Another Day In Medical Land

Thursday was an interesting day. I went in for blood work at the diagnostic lab down the hallway from my primary care physician's office. I called on Tuesday to tell them I was due for a test because I'm on Coumadin (Blood thinner for blood clots) and they assured be they would take the order down the hall to the lab and for me to go in on Thursday morning. I limp up to the window at the lab after parking my car too far away, give my name and hear "Sorry, we don't have any orders from your doctor." By the way, my primary care physician is great but he's been in Iraq for the past few months so my case has been passed around among the other physicians in the office. "I'll be right back" I told them and limped down the hall to the doctor's office. Of course the girl behind the glass was on the phone and when she got off I tried to explain to her what I needed but we kept getting interrupted by calls. After she took 3 other calls while I was trying to tell her what I needed, I gave up and sat down to rest my knee. She got off the phone so I tried again. "I don't see anything about it" she said. My blood pressure was beginning to rise at this point. "Look, when I called on Tuesday they said they would take the order to the lab. You need to find out what's going on because I have been walking and standing on a replaced knee that is not feeling well at all." "Did you speak with a nurse when you called in?"she asked. "Yes" I said. "Do you remember her name?" "If I knew it was going to turn into this, I would have remembered but I don't think she ever game me her name. Don't you have a file somewhere with my name on it?" So, between phone calls, she finds a file folder, pulls out a piece of paper and says "Here it is and it looks like Sheila signed it which means the order is at the lab. Go back to the lab and I'll call down there." So, I limp back down the hall to the lab. Now I'm watching the time because I have been there since 8:30 and it's about 9:00 and I have an appointment with my surgeon at 10:00. "Have a seat" they tell me when I get back to the lab. Meanwhile, more patients are coming in the door, defeating my purpose for getting there early. At 9:10 I go back to the window and tell them "if something doesn't begin to happen soon, I'm leaving. I have a 10:00 appointment. Finally, a lady speaks up from behind a desk. "I'll be right back, I'm going down the hall and see what their problem is." I decide to follow her back down the hall because I don't want it to get any more confusing than it already is as they point fingers at each other. But I'm impressed that this lady is determined to get it right. "Come back down to the lab with me" she says after she makes sure things are happening in the doctor's office. So, I limp back down the hall. I told her I was leaving at 9:20 because I have another appointment to make. At 9:15 she determinedly went back to the doctor's office again. At 9:20 I got up and left the waiting room of the lab and started limping back down the hallway headed for my car. I limped past the doctor's office and then the lady from the lab came back out in the hallway and shouts "Don't leave - c'mon, we'll get this done." She had taken control of the situation so I naturally followed her. She personally took me into the back and told the technician what to do and to do it quickly because I had to go. I was impressed. I asked her what her name is and thanked her enthusiastically. I plan on taking Brooke a small gift certificate to McDonald's or something when I go back in on Monday for more lab work; a token of appreciation for keeping my faith that some people still go beyond the call of duty. At 9:30, I limped out of that office and headed for the orthopedic surgeon's office with a list of questions to find out once and for all why this surgery is not going well. I looked past the fact that the lady up front in that office gave me a form to fill out about how my "hip" was doing. They actually took me to the examining room early. Jennifer, the physician's assistant walked in and I told her that I am normally a positive person but the only positive thing I had to say about my new knee (13 weeks post surgery) is that the incision healed nicely. "Something is not right" I said. She listened very closely and told me that they were frustrated too that the knee had not been progressing the way it should and orders x-rays. Jennifer I'm sure talked to Dr. Nichols about how disappointed I am with the whole procedure. About 15 minutes after I return to the examining room Dr. Nichols walks in with the x-rays in hand. He watches me as I limp across the floor to get on the examining table and pokes and prods around on the knee. I share my frustration with him too and assure him I have no desire to assign blame. I just need some assurance that this thing is going to get corrected. He looks at me and says "Something's not right. You have too much swelling, too much fluid, and too much pain." He shows me on the x-rays that nothing unusual is showing up. (It's pretty wild looking at a fake knee in your body on x-rays) But he says, either the alignment on the knee is off, the top part of the the prosthesis is not functioning properly, or the whole prosthesis needs to be replaced. Another surgery is needed. (This will be my 4th procedure related to the replacement) He also tells me that a guy who sits behind me at church had shared with him that I was not happy with the replacement. I couldn't figure out who the heck he was talking about because we don't even sit in the same place at church. Then I remembered as I was limping out, the anesthesiologist I had for the replacement surgery is in my BSF class. He sat behind me the other night and we talked in the parking lot for about 10 minutes about it. Anyway Dr. Nichols goes on to tell me he would understand if I want a second opinion so we talk about that. I asked him why he would say that. "Do you not have the confidence that you can fix it?" I asked. He said he has full confidence but wanted me to know he wouldn't be offended if I did seek another opinion. I told him it would be fine if he discussed the case with his son who is in the same practice and does hundreds of knee replacements too. He also tells me he does about 300 knees a year and 1/2 of his practice is fixing knees other doctors have done. This guy comes highly recommended. He also said out of the 150 knees he does the first time, he only has to go back in and adjust or fix two or three. I feel honored! I am one of the two or three. Surgery is set for May 21st (After the wedding) and actually, I am somewhat relieved. If he had said "Let's just stay the course for another 6 months" I would have told him no way. At least now we have a game plan. Maybe by July I'll be on track with another rehab; a successful one. Mary and I had lunch after my appointment and that's when I told her about the newly scheduled surgery. Ordeals like this are as tough on the spouse as they are on the person going through it. She has had to dig into her vacation time too often already. She's been a trooper and one of these days, we'll be walking Gracie together on a long 2 mile walk. At one point in the diagnostic lab, a fairly young man was wheeled into the waiting area and it was obvious from the huge scar on his shaved head and his semi-blank stare, he had gone through brain surgery. Suddenly, the knee didn't seem so bad. And that my friends is just another day in medical land.