Prostate Cancer – What Doctors Do Wrong, part 7

Dr. A’s scheduler, a nurse, called me the next day. She began by telling me the date I was scheduled for the procedure. So much for asking me what dates I might not be able to do it. This is the third time I was forced into what was convenient for doctors or their assistants. Fortunately the date was fine with me. I asked her about the timetable afterward, when would I have the external beam radiation therapy (EBRT)? How soon would I be able to resume normal activity after the implant procedure? Would I need care, such as someone to bring me medicines or a bedpan or whatever? She seemed totally unprepared for these questions but said she would find out these things from Dr. K’s office. She read me a set of instructions. I was to report at 6:30 AM for an 8:30 surgery. Really – two full hours? Since I would not be able to drive, that meant my son would have to get up before 6:00 to pick me up and take me, then come back many hours later. I knew better than to ask how long the surgery would take. I’ve had a few minor procedures and learned that they never know and will never tell you. The surprise for me was that it wouldn’t take place at my local hospital, Instead it would be at an affiliated hospital 10 miles south – that’s right, the one closer to where Dr. N usually practices. Go figure. She said she’d send me a message with all the instructions. She did send this the same day.

She warned me against taking aspirin or other blood thinners before the surgery, then mentioned I would be given a drug (I didn’t recognize the name) for “severe pain.” Wait! I’m going to have severe pain? Then she asked me what allergies I had. All of this I had provided to PAMF multiple times, but I repeated them and told her to add Cipro to the list. She did. Then she said she noticed I was allergic to Codeine and Vicodin. I confirmed that. Then she said oh, well then they’ll have to give you Ibuprofen. I told her I was allergic to that, too. She said that wasn’t in my allergy list they had on record. This ticked me off since it is always the first thing I list when doctors ask me. She then corrected herself and said yes, it was in there after all. She just hadn’t noticed it. This did not give me confidence she was competent since she had neither looked at my allergy list before deciding what drug I’d be taking, nor when she did look at it, noticed the most important drug I can’t have. It’s the only one that gives me life threatening reactions. She quizzed me quite some time on what my reactions were when I took those drugs as though she didn’t believe me. After I described my symptoms she became convinced I couldn’t have them. Then she asked me what doctors gave me for severe pain. I told her I didn’t normally have severe pain. I had severe pain when I had inflammatory arthritis and took heavy doses of ibuprofen at that time, but I can’t take that since I developed an allergy to it. When I had plantar fasciitis the doctor gave me a cortisone shot, which worked well, but that’s not something for general surgical pain. I had a very painful wrenched back and the doctor prescribed Naproxen, which I could tolerate, but it didn’t really help with the pain so I stopped taking it. After she heard this she acted frustrated and said she didn’t know what they could give me, then. Great – so I’m going to have severe pain and there’s no drug they can give me to relieve it. Comforting.

She called me back a few days later but said she couldn’t get the answers to those questions about the post surgery timetable. She said I needed to talk to my doctor about that. Great. I’d tried to get a timetable from Dr. N, Dr. K, and Dr. A. and got referred to this nurse for all scheduling questions and now she couldn’t answer them, although Dr. N had gone over this in very general terms. I needed to know specifically what days or weeks I would need to be in town for the EBRT. Dr. A had given me a fancy pamphlet printed up by Intuitive Surgical, the maker of the Da Vinci robotic surgery system used for the prostatectomy, giving all this kind of stuff in detail, along with a DVD worthy of Cecil B. De Mille. Brachytherapy is a rather common procedure that Dr. A performs. Why can’t they have a simple pamphlet or one-page flyer at least that provides this basic information? I’d gotten one for the biopsy. How about a standard email they can forward? You can find sites that give you a general idea about your physical condition and limitations for the first month or so, but they won’t tell you when the EBRT is likely to be. Besides, a patient should be able to get this kind of thing from his doctor, not the Internet.  Once again, another promise broken.

The instructions said I needed to have some tests, including a blood test and an EKG and they had to be done at that medical group, PAMF. They gave me a phone number to call and schedule these. I called and got a woman who was friendly and competent! Finally! She asked me when I would like to come in. I told her. She said that was fine. I about fell over dead from shock. Someone actually asked me what I wanted and agreed to it. I went there that day and they saw me promptly. The tests were done quickly and the phlebotomist was totally painless. They always like me. I have good protruding veins for them. I’m glad I finally have something good to say about PAMF.

See part 8.

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