Tuesday, December 14, 2010

Dr. Kildare's Crisis

Put My Cankly Foot Down

After a night of pain and cranky thoughts and almost no sleep due to driving yesterday, I woke up in a not so happy mood after my half hour of dozing.  I had found some of the records Dr. Kildare had me fill out requests for, so I called and left a voice mail for Nurse Goodguy saying that I had some copies of records that I would leave for him when I came in for my blood draw (the tests had to be fasting for Dr. Kildare).

Then I said (I hope in a nice voice but I wasn't feeling very nice) that I didn't want to say how they ran their practice or decided the frequency for visits, but if March 2011 was when I was going to get any follow up done then let's just cut to the chase and refer me to a bigger hospital in a major city. In this area, I said my preferences would be Barnes Jewish/Washington University in St. Louis (where Dr. Bellyfixer works) or KU Medical Center in Kansas City (where Doc Optimist works).  This seemed to hit a sore spot, as when I got home this evening (having worked around five hours  - trying to earn a paycheck even though I am in pain, and it is very difficult for me to sit or concentrate) there was a message from Dr. Kildare.

First off,  he tried to blame the March 2011 appointment on the computerized scheduler.  I work in health care, and I have trained schedulers, and even been a scheduler once upon a time about 20 years ago.  The doctor says what frequency you return in.  If they want you back in one day, and that day is completely overbooked, the scheduler STILL sticks you in that day somewhere.  Why?  Because a physician ordered it that way.  My return appointment was "the first Thursday appointment available".  The scheduler (person) using the scheduler (computer) put this in, the first Thursday appointment available was in mid March 2011.  I asked twice, "Are you sure that is correct?  Is this what was ordered?"  since I had just come from an exam room where they had said for me to "be patient" for just a little while longer.  I don't know what universe Dr. Kildare comes from, but in mine three months is not "just a little while longer" and is beyond what I am willing to patienty wait for.

Perhaps poor Dr. Kildare is having to serve penance in my mind because when Dr. Dense was my physician and I was in incredible mindboggling daily pain with The Headache unsucessfully medicated I had no way to get any care between appointments.  The practice paid lip service to "just call and we will take care of you" when in reality it was call, be ignored, call back, have the nurse get snippy, call back, be told you need to go somewhere else. 

I will call tomorrow and either talk to Dr. Kildare's nurse, Nurse Goodguy's nurse, Dr. Kildare, or Nurse Goodguy and reply to my message.  Dr. Kildare asked in his message that I give them a couple of weeks to read my records and come up with a game plan.  I don't mind giving them a couple of weeks or even a month if I have to, but I am NOT waiting another three months, just to find out in three months there is nothing that they will or can do and I am another three months in pain and another three months further disabled and another three months up the creek without a paddle.  This has been ongoing for about a month messing with this and that, and I have been messed with enough. 

He also said if I had a problem with my return visit, I should have said something at the time.  I did!  The nurse AND the scheduler told me they were not willing to question Dr. Kildare as he had distinctly scribbled "Next Avail Thurs" on my "superbill" in the followup section.  I wasn't going to sit there and argue with them, they knew Dr. Kildare better than I did.  Guess Dr. Kildare is more than a little defensive about this.

Hoping I get lucky and Dr. Kildare gets lucky and I have a nutritional deficiency.  Maybe that will fix everything and I can take a pill and everything will be perfect from then on!!!  Hoping my blood tests are back tomorrow then I can find out.

The Dr. Dense Backstory:
I was in excruciating pain so bad I was in tears the day I called it quits with Dr. Dense.  It was mid summer 2008.  Dr. Dense had tried different medications since I started seing her in January that year: none worked. She ignored the records I finally got transferred to her from St. Louis University Hospital where I had been diagnosed with an indomethacin responsive headache, although she was the one who referred me there. The last medication she tried had been lithium which definitely did not agree with me.  I refused to take it after the second week.  She refused to prescribe anything else.  This was the third time since I had seen her that she simply left me without any medication or adequate pain managment for a significant number of days/weeks.
The day before she said she wouldn't prescribe indomethacin (hemicrania continua is an indomethacin responsive headache disorder - nothing else really works well) but she would hospitalize me for a three day infusion with DHE, depakote, and steroids.  I agreed because something was better than nothing which is what Dr. Dense had me on at the time. The nurse got all the permissions/preauthorizations done, called me said she was waiting for the doctor to say when I should go in.  I waited and waited and waited when I should have been at an emergency room.  The nurse calls back at the end of the day saying Dr. Dense, although in the office, was not responding to her requests for an admission time. 
 I called back the next morning in full melt down, and the nurse said very apologetically that Dr. Dense wouldn't admit me until the middle of the next week, as she was on call then.  I asked why she wouldn't admit me this week, as I was getting to the place I would not be able to drive myself to the hospital, and Dr. Dense actually said because she didn't want to inconvenience the other doctor who was on call that day.  WHAT????  The last straw was when I got the office manager involved and asked if Dr. Dense would reconsider prescribing the indomethacin as it actually reduced the pain, and Dr. Dense told her she would do that ONLY if I came in and signed an agreement that I would not see her again and I would get another doctor.  WHAT??? 
Idiotic, egotistical, unprofessional, unethical, arrogant, rude and offensive all at once - she was giving me the complete Doctor God package.  I went to the ER got medicated by some miscellaneous ER doc and as soon as I could I went back to my PCP and got referred to sweet Doc Optimist in Kansas City.  I guess Dr. Dense got her way as I have not seen her again nor do I wish to.


  1. To be a doctor and make up one's own rules of torture...

  2. Kristin: I concur.

    Called Dr. Kildare's nurse today, she had the same spiel as Dr. Kildare left on my voice mail, and when I tried to interrupt she would start at the beginning and go again. Do people have any sense? I said I had the same message and I understood, but still they did not budge on the return appointment although I said I will wait a month to see what happens. I am sure they have every intention of not seing me again until March and giving me instructions over the phone. Telemedicine??? Doctoring by inference? Telepathy?? Good Lord.

  3. I love how you put play characters to these people. I loved Dr. Kildare and Ben Casey. Anyway, yikes Winny! ((((Winny))))

  4. JBR: I still remember those TV shows. I was surprised that Dr. Kildare went all the way back to the 30's in movies, books, etc. Wonder if there was a radio program too???

    Yikes Indeed!

  5. Isn't there an ethics class in med school?

  6. Heather: I think Dr. Dense flunked MORE than just the ethics class.

    The worst thing is, if you have ever been in a general neurology waiting room, there are patients that are severely mentally handicapped there, whether from trauma, stroke, illness, or chromosomal defect. How is their treatment managed if mine (a cognizent and able minded at times adult) is done so poorly? Who speaks up for them? Where are their advocates? I see many accompanied by nursing home personnel, who while maybe competent, don't always have the passion to push for adequate or accurate treatment. Sigh. Sad sigh. Very sad sigh.