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| From Bambini |
This week has been a very tough week emotionally because Barbara had to go beck to hospital and have another procedure performed under general anesthetic. There was something left behind in her uterus causing a mild problem, but no one knew what it was. Barbara had mentioned a couple of times that she was worried that something was not right and the doctor had told her it was probably nothing to worry about. Finally I suggested she write to the Doctor and ask her to take it a little more seriously.
This began a series of very inconvenient appointments for ultrasound, blood work, examinations, chest xrays and two hospital visits. These have to be scheduled between feedings and breast pumping every three hours. Our lives are completely full with carefully timed events as it is. Adding this imposes significant stress.
The ultrasound showed some material in the uterus. It was most likely a small amount of left over placenta, but the doctor felt it necessary to alert Barbara, in no uncertain terms, to the possibility of any and all causes of such a mass including a cancerous tumor! This set off a chain reaction that came to a head at 6am in the waiting room of the outpatient surgery.
After watching Barbara go through the experience of death emmotiaonlly before the C-Section while our Dulla and I were made to wait outside as they prepared, I realized that hospitals and surgery, particularly involving the reproductive stuff, is terrifying. In fact the whole labor was set in motion after the thoughtless nurses in the hospital got her totally freaked out about the state of her pregnancy during a visit in which they hooked her up to all the beeping machines and made their innocuous comments like "oh my god, you are so big", "you shouldn't be walking around".
If they were going to do any more procedures I felt I should be right there with her until they wheeled her into the O/R. When we arrived at the outpatient surgery, the first thing they told us was that I could not be with her and I would have to wait in the waiting room. After some gentle protesting nothing happened. Next the Doctor arrived. When she saw us in the waiting area she was not happy and emerged a few minutes later to try and talk us into proceeding.
I carefully explained why I wanted to be with her and my surprise that a hospital would exclude family members at such a time. She said it was hospital policy not hers, so I asked her to find a manager and ask for permission. She said there was no one available and that if we didn't go now, we would not have time and have to re-schedule.
At that moment I realized we were being pressured in the same way she pressured Barbara to get a flu shot during one the first office visits during her pregnancy that I could not attend. We had talked about getting the flu shot and decided not to do it in case there were developmental consequences that were as yet unknown.
The Doctor had insisted and when Barbara resisted, terrified with stories of phenumonia and loosing the babies! I was livid. There is no link between flu and phenumonia. We had gone to great lengths to avoid viruses, especially right in the middle of a level 6 swine flu pandemic.
I said to Barbara that as far as I was concerned, her Doctor had crossed the line and if she were my Doctor, I would be looking for a replacement. We talked about this for a while and she said that she wanted a female Doctor and that she was well qualified and she liked her. She decided to give her a second chance.
Had this been the children's Doctor, I might have insisted, but its her Doctor, so I had respected her choice. At 6am in the hospital waiting room that changed. I asked to please go and see if she could find a senior administrator. Finally she agreed and surprise surprise, two minutes later we were sitting in an office with one.
She was obviously not happy that the Doctor was not happy and curtly explained that I could not go with Barbara because of "patient confidentiality". I didn't know whether she meant that because we were not married I could not be privy to what was going on, or if she was talking about other patients.
I just sat there for a moment trying to comprehend the magnitude of this ludicrous statement, when she continued to explain that other patients were in the same room and their privacy would be compromised.
This didn't even pass the sniff test. It was quite clearly hospital administrator BS and I suggested to Barbara we leave. The Doctor followed us out into the waiting area where she explained that this was hospital policy and there was nothing she could do. I told her I had been with a girlfriend years ago while she had a similar procedure performed and was invited to hold her hand throughout the entire procedure.
I explained we felt that we pay a lot for this medical coverage, and "patient confidentiality" is not plausable. This is either an excuse created by the nursing staff to make their life easier, or hospital policy dictated by the lawyers afraid of loosing lawsuits because of eyewitnesses. Either way, we were not having any of it. We were not going to pressured by this Doctor or this hospital adminstrator. Last time I could not do anything as the babies had to come out right then. This problem had been going on for almost four months, so a few more days would probably not be a big problem. We left.
We felt the Doctor knew this and that's why she attempted to manipulate us by threatening to cancel. Barbara had prepared for days emotionally for this and really wanted to get it over. To have a scene like this on top of all that was really difficult for her. She was not at all happy, and rightly so. We spent the next three hours going over what had just happened and what we should do next.
Once the gun was removed from our heads, we talked about the possibility of doing the procedure in the Doctors office. The Doctor had said that she did not have access to the IV for the anesthetic there and would have to use oral anesthetic, but given her track record, I was not sure if an IV would materialize at the last minute if we elected to go that route.
I then began calling every OB/GYN clinic in the phone book to talk to a Doctor about this situation. I have now been up all night and its about 3am real time for me. We really wanted to know why this problem had occurred in the first place. She said that it happens from time to time.
Barbara had been very upset that the Doctor allowed it go on for so long and thought that she screwed up during the C-Section. I didn't think that was it. There was another surgeon there. and his picture was into foyer 6 feet tall with something like "Employee of the Month" emblazoned across it. I was very confident that the C-Section was done correctly.
When I woke up, we composed an email to the Doctor. I said I was "appalled" that family members are excluded, and Barbara added that she wanted to do this in the hospital. I was hoping that they would allow me to be with her this time, but if they didn't I would just have to accept it one last time and then we would change plans. I also mentioned that I wanted to write to the head of the OB/Gyn dept to complain about this.
The next day, the Doctor called. She would re-schedule and I would be allowed to be present during prep and recovery. Then she went to explain that she had consulted with some collegues (probably the head of department to do damage control and explain why an hour of O/R time was wasted and a patient walked out upset)
She then went on to mention that this could be a tumor and they wanted to do a chest xray to see if she had a metastisis in her lungs, they would have blood ready in case of excessive bleeding requiring a blood transfusion and they would be using ultrasound for guidence, she would get a full general anesthetic and everything tht was removed would be sent to the lab for a full analysis. She cried for an hour.
When I woke up I and was told this story, I realized the Doctor had no idea what it could be, was just covering her bases, and was finally taking this seriously. I suspect the head of the Department told her to pay attention! I was greatly reassured, as a good anesthesiologist would be present in the O/R. Of course if they did screw anything up, like accidentally perforating the uterus, they would be lent on by the hospital to say nothing, but I felt the risk of an emergency histerectomy was minimal. I was much happier.
Barbara took the Doctor literally unfortuantely, and proceeded to feel like she had the entire list of worst case possibilities and it was all a forgone conclusion. My surgeon friend returned from his trip so we spoke to him and he said he would be very surprised to find a tumor and the risk of perforation is something like 1/1000. But you know how it is when you have something unknown hanging over you like the sword of damoclese. It's hard to brush it off so easily.
I was also noticing that every time we have any interaction with this Doctor there is some "drama". I would even go so far as to say that the drama she creates in her patients makes her feel in control and powerful especially when patients have a shock reaction and become more dependent on her. When contrasted to the children's doctor, who is much older, I realize she is actually contributing to the problem.
So the day came this week for round two with Kaiser. This time we had been scheduled at a different department where the staff was fantastic. You can really tell the difference between LA and the bay area. We were laughing and joking all the way. The first thing they wanted was a sample of our money, then we were ushered into the prep area where the nurses attached the IV and the anesthesiologist showed up.
We had to wait about 45mins for the preceeding operation to complete so we hung out with the anesthesiologist talking about his child and vaccinations. The Doctor kept her distance. This guy was super nice and took the greatest care of her. Barbara was so relaxed by the time the O/R was ready, she was smiling and laughing. What a difference. We only had one nurse that came in with a hint of the hysteria that gets patients all nervous, but she left fairly quickly after she confirmed for the third time Barbara's identity and what procedure she was having done. There is no way you are getting medical work done at kaiser under someone else's name!
Although Kaiser is listed as a "not for profit" it turns out there are actually three entities to Kaiser and only one of them is "not for profit". Wow I am so shocked. of course it wasn't hard to guess which entities are for profit. Yes, yet another large American corporation run by the bean counters and the lawyers. If they placed as much emphasis on patient care as they do ensuring their profits, we would have truly great health care in this country.
I went back to the waiting room while the procedure was done. In the thirty minutes or so I waited, no less than five doctors came out into this waiting area and began to detail the procedures they had performed on the other patients there that day. Without wanting to, I could clearly hear most of what they were saying, There was absolutely no attempt made to protect "patient confidentiality". I was dying to see if our Doctor did the same thing after all the hoo ha they made about this the last time we were here.
Sure enough she came and stood a few feet away and proceeded to tell me everything went fine and then enumerate all the post op requirements including a full description of what may not go into what cavity and for how long. I just stared at her and then to underscore the moment I turned my head to the man sitting two chairs away from me and he returned my glance. The Doctor either didn't care or pretended not to get it.
I politely thanked her, but the air was definatly a little thick after all that had transpired. I had asked to be present when she came round and they told me they would "try". They lied. I was only allowed to go back and see her once she was fully conscious. They don't want any witnesses to any problems there either I suppose.
By now we had burned through most of the day and we had to back to let the nanny go home. I brought the breast pump with me because I figured they would not realize that she cannot go more than three hours without pumping or she will get another milk cyst. These are painful and take days of massaging and warm water treatment to break up. I was right. So we plugged it in and pumped her before she went into the O/R.
Barbara was really groggy and took a while to come around, but as soon as she could move she was asking the nurse to hurry up and get us out of there. He went as fast as he could but as usual leaving Kaiser was not so simple. Eventually he actually wheeled her to the kerb himself instead of waiting for the geriatric volunteers, and we went home.
The procedure was so smooth that Barbara has had no pain at all. Despite the drama and disruption, I think we finally got the experience we deserved. I thought we might take up the issue of "patient confidentiality" with them, but I am sure they would have some cleverly worded explanation that justifies both examples we experienced. I hope we may be ready to try a different Doctor now.
To add to all this Barbara had to prepare for a show that began on Monday. It is her busiest time of year. In other news, we had a visit from our friend Sandra. There was a grand sushi celebration (girls only) at the local sushi house which the two connoseurs assure me is better than anything they have had in LA. I look forward to trying it.
The boys are getting fatter and fatter with all the milk they are drinking. Soon they will turn into baby cows and moo. We are approaching the point where they can sleep through the night (if you define a night as six or seven hours). They had a very busy Sunday last weekend with a trip out for lunch and then a three year old's birthday party in the park. They were quite overwhelmed by the noise and commotion and slept like the dead for six hours straight.
