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Part 3 – When You Need Elective Surgery – Think Ahead!

When you go to your doctor for some new symptom, realize that there will be a clinical process for your workup that could involve many steps, so think ahead!

I’m not suggesting that you will know exactly what tests will be necessary to evaluate your condition, but you can still think ahead.  In many instances, your PCP will have a pretty good idea what kind of treatment your symptoms will require.  In most cases, the tests he orders are done to confirm his suspicions.  With that in mind, if surgery is a strong possibility and you have a history of a chronic condition such as diabetes or heart disease, you may wish to schedule a pre-op evaluation by the specialist who cares for you for that condition.  Why?  Because these doctors are often very busy and you may have a long delay to get such an appointment.  At the very least check with the receptionist how quickly you can be seen if you need clearance before surgery.  In my case because of my heart history I knew I needed to be cleared by my cardiologist.  I also knew because I hadn’t had a recent stress test, he would probably want me to have that done prior to his giving me clearance. I was correct & getting these done added about two weeks to the process.

Next time I’ll discuss evaluating your treatment options to make sure you get the best care you can!

For Your Health – Dr. Bob

When Plans Go Wrong

I heard about a situation the other day that I’d like to share with you to get your thoughts:

It seems a 62 year old woman, I’ll call her Susan, had been in the hospital for a few days due to vertigo.  She would feel the room spinning when she moved her head in certain positions.  It was so bad that she could hardly walk let alone drive, and she lived alone.  The vertigo was also accompanied by nausea and vomiting.  While in the hospital she was given a medicine, meclizine, that controlled her symptoms.  Her doctor discharged her with a prescription for the medicine.  He also wanted a home health nurse to visit her several times a week and a physical therapist to come to her home to give her some treatments that usually help control the symptoms as well.  Finally, her doctor wanted her to come to his office a week after discharge from the hospital to make sure she was progressing.  All in all, it sounded like a great Discharge Plan.  The trouble is – it just didn’t happen.

First, since meclizine is available over the counter, her insurer wouldn’t pay for it even though she had a doctor’s prescription for it.  Next, though she went home on a Friday, by the following Wednesday she had yet to have a visit from the home health nurse.  When Susan called the nursing agency to find out why the nurse hadn’t visited, she was told they had not received an order faxed to them from the attending physician.  And because the nurse was going to arrange for the physical therapist, she had not had any physical therapy either.  Susan called the physician’s office when she learned of this, but hadn’t received a call back from the doctor after several days.  Finally, because she didn’t get the medicine that was prescribed she was feeling worse since coming home and couldn’t drive herself to the doctor’s office for her Thursday follow up appointment.

Has anything like this happened to you or someone you know?  If you were Susan, what would you have done differently?  Please post your thoughts & comments.

For Your Health – Dr. Bob