaign routinely deals. I encourage you to share your feelings, whatever they may be, with this blog site.
I wrote the following response yesterday; the writer of the blog “declined” to print my response. Here it is:
I am shocked to read this op-ed blog on the use of brain activity monitors. I notice that the "principals" do not cite the studies upon which they have quoted stats and prices. Doctors, let me assure you that the "cost" of having anesthesia awareness-induced PTSD is "an emotional cripple for life." (Peter Sebel, MD., Emory University).
As for the $4000 per surgery figure, your lack of research is proven, without question! A brain activity monitor costs between $4,000-$9000, and is a durable piece of equipment offering information about patient safety not available elsewhere. In the case of one manufacturer (I don't have quotes for all manufacturers -- and I am NOT paid b y anyone!), the disposable sensors cost between $12 and $21 -- a small price to pay for any possible prevention of a life-changing and debilitating medical disaster. I don't know how hospitals using brain activity monitors charge their patients for this, but if the same pricing policies of, for instance, several dollars for an aspirin, are followed, there is little concern on my part that the cost of the strips is not covered and then some.
True, to be most effective, monitors should be available in every OR, so there is some initial output of funds for this patient-safety equipment. Few, including possibly you, realize that the gurney you lie on is $25,000 or more; the laser eye correction machine is multiple hundreds of thousands of dollars with additional costs in the tens of thousands every time the equipment is used. I won't even mention the cost of CAT or MRI machines.
The question remains -- your errors in pricing aside -- what is the emotional and traumatic health of even one human being worth? I wish I could let you speak with the almost 4,000 patients with ruined lives with whom I have spoken.
I had general anesthesia surgery last week -- the second in the ten years since my own awareness experience -- and as I continue to sleep in a recliner to avoid the trigger of being in a supine position; as I (and others) suffer the never-ending traumatic triggers that prevent me from being in crowds, sleeping more than 1-2 hours without waking, having exaggerated startle responses, avoiding doctors as much as possible, feeling a need to be in control because of the paralysis I experienced during surgery, and many other sequelae -- I know how smart I was to refuse surgery in a hospital that doesn't have brain activity monitors -- and have nothing but praise for a surgical team who learned about and reacted appropriately to an anesthesia awareness victim.
I suggest you read the JCAHO Sentinel Event Alert #32.
And I certainly hope you will distinguish between the cost of buying one permanent brain activity monitor for long-term use and erroneously considering such equipment something that will break the back of healthcare.
Upon being informed this morning, January 31, that the above response had not been published, I submitted the following, which may or may no stay on the site.
1. Good morning, Doctor. You have certainly started my day off on a note of unfairness in your refusal to publish my comment to your blog. I think it cowardly of you to ask for comments; refuse to publish valid ones — written by the person whose website you dispute. My comment to you addressed a very serious and simply wrong financial claim about the cost of using brain activity monitors. Your response to my unpublished reply to you fails to mention any comment about your spurious claims that use of brain activity monitors will add $4,000 to the cost of every surgery. This is simply wrong!
You say, “I have previously corresponded with a physician representing himself as her agent.” Sir, I have no agent. I belong to no person and to no company. I demand to know who you claim is “my agent.”
Are you afraid to say that you misstated the cost of brain activity monitoring in a single surgery? I’ve had my own surgery a week ago. I have not seen my bill yet., and an inquiry to the hospital revealed that my bill would not yet have been completed.
Where did you get the quote that awareness occurs 1:100 surgeries?? Not from me! The literature states 1-2 per 1,000. You fail to mention that when 21 million general anesthesia surgeries are performed in the US annually, that the 1-2 per thousand (get it right!) amounts to 20,000-40,000 cases of awareness per year in the US alone.
I request you publish my comments of yesterday, exactly as given to you. I demand to have you substantiate who you claim is “my agent.” You may call me at 703-437-7327. At least I give my readers a way to reach me directly, and I respond to them in person with the e-mail address provided rather than speak only through my website.
Let’s put both sides of the discussion out there for the public.
If we are to ever effect change, be taken seriously, and receive patient-safety oriented healthcare for ourselves and our neighbors, we must not let such misinformation and personal attacks go unanswered. I urge you to respond.
As always,
Carol