Friday, October 31, 2003
Randy saw Dr. P (cardiologist) at 10:00 for a follow-up on his cath site; all was well. Dr. K's office called Randy and told him they'd finally heard from Dr. B. They will call him as soon as they have more information. They said we should check the films out at BRMC to bring them to the neurosurgeon in Johnson City, and that she'd call us Monday with an appointment for the neurosurgeon. Randy told Dr. K's nurse that he's having trouble sleeping. She said we'd have to call Dr. R (internal medicine) for a prescription. We made repeated unsuccessful attempts to contact Dr. R; our calls were continually routed to a "nurse's line". Our call was finally returned by Dr. R's nurse about 5:30. She had only received one message, and that wasn't until Dr. R had already left for the day. She said either she or Dr. R would contact Randy Monday morning without fail.
Thursday, October 30, 2003
We went to BRMC at 4:00 for the CAT scan and abdominal x-ray. When we came out of radiology, I found that we still hadn't heard anything from Johnson City. I called Dr. K's office and learned that they'd never heard from Dr. B. I called Dr. B's office; his assistant told me Dr. B "probably forgot", and that she'd remind him to call.
Tuesday, October 28, 2003
Dr. B told us that he didn't want to put Randy to sleep to relocate the shunt because of the risk to his heart. He said their were two options: 1) us a local anesthetic and route the shunt to a bag outside his body until after his bypass surgery or 2) refer him to a neurosurgeon in Johnson City and have the shunt relocated after he's put to sleep just before his bypass surgery. We agreed that the second option was preferable. Dr. B said he would call Johnson City the next day (Wed. Oct. 29) to talk to a neurosurgeon there and tell them what needs to be done. He also scheduled a CAT scan and abdominal x-ray at BRMC.
Wednesday, October 22, 2003
Dr. K's office called to tell us to expect a call from Dr. B. She cautioned me that if we did not hear from them early in the day, I should call Dr. B's office. Over the course of the day, I called three times and left voicemail for Dr. B's assistant, but received no reply. I called Dr. K's office; they couldn't reach anything but voicemail either. After I left the third voicemail, I called Dr. B's office again and explained to their receptionist that I hadn't reached anything but voicemail all day. She gave me another number to try; it turns out that the number she gave me was form Dr. B's insurance clerk, who couldn't help us. She said I needed to talk to Dr. B's assistant; I explained that I'd left three voicemails, but had no reply. She asked me to hold a moment; the next voice I heard was Dr. B himself. I explained that Dr. K's office had told us to expect a call; Dr. B said he'd talked to Dr. K and would be glad to take care of Randy, but that he wanted to talk to me first. I said that would be fine; Dr. B proceeded to tell he that he wasn't going to have anyone yelling at his staff. I was stunned, and told him I hadn't yelled at anyone. He curtly informed me that his office would contact Randy to make an appointment. I waited a few minutes, then called the insurance clerk to ask if I owed her an apology. She said no, that I was fine. She had just told Dr. B's assistant that I was upset because no one had returned my calls. The assistant apparently wrongly assumed I'd yelled, and told Dr. B as much. Later, the assistant called Randy and gave us an appointment for Tuesday, Oct. 28. Randy was upset because Dr. B had spoken so rudely to me. I told him that I deal with jerks every day, and one more wouldn't make any difference. As long as Dr. B took care of Randy, I could get along with him.
Tuesday, October 21, 2003
Reported to Cardiac Cath Lab at JCMC at 7:00 a.m. Dr. P performed cardiac catheterization. He found "multiple extensive" blockages and referred us to Dr. K, a cardiac surgeon. During Randy's "waking up" period from the cath, we were visited by an anesthesiologist, a representative from cardiac rehab, and Dr. K. Dr. K explained that multiple bypasses are necessary. Randy has one cardiac artery that's half as big around as it should be (born that way). He has long areas of narrowing in his coronary arteries. Dr. K said that there were only three treatment options: 1) let nature take its course--not an option in Randy's case; 2) medication--this would relieve the pain, but would not reduce the imminent risk of heart attack; 3) bypass surgery, which would correct the problem. Dr. K asked about previous surgeries. Randy has had a total of six brain surgeries, starting in 1988. The first surgery was to remove a cyst in the third ventricle of his brain. Successive surgeries were necessary because: the flap of skull began to sink, requiring a plate to be put in; adhesions developed, causing seisures; and a shunt had to be run from his brain to his abdomen to regulate the pressure of the fluid in his brain. When I pointed out Randy's scars from the shunt (at the top of his breastbone and on his abdomen), Dr. K became concerned that the placement of the shunt might have it in the way. Randy was sent to x-ray for a chest x-ray and carotid ultrasounds. X-rays revealed that the shunt does, indeed, run midline through his chest, putting it in a bad position for heart surgery. Dr. K's office contacted the office of Dr. B, the neurosurgeon who performed Randy's brain surgeries. They told us that Dr. B would contact us re: relocation of the shunt prior to bypass surgery. Bypass surgery had already been scheduled for Monday, Oct. 27, but is now postponed until the shunt is relocated.