This Medication Can Kill You

This is difficult for me to write.  Occasionally, I’ve written about health issues, such as sinus infections.  This time things are more serious.

Last week, my ENT specialist prescribed a different medication for an ear infection that appeared in December and doesn’t want to leave.  I picked it up the prescription from the pharmacy and after getting home, began reading the 9 pages; 5 titled “Medicine Information Sheet” and 4 titled “Medication Guide”.

In the third paragraph of the “Medication Guide”, in bold letters it says, “Some of these serious side effects can happen at the same time and could result in death.”

I’ve not started taking this medication and honestly, don’t know if I will.  Only, it doesn’t stop there.

Yesterday, I got the frightening news from a diagnostic surgeon that I might have malignant cancer.

Now, out comes the soapbox.  I miss the old days when there were neighborhood physicians who took care of mostly everything.  Back then there was only hospitalization insurance.  Doctor visits costs $20 to $50.  If the neighborhood physician decided surgery was needed or tests, he would admit you into the hospital so the insurance would pay for it.  All providers would be together, and staff made sure that you received the proper diet and medication on time.

Now, patients might have several doctors.  Indeed, I have 6, and if we count the nurses who take vitals and asks questions, that doubles the number of times that I have to repeat the same thing.  Shall I add in the physician assistants who I see me more than the actual physicians?

Why do they ask for all the medications you are taking, to prescribe a medication that when you get home and read the inserts, it tells you not to take it if you have certain health conditions, or are taking certain other medications when they should know your health conditions and prescription meds?  And, you find that there are conflicts.  For example, I read in the inserts with the medication that can cause death that if I’m taking Vitamin D, that it has to be taken 2 hours before or 6 hours after taking the medication that can cause death.  Yet, in my chart it is documented that I am taking prescription strength vitamin D.   If I was going to take that medication, it’s a good thing that I read the inserts because the ENT Specialist told me nothing about that requirement.

What would you think of having your physician tell you that he is making extensive notes on your chart, and you sit and watch him do so for at least 10 minutes.  When you get to the Specialist you are referred to, you find that they haven’t taken the time to read the notes, so want you to repeat everything in 1 minute or less — but only the issues that they specialize in.

After neighborhood doctors went the way of the dinosaur, came the HMOs and with them, limited physicians and limited hospitals.  Subsequently, that changed with the addition of more physicians and more HMOs entering the market.  However, with HMO’s and PPOs, came almost a complete elimination of hospital service unless you’re admitted through the emergency room.  Don’t get me wrong.  Outpatient surgery has its advantages, but when a patient has multiple issues with 5 different doctors prescribing medications and ordering tests, and none of them know what the other is doing, I can see the advantage of admitting a patient for a day or two until all providers get on the same page.

And, what’s this thing now with having to talk to a nurse before you can make an appointment, and having the nurse ask if you want a referral to a specialist?  Isn’t that for the doctor to decide?

The routine. Once I got a referral and my insurance company approved it, I paid the co-pay, see the new provider who wants to perform a procedure because the tests show that I have malignant cancer.  To be sure, they want to perform an invasive biopsy.  I contacted my insurance company and they told me that I need pre-authorization.  Then I learned that the provider’s office doesn’t submit pre-authorizations but the network does.   A week later, I received documents in the mail from the network of the scheduled procedures.  I received a phone call from the network regarding the preauthorization.  On the day of the procedure, I arrived to learn that;

– The insurance company had not approved the preauthorization.   This means I had to wait an extra 15 minutes until calls are made to get all that properly through.

– I went in for the procedure to learn that although I was sent documents that two procedures were going to be performed, they were only going to perform one BECAUSE they don’t perform the other. Their excuse for the document was that it’s standard in their system.  That would carry some credence had I not been told that I was having TWO procedures by the first nurse who scheduled me for both.   But, the second nurse doesn’t check with the first nurse and automatically blames it on the “system”.

– No one on staff has discovered that the system needs to be changed so that patients don’t feel they have been misled or deceived? No one seems to be concerned that getting a pre-authorization for a procedure they say they don’t perform might raise eyebrows about possible insurance claim fraud?

– The surgeon still wanted me to have the first procedure, and he doesn’t perform the second to help eliminate pain because all he does is remove parts of the body for biopsy.  The nurse who blamed the system wanted to hand me a card for a surgeon.  Why?  Because I need a surgeon that does more than just cut body parts for biopsy.

– I will need another referral to yet another surgeon for removal of what is causing pain, and will still need to return to my primary care physician for pain medication because all surgeons do is perform surgery – not pain management.  Oh — and that surgeon can also submit parts for biopsy.

WHY DIDN’T THEY SIMPLY REFER ME TO THAT SURGEON IN THE FIRST PLACE?

 – Then I was asked why I hadn’t asked my primary care physician for pain medication.  UH?  Why would they assume I had not?  The nurse instructed me to stop all pain medication 3 days before the procedure in order to control bleeding. Still, that does not address the fact that after a surgeon has made holes in my body that he can simply walk away and hold another physician, in another location, responsible for prescribing pain medication.

– Oh, but now I get it. I’m responsible for making an appointment with my primary care physician on the day of an invasive procedure and commute to his office for him to prescribe post-op pain medication although he and the surgeon have not communicated with each other.  Did I get that right?

– Then I learned that several weeks ago when the biopsy was scheduled, that I should have been assigned an advocate. This information came from the main office.  However, that information was contradicted by yet another nurse in the local department.  “We don’t do that here. The person who told you that doesn’t work at this location.”  DARN RIGHT SHE DOESN’T WORK LOCALLY!  She works at the main headquarters for the hospital — you know, where decisions are made.

It didn’t stop there. The manager of the department, like the main headquarters, is also of the impression that I should have been assigned an advocate.

Did I keep my mouth shut at the medical center?  Nope.  In fact, I told three specialists that I understand that as a result of their medical malpractice insurance carriers, they can no longer treat patients. Their specialty doesn’t limit them.  Their medical malpractice insurance does.  They no longer work for the betterment of patients but rather, under the constructs of their medical malpractice insurance carrier.

They can’t put on a band aid because if the patient has an allergic reaction, the doctor is afraid of being sued.  Without a band aid, the area becomes infected. The patient is asked why they didn’t ask to be referred to a Dermatologist. (sigh)  Okay, Maybe that is a bit of an embellishment, but it’s an example for how the system is currently organized under a culture of sue happy attorneys, and medical professionals driven by fear of sue happy attorneys.

Dentists and eye doctors have now become clients of brands and upgrading.  The sales pitches for upgrades  resembles visiting a used car lot.   For 3 months last year, I went back and forth with an eye doctor on prescribing a particular contact lens for one eye.  I’ve worn the same prescription since 1998 but oh no!  He wanted to try a different brand that doesn’t make the same prescription.

After trying out 5 different lenses, with none of them working, they put me off for yet another month to make another appointment.  My insurance company then said that it had been too long since my first visit, so my plan will not pay for contacts until October.  It will be a year since I was able to see clearly out of the one eye.  That doesn’t include the problems that I saw an ophthalmologist for last month.

How can medical professionals hold patients accountable for participating in their healthcare when the system  aggressively prevents full understanding of protocols?

Me?  I’m tired, still in excruciating pain, and waiting until Wednesday for a call for an appointment with a surgeon.