Saturday, September 25, 2010

Where did all the good doctors go under ObamaCare?

I grew up in Cary North Carolina with a family doctor (Benjamin Thompson, MD).  Dr. Thompson did everything from stitches to injections for strep throat.  Whenever we broke a bone, Dr. Thompson referred us to a specialist.
When I was a sophomore in college and the stomach aches I had during my childhood turned out to be a birth defect as opposed to stress, Dr. Thompson
predictably communicated with the surgeons in Greensboro, North Carolina.   When the Greensboro surgeons could not "fix me," the next step was Duke.

Cary is very near Durham North Carolina (and Duke Medical).  There was actually a time when the only way to be seen by a Duke Private Diagnostic Clinic physician was to have a referral from a family physician.  The Duke PDC physicians were amazing.  My general surgeon was William Peete, MD.  

Dr. William Peete (and his brother Dr. Charles Peete) were tremendous human beings.  And if they did not care about patients, they faked it well.   It was 1985.  I was a runner, swimmer, gymnast.  I was approximately 5'4" and severely underweight at 90-ish pounds.  The problem my volvulus was untreated for 3 years. I trusted Dr. William Peete from the moment I met him.  Dr. William Peete fixed the intestines - done deal!

In 2006, I temporarily left Chicago to be treated at Duke for my cancer.  Disappointment.  My oncologist is back in Chicago.  

From 2007-2010, I was my dad's medical advocate through the horrors of his medical care at Duke.  I was like a battered wife --- I thought I could make Duke Medical understand they were basically good but their procedures were really bad!  That mindset never works. 

Fast forward to today (Saturday 09-25-2010):  I woke up with a fever, back and chest pain (and obviously leg pain).  I asked my mom whether she thought any of my doctors even wondered whether I was okay.  Without hesitation, she said "no."  

My mom is right.  I know that and I am fine with that.  I just wondered how much less physicians and surgeons are going to be able to care under ObamaCare?

Again, even if I knew the Duke orthopedic surgeons would treat me poorly after I advocated for dad, I still believe with all my heart that the elderly and fragile need a voice . . . especially my dad.

So how bad has the infection gotten for me?  Not nearly as bad as it did for my dad.

My left leg incision (bone infection treated by Duke) on 09-25-2010

My dad (Robert Handy) being treated for osteomyelitis at Duke in 2008

Dad could not beat the bone infection.  I hope I can find a physician that can treat osteomyelitis soon.  I want to beat it for both of us!

Friday, September 24, 2010

Duke Medical gets last laugh as elderly's medical care advocate (me) needs care

If I had to do it all over again . . . I would in a heart beat. 

My dad died in January 2010.  He needed a roller walker (per his Duke Medical orthopedic surgeon, Dr. Mark Easley).  But apparently it was not that important. Duke physician signature forged, Medicare fraud and (long story shortened) dad gets no roller walker.

Too bad that dad was not being treated for a bone infection (or any infection). Dr. Easley just kept telling my dad that the ankle bones were not healing because dad was not doing enough walking and weight bearing.

Dad started the New Year (2010) on Saturday January 2, 2010, by walking out to the driveway to get the newspaper.  Dad was following Dr. Mark Easley's orders. He was weight bearing.  He was walking.

Dad almost made it back into the house but fell down at the door.  He got the newspaper.  But the pain of unhealed ankle bones were too much for my dad.    I made telephone calls to Dr. Easley's office and to his PA after the fall.  I never heard back from Dr. Easley's office.

Dad died 13 days later on January 15, 2010.

Dad was treated at Duke Medical Endocrinology Clinic for over 20 years but never needed more than a cholesterol tweaking until January 2007.

From February 2007 and until dad's death, I warned Duke Medical that there was a lack of communication, cooperation and coordination between the Hospital and Clinic.  The silence was deafening.

We learned from dad's autopsy that dad suffered mightily during the last year - with ailments that Duke Medical absolutely ignored.  One such ailment was bone infection - known as osteomyelitis.  It was first ignored by Duke Hospitalist Dr. Veshana Ramiah during an August 2008 hospitalization.  Then it was partially treated in November 2008 by Dr. Mark Easley.    But Infectious Disease dropped the proverbial ball.  Dad's bone infection (osteomyelitis) either came back or never went away.

Fast forward to today.  After a series of unfortunate events, Duke Medical's orthopedic surgeon Dr. Michael Bolognesi performed surgery on my bone infection (osteomyelitis) on September 13, 2010.  For whatever reason, the surgery did not work.  During my eight day stay at Duke Hospital (Durham), I could tell that something was wrong.  

I was vomiting every day while I was in Duke Hospital and each time I vomited I could feel the stitches in my leg pulling.  I expressed my concern to doctors and nurses.  Crickets.

It was no secret that I did not want to be at Duke Hospital (based on the last 4 years of past experience, I do not trust the ability of Duke Hospital to effectuate cooperation, coordination or communication between the Hospital entity and the Clinic entity).  It's the whole Hospitalist Program Model not being standardized yet that bugs me . . . but I digress.

A physician I do trust at Duke (and who actually makes a remarkable effort to facilitate a transition for his department's patients to transition from Duke Hospital back to Clinic care) arranged for me to be seen by a UNC Chapel Hill orthopedic surgeon with experience resolving osteomyelitis cases (Dr. Laurence Dahners).  I was so relieved because the hole in my leg (and now arm from the PICC line) had become larger.  

My relief was replaced by raw shock when the UNC Chapel Hill orthopedic surgeon's professional staff interrogated me about my experience at Duke orthopedics.  The young doctor actually said to me (paraphrase) "you have to understand the difficult situation I am in since there are discrepancies between Duke's version of events and your version of events."

This was the condition of my left leg yesterday (9-23-2010) as I sat on the exam table at UNC Chapel Hill Orthopedics Department.  And, I was having to explain the discrepancies in my version of whether Duke offered to allow me to speak to an Infectious Disease physician or not.  The UNC orthopedic surgeon also held up my Duke discharge paperwork and suspiciously said "I don't understand how you got this."  What? Are you kidding me?  I "got it" from Duke Medical.

I tried to explain to the UNC Orthopedic surgeon that my dad recently died while a patient at Duke during a period of time when he was being treated by Duke Orthopedics and he died with (among other infections) osteomyelitis.  I said that I just did not want to be treated at Duke for this disease.

Am I living in Wonderland?  Is this so hard to understand? 

The UNC orthopedic surgeon asked me what other questions he could answer for me.  I mentioned the PICC Line sore, drainage and fever.  The surgeon shrugged his shoulders and said "that's what happens when you leave the hospital with a PICC Line."  

I'm not sure why I thought any clarification would be of value.  But, I told the surgeon that I had the Line removed at the Duke Orthopedic Clinic the prior day.  The UNC Orthopedic surgeon just shrugged his shoulders. 

My PICC Line site in the UNC Orthopedic exam room (09-23-2010)

It was as though I was not sitting right in front of the surgeon with a hole in my left leg and another one starting in my left arm.  I was on the verge of tears.  I was shaking as I picked up the bandages that I was told to remove (for what reason I don't know) and tried to get out of that place as quick as I could. 

My initial reaction was that I wish that every physician that dismisses a patient who is scared or in pain could feel a fraction of what patients and families undergo.  But, in reality I don't.  I would not wish the sleepless nights and tears that myself and my family (especially my recently widowed mom) endure on anyone.

It is however good/interesting to know that the desire to protect fellow professional medical colleagues is so profound in Durham ("the city of medicine") and Chapel Hill.  

One might have expected the competitive nature of NCAA athletics  to leak into academia.  

Nope - not even patient safety, health and well-being can break the professional bond of doctors in NC Triangle area

Sunday, September 19, 2010

My week at Duke University Medical Hospital

Against my better judgment and my gut, I was persuaded by two doctors that I respect very much. I agreed to be admitted through Duke Medical ED and (G*d help me) allow a Duke orthopedic surgeon to perform surgery on me.

The thought was that I had an infection. As such, I would need Duke Orthopedics and Duke Infectious Disease to work as a team. The surgeon boldly assured me that they would get it done because "that is what we do." I squarely told the man that my dad relied on Duke Orthopedics and Duke Infectious Disease to work together and they did not and my dad died in January 2010. I told the Duke Orthopedic Surgeon to "prove me wrong. Prove to me that the two departments can help me."

The Duke Orthopedic Surgeon was unable to prove me wrong.

I was admitted 9-10-2010 and discharged on 9-18-2010. I have a worse gash on my leg than I had on 9-9-2010. With every pulse elevation and flood of blood, the gash enlarges.

I seriously contemplated a second opinion. There was no medical health professional from Duke Orthopedics or Duke Infectious Disease that had enough human compassion or medical knowledge (or perhaps interest) to convey to me what was going on in my body.

I even kept a PICC line in my arm in case I decided to continue the recommended antibiotic regime for the diagnosis of osteomyomyelitis.

But now I have decided to focus on using my time and energy for the cause of patient safety. I do not intend for the legacy of my dad's death to be lost as I become weakened by the same indifference and lack of care for the patient that killed my dad.

I have to stay strong enough to get out the message about dad and to warn others about the importance of remaining vigilent about your personal health.

The medical care system has changed. Doctors have changed. Hospitals have changed and it is only going to get worse under Obamacare.

I have had my full of egotistical doctors who refuse to answer questions and think of lives as merely a means of making money. I have met them in Chicago and Duke. I am sure they are in your town.

Take care of the ones you love.