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Archive for November, 2010

Are some doctors too busy or “only in it for the money”?

November 26, 2010 2 comments

I completely understand that doctors are busy. They have large patient loads, hospital rounds, mounds of paperwork, and a plethora of other things. I completely get this. I really do.

As a working woman, I know how busy it can get, and I can often lose track of time, and I struggle to return phone calls. While the people who call me are important, none of them are relying on me for health care.

This brings me to the matter at hand. Recently Mark developed an infection of some sort in the area where the catheter was removed. The wound started becoming inflamed, red, and it had developed pus pockets. He spoke to the nurse at the dialysis center, and she put a call into Mark’s vascular surgeon, Dr. Alfonso Ciervo, who did the removal of the catheter. A nephrologist was in the dialysis center that day took a look at the infected site, and he put Mark on some IV antibiotics. The dialysis nurse cleaned the wound, and put a sterile dressing on it.

The next day, Mark called Dr. Ciervo’s office to see if he could get an appointment to have the wound looked at in the office. The receptionist there told him that Dr. Ciervo was in surgery all day, but she would relay the message to him, and someone would call Mark back. Mark did not hear from Dr. Ciervo or his office, so he called again the next day.

He was told that Dr. Ciervo was completely booked up all week, but she would relay the message to him. Mark NEVER heard from Dr. Ciervo regarding this matter.

The dialysis center called Dr. Ciervo’s office several times also. They wanted to know what he thought about the situation, and see if he had a plan of action. Sadly, he never called them back either.

The nephrologist who saw Mark was the one who prescribed a course of IV antibiotics, and he recommended the cleaning of the wound and applying a new bandage each day. Luckily the site is clearing up nicely now. The antibiotic seems to have done its job. The wound is closing up. The pus has stopped forming, and the swelling is going down. We are still changing the dressing each day.

While it all seems to have worked out well, I am quite disappointed in Dr. Ciervo’s lack of follow-up. I realize that he is not the primary care physician, nor is he getting paid for a phone call, but he was the surgeon who inserted the catheter, and he was the one who removed it. I would think he would want to know about a problem.

On a side note, I always make it a point to do a google search of my doctors. I like to know what others are saying, and what opinions people have. I did a search of Dr. Ciervo when I found out he was going to put in the new graft in Mark’s arm.

While he was the surgeon who removed the infected graft when Mark was in the hospital, I did not have any time at all to research him. I knew nothing about him except for his name. Since it was done in an emergency, I was pretty much at his mercy.

However, afterwards, I googled him, and I found he had a good background. I did find one negative review on the site called Vitals.com. (The review is located here… http://www.vitals.com/doctors/Dr_Alfonso_Ciervo.html). The review was from 2009, and it was not very flattering.

To quote that review, it said:

He will operate on anyone for money. Surgery anytime of the day. Stay hungry all night and all day waiting for him to show up but be ware your surgery might get cancelled because he is “tied up” at another hospital for some “emergency”. Overbooks himself with amount of surgeries he cannot handle

I took this review with a grain of salt as it is simply one person’s opinion. I personally found that Dr. Ciervo was pleasant (although a bit rushed) when he came out to talk to me after the emergency surgery to remove the graft, but I was just grateful that Mark was okay.

When Mark had his surgery to put in the new graft, Dr. Ciervo was an hour and a half late to the hospital. That made the surgery start time late, and made an already long day even longer. While I know that emergencies happen, I find it very frustrating and annoying to have to wait and wait. We overheard the nurses talking about how Dr. Ciervo was going to be “late again”. This made me realize that he is often late, and it was quite possibly due to “over booking” or overextending himself.

Overall, I thought he was a decent enough doctor. His office was nice enough. The place was clean. He was pretty accommodating and took time to talk to us and answer our questions.

Yet this recent lack of follow-up makes me feel as though he really is only “in it for the money”. He didn’t stand to earn money by giving a consult or calling the nurse back, so he didn’t. He didn’t even have to call Mark or the Dialysis Center himself. He could have simply relayed the message to his nurse/receptionist, and she could have taken care of it. Yet for some unknown reason, everyone in that office just dropped the ball.

Being that an infection caused all of this to begin with, I would think that Dr. Ciervo would want to be involved. Yet, he remained out of the whole thing, leaving it all up to everyone else to figure it out. I was very disappointed with him. I felt like he just didn’t care about Mark now that there was no money in it for him.

Mark was pissed about the whole thing. He wants to find a new vascular surgeon who can monitor his graft. He wants to have a choice in the matter. He was “assigned” Dr. Ciervo when he was in the hospital, and now wants to find someone else.

I can’t really say that I blame him. I mean, you want to believe that your doctor cares about you. It’s hard to believe that when your doctor does not call back when you are having a problem. It’s not even as though he did not call Mark back, but he also did not call the dialysis center either. He is one of their recommended vascular surgeons. Would he really want to burn his bridges?

Mark told me that the Head Nurse there was quite angry that Dr. Ciervo did not call them back. She couldn’t really say anything bad about him, but she did give Mark the distinct impression that this was unacceptable on Dr. Ciervo’s part.

I don’t know if Mark is actually going to change vascular surgeons. I know he feels like Dr. Ciervo is one of those doctors who are only in it for the money. And I am tending to agree with him after this latest event.

Hello Bon? You out there???!!!

November 3, 2010 2 comments

Things here are going along quietly, and while that is good, I am often afraid to hope. I did that back in July by saying that things were going really good, and we know how that turned out. Two weeks in the hospital with a case of sepsis!!!!!

So with that, I will silently hope for the best, but not brag. Every time I allow myself to think that things are going well, I get into trouble!!

You can’t run away from trouble. There ain’t no place that far. ~ Uncle Remus

So anyway, around here, Mark’s been doing pretty good. He got his catheter out on Columbus Day which was the 11th of October. I actually got to watch the procedure!! I thought the vascular surgeon would kick me out, but he didn’t!! I found it pretty fascinating, in a sick kind of way!! Dr. Ciervo cut into the area around the catheter. I should have video’ed it!! Now THAT would have been cool!! Dr. C had a bit of trouble getting the catheter out due to the scar tissue build up, and the fact that, due to Mark’s body build, the insertion had to be pretty deep, but he got it out with some tugging, pulling, cutting, and blood!! But a few stitches and it was all good.

Mark is STILL afraid of infection, and he still has me putting neosporin and bandages on it. It is closed up now. It is healing nicely — considering that it looked pretty nasty when the procedure was first done. The surgeon told him that he should monitor it for about 3-4 days, and then it should be fine if it had no signs of infection. Well, it’s pushing 4 weeks now. But who am I to judge?

The graft is working pretty good so far. It gets checked again in January for any blockages or clots, etc. No more problems for a while PPPPPLLLLLLLEEEEAAAAASSSSEEEE!!!

Mark’s job is going pretty good too. He seems relatively happy teaching again instead of being the Technology Coordinator. He enjoys the kids, and I do believe the teaching is easier on him. The Tech job became pretty bad when they assigned the coordinators to handle TWO SCHOOLS. So he would have been doing double the work, in the same amount of hours, for the same amount of money. I think not!!! Glad he is teaching… and he is teaching the 3rd, 4th, and 5th graders. They are still teachable, and they don’t bring guns, knives, and other weapons to school!!!

Oh, we also got a different health insurance company, effective October 1. We had Horizon Blue Cross Blue Shield, and now we have Aetna. All co-pays and stuff remain the same — and in some ways, the new insurance is better. Aetna does not charge a $35 co-pay for Mark’s dialysis, so he just pays our normal $5 co-pay. That saves us a nice bit of money since he was able to drop his medicare insurance.

Luckily our doctors and specialists all accept Aetna. I would hate to have to deal with finding new doctors and stuff. That would just not be fun.

As for me, I am exhausted. And to be honest, I have not been feeling well.I thought it was stress related since it started in late July when Mark got sepsis. But it has not gone away. For the record, the stress didn’t go away either (although some of the pressure has been lifted), but I don’t think my symptoms are normal. I will spare you the gory details, but I felt “unwell” enough to visit my doctor. I’ve been having intestinal and digestive problems. I talked to my primary care doctor about it, and she thought it best to refer me to the gastroenterologist in the office for evaluation. Dr. Webber did a Celiac Panel because he thought that my symptoms could be indicative of celiac disease. And, as if I am not having enough fun these days, had me schedule a colonoscopy. Oh joy. Can’t wait for that!

The Celiac Panel gave back negative, so now the colonoscopy is imminent. I was hoping that I could avoid it for a couple more years. I also went to the gynecologist for a check up to rule out any “female issues”. I figured it couldn’t hurt. He said things seemed normal. I told him about my symptoms, the Celiac test, and the colonoscopy. He seemed to think that was a good plan. He did mention that although the Celiac Panel came back negative, I could still have Celiac Disease, and the best way would be a small intestine biopsy. He said that my symptoms certainly are those of Celiac Disease, although, they could be many other things. Ugh… not something I want… so we will see what the colonoscopy reveals, if anything.

I am also battling insomnia. That’s nothing new though. I usually stay up pretty late (12-1 AM) on a week night, but these days, sleep does not come so easily. I’ve been up at 2AM, or 3AM, or even 4AM. Not a good thing when you have to start the day at 6AM!!! Not sure what the problem is. Stress? Anxiety? Life? An underlying medical issue? Who knows. It’s ugly though. I feel exhausted by 6PM, and then all motivation just about leaves me. I just want to sit on the couch and do as little as possible. I try to do some stuff during the week so that all the chores are not waiting for me on the weekend, but lately I have to FORCE myself to do anything that requires moving or thinking. Look up “couch potato” in the dictionary… I bet my picture will appear!! 🙂

Being that blogging requires thinking, I have been pretty silent lately. I just don’t seem to have a desire to write. That’s odd for me. I enjoy writing. It frees my mind. Now I free my mind by endlessly watching TV, playing Spider Solitaire, and Farmville. How pathetic!!! I think that it’s all catching up with me. Sigh…

But I guess I do need to be more chatty when it comes to writing this blog. I know it’s all about my struggle with Mark’s kidney disease, so I suppose this qualifies as my “struggle”. Even though the insomnia has reared its ugly head recently (which is not something that its done in quite a while), and the gastro disorders are causing me discomfort, and the stress/anxiety is still around…. it’s still MY struggle… and I get to write about whatever it is that I feel like it.

So that’s where we are these days.