I went down to see Dr. “Q” today, and things couldn’t have gone better!
Another Dr. came into the exam room first, (apparently an intern or assistant to Dr. “Q”,) and after we talked for a few minutes, he said he didn’t think Dr. “Q” would agree to do the surgery, especially since he said the hemipelvectomy has a 60% mortality rate. This figure rocked me back on my heels, (figuratively speaking,) since it’s so much higher than anything I’d found previously in my researching this surgery on the ‘net. He left and after a few minutes, he returned with Dr. “Q”.
We talked again for a few minutes, and since he was already answering some of the questions I’d prepared, I just gave him my notebook with the things I wanted him to know about me and the list of questions I had for him. He went through the list, addressing each of my statements and answering all of my questions clearly and concisely.
Then came the good news…
He said that if I wanted the surgery done, he’d be happy to do it; that in my case, since I’m in good health other than this infection, the mortality rate I could expect would be 1-3%, that the radiation treatments I’d had so long back weren’t even a factor, that he was pretty sure he wouldn’t have to remove all of the left half of my pelvis, that I’d be out of the hospital, (I’m sure referring to UNMH and getting back here for my recovery,) in a day or two, and that my chances of getting back in the wheelchair are 100%.
In simpler terms, everything the expert in hemipelvectomies said is diametrically opposed to what the chief of ortho here at the VA has said. He strongly approved of getting the surgery done now rather than waiting for the infection to spread, that it WOULD cross to the other side of my pelvis and into my spine eventually, (the ortho chief here said it wouldn’t be able to get through the thin covering of the bones,) and that getting a partial hemipelvectomy done now would prevent a total hemipelvectomy, or even total pelvectomy, (where they cut me in half above the pelvis,) later.
Dr. “E”, (my regular Dr.,) started a vacation today and won’t be back until the 14th, but he’s already OK’d me getting a new set of scans 6 weeks after the previous set, which will be in two weeks, and Dr. “Q” said to get that done and then bring him back the original disk of scans I gave to him, (he returned that to me to hold on to, but kept the reports I gave to him,) and get the new scans burned onto a disk and bring both back to him when I get them done so he can take a look at the condition of this infection immediately after they do the new scans.
He said he could do the surgery as early as mid-April, but I want to get that second set of scans and have him talk with my doctor, (Dr. “E”,) to get everything coordinated between the VA and UNMH for this surgery, as well as get that second set of scans done. The antibiotics I’m on are very powerful ones, and my blood work indicates they’ve done a good job of knocking the infection back, but they’re not something I could have at home since the most powerful one is administered via IV twice a day. If I didn’t have the surgery, I’d be taking oral antibiotics that wouldn’t be as effective both because they’d be taken by mouth rather than going directly into my bloodstream and they’re not as powerful as the vancomycin IV antibiotics I’m on now.
Given all of this, I’ve decided I’m definitely going to have this surgery done. What a difference between dealing with the VA doctors and a civilian one!
A perfect example is the doctor who’s assigned to me while my Dr. “E” is on vacation. I’ll call him Dr. “S”. The last time I was in, he was my doctor for a few weeks after Dr. “P” retired and Dr. “E” got moved to the spinal cord unit, and he kept insisting that I needed to start using an internal catheter rather than the externals I use now. He even put an order in for me to have one put in AFTER I’d refused his insistence for over a week and didn’t bother to even talk to me about it. I refused it and he got upset with me for not following his orders, in spite of the fact that the only result would be guaranteeing that I’d end up with bladder infections.
Well, he asked what Dr. “Q” had said in our consult today, and when I told him, he said that he could hardly wait to talk to him and read his notes. He’s going to be my doctor for exactly 9 days, and wants to be the one making the decisions in this??? I told him that I’d already told Dr. “Q” that I’d be having Dr. “E”, (my regular doctor,) call him after he got back from vacation.
Then this jackass tells me that he’s changed my IV times from 9 AM and 9PM to 7 AM and 7 PM. I asked him why, and he told me that it was because it would be more convenient for me, even though he never spoke to me about this at all. I told him that it would definitely NOT be more convenient, and we argued about it until I got him to put it back to 9 AM and 9 PM.
Then he tells me that what he’d really like to do is STOP all my antibiotics for ten days or so and try to get a culture of the infection so they could find out what it is. They’ve already done that, and it’s a staph infection, but this brilliant idea is basically, “let’s let the infection get back up to full strength, (and destructiveness,) again so can try to get a sample of it, even though the small hole in my groin area that it WAS draining through has apparently closed off and there hasn’t been any drainage from it since we stopped putting the gauze in there, and so there’s no way to GET a sample anymore.
Then he pulled another dumbfuck move. For the past week or so, Dr. “E” had reduced the dosage of the vancomycin IV because it was building up in my system faster than my system could get rid of it. When they hung the IV last night, I noticed that there was more fluid in the bag than has been the case over the past week, and when I looked at the IV machine, sure enough, he’s bumped it back up to it’s previous level for some reason, even though he KNOWS it was building up too much in my system. (I can tell because it gets infused over two hours, regardless of dosage, and the rate of infusion was back up again.)
Who the hell takes over for another doctor while that doctor goes on vacation for nine days and immediately starts changing all that other doctor’s orders for treatment? He’s been wrong on damned near everything he’s wanted done, not wanted done, predicted, etc., (he’s one of the doctors that STILL insists that because I had the radiation treatments on the hip more than 25 years ago, any surgery on it will never heal, even though he SAW the surgery from last year heal just as I’d predicted it would.)
I’m seriously starting to think that, to him, his patients are all just subjects for him to experiment on and see what happens when he does this or doesn’t do that. He doesn’t talk about any changes to treatment he wants to make beforehand to get the patient’s input, but just makes changes arbitrarily, doesn’t keep up with what’s going on before he decides this or that might be a nice experiment, (such as his idea of just stopping the antibiotics to get a sample of the infection for the labs when there’s no access to the infection anymore without doing surgery that he doesn’t want done because the patient that healed up perfectly from every surgery ever done on him won’t ever heal,) and doesn’t listen to what his patients have to say, even though in cases such as mine, where I’ve been doing this stuff long enough, I’m familiar with just about everything they might do, and know what will and won’t work.
I’ll say it again… This is typical of the government health care that all those lib-dipsy’s who’ve never experienced it want EVERYONE to have. There are two types of doctor’s in the VA system. Good ones who are willing to take the lower pay than they could get in private practice because they genuinely care about helping veterans out, and the ones who couldn’t survive in private practice because they’d be sued out of existence due to malpractice. Most of the docs are good ones, but there’s that 10% that fall into the latter category that end up in the chain somewhere to really screw things up for the patients.
The 14th can’t get here fast enough so I can get MY doctor back, and I’m guessing he’s not going to be very happy with all the changes Dr. “S” has made to the regimen of care for his patients in his absence.
When it does, I can get the ball rolling on getting those scans done again and getting the surgery scheduled BEFORE things go from bad to disastrous yet again!
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