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Misc. News : C.onsumer A.ffair Last Updated: Nov 12th, 2006 - 20:38:00


The Human Cry in New Orleans
By Amanda Gardner, HealthDay Reporter
Aug 28, 2006, 09:41

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Katrina survivors still staggered by mental-health problems

MONDAY, Aug. 28 (HealthDay News) -- It's a cruel paradox for Hurricane Katrina survivors that the dying are sometimes better off than the living.

Myneka Dyer, 24, was rescued by boat from knee-deep water in her home in the Gentilly area of still-devastated New Orleans after the storm struck last Aug. 29. She soon left for Houston with just her two small children, $20 and a few pills to ease the pain of the bone cancer she'd been diagnosed with five years before.

Reunited in Texas with her mother and other family, Dyer tried to replenish her supply of painkillers. But doctors in the emergency rooms of three hospitals repeatedly refused to give her medication, even though her physician back in New Orleans routinely prescribed her drugs such as Percocet and morphine.

"They thought I was an addict and wanted to put me in a methadone clinic," recalled Dyer, who lost all her medical records to the storm. "They called me a frequent flier, bouncing from hospital to hospital looking for pain drugs."

Even though Dyer had a chemotherapy port in her upper chest, that wasn't enough to convince the hospital doctors. So, she resorted to swallowing a bottle of Tylenol every other day. "My left side was hurting me to the point where I wanted to curl up and die," she said.

Dyer eventually returned briefly to New Orleans where doctors at Ochsner Health System confirmed she had bone cancer. She's back now in Houston, this time in a hospice program with her pain more or less under control. Doctors give her another three to six months to live.

"I have some days in pain, but I have my good days," she said.

Stories like Dyer's are often the rule, not the exception, in New Orleans, 2006. The health-care system is in shambles and mental health needs, in particular, aren't being met.

Anecdotal reports indicate the city's suicide rate has tripled, depression is widespread, and federal agencies estimate that 500,000 people are in need of mental-health care.

"All that is really directly related to the slow pace of recovery," said Dr. Janet Johnson, an associate professor of psychiatry at Tulane University School of Medicine in New Orleans. "People are still struggling with insurance and living in trailers and under very, very stressful conditions. We've really got a crisis going on."

"People are having problems with depression and anxiety, and a fair number are also having PTSD [post-traumatic stress disorder]," added Dr. Richard Weisler, an adjunct professor of psychiatry at the University of North Carolina at Chapel Hill. "The depression and anxiety can be quite profound, so that a lot of people appear to be reaching levels of major depression."

Weisler, who's also an adjunct associate professor of psychiatry at Duke University Medical Center, recently co-authored a report in the Journal of the American Medical Association that examined the mental-health system in New Orleans.

Weisler's article, which he co-wrote with colleagues at Louisiana State University, estimated that only 140 of 617 primary-care physicians have returned to practice in New Orleans. And only 22 of the pre-Katrina total of 196 psychiatrists continue to practice in New Orleans, while the number of psychiatric hospital beds has been sharply reduced. As of June 14, there were only two psychiatric beds within a 25-mile radius of the city, he wrote.

Said Johnson: "We have very few resources in the city, primarily because we have a real shortage of both providers and psychiatric beds."

According to Weisler, some patients are spending their entire hospital stay, whatever the health problem, in the emergency room because there aren't enough beds. And the Times-Picayune newspaper recently reported that an influx of acute psychiatric patients at one hospital was causing waits of 24 hours or more for patients with minor emergencies. Meanwhile, psychiatric patients often have to wait several days to be admitted.

The Stafford Act authorizes federal money for short-term help for victims of disasters, and it specifically excludes people with substance-abuse problems, developmental disabilities or any preexisting mental conditions. "Who is going to need the help the most?" Weisler asked, referring to people already struggling with emotional problems.

Churches and non-governmental organizations are stepping up to the plate, but it's not enough to meet the overwhelming need.

The results have been catastrophic, in some cases. Some people have gone off medications and become psychotic. Others have had confrontations with the police; one man even tried to commit "suicide by cop" -- trying to get a police officer to shoot him dead, Johnson said.

Yvonne King, a 60-year-old native of New Orleans, could be considered lucky. She's getting free psychiatric treatment from Johnson, but even so, she has a rising stack of medical bills for lung and skin problems, and has trouble affording medication.

King lost everything to Katrina, including her job of 26 years in administration at Charity Hospital in New Orleans and her home in the 9th Ward.

Soon after the storm, when she had evacuated to her brother's house in Georgia, King was diagnosed with PTSD, depression and stress. She cried all the time, couldn't sleep and had flashback dreams about the flooding. She was on one antidepressant, but switched to another because her doctor could give her free samples. Still, she can't afford prescription sleeping pills, settling for Benadryl instead, because it makes her drowsy.

"My days are very depressed," King confided. "I find myself sitting, staring off into space a lot. I cry at the drop of a dime, and I've never been a weepy person. I don't know who this person is. This is so not me."

Now living in a spare room in her sister's house in Metairie, La., just north of New Orleans, King said she's evacuating if anything bigger than a category 3 hurricane approaches the city.

"I really don't think I could go through this again," she said.

More information

The U.S. Centers for Disease Control and Prevention has more on coping with disasters, including hurricanes Katrina and Rita.



SOURCES: Richard Weisler, M.D., adjunct professor of psychiatry, University of North Carolina at Chapel Hill, and adjunct associate professor of psychiatry, Duke University Medical Center, Durham, N.C.; Myneka Dyer; Janet Johnson, M.D., associate professor of psychiatry, Tulane University School of Medicine, New Orleans; Yvonne King; Aug. 18, 2006, The Times-Picayune; Aug. 2, 2006, Journal of the American Medical Association

Last Updated: Aug. 28, 2006

Copyright 2006 ScoutNews, LLC. All rights reserved.




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