Tuesday, May 31, 2011

seven words I never want to hear

"Mom, I want to be a doctor."

Vet, OK. But no doctor. Not unless the medical profession and its operating practices change a lot in the next 10-15 years. I've had to witness some of the most calloused, jaundiced behavior from docs over the past few weeks that have both shocked and soured me to the entire profession.

Last week my mom's doctor's office called on a Friday, late afternoon, to say that something showed up on a routine scan — a thyroid nodule. She would need to get a thyroid scan now. And we should probably make an appointment to see an endocrinologist. That seemed more than a little preemptive to me.

Well, in case it's something.
But she hasn't even had the scan yet. How big was the nodule?
Doesn't say.
You got a report from a doctor's office that they say there is a nodule, but they didn't measure it? And you want me to make an appointment with yet another doctor without any results?

I was not in an immediate panic about this nodule because I had gone through something similar two years ago. Apparently thyroid nodules are very common and usually nothing. Not to say we won't get the scan, but why are they calling us on a Friday, when nothing can be done until Monday anyway except worry about it? Because the doctor wanted to check something off her list. Because she basically doesn't give a shit. That is the state of medicine today. Refer to a multitude of specialists, don't practice compassion, forget that you are dealing with humans, just check, check, check, get the check in the mail and cover your ass.

As if that wasn't enough, this week, at another visit, with a different doctor, one of her specialists, where it was suggested that we switch out one of her medicines for another to see if that might get some better results. We started the new medication and within two days she was having a very extreme, adverse reaction of severe nausea (One of the side effects on the bottle where it says "Call your doctor if ...") I called the doctor's office, saying that I thought we should probably switch back to her original medicine. Her regular, prescribing doctor wasn't in, but another doc on staff OK'd it and suggested that I phase back in to her previous medication at just half a tablet, as that would help avoid any serious side effects. Hmmm. Why hadn't her doctor suggest we phase in the NEW medicine at a half dose? Maybe she wouldn't have had to go through this at all.

Once the nausea abated, she started having severe back pain. I did some online research and one of the uncommon side effects of the medicine is joint and back pian. Her back is a weak area anyway, as she injured it years ago and it's sore from time to time, with arthritis and mild osteo. After a day of suffering with that and Tylenol Arthritis not being effective, I called the doctor again. First, to let him know what was going on, and second, to see if we could get something a little stronger for the back pain, as she had been essentially bed-ridden for the majority of the day since this whole debacle started. My first call to the office was at 9am. No living person ever answers the phone, you need to leave a message and they call back.

His assistant called me back and told me the doctor usually returned calls by the end of the day. Fine. But how about a pain prescription to help her out in the mean time? Surely they could pass him a note and he could write a quick scrip? They shuttled me to the prescription line. That made me nervous, so I called again and said that I would still like a chance to speak with the doctor, even at the end of the day, as this all seemed a cause and effect of switching medications.

I got a call back at 3:15pm from the woman who handles prescriptions for the office who had no idea what my original message was. I went over it all again and she said she'd ask the doctor. At 3:45 I called back and left my cell number, as I had to pick up my daughter. I actually got through to her and she said not to worry, she'd call me back as soon as she called something in. At 4:45 I called back when we got home from school and got the office answering service. I had to argue with that person that this wasn't just a prescription refill — she suggested I just call the pharmacy. I told her that I needed to speak to my mom's doctor. The on-call doctor called me back around 5:10 and suggested I take her to the emergency room. Jesus. I stood firm until he finally said he'd call in a pain medication. I was able to pick it up at the pharmacy 45 minutes later and she got her first dose at 7p.m.

Her original doctor never called us back. Did he get my multiple messages? Does he just not care? At the beginning of this week, after our office visit where the medication switch was suggested, when we were leaving his office, my mom said to me, "I'm never going back." I had pooh-poohed that at the time as she hates going to the doctor. But you know, now I feel differently. We are never going back to his office, that's for sure. And when I speak to her regular doctor, I am going to mention that. And that I wish her office would hold all calls, unless they are good results, until a Monday. How about good practice and good medicine?
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