Saturday, August 12, 2006

Doctors ...

After my recent doctors visits - had to write a blog entry. There is definitely some good and some bad in here. Seems representative of our medical system / industry.

  • Scheduling a visit - from Europe
    • Bit of a challenge as we were in Europe. Wanted to go see a specialist. Of course they want you to see your general practitioner. I have had enough experience with my back to know that I needed to see someone else:)
    • I called the doctor who did my back surgery. He was going on sabbatical, so did end up with the doctor who had seen my shoulder.
    • Had to be a bit adamant to get them to schedule a time. Then of course they had an opening while we were still in Europe, but nothing soon after we got back.
    • Had to call regularly to get a cancellation:)
  • Had my appointment and we decided that I needed an MRI.
    • Scheduling this is hard as well. They gave me an appointment two weeks out, to work around some travel.
    • I got my name on the list for cancellations.
    • Good thing is that they called me every time someone cancelled. Bad thing is that even though I told them when I would be back from my travels, they called me anyway.
    • Did get an appointment for the day I returned:)
  • The MRI appointment was good
    • Only thing was that I needed them to evaluate the MRI ASAP as I was meeting with my doctor again the next day.
    • They did this:)
  • Second doctors appointment
    • He recommended that I go have an epidural cortisone injection.
  • Scheduled the appointment for the cortisone shot
    • Two choices - with the experienced doctor (10,000 plus shots) or the inexperienced doctor (not clear how many shots, two years of experience).
    • Appointment was either a week away or a couple of days away.
    • Turns out after talking to folks who schedule a couple of times - each doctor has a day when they do the shot, so the difference in appointment dates was pretty irrelevant.
    • Went with the experienced doctor!
  • Meeting with the experienced doctor
    • Did an exam, discussed the process, asked all of our questions, sounded like the right thing was to have the shot.
    • Went back to his office to look at a model and to schedule the shot. Thought that we would also look together at the MRI. Found out that he hadn't even seen it. And found out that I couldn't' get the shot at the next slot three days away because I had taken Ibprofen (blood thinner).
    • Discussed why he had not seen it (power problems, shortage of people, etc). Pretty annoying. Agreed to meet again to review. And that I would go pick up the MRI MYSELF and bring it to the next appointment.
    • Also annoying that no-one told me I should avoid Ibprofen within three days of the shot or they would have to pick a later date ...
  • Went to pick up the MRI
    • Very nice folks helped me to determine that it made it to my doctor (not the guy who gives the shot).
    • My doctor is in the SAME BUILDING as the other doctor - all they had to do is bring it over.
  • We met again to review the MRI
    • He showed me the L4/5 where the bulge / herniation is. On the left side of the MRI film.
    • I asked to see the other film that showed the scar tissue (they did one with die that was so that the doctors could see what is new and what was a result of the surgery).
    • He put this up and showed me the scar tissue on the right side of L4/5.
    • I asked why it was on the right on that film and on the left in the other film.
    • He said that is because the films are flipped. What looks like it is on the left is actually on the right. What is on the right is actually on the left. My surgery was to take care of a problem effecting my left side and the new problem is effecting my right side.
    • Wellllll - the problem is again on my left side. When I said this - he went to his computer to review the notes (like I was confused as to what side the problem was on).
    • He then said - see on the other side there is a bulge, that is what is causing the problem and that is where we would do the shot. Like it was no big deal that he completely missed it!
  • Things seem to be healing up, so I cancelled the shot
    • He had said that it was 90-95% likely that my back would heal itself. The shot would make this happen faster as it would put cortisone directly on the problem and help reduce the inflammation more quickly.
    • But it seems to be doing pretty well itself. The pain is gone (almost completely). The numbness is going away. And the muscle strength is coming back!
So there are some positives in here. You can get appointments pretty quickly. And if you know the right folks, you get a lot of help. Most people are really nice. But it is clear that the doctors are pretty overloaded and don't really take to be thorough. So you have to take some of that responsibility on yourself.

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