Oct. 20, 2017

Temporal artery biopsy consult/preop?

Last week, I went for an appointment with a surgeon for a possible temporal artery biopsy.  I thought it was a consult and it turned out to be a kind of consult/pre-op appointment without the actual pre-op details.  It was weird, to say the least.  I’ve gone through quite a few procedures, so this would be normal to me, right?  Not this time. 

When I checked in, the lady greeted me right away and was friendly, yet professional.  As she should be, right?  In my opinion, she did an excellent job of verifying everything necessary and explaining what to expect while in their office outside of the actual time with the surgeon.

When the medical assistant brought me in for vitals, she was professional.  She listened to me as I explained my experience with simple vitals.  The blood pressure machine that is used in all the medical clinics I have been to rarely work well with me.  I always end up with that second round of squeezing that becomes painful.  Oh well.  What happened next surprised me.  She walked me to an open exam room.  Normal, right?  Maybe I expected too much in the way of courtesy or maybe I don’t know the arrangement of the exam rooms, but she walked me to the very last exam room at the end of a long hallway.  Not so bad, right?  Except I have mobility issues.  I walked in, leaning heavily on my cane and had honestly told her my pain level and where it was all located when she was taking my vitals.  We walked past several empty and seemingly available exam rooms.  Granted, I am a big woman and I need to exercise.  However, when I’m in pain that affects my mobility, there’s not much I can do.  I didn’t expect to have to walk down a long hallway twice.

Next, I waited in the room and the surgeon came in with another medical professional.  I did not know that it was a normal practice.  I need to do more research, but I wonder if it’s normal to just bring another “medical professional” into a patient’s appointment without the patient’s consent.  She didn’t do anything but stand and type into a laptop.  What are the patient’s rights in this case?

Moving on, my surgeon spent a lot of time screening my medical data that was sent from Dr. T.  He didn’t understand why she referred me to have this type of biopsy considering my main “complaint” then as he explained the other symptoms for temporal arteritis, I realized that I do have several of them.  He explained what he would do, even examined my temporal arteries.  He asked if I had any questions, and I asked about being put under during the surgery.  He explained that topical anesthesia was the normal route as it’s a very minor procedure that usually only takes about 45 minutes.  I explained that I have an aversion to people touching my head and I can’t control my reflexes when I feel or see someone reaching out to touch it.  He didn’t seem to take me seriously.  All he did was say that if we went through the procedure, I’d have to talk to the anesthesiologist.  And then he went back to reading my chart.

Then, while he was trying to reconcile my symptoms and history with the normal prompts for this type of biopsy, he received a call on his cell.  He stopped what he was doing, looked at the screen, and after a muttered, “excuse me,” he answered the call.  From what I could determine, since I was sitting four feet from him, it a personal call.  What kind of doctor answers a personal call during a patient’s appointment, especially as they sit right in front of them??  Anyway, he finished his call and ended my appointment saying, “let me call Dr. T. and see if she really wants you to go through with this.”  He stood up, and the other person gathered their laptop.  He opened the door and tells me, “you’re free to go.  But we will call you if we’re going to go through with the procedure.”  I left, and half an hour later, I get a call from a nurse or someone, saying that I’m scheduled for the surgery the following Monday at 1:30pm.  No other instructions or suggestions.

Later that night, I thought about it and sent a message via MyChart to the surgeon, asking for preop instructions as I wasn’t given any.  A surgical procedure that will include anesthesia requires instructions, especially for someone like me, who takes numerous medications.  Did I mention that this appointment was on a Thursday afternoon and the procedure was scheduled for the following Monday afternoon?  I couldn’t believe this was happening this way.  Suffice it to say, I’m pretty impatient, so I called the office the following morning and asked for those instructions.  Then later in the day, I received a reply from the surgeon’s nurse, telling me to take my medications as usual and if I want, I can take a week off after the procedure.  That’s it.  Good thing I called their office that morning and got detailed instructions.

Those that know me personally know that I’m pretty upfront about things and have no issues asking questions or demanding answers.  However, this past year has been pretty rough for me and I was tired of all the medical stuff, so I didn’t push for questions or take action when things didn’t seem right to me.  Do not let this happen to you.  Ask your questions, regardless of what’s going on outside of that office.  Speak up when things don’t seem right.  Now I’m not saying to go in and be difficult.  I’m saying that if you’re like me, you must remember that no one will take care of you unless you do.  Do not be afraid or too tired to ask questions.  It’s YOUR health and well-being at risk.