Category Archives: Medical Office

Lost Time Is Never Found Again


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Time Is What We Want Most, But What We Used Worst…William Penn

This week we motored to the Eye Doctor for an appointment for TLO.  This was a new doctor added to our portfolio as his previous Eye Doctor was no longer on the TLO’s insurance plan.   Like many caregivers, I ended leaving 

eyecheckwork early in the afternoon to pick up TLO so that we could head west to the appointment.  Twenty minutes from work to home; Twenty minutes from home to the doctor’s office, I guess you can say I was ‘Driving TLO’  (Driving Miss Daisy just did not sound right!)

On our way to the Doctor’s appointment, I got my first indication that this appointment had the potential to be a problem.

  • TLO: “When I made the appointment I asked them to send me the paperwork so I could fill it out and have it ready when we arrive.  I never received the paperwork, so if I do not have any of the information they need, I am going to write on each line, “I’m too old to remember because you did not send me the paperwork ahead of time!”
  • Me:  “How long ago did you make this appointment?”
  • TLO:  “At least six weeks ago and I called them in the mean time to ask them to send me the paperwork”
  • Me: “So you made two request for the paperwork”
  • TLO “Yes!”
  • “Oh Boy” I thought to myself…”This is going to be a long afternoon”

 We promptly arrived 15 minutes ahead of schedule and TLO started to fill out his paperwork.  Surprised that he did not say something to the receptionist about not being mailed the paperwork prior to the appointment, he took pen to paper and started to fill out the requested information.  (Of course, they took his Co pay first!)  As I peeked over to see what how he was doing with the paper work, I noticed a few long answers which started…”I’m too old to remember”… I chuckled, but made sure he was not missing any critical information that the doctor or staff needed which was important to his care.

While completing the paperwork we sat in what I thought was a waiting room, which was empty.  “We are going to move through this appointment quickly I thought.”  WRONG!  45 minutes later the receptionist called us and pointed us down the hallway to a second waiting area.  We were shocked to find 12 people in this waiting room to see the ‘tech’ then the doctor’.  Another 45 minutes, and finally he is called in for his eye exam, which took all of about 15 minutes.

While watching the other patients in the waiting room, I was trying to determine how people were being called in for their exam.  There seemed to be no rhyme or reason as patients who were there before us, were called after us.  You know that is the case when you get the evil eye from someone sitting across the room from you when your name is called, and their name is not.  I could see the nurses, tech support, receptionist all fluttering around the office, but no one taking charge.  Patients sitting there getting frustrated: receptionists with their glass window closed.

Soon TLO returned with the nurse who said…“Take a seat, Mr Schiffer the doctor will see you soon!’  I said to him, ‘What’s up, did you not see the doctor’…’no’ he replied, ‘they just did the test, they will call us again to review with the doctor.’

Oh boy, more delay’s, there is just so much daytime TV one can take; How do people watch those judge shows?

Time continues to drag on, and on and on… now we’re past two hours waitingeye rolling in this office, (as were many of the other patients) and we’re both started to get frustrated.  One of the nurses approaches us wanting to know his primary care doctor and his previous eye doctor. “All that information is on the paperwork, what seems to be the problem” we said in unison. (Yes, he did put that info on the paperwork!)  ‘Oh, we’re just waiting on the referral’ the doctor will not see you without the referral.  YIKES!

One of the great things about TLO is that he follows up with his Primary Care Physician on a regular basis when there is a need for a referral.  He confirmed weeks prior to the appointment that the referral had been sent by his PCP.

Before I could even get to the receptionist to straighten out this mess, TLO had beaten me to the punch.  Let us just say that we have two very diverse ways in handling conflict.  I will let your imagination  run wild about his loud and direct conversation with the receptionist!

thumbsdownTwo and a half hours into our extended stay at the Eye Doctor’s office, we finally just left. 

We have reported the Eye Doctor to our Primary Care Physician so that they do not make any more referrals to that office.  Knowing that they have the needed referral, we have also reported the Eye Doctor to our insurance company because we are both confident that they will bill for the appointment.

Time is a precious commodity. Too often time waiting in doctors’ offices is wasted by inefficiency of the staff; we have all experienced it.  But how do we combat it?

  • Always tell the doctor about your positive and/or negative experience with staff or office procedures, often doctors are the last ones to know.  It is their reputation!
  • Always tell the referring physician about a positive/negative experience with a referral they  have made.
  • When going to a new doctor, always ask for the paperwork in advance of the appointment to help expedite the wait time.
  •  Inform your insurance provider of a problem with a referral
  • Always double-check with your PCP to make sure that the referral has been made.

 I would love to hear what you do to combat wasted time at the doctor’s office!

You see…We Might Have Cancer, But Cancer Does Not Have Us!

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Florida arrival


We arrived safe and sound in Deerfield Beach this week. While we miss our family and friends in St. Louis, We are both thankful to be in South Florida.

This afternoon we are visiting the primary care physician; Monday the cardiologist and Tuesday the Oncologist. The report today at the PCP has been great. There is weight gain, all the critical numbers are good. The doctor is quite pleased, and so are we…This has been a remarkable recovery!

It’s great to share our sunshine with you from the Sunshine State!

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Downsizing


While we know that the tumor has been downsized by the radiation and chemotherapy treatments, we have taken a long look at our personal belongings and have started the process of downsizing in this area too.  So far, the experience has been quite cathartic.

How much ‘stuff’ does one really need to be comfortable in life?  China that has never been used, kitchen gadgets (well, except for the Tumor Extractor!), glasses, roasting pans; yikes where did all this stuff come from?   And better yet… what really is the need?

Funny as it seems, when I was in the seminary those little rooms we lived in seemed so small…now as I look back at that experience, living austerely has its benefits.  Thomas Merton does know what he is talking about!

Cancer is a life changing experience for all who are involved in it.  We have grown closer because of the disease and have I have come to a reality check with my life.   You see, what is important is not how many items you collect, rather what is important is how many lives you touch.   The last few years I have lost touch with my own reality; cancer does have its peculiar benefits.

As the green leaves transition to beautiful autumn colors, we are in a transition mode as well.  What we do for ourselves dies with us.  What we do for others will ever be immortal.  I am honored and proud to be a caregiver, it is one of the most remarkable experiences in life.  I am also grateful for the reality check that our downsizing has provided to us.  May the ‘Little One’s’  health continue to improve; let the downsizing begin!

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In Medicine…East vs. West


As ‘The Little One’ continues to show signs of regaining his strength, we decided to take a detour and visit Dr. Mo this past Saturday.  Who is Dr. Mo you might ask…well Dr. Mo specializes in eastern medicine, specifically acupuncture.   We visited Dr. Mo earlier this year for treatments of sciatica and after four treatments we were pleasantly surprised at the relief ‘The Little One’ received from the acupuncture.   ‘Why not consult with Dr. MO’, we both asked each other this past week. 

While we will not know for a least another month what effect the radiation and chemotherapy has had on the tumor; we know very well that the chemo and radiation has ravished his body, zapped his strength and pretty much turned his life upside down.  Traditional medicine, while proper seems to have a wait and see attitude during this ‘down time’ before the next PET scan.

This attitude was confirmed during my phone consultations with the oncologist and primary care doctor this past week.  The nurse for the oncologist told me over the phone that ‘The doctor normally does not call patients back’…my response to that was simply…’That is odd, don’t you think?’   The primary care doctor referred me back to the oncologist…(they share the same office!).   My response to the primary care doctor was just a tad more direct…”In the patients best interest, one of you needs to be taking the lead in the decision-making.’

That comment rang a bell with me.  The ones who need to take the lead in the decision making are the patient and the caregiver.  While we are all striving for excellency, when it comes right down to it, we are the captions of our own ship.  Authority while respected, is not all-knowing.  There is a reason that medicine is a science.  There are no two bodies alike!

We both know what we are facing with this disease, sometimes you just have to think outside the box.

What do we expect to gain from Dr. MO?  Alternatives, options, hope…just as we expected to gain from the traditional forms of medicine.  Yet not to pursue all options available to us, does not give life a chance.   We both saw the results of the acupuncture in March and April of this past year…why not give it a chance? 

In life…there are plenty alternatives, there are plenty of options, and there is plenty of hope…we just have to engage these options ourselves….rather than waiting for that call to be returned.

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The Paper in Hand or the Words From Your Lips?


Medical Directives, Durable Power of Attorney, Health Care Proxies are all important documents to have readily available when you or your loved one is working through the health care system.   These documents are equally important for non traditional families in order to establish communication between health care service providers as well as securing  visiting rights  for their partners and loved ones.

I was recently told of a story of a women who had enlisted her sister as her health care surrogate.  The health care surrogate did not agree with her sisters life style, denied her access to all her friends, instructed the staff to dress her  only in the clothes she had purchased for her only because the surrogate did not approve of her life style.   This cliff note version of this story is one of the saddest stories that I have ever been told in regards to heath care directives.

Imagine spending your life with someone only to be denied access to them because of someone’s bigotry? 

 

In my book, advocacy does not mean control, rather it means to stand up for your loved one in the manner in which they want to be represented

As ‘The Little One’ and Imuddle through the legal jargon in order to get him the best care plan possible,  these documents are critical to have in place.  I bring this topic up today to remind all of us for the need to have ‘all our ducks in a row’ because you just never know when you are going to need your medical directives, health care proxies and living wills.

However, it just makes sense that when a patient is of sound mind and body, a simple verbal permission by the patient should be sufficient to ensure communication between the patient’s advocate and the health care staff.  That is not always the case, which is way having the legal documentation in place is critical at these times.  Dealing with a critical  illness is difficult enough, having to worry ones advanced directives just makes it even worse.

 I am so proud of ‘The Little One’ as he fights to rid this disease from his body.   His determination to see this through is admirable; I am not sure that I would have the same strength and courage that he has demonstrated these past four weeks.     With just seven more treatments to go of radiation and one more treatment of chemotherapy, we are in the home stretch of this first and hopefully last round of cancer treatments.  There is indication that the tumor has shrunk, yet we will not know the results of the treatments until 30 days past the completion of the radiation and chemotherapy.

We will make it through these next 10 days and point to Wednesday October 5th…When ‘The Little One’ returns to our northern home

 

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Back On the Same Page


Earlier this week I posted about ‘mixed messages’ that we were receiving from the radiologist and chemotherapy in relation to the amount of protein drink that the little one should be drinking on a daily basis while going through his cancer treatments.  I am happy to report that we are now all are on the same page, it was just a minor philosophical difference in their treatment plan that needed to be tweaked.   Treatment plans are just that… plans; sometimes the game plan has to be changed in the middle of the game.  The key to any change in game plan is to have the proper data at hand so that intelligent adjustments can be made.   It is not unusual for professionals that have diverse opinions on how treatment plans should be administered.  What is equally as important is for those professionals is to  have the ability to communicate and change the game plan in order to have a winning formula.  Every game is different, as is every patient. Sometimes you just can’t go by the book, you have to make an adjustment in the middle the game. Earlier this week I had not intended to be critical positions as not meant to be critical of physicians, but rather to demonstrate the need for communication and consistency within the team. The physicians are the “managers,’… the caregiver is the ‘coach,’… the ‘patient’ is the player in the field;  if all three components of the team are not communicating properly, then the team is in chaos.  The coach is often the advocate between the manager and player.  Advocacy is the main role of a caregiver:  I am happy to say that we are now all on the same page!

The news continues to get better for ‘The Little One’ as we have had a number of good days in a row.  Lots of energy, eating well and good conversations with the staff at both the radiologist and the chemo-therapist this week.  We believe that the tumor has shrunk as food is going down the esophagus with a little more ease.  One of ‘ The Little One’s” favorite food is baked chicken and  until this week,  ‘The Little One’ not been able to enjoy baked chicken because of the tumor in the esophagus, it was just to difficult to get through the esophagus path: Quite a relief to enjoy something so delicious as your favorite meal without the worry of  pain as the food travels down the esophagus. How often we take things for granted like eating a moist juicy piece of chicken, until that delight is taken away from you by this insidious tumor.

We have now completed three weeks of the five week program. While it’s been an uphill battle, we are pleased with the progress that has been made. The unknown causes fear and trepidation, we certainly experience that during these past few weeks. We know more than we did three weeks ago, and I am sure that we will learn more over the next two weeks leading up to the completion of the treatments. The treatment plan calls for a 30 day reprieve from chemotherapy and radiation after the completion of the treatments in two weeks.  Once we are past 30 days from the last radiation treatment, ‘The Little One’ will have to go through the same set of tests that revealed the tumor in August. These tests  will reveal what the aftercare plan will be; we are hoping for the best!

As we move forward trying to cure the physical aspects of this disease, we are keenly aware of what this disease does to the psyche. While cancer affects all of us, the emotional roller coaster of having cancer can only be realized by the person who has the disease.  While we hope and pray that the chemotherapy and radiation destroys and obliterates the tumor, we are mindful that in order to successfully complete these treatments, there has to be a holistic component to the treatment plan. That is where our faith our family and our friends come in because it is through your love and compassion that we are able to make it through these treatment days.

 

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Mixed Messages?


Anyone who has had to deal with multiple (specialist) physicians at the same time know that is can be difficult to get  physicians to communicate and share patient information.     In my opinion, the perfect physician is one who takes the time to explain medical terms in common language, while collaborating with other physicians (who are on the same team with the patient) so that the information that is being delivered to the patient is consistent and  understandable to everyone involved with the patient; but most importantly.. to the patient them self. 

As ‘The Little One” enters into his third week of radiation and chemotherapy,  we have been getting mixed messages from some of our team members of physicians.    While it is agreed by all team members that “The Little One’ needs to add as much protein  to his diet as possible,  an issue came up this week that left us scratching our heads.   Just how much protein is enough...I guess that depends on who you ask!

Until you experience  chemotherapy and/or radiation,   you really don’t know what to expect.  ‘The Little One’ has had a roller coaster of experience over the past two weeks  because, as we know…’what goes in the body, eventually has to comes out of the body!

Which takes me back to the issue of the protein.   Both the radiologist and the chemo-therapist have suggested that “The Little One” drink over the counter protein drinks…Boost, Ensure…etc to help inject additional protein into his diet.   Yet here is the puzzlement…radiology suggested that “The Little One” drink as much as possible, while the nurse in  chemotherapy suggested no more than one a day?   “‘The more protein drink, the more likely for you to experience constipation”, said the (chemotherapy) nurse.  “Drink as much as you can as the protein drink will build strength, it is good for you” said the radiologist!

Confusing…YES!!!   Both “Team Members” believe their philosophy is correct; yet both Team Members do not have to deal with the after-effects of  chemo, radiation, or the liquid protein drink.   Remember…what goes in the body, somehow has to come out of the body.  The stress is only heighten when we receive mixed messages on how to resolve these uncomfortable symptoms of diarrhea and constipation …all at the same time!    Both of our team members are steadfast in their professional opinion; both of the team  only deal with the cause (cancer) not the effect (chemo/radiation etc) which makes me wonder, how this “team” should function?

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Most successful teams work within a structure and communicate well; this team has to act in the same manner.  This week, The Team will be instructed to provide an updated care plan for  The Little One with clear directions on food and liquid intake; we will engage the dietitian as well.

We are two weeks into the process and there is a clear pattern on how The Little One is reacting to the treatments.  His best two days are Tuesdays and Wednesdays;   His worst days are Thursday thru Saturday as the Chemotherapy passes through the body. (The addition of the protein drink on Thursday thru Saturday only heightens the dualistic symptoms that he experiences on these days.)  Sunday and Monday seem to be the neutral days,  yet he is tired and worn out both mentally and physically from the  calamity of the chemotherapy passing through the body.

Good teams make adjustments, while listens to messages both verbal and non verbal, along with providing  consistent communication so that everyone involved in on the same page.  This is no time for individuality or for ego; no teams wins on mixed messages, no team wins as an individual.

We  continue to move forward with hope, with determination and most of all…with love.

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I’m radioactive!


The phone rang and he said….”I’m radioactive” …I said to myself…”I’ve seen you go nuclear a number of times!”

The first two days are in the books and we are quite pleased at how ‘The Little One’ has reacted to the radiation and the chemotherapy. As he said to the chemo-therapist today…” I don’t care what you put into my body as long as it is going to help me beat this cancer.” This is the prefect attitude that we need in order to achieve our goals and beat this disease! As we continue to move forward, we are taking it one day at a time. Funny that he had a ferocious appetite tonight, something that has been missing for quite some time.

The nurses who work in the Chemotherapy office are to be commended for their care and their attitude. So many difficult cases to attend to on a daily basis, yet they are the on the front lines providing hope, dreams and the reality to all of their patients. We have the utmost respect for the nurses; they comfort, they care, and they become attached…nursing is a particular calling; we are regretful for their kindness and help. During our three hour treatment today, we were informed that ‘The Little One’ is receiving a mild form of Chemotherapy; we are thankful for that news because one never knows what the reaction will be to these treatments. May the good news continue to flow and may there be a gentle breeze at our backs.

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Hello, This is the Doctor’s office…


Anyone who knows this ‘Mutt and Jeff’ combination called Chris and Richard, know that one of us is blessed with patience, the other…while he does have a halo, can be just a tad short on patience at times…Today, rightly so!

For the past ten days, we have been awaiting word from the Chemotherapy office on confirmation on our appointment for next week.   When I left the house on Tuesday morning, we agreed that if we did not hear from the Chemotherapy doctor today, we would call to inquire about the date for the  appointment for next week.   We sure did hear from them today as the conversation started out like this…’You missed your appointment today.’

Of course, they laid blame to us stating…”we called you and left a message”…’funny’ how people still use that line when everyone now has caller I.D.   ‘Funny” how both the radiologist and the chemo-therapist, (who have been coordinating the treatments from the beginning) can’t seem to be on the same page with scheduling treatments.   I understand that these jobs can be daunting, yet to lay blame and to upset the patient shows a lack of  respect due to the individual who is dealing with the illness.While it is not Christmas, every patient should be treated like it is Christmas…with kindness, with understanding, with warm greetings.   Today’s call was quite upsetting to ‘The Little One’…It is his body, it is his mind, and it is his life To be berated over the phone for a ‘missed appointment’ when there was clear confirmation that both treatments would be stating the week of the 29th, is  unprofessional.  ‘Can you come tomorrow’ she said…’we’ll just fire up our corporate jet”, he said. She was clearly out of touch; it through him into a whirlwind of anger, frustration and contemplation.   Emotions that he did not need at this time, as the past few days have been difficult for him.

The role of an advocate is to intercede and intercept these types of conversations so that the patient can focus on getting better.  This one slipped through our hands today, now all communication will be handled  through the advocate, the partner, and the friend.  No office staff will have the opportunity to be insulting to this patient ever again.

May our hills be light and a gentle breeze always be at our back…

It is an HONOR to be an advocate…

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