A Shocking Followup

You might remember that, a month ago, I had my nose electrically cauterized.  Well, yesterday I had my followup appointment.  Perhaps I should have known how things were going to go a few days prior when the doctor who did my procedure had to cancel due to emergency surgery and I was given an appointment with another doctor.  But I figured that these things happen.

Getting to the office and into the waiting area for the doctor went without incident.  Then the doctor came in.  She was nice, listened to my history and looked in my nose.  She got it to bleed which was a good thing because she seemed to be actively trying to find where it was bleeding from.  Doesn’t make sense to treat areas that you *think* are bleeding when another area might be the actual bleeding spot.  So far all good, but we’re about to head downhill fast.

She said she was going to put some stuff in my nose.  I didn’t quite catch the name, but I thought I heard "Afrin" which I had taken to reduce the size of my nasal blood vessels and so reduce the number and severity of the bleeds.  I figured she was going to pack my nose like was done one time before to help it heal.  As she stuffed a cotton ball up my nose, liquid ran down my lips.

"That’ll just numb your lips a bit," she joked.

Numb?  Excuse me?!!!  Just what was she planning on doing?  I told her that I didn’t want another electrical cauterization done.

"Well, I’m going to have to do something," she said as she walked out of the room.

Now alarm bells were going off.  Just what was "something" and why would she leave the room mid-discussion like that without giving me a chance to respond?  I was left to sit there and think this over (and text message) a bit before she came back in.  I reiterated my stance against another electrical cauterization.  I told her how painful it was last time, how I was so clogged up that I couldn’t sleep last time, and how I had nobody to drive me home should I not feel up to it.  She insisted that she was going to do a silver nitrate cauterization.  She said it’s less intense and I won’t get as clogged up.  I grudgingly accepted, half feeling like I was backed into a corner.

The procedure went smoothly, I guess.  The two main problems during it (for me) came when a flood of fluid spilled from another cotton ball stuffed in my nose into my mouth causing me to swallow numbing solution.  She made sure to squeeze the cotton balls better next time to prevent a recurrence.  The other incident happened when a gush of something came out of my nose and went *under* the bib they put on me right onto my white shirt.  During the electrical cauterization, a similar incident involved blood so I was fearful that my white shirt was now ruined.  Luckily, it was that numbing stuff again which is clear and doesn’t stain.  Still, her joke post-procedure that my white shirt is "too much pressure" for her was in poor taste.

After the procedure was completed, she said she wanted to see me on a weekly basis to keep an eye on the bleeds.  She explained that you can cauterize one area only to have another bleed form slightly higher up in the vessel.  Apparently, she was planning on repeating this procedure many times until the bleeding stopped.

I went to check out and was told I owed a $30 co-pay.  I asked why.  After all, this appointment was a follow-up to my electrical cauterization procedure.  I was informed that followups don’t need co-pays only when dealing with a surgical procedure and electrical cauterization doesn’t count as a surgical procedure.  Then I asked if this meant that my weekly followups would have co-pays as well.  Yes they would was the answer.  This was the last straw.  I can’t afford to spend $30 per week to have someone chase nosebleeds in my nose!

They gave me the number of their billing manager (the person at the desk had no authority to do anything except collect co-pays and schedule appointments) and I called the next day.  The billing manager told me that they had zero leeway with this.  This is what my insurance company mandates so this is what they charge.

Meanwhile, I had had a chance to stew about some of the problems with what went on in the doctor’s office and asked to speak with the patient representative.  I explained to her the situation and she (with my permission) said she’d talk with the doctor.

Now it gets *really fun*.  The doctor called me back and started all but blaming me outright for the situation, telling me that she "can’t read minds."  EXCUSE ME?!!!!  A doctor is not supposed to start a procedure on a patient and just assume they’ll get up to speed about things.  A doctor is supposed to give the patient options and discuss a course of action before starting something.

She said the only other option was packing my nose and I told her that’s what I thought she was doing before I felt the numbing stuff inside my nose.  I quickly realized that I wasn’t getting anywhere with her and got off the phone with her.  B called the patient representative back and lodged a complaint.  Curiously, the doctor didn’t want to see me and the doctor who did my electrical cauterization will now see me on my appointment this Friday.  (If I keep it.)

In any event, this whole situation could have been diffused by five minutes of sitting down with the patient (me) and telling me what our options were and what she thought was needed.  I’d have likely agreed and the rest would have gone the same, but at least I’d have known and agreed to the medical procedure *BEFORE* it was started and not *AFTER* the doctor began it.

Maybe it’s a sign that "Patient Representative" is the first option on their phone menu.