Friday, April 24, 2009

Confused

Well I have my surgery scheduled. It is scheduled for 5/7. Let me tell you, this is a huge leap of faith for me. You know I am having serious pain when I have agreed to let a new dr do a surgery on me in a university hospital. I hate university hospitals. The last time I was in one was with Kirsten and I was passed from dr to dr because my dr went on vacation and didn't bother to tell me when she admitted me. I felt like a science experiment for all the residents, med students, and nursing students, cause I got to see them all. I didn't like it one bit. I hated being passed from dr to dr. Then again, I just had a terrible experience when I had Cate with a small community hospital. I have decided to make sure that I am my own patient advocate. I will never sit back and let a nurse make comments that are not right and treat me like crap as a patient.

I am encouraged by what I have seen of the big bad university hospital so far. There is a HUGE emphasis on patient satisfaction. HUGE. I had to change the date of the surgery they originally scheduled (4/30) because it was a bad date for us. The OBGYN secretary was sooooo sweet. I mean she couldn't have been nicer. When I expressed surprise and gratitude at how nice she was. She said honey we are here for the patient. We want you to have a good experience. WOW. What a difference from my home hospital. I mean you shouldn't be grateful for a nurse being nice to you. Which doesn't make sense and means the hospital is NOT doing enough to work on customer service within the hospital. I mean they advocate it on tv commercials. Their staff is NOT walking the walk. So I am feeling a tiny bit better about going to the big bad hospital. At this point, I am desparate to not have this pelvic pain anymore.

I came across an article on about.com regarding intuition as a patient. It was written by a dr and it said ALWAYS trust your intuition. If you feel you are not getting the best care possible. Listen to that little voice inside you. That's what I did this time. I can't live with having to take a narcotic to control the pelvic pain. I shouldn't have to do that. I know something can be done. I am encouraged that the specialist said she is going to cut it out.

I am very worried about several things. 1) What if the operative reports are wrong? I mean I am totally confused about my ob and why he has done certain things. My first surgery I had adhesions which he cut and took out. He didn't see lesions of endo. However, I had adhesions for no reasons. I didn't have any risk factors for them. According to the specialist, they were most likely caused by endo. My second operative report done 8 months later states that there was scarring and old endometriosis between the tubes and ovaries. Yet when I had my post op appt and after my surgery, my ob told me he didn't see anything? Maybe he didn't think much of the endo and scarring. However, that was a major change from my last report. Why didn't he just tell me what he found? Why did he say he didn't see anything? Why did he open me up only to sa yep it's there. Then he didn't do anything about it. That is not what we agreed to. My only guess is that since he is a regular obgyn, he just doesn't know what the hell he was doing. Which is why I am now seeing a specialist. She has promised me she will not leave it in. She has said it will be a very extensive surgery unlike before. That scares the pants off me too. What if it is worse than he said because he didn't know what he was looking at? What if I end up losing a tube or an ovary or it gets converted to a laparotomy? I have some of these questions for the surgeon.

2) Of course I am terrified of terrible nursing care again. I plan to discuss this with the specialist at the preop appt so that I know what she is prescribing for me and what to expect at this hospital.

3) This doesn't have to do with the surgery coming up but the one I had with the miscarriage. The reports do not make sense. My ob had on the operative report blighted ovum/intrauterine fetal demise at 13 weeks. WTF. That is like an oxymoron. You can't have both. This baby was certainly not a blighted ovum when it measured 13 weeks and was a fully formed baby on the US screen. Which led to me going and looking at the pathology reports. I expected the path reports to say that there was a baby of whatever gestational age. That's not what it said. It said basically it received placenta, uterine lining, amniotic bag. HUH. Then I had a couple of drs review the records and discovered he missed the baby. How could he miss the baby? That is why I had such horrible pain for 2 days and bled so heavily. That clot that I thought I passed that I had to push out was really the baby all messed up from the D&C. I can't be mad about that he missed. It's a known complication of the d&c. Dammit, I am mad that he didn't tell me. My ob HAD to have known. I mean when you expect to pull out a dead 13 week fetus and you just get some tissue, wouldn't something click? When you see the path report telling you what was found wouldn't you think? When I describe passing an enormous clot bigger than my fist and that there was a lot of blood and pain, wouldn't you think maybe you missed? What about an US report from the ER that says there is a 10x6cm structure still in the uterus, wouldn't you think hey I missed? He told the ER dr no way that he missed. He was positive he got it all. The ER dr did not question him. I was told by the drs that reviewed the chart (these were a friend/acquaintances), that I should NEVER have been allowed to go home from the ER with a mass that large in my uterus. It wasn't like my ob didn't do USs in his office. He did two. One at 8 weeks and one at 12 weeks. He should have documented the heartbeat in my chart. Wouldn't that cross your mind that this was not a blighted ovum and you are missing something.

So I am confused. Honestly, he took excellent care of me with Sara and Cate. Couldn't have asked for anything different. Gave me everything I asked for. The endo thing, most obgyns can and do not know how to treat. I am referred for a specialist to handle that now. I am terribly bothered that he did not tell me about the d&c botch after the miscarriage. I wondered when I had the first US with him with Cate WHY he took over 20 minutes to US her. Before it was yep, baby is in the uterus, there is the heartbeat. Baby is moving. Done. He took over 20 minutes at that first appt to check her out. I worried terribly something was wrong. It was because of the D&C I think. I have honestly thought about changing drs because of the two surgeries. However, I don't like the other two obgyns in town. To go out of town would mean at least 45 minutes each way for appts. That sucked when I was pregnant with Cate and Sara going to the peri each week.

I have wanted to discuss what happened with my ob. I don't know how to approach it. Because honestly it is impacting my trust of him. I mean I feel like if I have any tests done, I need to get a copy of it. Because what if he is not telling me something, kwim? I can get copies of tests through my pcp. I know with pregnancy, my peri wants copied on the tests and she gives me the actual numbers. So I either get it verbally from her or I take a copy from my pcp or ob.

I honestly believe the er dr covered for my ob thinking I would never find out that he missed. I mean you shouldn't tell a patient your uterus is filled with old blood, debris, and clots. When the US report said there is a 10x6 cm structure in the uterus. Big difference. Both of them should have been honest with me.

I think that is why I didn't bother calling my ob with what the specialist said. He was pissed I had gone behind his back and gotten the referral through my pcp. I refuse to deal with HIS billing clerk cause quite frankly she is a real bitch. I can't beleive she gets away with treating patients the way she does with her rude attitude. Fortunately, I don't have to deal with her very often. Maybe 4-5 times in almost 5 years. Then when he realized I was serious, he wanted to know what the specialist said? I just let him read the report which said that we discussed medical therapy (I failed it), lupron (not doing it ever), hysterectomy (She put in the report that I was unsure of ending childbearing, which is true. I want one more!), and conservative laparoscopy. I chose the lap with her promise that she would cut it all out. My ob probably died when he read I still wanted another. lol.


So I am torn. It's really easy to say dump the doc. However, they are in short supply. I don't want to travel hours to see one. Honestly, my biggest issue is telling me exactly what my reports say. I am terribly bothered he wasn't honest with me with two of the surgeries. I would like to address this with him to clear this up in the future (hopefully there will be no more surgeries except my hysterectomy when I am done with babies). How can I know he will be honest with me on anything else? I would like to get this resolved but don't know how to approach him about it. Other than that he is a good doc. How do I know I won't get the same elsewhere?

1 comment:

The Queen said...

Thinking of you today, hope it went well.