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Ridiculous? Irresponsible? Come Work For City Hospital!

thestrangequark

Admiral
Admiral
I am ranting again. Sorry. You guys are my new favorite outlet.

I went for a doc's appointment today, mostly to get a referral to see an endocrinologist about my type 1 diabetes, but also to ask why my hair is falling out, and why I've gained 10lbs in a month without changing my diet or exercise habits. I think I know the answers to these questions: telogen effluvium is likely the cause of my hair loss, which is temporary and due to my recent brush with DKA, and my increased insulin dosage is the likely culprit behind my weight gain. Still, I wanted to ask the doc about it to be sure. I was expecting today not to solve any problems, but at least make them easier to bear. Instead, I'm more exhausted and frustrated than before.
First I saw the nurse, a ridiculous woman who tried to give me some pointers on eating to help control my diabetes. She recommended I eat 5 or 6 small meals a day to even out the rate at which my pancreas produces insulin. I told her that I'm a type 1 diabetic, not a type 2 diabetic, and my pancreas does not produce insulin. She continued to tell me that, no, no, eating smaller meals will help it to produce enough insulin. So I told her again that I am a type 1 diabetic whose body is incapable of producing any insulin. I don't know if it was the language barrier (Russian was her native tongue), but it took me four times saying it before she actually listened to what I was telling her and said, "OH! You take insulin? Then maybe not the many meals during the day?" No. Maybe not. "But you should eat grapefruits!" she informed me with gusto.
She also had me fill out a depression chart -- and I'm really depressed, I know it. Next to written statements like "I feel like I am a disappointment and that I let down my family and friends," "I have trouble sleeping or I sleep to much," "I sometimes feel I'd be better off dead," there are ratings: Never, some days, Many days, Nearly every day. I filled it out honestly, checking Nearly every day for everything but the suicide statement. The nurse looked at it and told me that I oughtn't worry because God is watching.

Eat grapefruit and remember that Jesus Loves Me. Unfortunately, the doctor wasn't much more helpful.

The doctor spent the first half of my appointment trying to explain to me how to control my blood sugar, despite my explaining that I've been controlling my blood sugar just fine since I was 12 years old. Then, when I asked her about my hair and weight gain she simply said I should ask the endocrinologist when I see him/her. I was kind of annoyed that she didn't take any interest in my problems (no one listens to me!), but fair enough, I was mostly there for the referral anyway. She writes me the referral, I make the soonest appointment. Guess, just guess when the next available appointment for an endocrinologist is. You won't be able to do it!

Fabruary 2nd 2010.

What the fuck am I supposed to do? I just don't know anymore. I'm so depressed I can barely make it to work. I overslept till 3pm yesterday, without even the tiniest realization of the time passing. Now for the second time I'm opening a whining, venting thread...something not really in my nature to do, but I just need to say it as many times as I can, as if saying it will allow some of the anger and frustration, and some of the experience itself to pour out of me with the words. But I don't think it's helping. I just want to give up.
 
Sorry to hear this. I'm assuming the doctor that saw you was a GP? If you can impress on him/her your sense of urgency about your situation, they might be able to squeeze in an early referral. Also consider getting another primary care doc to take a look at you in the meantime.
 
Um...wow. First, Grapefruit + God = the most absurd medical prescription I've ever heard of.

Second, 2010?! Holy cow, I don't even know what to say. I don't even know what an endocrinologist does, but they must be in short supply. I can't even wrap my head around how far away that is.

Third (and this is a story about me), I have the opposite reaction from doctors. They listen to and believe everything I tell them. Like 5 years ago when I went to the doctor and told him I thought I had strep throat (I got it about once a year, so it was nothing new to me). He didn't run any tests. Instead, he said, "You get strep throat often enough, so I'm just gonna pretend that's what you have and give you some anti-biotics." 3 months and 4 different prescriptions later, I am sitting on the operating table getting my tonsils removed because, guess what, it wasn't strep throat after all.
 
Crap, I am sorry TSQ. There has to be an endicronologist with an appt before next year somewhere.
 
Sorry to hear about your experience.

I think a new primary care physician is in order here.

Your type I diabetes information would have been in your charts. Your experience shows that they didn't even bother to read your chart before seeing you and don't realize that you should be a higher priority to see the endocrinologist.
 
Um...wow. First, Grapefruit + God = the most absurd medical prescription I've ever heard of.

Yeah no kidding. You're supposed to pray to Jesus not God while you eat your grapefruit, what are these people... a bunch of crackpot quacks? Jeepers. [you aren't helping! --Someone off screen]

Ok on a more serious note... Bang heads together. I suffer from mental illness and when I was "really bad" not that long ago SOMEONE went apeshit bonkers on my behalf and got me into the hospital and medicated.

Remember, these people serve you not the other way around. TELL THEM you are going to see someone else, someone who can be assed to help you then get up and walk out on 'em.
 
Rant away, tsq - you have every right to tell us everything you want to say. :)

Once again I'm sorry to hear that you've been having problems with your nurse ("you should eat grapefruits"?! Oh dear... :rolleyes:) and doctor there (the doctor ought to have understood your problems better too). I don't know the US system much, but here, if you have a good relationship with your endocrinologist (or any other specialist you see often), they'll very often let you contact them directly (usually via their secretary, especially if it's a good secretary with some medical insight) if you have problems. Very often one might be able to get a quick appointment in weeks, if not days, or sooner if it's a more pressing matter.

Maybe you could get a second opinion from a different family practitioner either in the same or another doctor's surgery. Failing that, you could try and get hold of the endocrinologist yourself (the one who treated you last time for your DKA) via their secretary and ask to see them personally?
 
I went for a doc's appointment today, mostly to get a referral to see an endocrinologist about my type 1 diabetes, but also to ask why my hair is falling out, and why I've gained 10lbs in a month without changing my diet or exercise habits...

To be honest, it sounds like a typical day in the hands of the British health service too. :( Things aren't run like they used to be. A&E do just fine, it's all their non-urgent services that have the problems. Whether its loosing track of people who are in the system, absurd waiting lists, or just plain incompetency.

I'm sorry to hear of your troubles tsq, but the only real way to get these services working for you is to make a fuss and present yourself as a priority, and doing their administration for them by contacting the specialists yourself and booking your own appointments, instead of letting them 'refer' you, etc.

I hope you have more luck and happiness in the near future. :)
 
No endocrinologist for a year!?!

How can Americans possibly say health care in Canada is not good? All I ever hear from citizens in private, non-covered health care countries is "Yeah, free, but I've heard the wait times are horrible!"

I could get you into an endocrinologist tomorrow, if not today.
 
11 months for an endocrinologist? That's absurd, especially in a metropolis where you apparently live. You need a new doctor, I would imagine there are plenty to choose from there.
 
If she's in an HMO, she can only go to doctors who are "on her plan." Which means the doctors are willing to accept the hassles of taking her health care provider. You choose from a tiny list of overbooked specialists or you sit at home with a band aid and wait it out.
 
Guess, just guess when the next available appointment for an endocrinologist is. You won't be able to do it!

Fabruary 2nd 2010.

What the fuck am I supposed to do?

You do what I had my wife do when the allergist couldn't see her for four months for a rash - you call your doctor back.

Tell your doctor to call the one they referred you to and get an appointment for next week. If they can't they need to find you a doctor who can see you next week.

The squeaky wheel gets the grease. You deserve to be helped. You deserve to be treated right. We all think you are the best. Don't you ever forget that.
 
I thought my doctors were bad. Hang in there, tsq. There's got to be a way to get you to an endocrinologist somehow. If it's urgent (and it sure sounds like it is), somehow you'll get in. 2010 is just fucking ridiculous.
 
Definitely! Call and insist that they refer you to someone who can see you NOW. Not next month, not next year, NOW. Don't stop calling until you get what you need. This is your health and FFS, they should know that it's not something to screw around with.

On a side note, have you had your thyroid levels checked? Any GP can do it, and your symptoms sound a lot like what I went through when my thyroid failed.

Use your frustration to your advantage. Get on the phone and yell at whomever you have to in order to get what you need. If you need to get someone else to do it for you, do so. Just find a friend with a bull-dog determination. You CAN and WILL get the medical attention you require and no one can tell you otherwise.
 
Making threats and lots of noise always works. Believe it.

Anyway, this sort of thing isn't rare at all. The hospital closest to my childhood home is in bussiness purely to employ lazy, ineffectual staff members who don't follow procedure. They might (or not) have one Doctor on call at any given time, and they tend to all go on break at the same time, therefor leaving patients unattended. Any serious operations get shuffled to other hospitals. The healthcare company my mom works for as a nurse pulled out of a partnership with them, essentially leaving them with no good doctors, because they saw how terrible it was and didn't want to be connected to it.

I remember going there for a head injury once. I had to wait like 2 hours with a bleeding head wound to see a doctor because he was the only one there who could operate a medical staple gun apparently. (They use staples instead of stitches now)

So anyway, take it from me, if you make noise you will get service. Usually you'll find someone, a nurse or doctor, or a supervisor, that will notice you and make some calls on your behalf.

Go USA!
 
Hell, I'll make the call for you. There is always a spare slot being held for someone, or a light day someone wants to leave light to get in a round of golf. A dominant (but not threatening) voice over the phone tends to push people into finding ways of making it work.
 
See if the hospital (or even your insurance company) has a patient advocate. Start there and have that person do the heavy lifting for you.
 
You guys are great, thanks for patiently reading my rants and raves, and responding with so much support.

I suppose a little background would help:
I've had type 1 diabetes since I was 12 and have always been in excellent control, healthy eating habits, healthy weight range, good amount of exercise. In college I remained under my dad's company's insurance. His company switched plans abruptly, though, and I suddenly found myself without coverage (my job doesn't have insurance -- I've been looking for another job for ages, but you know how the economy is). I haven't had insurance for over 8 months. At first I was so caught off guard I didn't really know what to do. I started paying for prescriptions out of pocket which cost anywhere from $300-$800 a month depending on what supplies I needed. As a result of rationing my supplies, and of the extreme stress I was/am under (I don't manage stress well, and I'm working on that), I haven't had such perfect control for about 6 months. It's not been horrible, but not great, and I have to admit that it probably contributed to my being so susceptible to the infection and DKA I suffered last month.

Two good things came of my being admitted to the ICU for three days: the first is that I got the dose of reality I needed -- I'd been so used to having good control, I was taking my health for granted. The second was that I learned I qualified for a city assistance program called Artist Access; based on my income and expenses I pay $150 for my entire hospital visit (the actual bill was around $13,000), $15 for doctor's visits and $2 for prescriptions, and I can also work for free health care by earning points for providing artist services to the hospital, i.e. giving a painting or picture to the hospital, teaching a crafts class to kiddies, etc.

I was elated when I first learned about the plan. I knew it wouldn't be the greatest health care, and there'd be lots of waiting and hassle and stinky clinics. Still, it's health care I can afford until I get a job with benefits (or until this country joins the civilized world and institutes global health care). My first appointment on the plan even went really well; I saw an ophthalmologist for my crazy temporary vision loss and he was great. (Actually, I fell in love -- O! Dr. Patel! Why are you so beautiful and possessing of such a sexy English accent?!). I can deal with the difficulties and inadequacies inherent in the system, so long as they're not completely unreasonable. Waiting a year to see an endocrinologist, though, is completely, utterly, and fucking unreasonable. (Oh, and RoJo, endocrinologists deal with hormones. Insulin is a hormone, so endocrinologists are the specialists who treat both type 1 diabetics like me, and type 2-ers. There are not generally hard to come by, but the city hospital system is way overstressed.)

Because of my situation, I don't know any of the doctors I'll be seeing. I tried calling the endocrinology clinic and reasoning with them, but they said there's no way I can get in earlier.
 
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