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Thursday, July 18, 2013

The Accreditation of Wexford -- June 29, 2013

Wexford, the health care provider for the IDOC, is attempting to gain accreditation. The approval of whom and how this is being overseen is uncertain to me. What is certain is that nurses are following some redundant and stupid rules which have greatly annoyed me over the past couple of weeks. It seems procedure and appearances matter more  than the quality of health care. Although I have noticed some improvements this year, many men continue to be denied or delayed treatment for serious medical problems.

Last month a nurse passing out medications during the evening brought me Gabapentin. When I saw the two large capsules, I asked her what they were for. I was told there is a new policy and the medication can no longer be kept by prisoners in their cells. It must be delivered to them and taken on the spot. I said, "In that case, I do not want it," and gave her back the pills. She asked me if I had any in my cell because she had to confiscate them. I told her I did not. This was a lie, however, I was not going to cease taking the medication abruptly nor was I going to give her pills I had been prescribed by the doctor to help with my back pain.

Gabapentin is the generic drug for Neurontin. Its initial use was to help people with seizures, but it was discovered it also had the benefit of helping those with nerve damage. The two injured disks in my spine have crushed some nerves leading outward and I suffer with sciatic pain. Gabapentin helps reduce this pain, however, it has bad side effects. The medication causes drowsiness and disorientation. Because of this, I have never taken the full dose prescribed me and I am very particular when I take it. I will only take it before going to sleep or when I plan to take a mid-day nap.

Medications are not passed out at the same time every day. In the evening, I can be given pills anywhere from 6 to 11 p.m. In the mornings, medications can be brought from 8 a.m. until noon, but typically nurses come very early on the first shift. Usually mornings are my busiest time of the day. It is when I will exercise, write, and read. After awaking, I do not want to be made sleepy, lose my concentration, or have my reflexes dulled. Gabapentin has very little benefit for me and is definitely not worth having my routine disrupted by the side effects. Because the drug affects the neurons, I know it cannot be stopped suddenly. There is even a warning I have read from an Internet pharmaceutical website not to do so. I take a small dose, but slowly tapered off my use and now I do not take any. The remaining pills I had were thrown away.

Despite telling the first nurse I did not want to take the medication under those circumstances, nurses continue to bring it to me twice a day. Every time I will refuse it. Most nurses just continue to do their rounds, but a couple have inquired. I explained to them why and they said they understood my dilemma. A guard escorting one of the nurses also spoke about how he takes allergy medications and those have similar effects. He also would not want to be forced to take the pills at times not convenient for him. The nurse explained though, that their administrators have told them to cease giving prisoners bubble packets of Gabapentin and pass them out instead.

After repeatedly telling one nurse I did not want the medication, she said she was obligated to continue asking me until a doctor changed my chart. I am regularly preoccupied when she stops by my cell bars in the morning and she apologized for being disruptive. On one occasion she asked if she was annoying me and I thought it was kind of her to be concerned about my feelings. Typically, I am very aggravated by disruptions and I am very nonsocial, particularly in the morning. However, I told her she was not upsetting and she can continue to greet me despite how I will never change my mind about the Gabapentin. She has pretty blue eyes and those were worth being distracted for.

Other nurses have not been so friendly and one who formerly worked at Dwight C.C. told me they never allowed the women there to have the medications in their cells. She was critical of Stateville's former policy, and said she believes all the penitentiaries in Illinois pass out Gabapentin. In the last few months, there has been a large influx of staff from Dwight and juvenile detention centers which were closed. I get the impression that these new people are bringing their own policies with them to be adopted here. Unfortunate that they only seem to bring new security measures, rules, and regulations rather than all the nicer qualities of where they came from. At Dwight, the women were treated much better and had much better living conditions. It was a stark contrast to the environment at Stateville from what I am told.

Yet another nurse from Dwight expressed disagreement with Stateville policy when she saw that I was prescribed Klonopin. She told me at Dwight prisoners never were dispensed the drug unless they came to the health care unit. She was even hesitant to give me the packet of pills until I took it from her hand and told her she was not in Dwight anymore. The only men who must go to the H.C.U. for medications are those taking narcotics such as Tylenol #3 or Norco. I have been receiving Klonopin for years since I came to this miserable place and it has always been delivered to my cell. For my back pain I have been offered pain relievers with codeine, but I have refused. I do not need the additional aggravation and stress of going back and forth to the prison hospital. The reason I am prescribed Klonopin is mainly to relieve the tremendous amount of anxiety I experience.

I expressed my disappointment that I was no longer trusted to keep Gabapentin in my cell to my cellmate. He asked why I cared since I rarely took it anyway and throw out most of the bubble pack of pills. I said it was the principle of the matter. What if I did use the entire dose twice a day? Then I would be forced to take the medication at various inconsistent times and it would disrupt my schedule. Furthermore, they may begin to force me to go the H.C.U. for the medicines I take every evening.

My cellmate was curious about the side effects of Gabapentin and asked what would happen if I took 20 or even 50 of the pills. I said I didn't know. I have never taken more than the prescribed dose. I speculated it would make you feel extremely disorientated, dizzy and one would be unable to think. A person may stare at the wall and drool on themselves until they fell asleep. What kind of retard would want to experience that? Then we both said at the same time, "Lunchbox," a man who once huffed various toxic chemicals for a high. There are a lot of idiots and drug abusers in prison. Regardless, I commented, "I am not Lunchbox and they can limit prisoners to a week's worth of the drug."

I knew the new policy on Gabapentin was just the beginning and I was correct in my assumption. On the first of the month, nurses began to ask all prisoners who are brought medications for their ID card and to have water with them. The ID card is to make sure the nurse passing out the pills is giving them to the correct person. The water is so prisoners will swallow the medications in their presence. Both are stupid rules and only serve to delay nurses rounds and annoy prisoners.

On the evening of June 1st, I was eating a snack and watching "The Empire Strikes Back" when the nurse came to my bars with my medications. I know nurses are in a hurry to pass out all the packets of pills they have to hundreds of prisoners and I quickly got up off my bunk to come to the bars. I also moved quickly because this was one of my favorite scenes in the movie where Luke Skywalker faces off against Darth Vader and is told his nemesis is in fact his father. The nurse, however, wanted to see my prison ID card and for me to bring a cup of water to the bars. This nurse knows who I am from bringing my meds numerous times before and even engages me in small talk on occasion. I asked her why she needed to see my card. Did she forget who I was? She told me it was a new policy and Wexford was trying to gain accreditation.

Asking a prisoner whose identity you already know for his identification card was idiotic. I was about to ask the nurse if she was Polish, which I knew she was, but a lieutenant was hovering over her. He chimed in saying this was the new policy and all inmates had to follow the procedure. I was not going to argue or joke about the stupidity of the rule with the lieutenant and went looking for my ID card. After showing the nurse my card, I then went to the sink to fill up my water bottle so I could take the pills in their presence. Needless to say, I missed Darth Vader say, "Luke, I am your father".

The following day I asked a prisoner who is given an allergy medication which is sold over the counter if he was also asked to show his ID card. He told me he was and agreed with me it was a dumb and redundant policy. If a nurse knows who you are, there is no point having you prove your identity. Furthermore, what great harm would it cause if a nurse gave medications to the wrong person? What prisoner would want someone else's medications and pretend to be someone they are not? Finally, if a nurse was not sure of the prisoner's identity despite the envelope being marked with the cell number, she could simply then ask for his identification number. As for the water, this in no way proves a prisoner takes his medication immediately. A prisoner can simply gum the pill while swallowing the water. Nurses do not ask men to open up their mouths and peel their lips up or down or pull the sides of their mouths outward. The prisoner I spoke with speculated the new policy will only last for a short time. The formality was simply for appearances and made no sense like a lot of the policies here.

My cellmate wanted to know who Wexford was trying to gain accreditation from. I have not bothered to ask any of the nurses. It was clear no one was overseeing that the policy was implemented. The declaration that Wexford nurses were asking for IDs and for prisoners to take water to the bars with them was proof enough. Regularly, watchdog groups will simply take the word of prison officials or medical supervisors.

Earlier this week, a different nurse brought my medications during the evening. She also knows me very well and greeted me by name. However, when I put my hand out the bars, she asked me for my ID card. I asked, "Now what is the point of verifying who I am if you already know?" She said there were eyes and ears watching and eavesdropping. As I glanced to the left and right on the gallery, I asked "Where are those eyes and ears?"  No one was around and I asked if she was concerned about me. Some nurses are aware I have a blog. However, the nurse did not have me in mind and simply had a general opinion that word would get around if she did not follow the asinine protocols.

Fortunately, not all the nurses are paranoid automatons, and on one occasion when I was busy, one stopped by my bars. I asked if she also wanted to see my ID card. She said, "What for? I know who you are." Finally, a woman with some common sense. She went on to say the new nurses must be asking for ID but she has been here a long time. After she left, I complimented her attitude to my cellmate who had previously argued that policy had to be universally applied. I told him only a person without any independent thought would apply all the numerous, redundant and stupid rules of the Illinois Department of Corrections.

Generally, I will see two mental health care doctors a month, or every other month. The psychiatrist is basically just interested in how the medications I am given are working, and the psychologist simply wants to monitor my state of mind. Neither have any expertise treating or helping those with autism and are not very helpful. The last time I saw the psychologist, she gave me a very rudimentary anxiety management and social etiquette workbook made by Wexford. They seemed to have been written for children and I thought she should have also given me a set of thick crayons to go with it. Ironic how much Wexford is concerned with ID verification and convicts possibly abusing their medications rather than on giving quality treatment or care.

Stateville has more nurses since the closure of Dwight C.C., however, the extra staff is mainly being used for more superfluous security or protocol. Furthermore, although there are more nurses, no additional doctors have been hired. In fact, to my knowledge, the only full time doctor at the prison is the Medical Director. Dr. Obaisi seems intelligent and competent, but he cannot tend to the needs of nearly 2,000 men. Prisoners often complain about the delay in medical appointments or not receiving any treatment at all. I also regularly hear about how poor the health care is and how some medical personnel are incompetent. All of this I can relate to because I have experienced the same. I am certain many readers could care less if convicted murderers receive proper or even perfunctory medical care. However, it is absurd Wexford is seeking accreditation based on some stupid and redundant procedures rather than what should be the focus and primary concern of their business. The State of Illinois has health care providers bid for contracts with the DOC and the lowest bidder wins. Apparently, the saying "You get what you pay for" is true.


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