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

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