Prostate Cancer – What Doctors Do Wrong – part 11

It is now a month after I had brachytherapy for my prostate cancer. I still have some unpleasant side effects, but they are much less intrusive than before. I also still have some unpleasant interaction with doctors. Read on.

A couple of weeks after the procedure I received a letter from my health insurance company that if I needed a long-term (90 day) prescription for Tamsulosin (generic Flomax) I needed to switch from the drug store I used for the first prescription to their mail order service or another local pharmacy that participates in their discount service. I could tell I would need a refill, so even though it was cheap at the pharmacy I used first (about $5.00 for a 1-month supply) I wanted to make it cheaper for the health plan as they had requested. I messaged Dr. A that I wanted to switch from the pharmacy he had sent the first Rx to and to send a 90-day one to Pharmacy #2. He replied quickly that he would. Three days later he still had not and I was down to my last five days worth. So I called my health plan’s drug service and explained and they said they would contact the doctor and get it renewed through them and they would send my refill by mail. Two days later I got an email from them saying the doctor had not responded. I was down to my last two pills and had decided I would have to get a refill at the original pharmacy. However, before I got around to that, that pharmacy called me and told me my prescription was ready. Dr. A had sent a 90-day refill there instead of to the one that participated in the discount program. Even though he had read my message, he apparently had not understood anything other than I wanted a refill. He totally disregarded which pharmacy I wanted it sent to, even though I included the name, address and phone number of that pharmacy in my written message. He also disregarded the request from the mail order people. Ironically, the new Rx cost the same amount ($5 a month) as before, and less than the mail order service provided, and it was for twice as much because the doctor had doubled the dosage. I didn’t need the double dosage, so now I have a six-month supply at what is effectively $2.50/mo but will probably only need another two or three weeks worth, based on my progress. What a waste; only drug companies benefit while your premiums and mine go higher. All because the doctor didn’t read my message carefully and didn’t do what he said he would. Doctors are clueless about insurance.

So a few days ago I was sitting at home and got a call from the office of Dr. K. The woman there asked if I could come in for my 1-month follow-up. She wanted to know if I could come right away. What the heck!? If I was supposed to have a 1-month follow-up, why didn’t they schedule that much earlier, at the same time they scheduled the procedure, for example? The patient is supposed to drop everything during the holidays and run right over if the doctor calls? She told me it would only take 15 minutes and if I couldn’t do it, I wouldn’t be able to get an appointment until mid-January (three weeks away). I had another doctor’s appointment (annual vision check) right after lunch, but fortunately I was free for the morning so I decided to get it over with. I took my book (foresight!) and went. I was quickly given a CT scan, which is standard procedure to verify the seed placement after the swelling has gone down, The attendant tried to put me in an examining room, but they were all full (which flummoxed her), so I sat in the waiting room reading waiting for the doctor. They obviously weren’t really prepared for me, which makes we wonder why they called me in. Half an hour later I was getting visibly peeved and the receptionist noticed it. She apologized for the delay. I told her I had another appointment and wasn’t going to skip lunch to make it, so if the doctor didn’t see me in the next five minutes I was going to have to leave. Two minutes later Dr. K emerged and asked “who’s next?” The receptionist pointed to me. I sat down with him in an exam room and he asked about my post-operative side effects, etc. It was pretty standard stuff, no surprises for me and apparently not for him. But when I asked him the results of the CT scan he told me “they’ll be fine – they always are.” He obviously hadn’t looked at them yet. I then asked him to confirm what I’d remembered about the number of seeds and needles used in the procedure. He didn’t remember and left the room to get my file, which he obviously hadn’t even reviewed before seeing me. He came back and confirmed that my recollection was correct as to those numbers. I asked him what my prostate size was, something that is sometimes important in rates of recurrence or future treatment options if the PSA goes up again. He didn’t remember that either and flipped through some pages, but couldn’t find it. That was what I had come in for the first time I saw him, to measure my prostate, but now he can’t find it. He obviously had no recollection of me as a patient and was making almost no attempt to answer my questions.

For what it’s worth, my eye exam was done quickly and professionally and everything was fine there. I have a great ophthalmologist. She and the optometrist in her office are female and had to stand near me, but I’m safe for a pregnant woman or anyone else to be near now. I’m able to run again, although I need to stay near a bathroom. My Achilles tendon is manageable, although there’s still some tendinitis. I’m way out of shape from the long layoff from running, but I feel like my life is returning to normal now.

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