Wednesday, November 15, 2006

Medical bureacra-zy

Well, as if it isn't emotionally difficult enough to handle a miscarriage, the medical system here really does everything it can to make the physical part harder as well. Monday morning, first thing, I called my doctor's office to tell them I miscarried the night before. The lady said, "Okay?" and then was quiet, as if to say, "And?" I told her I wanted to see the doctor for an exam. She did not offer an appointment, but said she would take a message for the doctor. After 2.5 hours and nothing, when my cramps started becoming worse (in spite of the 800 mg ibuprofen I was already taking every 4 hours), I called back and talked to the nurse, who told me it was normal and that I could take ibuprofen. Didn't I just tell her what I was already taking? She offered to talk to the doctor and call me back, which she did, and asked for someone else. I told her I was the one who called, at which point she realized she had been given the wrong person's chart, so she wasn't even looking at my chart. She put me on hold, then came back and said the doctor wanted me to go for a "STAT" ultrasound - meaning urgent. That was at 10:30 a.m. She told me the radiology place would call me to tell me when and where to go. At 2:30 p.m., they finally called and said to be there at 3:30 and to drink 48 oz of water before I went and then hold my bladder. I got there, and of course they didn't call me in until 4:05, so I had to let the edge off my bladder 3 times just to survive.

So I had the u/s, and the tech said it all looked good as far as the miscarriage, that it didn't look like there was any tissue left behind (which would require a D&C - surgery where they go in and scrape the inside of the uterus). She faxed a handwritten report to my doctor's office before I left. I called the doctor's office, this being around 4:45 p.m., to make sure they received the report, knowing their office closes at 5 p.m. The lady told me they got the report, it was sitting on the doctor's desk, but he was still seeing patients, so he would call me later. By the time I got home, the doctor had called my home phone and left a message, not saying the results, but I couldn't call back because the office was closed and the phones were already turned off.

So that evening (Monday) I started to run just a low-grade temp, never went higher than 100.6, but considering I was taking ibuprofen regularly, it concerned me a bit. Plus, I was still having significant cramping. By Tuesday morning, the cramps were getting really bad. So first thing Tuesday morning, I called the doctor's office and reported the increasing pain and the low grade temp, and again requested to be seen. She told me the doctor was in surgery all day and was unavailable all day, so if I wanted to be seen, I would just have to go to the emergency room. She didn't even offer to let me talk to the nurse, let alone offer to page the doctor and ask him what to do.

By this point, I'm bawling my eyes out. I was in so much pain, and I was so frustrated I just felt like throwing my hands up in the air. I did NOT want to go sit in an ER waiting room for hours while I'm in pain and hysterically crying. I wanted to call Darrell, but he was in court in the morning, and I felt bad interrupting him, so I didn't. So I called my insurance company, Kaiser, to see if perhaps I could get in to see my primary care physician (whom I still haven't ever met). They wanted me to see an OB/GYN, so they insisted I call around to some other OB offices to see if anyone could see me. Of course, they all said no, because I was Dr. Bernard's patient and they didn't want to get involved. At this point I called my boss, who's an RN, to get her advice. She really wanted me to go to the ER, but I really didn't want to. So I called Kaiser back to see if I could just go to Urgent Care, and they gave me an appointment at their Indio office with a family practitioner.

Thank God they did that. First of all, the guy was so kind and compassionate. He took a LOT of time with me, listened to my whole story - incredulous that I was having such a hard time just getting to see a doctor. He did a complete pelvic exam, and thank goodness he did, because there was still some tissue hanging out in there (sorry if TMI), which he was able to pull out with a long utencil. He took cultures, too, because he felt strongly that I was already starting to get an infection because of the tissue having stayed in there for a couple days after the miscarriage. He said the pain and low grade fever were caused by the infection. So he started me on Augmentin and gave me some Vicodin for the pain, but told me if my fever went over 101, I would need to go to the ER and probably get admitted for IV antibiotics and a D&C. He also said he wanted me to f/u with the OB.

So I called the OB's office again, told them what the other doctor did and said, and the magically offered me an appointment for 11:30 a.m. today. Unfortunately, this morning upon waking, I was in so much pain I could hardly walk or stand up straight. I took my vicodin and ibuprofen, and thank goodness it has kicked in; the pain isn't gone, but I can stand it now. Otherwise, I would've had to give in and go to the ER. So now I'm just waiting for my appointment, and we'll go from there. My gut tells me they may really need to do a D&C, because the cramping is so bad that there must still be some tissue left. My fever is completely gone, so I don't think it's the infection getting worse.

Anyway, thank you for your continued prayers and thoughts. I'm gonna go lay down!

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