Monday, December 17, 2012

Wrong procedure! First lesson, listen to your patients.

I was planning on writing about meeting another gutless cyclist on a local shop ride, on Saturday, while I was taking it easy and still feeling pretty rotten after getting out of the hospital only 36 hours prior.

And, before that, I had intended to write a post about how becoming suddenly and cripplingly ill, and landing in the hospital for a few days does things to my perspective and priorities - and I don't mean that in the cheesey, lifetime special, sort of way. I mean, sincerely, that on Saturday after getting out, I rode my bike like it was both the first and last day I ever would again. And, it was glorious... and rainy.

And, finally, on the list of upcoming posts is one that was triggered by a request from another blogger. She asked a few folks with Crohn's or an ostomy to write about how their age of diagnosis effected their life course and development.

But, instead, I find myself with a burning desire to write something short about the events of the day. At this moment I am feeling frustrated, close to downright angry. In followup to my recent illness I was scheduled for a bunch of appointments with my primary care physician and GI doc, and one minor procedure. However, my GI had to go out of town, and instead I was rescheduled with another physician for both my upcoming appointment and procedure. That's fine. Stuff happens, as inconvenient as that is.

Today, when the scheduler called me with the normal ramble about when to arrive, where to arrive, etc, she also said, "The procedure will take about 3 hours and you will need to have somebody pick you up afterwards".

Whoa! What!?

I said, "I think you must be mistaken. I do not need to be picked up because I will not be under any sedation. And, I think you have me down for the wrong procedure because 3 hours is too long".

Apparently, somehow there was some sort of major miscommunication and I was scheduled for a colonoscopy with general anesthesia! So, the scheduler apparently called the physician doing the procedure to try to figure it out. But, still the same thing! She told me that was the procedure I was scheduled for and was supposed to have.

Now, I'm a well educated and well informed person. I have no memory deficits, and I don't get confused about medical details. If there is one thing I know, it's that a colonoscopy 1.) won't work 2.) isn't appropriate followup!

At this point, I asked for the physician to call me so we could try to figure out how this confusion ocured and fix it.

The physician then had a medical assistant call me instead of calling herself. The medical assistant was in no way equipped to have any sort of conversation about the appropriateness of procedures, and was only able to reiterate that I was scheduled for a colonoscopy. She was very nice. I expressed my frustration that the physician had not called me, and that I thought instead of a one way conversation we needed to have direct two-way communication before I showed up on Thursday.

So, what happens next? The scheduler (who has some medical knowledge. a retired nurse ?) calls me back and reiterates again that all they are showing is a referal for a colonoscopy and that is what I am being seen for, and that I will be under general anesthesia. And, the tone was now changed, as if I was being a difficult patient and was making unreasonable and outragious demands: to not show up for a procedure that isn't correct or beneficial in followup - nevermind everything else.

Is this groundhogday the medical version!? Am I speaking a different language here?

Any patient should be able to voice concerns when they believe they are receiving or in danger of receiving the wrong treatment/surgery/medication/any care!!! It is our job to advocate for ourselves. If we don't, many times, nobody else will.

One of the first lessons I learned as a Paramedic was to listen to my patients (the coherent, lucid ones... and sometimes, especially the ones who aren't). They often have the answer. They know what happened last time, and can often be a great crystal ball for predicting what treatment will work best.

Sadly, I have yet to be taught that lessson at the Yale Medical School, either in the classroom or by example from the physicians practicing here at the teaching hospital.

And, here's an interesting scholarly article about how these sorts of errors in performing the wrong procedure or performing it on the wrong patient happen.

For the sake of my own health, I'll remain a trouble maker of a patient in their eyes. Who in their right mind would go under anesthesia if ANYTHING at all seemed wrong about the plan?


  1. I assume you meant to post a link to an article at the end, but it's really just a link to that cute Sesame Street image. Also, I've had experiences with wrong tests too, and it's terrifying. If I've been in the ER or hospital, usually they finally listen to me when I'm in a procedure room, crying, and refusing to sign consent forms or touch me with any medical equipment. There must be a more dignified way to straighten these problems out!

  2. Oh, rats! thanks for catching that! fixed now.

    Also, I love your handle, "loveformutantguts". Awesome.

    I do wish there were a better way to handle these things before it goes so far. Which is why I'm canceling all appointments this week and in the future until there is a serious conversation about what happened wrong here. *sigh*

  3. I can't even imagine going through something like that. The closest I have been was in college. Senior year, reading week, I woke up at 4 am with HORRIBLE pain in my lower right abdomen and a fever. Tests show elevated white blood count, low blood pressure & extreme tenderness and pain. ER doc who first diagnosed me was quick to say it was "obviously" an ovarian cyst. Wait. Back up a second. I have CLASSIC appendicitis symptoms. Text book. Home Run. No history of ovarian cysts, but you go with that because... I have ovaries? Luckily CT revealed a VERY close to rupture, very angry appendix, so that was out.

    Hope you are feeling better and you get everything sorted out.