Tuesday, September 3, 2013

Complications for My Healthcare

 Part 1

Jessica moved in approximately three weeks after my discharge from the hospital that second time. The combined trauma to both my body and my psyche from the three surgeries and all those side effects left me flattened more dramatically than I could comprehend. Even though I knew better than to expect the kind of recovery I'd had when I was 18 surviving a near fatal episode with appendicitis complicated by an extreme case of peritonitis that precipitated a 45 day stay in intensive care, I did think there were similarities for comparison so I could have some frame of reference. I knew my age would affect my recovery but I still expected to see some kind of improvement as the days went by.

Initially visits to the doctor were limited to trips to see the surgeon so he could monitor my condition and to my primary care physician so he could prescribe medications for me. Neither was concerned about the slow rate of my healing so I tried to be patient even though by now I was sick and tired of being sick and tired. I believed my attitude could affect my recovery so I tried to stay positive despite the fact I was dying to be able to spend time caring for my horses.

When I was still sleeping all the time because of the trauma to my body that was easier than it would be later when so much time had passed I had reason to believe I should be fully recovered but wasn't. Time may heal some wounds but it salts others. Jessica's behavior along with the others poured even more salt into them.

I remember the surgeon joking that I had "survived despite his best efforts to kill" me. At the time I thought it was just his odd sense of humor but as time has progressed, I have come to realize there were mistakes made that will probably haunt me the rest of my life. At this time, however, I was so grateful to be alive and assuming I would recover fully, I was not thinking of anything but getting better so I didn't see the implications of his remark.

What was most disturbing at this time were my pain levels. In between hospitalizations, the only predictable part of my condition seemed to be the amount of pain I experienced and that was off the charts, all the time.  When speaking about it to a close friend who is a medical professional, she had never known anyone to experience such protracted bouts of pain from surgery so that concerned me. The surgeon explained it away as low levels of body fat leaving me unprotected against internal stitches. He said once they dissolved, the pain would go away and he projected that could take up to 6 months. The time between my first and second hospitalizations was less than that so he didn't seemed concerned there was no improvement in my pain levels when I entered the hospital that second time.

After the third surgery the surgeon was still standing behind this explanation and who was I to know differently. The old stitches had been removed but new ones put in their place. That meant the time for them to dissolve was now reset to accommodate the new sutures. If these dissolved as slowly as the last, I was looking at a minimum of a full year living in excruciating pain so I tried not to think about it in this manner. It was just too overwhelming.

Because I knew I had extensive adhesions after my second surgery, I asked the surgeon about the possibilty my pain was due to adhesions returning but he was dismissive putting his finger up to his mouth to shush me. He said we needed to think positively implying talking about them would be bad. As far as he was concerned my pain was about those heavy duty internal stitches. 

These visits to the surgeon only continued until he was sure I was healing as he expected. Before I left his care I had asked for an estimate of how long I could expect my recovery to take. His answer had been sometime around a year.

While I wasn't happy about that prospect, at least it gave me a time frame.  I could hold on knowing there would be an end to this ordeal. Little did I know nothing about my case was typical. These projections would not apply to me.

I had talked with my primary care physician about the issues I was having with pain and the surgeon's explanation. This doctor was the first to suggest the stitches might not dissolve in the amount of time suggested by the surgeon. Instead he claimed he had seen stitches take much, much longer to go away and that I shouldn't be surprised to see stitches work their way out through my skin either individually or long pieces of material depending on what type of stitch was used.

All of this information was disconcerting but the conversation happened before my last visit with my surgeon so I questioned him about these possibilities. He denied the stitches would do anything except dissolve but he did agree sometimes it could take far longer for them to do so than what he first said.  This certainly changed the possibilities for resolution of my pain but I still believed there would be an end to it even if I didn't know when that would be.

Before I left the surgeon's care, he'd recommended my continued treatment might be more thorough and less complicated if I let my primary care physician order the tests needed to track my cancer's status instead of going to the oncologist. Because I wasn't getting radiation or chemotherapy, I didn't need to deal with one more doctor for tests that could be ordered and interpreted by my primary doc.  Since I would need him for normal routine care and prescriptions for pain medication, it made sense for him to order both the blood tests needed to track markers and yearly colonoscopies and the surgeon stated the fewer doctors I saw the less likely things would get screwed up.

I have gone to this primary care doctor for over twenty years. With a relationship that long there is a level of trust built that made the decision to leave the tracking of my disease to this man an easy one. It also made it easy for him to trust my input about my symptoms and pain. We were a good team and I was slowly improving while in his care.

Unfortunately not long after the first of the year, this doctor made the choice to leave his practice. Neither of us had seen this coming and there were a number of things that set these wheels in motion but it couldn't have been at a worst time for me. I was in a precarious situation and I needed this doctor who knew me and trusted me, as I trusted him, but it was not to be.

I believe the final straw for him had to do with the dramatic changes in the practice of medicine being dictated by insurance companies and the government. The resulting indifference to patient care over increasing profits made it difficult for him to practice medicine the way he believed it should be done.  While I understand his motivation his decision did leave me, and all of his patients, high and dry. We all got a couple of months warning before he left his practice but aside from that and a few months worth of pain scripts, that was it. I now had no doctor to manage my care.

It might seem like 3 months should be plenty of time to locate a new doctor but there is a shortage of doctors here. I am told the beaurocracy that caused my doctor to leave private practice has also deterred young people from pursuing careers in medicine leading to this problem and its not just here. Shortages of primary care physicians are sweeping the country. Finding a doctor taking new patients, let alone one taking Medicare or ongoing medical issues like mine, was a mess. At the time Jessica left here I had not yet found a physician who would take me as a patient.

When I did find a doctor who would take me, he was young and inexperienced so he did not see things the same way as my original doctor. That combination would prove to have severe consequences for me. As if that wasn't bad enough, I had two more people working at an opening to move in. Despite the ugliness of the ride with Jessica, the darkness here was not over. It was just time for new chapters to begin.

To be continued....

A New Player Enters.......


  1. My doctor is leaving his practice too. One Size Fits All does not work in medicine.

  2. What in the wide world? First off, it's difficult to imagine the pain you were/are in. I'm so sorry and wish there were words. Also, it's difficult to fathom WHO in the world else is going to take advantage. As always, I nervously anticipate the continuation of this story!

  3. Scary situation to have to find a new doctor. I do hope the new doc was helpful.

  4. the restucturing of our health care system has had the same impact over the years as well, now we have to "interview" with a prospective doc to see if they will take you on, lucky for me I have a professional relationship with several good ones and I kind of stuck it by , with my new doc, she accepted me as her patient immediately and is working very hard with me to manage my health and pain levels