Friday, January 23, 2015

Progress in America: (9) A Non-Cancer Diary? Part I

    These next 4 entries constitute a diary of errors.  Doctor errors.  Patient errors.  System errors.  A fantastical tale of medical slippages.  And here’s the spoiler alert - it comes with a happy ending.  I apologize but this twisted tale requires multiple entries to the blog.  (To not embarrass any of the doctors central to this story, I refer to them by a fictitious first name only.) 

Hint of a Problem

    Last year, I spent a wild last weekend in June with 3 young grandchildren.  Roughhousing.  As I dared them with a most threatening growl, they jumped on me.  Lack of judgement?  Not advisable for an old man?  A man quite out of shape.  After arriving home, I found that I could not sit up in bed.  I had, what was most surely, a pulled abdominal muscle.

    Wife said, “Get thee to a doctor.  Check it out.” 

    Dutifully, I made an appointment at my bone doc, Jim.  I always see him for my self inflicted wounds.  But Jim was on vacation till after the fourth, and my wife was insistent.  I went to my good family doctor, Lisa. 

    There I complained of a pulled muscle.  I explained that my wife didn’t want me to wait till Monday to see a doctor.  So she checked my abdomen.  Immediately, she found the bad muscle.   But not finished she continued.  Feeling, pushing, prodding around my middle, she asked over and over “Does this hurt?”

     “No, nothing.”  “No.”  “Nope.” 

   But eventually she hit a spot.

   “Yes,” I responded.  She was pressing somewhere above my right hip. 

   “How much on a scale of 0-10 would you say this hurts?” asked the good Doctor Lisa.

   “Almost not at all.  I mean, maybe = .5.”

   “Have you felt it before?”

   “Yeah, but only when I either have to pee or crap and usually only at night.  That’s not why I came in.” 

    “You know, I think we need a CT scan.  Just to find out what this is.”

    This sounded absurd.  Had my good doctor Lisa joined the great medical-industrial complex?  I said something like ‘overkill’ and ‘can’t I just go to my orthopedic guy’ - but she insisted. 

    “Here’s an order for a CT scan.  Go to the lab downstairs.  Then come back up.  Let’s see what the scan says.”

    Down, scanned.  Back upstairs.  I knew I would be told nothing was wrong.

    After a wait, I got back into the doctor. 

    “Well, Joe, they found a fuzzy unclear patch in your lower right pelvic area.  They want an MRI to clarify what it is.”

    “But I just have a pulled muscle.”

    “I know, but you know these radiologists, they always ask for more tests.”

    “We have vacation plans.  We’re off to Iceland and Denmark in a few days.  I don’t want to start a series of tests now.”

    She seemed to give in, “OK - take the results to your orthopedic guy and ask him what he thinks and get back to me.  When is your appointment?” 

    Monday, the 7th, I went to see Dr.  Jim.  He felt around.  “Pulled muscle for sure.  What the hell did you do, Joe?”

    “The kids ...”

    “You have to let this heal.  Then start doing crunches.”   I got back to Dr. Lisa.

    “Did you show him the CT scan.”

    “No, he didn’t need to see it: he could tell it was a pulled muscle.”  Lisa said we’d talk about it after vacation when I had to come in for a full checkup.  That seemed weird: I didn’t think I needed a checkup till January or so.

    And with this, it was over.  Right?  Went on vacation.  Came back.  Settled into life.  Almost nothing to do.  Everything on track until the end of August.  Two phone calls interrupted my paradise. 

    First, out of the blue, I received a message from my urologist, Benny.  I needed to make an appointment for my occasional check up for my very non-aggressive prostate cancer.  First do a PSA test.  Then Doctor Lisa interrupted my pleasant trip to nowhere, “Need an appointment for my check up.”  (I still thought this should be in January.  Nope, the Doc wants to see you now!) 

    September 23rd I’m there but I do not really get a check up at all.  Rather, “Here’s a chit for an MRI, I want to check on that fuzzy spot.  It’s probably nothing but a bone island but it’s blurry.  We need to know what it is.”

    Not really understanding why, I scheduled the MRI for 10/6.  I would soon find out.  Of course, the MRI showed a similar bone island.  Doctor Lisa told me so.  What she didn’t say was that unknown to me, the radiologist who read the CT scan in July reported a possibility of metastasized material.  Also unknown to me, this was more shrilly seconded by the Doc who read the MRI.  She called it likely metastasized. 

    Thus things took off – rather quickly.  Already some problems were showing:  What should Dr.  Lisa have done?  What should I have done? 

    Lesson 1 for the doc: Keep the patient fully informed as to what is going on. 

    Hint 1 for the patient: Always ask for full information as to what is going on.  Make sure you get the full reports for the tests you have had, such as CT and MRI scans.
(to be continued)

No comments:

Post a Comment