Monday, April 22, 2024

Random Medical Notations

 Dr. Alan Boulos, neurologist, is now the 18th dean of Albany Medical College. Last year, I'd had an appointment scheduled with him through a physician referral, but his office changed the appointment to another neurologist there. Dr. B. was out of office on another project.  (All went well without him.)

Columnist Gene Lyons, whose Commentary I read in the Troy Record, wrote that he recently became ill and thought he was dying. He awoke one morning too weak to move, couldn't get out of bed. He was resigned to his upcoming death more than frightened by it. A trip to the E.R. revealed he had COVID, serious this time as it had gotten into his heart, and despite  agressive treatment he was diagnosed with acute urinary retention, treated by catheterization. He developed pneumonia, treated by a course of antibiotics, but suffered weakness and depression due to his atrial fibrillation. A cardiac electrophysiologist stimulated his heart back to a normal rhythm. So far so good, he writes. He is 80 , but no mention of hospice.

At last week's office visit, I asked the cardiologist if heart stents would prevent a symptomatic patient from having a colonoscopy.  He said no; he is an interventional cardiologist and just cleared a patient for that procedure. He also said he highly recommends cardiac rehabilitation for his patients. He added that my account of an  MCI was a "good description." How would he know. 

My medical journeys have been so far successful, to the point that the nephrologist I'd been referred to several years ago said my last medical report shows no issues so I don't need to return to his office unless I wanted to. The urologist's office said I don't need any follow-up visits unless I develop a new problem, that tests were fine. And the cardiologist I'd been with for a number of years said he didn't think I needed cardio rehab.  The hospital's chief cardiologist, the surgeon and the hospitalist all recommended it though. Moreover, the gastroenterologist where I'd been a patient for about 20 years told me 2 years ago that he was unable to remove  "flat polyps"  and treatment would be surgical removal of that part of the tract. He was honest but wrong. (I guess he never heard of referring to another surgeon with more modern skills. 

   I could go on, but enough is enough. We all know doctors and medical staff in general are human, and make mistakes in judgment, and some are burned out and'or lazy and selfish, as we all are. We also realize that the aged and aging population are burdening the health care system and that old people account for an extraordinary percentage of medical care. ERGO---hospice enters the scene, but that's a topic for another entry or rant, Dear Blog.

Recurring thoughts

   When Dorothy Bartholomew learned she had cancer and with a bad outlook, she wrote me a letter meant for "all her family." I still have it. 

When my friend Barbara Schoen learned she had terminal cancer, she wrote and told me about it. When she died, her daughter called to tell me. 

ELO wrote me a 5 page letter detailing his health struggles just a few weeks before he died, in retrospect an alert ot what was to come.

I  don't mean to overinflate my sense of importance, but am at a loss to understand. She had put my name as one of her health care proxy agents, so I don't think she meant  to exclude me . But what do I know, really.  (And why did hospice let her die alone; was it a surprise?  I've been at a number of hospice deaths, and usually there was a type of controlled notification. (Excluding Don's death, that is.And, as it turned out, I was called first then, in the early morning hours, because B. didn't hear her phone ring. I called her to tell her to call the nursing home.


No comments: