Tuesday, September 26, 2006
Time Wounds all Heels
Time may not heal, but it has allowed me to calm down since my last rant about the doctor visit. The next day, the doctor called me with lab results and they weren’t as I expected. I brace myself to expect the worst of every medical report and in my head the worst would have been cancer related. Instead, my results were more treatment related. It seems my already challenged thyroid has slowed down even more. In fact, my dosage of meds is higher than some people who have had their thyroid removed and it is still underfunctioning. Nice, huh? Off to the endocrinologist . . .

In the meantime, the increased doses of the meds has relieved some of the muscle pain in my legs and given me more energy. My doggies, who have now gone on extended walks and a couple of runs in the park, are eternally grateful. Of course, I too am grateful for not feeling like such a rundown crabby slug. The thyroid is an amazing cog in the body machine and when it isn’t working properly it is amazing how overall crappy one feels both physically and emotionally. Seriously. It also has an effect on cholesterol levels and a whole slew of other health indicators. Women are particularly susceptible to thyroid conditions and Tamoxifen can also interfere with thyroid function and/or thyroid medication. I highly recommend that anyone experiencing symptoms of thyroiditis request a simple blood test to check TSH levels at their next wellness check.

I’m also patiently awaiting trips to the dermatologist as well as the gynecologist. With an aging population and the spike in obstetrics malpractice insurance, I’m surprised there aren’t any (at least in my area on my insurance plan) plain old gynecologists who don’t practice obstetrics. It would be nice to have a doctor focus on gynecological wellness without the office being a happy baby office. I think the happy baby people should be segregated in their happy baby environments and let those of us not dealing with happy baby issues not be faced with photos of happy new babies, parenting magazines, and glowing women mindlessly rubbing their pregnant tummies. In the meantime, until a qualified doctor picks up on my great suggestion, I will visit the happy baby office and see my new gynecologist who looks like a ten year old that shouldn’t even yet know where babies come from let alone be examining those parts.

And if three referrals and a follow-up recheck weren’t enough, it is also time to see my favorite plastic surgeon soon to talk about my final reconstruction issues. Although I haven’t actively had anything done for the last ten months outside of a recheck, it sure seems like reconstruction is taking longer than puberty did. All in good time, I suppose. All in good time.
Written by Jeannette Vagnozzi
10 chimed in

Tuesday, September 12, 2006
Dr. Bombay Come Right Away . . . or at Least at the Scheduled Appointment Time
I have been lucky to have had excellent doctors throughout my experience. I have praised them, expressed my undying love for at least one (if not two) of them, and I have been most grateful for the role they all have played in my healing. However, throughout this process, I have had nothing but anxiety and grief from my primary care physician. I am a firm believer that most primary care physicians are great at healing slightly sick people. Once stricken a major illness, there should be a "specialty" primary care doctor to whom one can be assigned. My issues seem to be outside of original diagnosis for my oncologist, yet over the head of my primary care physician. To add more frustration to the mix, my primary care physician apparently does not own a watch.

I have struggled with some minor, troubling issues since treatment. One is this awful rash on my feet which by this point has crept up my now permanently scarred and hyperpigmented ankles and calves. Another is the persistent leg cramping as well as other issues. It was time to follow up once again with the primary care physician. It took two and one-half weeks to get an appointment. My appointment was scheduled for 4:30 p.m. When I checked in the receptionist informed me the doctor was running about an hour behind. I left to do some errands and came back in 45 minutes (any later and I would have been locked out). The doctor finally came in at 7:15 p.m. Let me repeat that, in case you missed it. I was finally seen at 7:15 p.m. for a 4:30 p.m. appointment.

I was furious, but trying to be patient because, after all, I needed this appointment. I had now waited two and one-half weeks and three hours. I was too invested to walk out or get poor treatment by being a difficult. The first thing she said was, "It is getting late for both of us." Um, whose fault is that? I was fifteen minutes early for my appointment.

I explained my list of troubling symptoms. She looked at my legs and said I needed to see a dermatologist (which is what I requested three appointments ago) and that it was likely related to the Taxol I had during chemo (which is what I stated three appointments ago). As I rattled off my other symptoms, she kept writing and checking her medical reference handheld device. At one point I stated, "It is painful here (gesturing to the troubling area) even if you apply only a little pressure." She never once laid a hand on me. Never once examined any of the other issues I addressed. She said she would take some labs and then pulled out her prescription pad and starting listing vitamins that I should take followed by, "and these are all available here." Guess what? I ALREADY TAKE THEM.

I left without my derm or lab referrals because no one was left in the front office (or back office besides me and the doctor) at 7:30 p.m. I waited and watched the mail for four days. Nothing. I call and convince them to prepare it for me to pick up. The next day I go to the lab and have fifteen tubes of blood drawn for some 30 odd tests (at least I can give her credit for gathering information). I go back for my follow up appointment and after waiting two hours I am told they don't have the results. NO RESULTS.

I am so not happy with HMOs. The HMOs limit the doctors in what they can charge for regular services and dictate what services they are willing to cover. It seems that doctors have to offer some type of cosmetic service or sell some product line in order to stay in practice. Where is the integrity though? Is it ethical for a doctor to "prescribe" a product they sell? Do I want an oral surgeon to be my Botox provider? Do I want cosmetic procedures with my annual pap? (Hmmm...is there a discount if I do a two-for-one?)

I think it is all part of a vast left wing conspiracy for our medical system to be run so poorly that we clamor and beg for socialized medicine. If my legs didn't cramp so badly I would already be on at least one knee. Even if doctors need to be entrepreneurial in order to succeed with the business end of things, it is not okay to be so far behind schedule due to your vitamin sales pitch with each patient. It's not okay not to apologize. It is not okay to not have the results in for a scheduled follow-up. It's just not okay. It certainly doesn't uphold your overly wordy mission statement posted in each exam room that includes among your objectives to do no harm and to esteem each patient. Check my blood pressure and stress levels after I have waited hours to not get results for issues that have bothered me for over a year. I do not feel esteemed. Or even respected.
Written by Jeannette Vagnozzi
7 chimed in

Name: Jeannette
Location: Southern California, USA

This is my story about being diagnosed with breast cancer at age 39. I thought I was out of the woods, but four years late it came back. This is my quest to be a two-time survivor.

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    "Be joyful in hope, patient in affliction, faithful in prayer." Romans 12:12