November 11, 2003
Community Resources, Complications
Question from Baltic, Connecticut, USA:
My brother is waiting to get on dialysis but the VA wouldn’t take him until his kidney function was at 12 or 13%. They were going to insert a port in his other arm (first one had to be removed) to get him ready for dialysis, but his sugar reading was 635 mg/dl [35.2 mmol/L], and even though they were really concerned, they did not admit him to bring it down. Medicaid won’t kick in until he has had his first dialysis treatment at the VA and when there is an opening at the local hospital to do dialysis Medicaid will kick in. So he has been home and his sugar readings are over 500 mg/dl [27.8 mmol/L]. Shouldn’t he be in a hospital? Are we supposed to wait till he collapses before anyone will do something.?
Answer:
It sounds like your brother has hit the “insurance web” that many patients are experiencing in this era. I would definitely discuss this with his physicians and yes, in my opinion, given the situation, my colleagues and myself would admit your brother and improve his control and then place his access.
I would consider appealing to the VA directly, if not, seek other means of treatment. Your brother should not be without some treatment, and I would not wait until he collapses. The other alternative is to take him to an ER, not the VA, but a community hospital or academic center and have social services assist you and your family.
ABS
