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.

A Shocking Experience

For as long as I can remember, I’ve had trouble breathing through my nose. The problem is especially bad in my left nostril. Over a decade ago, I had surgery back to cut back my turbinates, but didn’t get a deviated septum operation as my insurance company at the time denied it the day before the operation. (They claimed it was cosmetic only.)

Last month, I went to an ENT specialist concerning my nosebleeds. I was getting them on a daily basis and they were really troubling me. Now when I say nosebleeds, I don’t mean a bit of blood coming out of my nose, I mean a gush of blood necessitating constant pressure for 10-15 minutes. The nosebleeds always came from the same nostril, the left one. Yes, the same one that I can hardly breathe through.

Last month, the ENT packed my nose with special gauze to help my nostril’s blood vessels heal. This worked for a week or two. Then I got a nosebleed. The next week, I got another one. Then they started coming every 2 or 3 days.

Meanwhile, last week, JSL had strep. When I developed a sore throat (and heard that a few of my co-workers had sore throats), I wondered if I was getting strep as well. So I went back to the ENT, figuring I’d find out about the strep at the same time that I talk with them about my nose. They didn’t think I had strep, but did a culture just to be sure. (Results will take a few days.) Then it was time for my nose.

The nurse practitioner took a look in my nose and said that it was time to go for electrical-cauterization. They got their tools ready and here’s the intrument of torture:

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First, they soaked a cotton ball with some numbing solution. They shoved this up my nostril, causing numbing stuff to run down my lip and into my mouth. YUCK! After it had a few minutes to work, and after B took JSL out of the room, they began the cauterization. Think of the static electric shock you get from time to time when you touch a light switch. Multiply that by 10. Now put that shock inside your nostril. Yes, it was painful. Very painful. And, even worse, I could smell my nostril burning. (This burning smell would persist for hours afterwards.)

As a side effect of this procedure, I can’t breathe through either nostril now. (Not going to go into any more details since I think I’ve already strayed into TMI territory.) Last night was spent passed out for an hour, then up for an hour hacking and coughing and trying to, somehow, get comfortable enough to sleep.

I know that, in the long run, this will help me avoid nosebleeds. It was also a prerequisite for even considering any form of surgery on my nose to correct my breathing problems. Still, in the short term, it was quite the nasty procedure. I’m hoping to be able to rest a bit more today so I can go back to work tomorrow. (Not to mention being able to breathe a bit better.)

Of Skepticism and Being Mean

I’m a fan of skepticism. Really, I am. I was reading a post recently about a necklace that supposedly cured eczema and I thought how ridiculous that might be that a necklace would cure a skin condition that it didn’t even touch. In cases like this, skepticism means looking for scientific evidence that a certain product works or doesn’t work. However, one thing skepticism should never involve is being mean.

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Scary H1N1 Spread

Unless you’ve been living under a rock, you already know that H1N1 seems to be spreading all too quickly and that the vaccine is in short supply.  Our doctor told us today that we are on a four page list of people waiting for the vaccine.  We also found out that 66 of the 270 children in NHL’s school were out today.  That’s nearly 25% of the kids out!

After picking up NHL, B told me that he was complaining of having a headache.  That sparked a memory of him complaining of having a headache this morning.  That, combined with B not being sure if he had a fever and the obvious rampant infection rate in his school, leads us to worry about NHL having H1N1.  B, JSL and NHL are off as I type this to get NHL some Tamiflu to have onhand in case he really has influenza.  Meanwhile, I’m going to keep my fingers crossed that he’s just feeling tired and run down and not H1N1-sick.

In related news, I checked out the CDC’s FluView website.  The map intrigued me and I wanted to see how H1N1 has been progressing.  I managed to locate all of the archival maps (except for week 16) and strung them into a Flash animation:


Note how the brown "widespread" states multiply starting the first week of September, aka When School Starts.  I have a bad feeling that NHL’s school in particular and schools in general are going to see worse infection rates before things improve.

Here’s hoping that everyone out there stays healthy!

Vaccine Time

I’ve written before about the Sid The Science Kid on PBS.  Well, I was recently informed that Sid was going to have a special vaccination episode.  For children, vaccinations can be scary events.  Kids don’t always recognize that the small amount of pain now (from the needle stick) prevents a lot of suffering later (from the disease) and possibly even hospitalization/death.  Diseases that used to cause thousands of deaths a year just fifty years ago are rare today thanks to vaccinations.  Kids don’t see all this, though.  They just see an adult coming at them with a needle.  That’s why shows like Sid The Science Kid can be helpful.  If kids see their favorite TV characters getting a shot and being just fine, they’ll recognize that the shot won’t be that bad. Here’s a quick video of the Sid episode, airing this Monday, October 26th:



In related news, my employer just got in their supply of H1N1 vaccine so I’ll be headed down to Employee Health to get my jab.  Not just to keep myself from getting sick, mind you, but to also reduce the possibility that I will pass H1N1 on to NHL or JSL.  NHL and JSL will get their H1N1 shots when our doctor’s office gets their supply in.  I’d urge everyone to get their child vaccinated as soon as possible.  The more people who are vaccinated, the less victims the flu will claim.

EDIT: When I went down to get my shot, my Employee Health department told me that they aren’t giving them to people who don’t have direct patient contact.  This is a change from what they said before.  So I didn’t get my shot today, but I still plan on getting it as soon as possible.

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