Thursday, September 10, 2009

Ask questions before you take off your clothes

My angiogram is scheduled for 9:00 am on Thursday, September 10th. I haven't been looking forward to it and I get a little anxious the night before. I'm also a little disconcerted at the lack of information and instructions about the procedure. Last time I wasn't able to eat beforehand and after I had to lie down flat for 4 hours. How does that work as an outpatient?

The night before I put together a playlist called "Angiogram". It was meant to be soothing songs I could listen to after the procedure - like "O, Holy Night."

Thursday morning Adam arrived early to get me to the hospital. We we're going to have breakfast together but given that I didn't have an answer about fasting I figured it was safest to skip breakfast.

Adam and I were in the radiology waiting room. We had asked to talk to someone about eating and what happens when this is done. Someone comes out and gives me paperwork to complete.

She also gives me a one page playlist and asks me what music I would like to listen to during the procedure.

Hang on.


There's no way I'm listening to music during this procedure.

"I'm scheduled for an angiogram"

"Yes, You're scheduled for an angiogram."

After a few phone calls, I learn that the term "angiogram" appears in a few different medical contexts.

There's a cerebral angiogram (the thing that I was expecting with the catheter through the groin and the dye squirting in the brain) and then there's an MRA, magnetic resonance angiogram.

The procedure was ordered by my PA's office: Raleigh Family Practice (RFP). I had a follow up appointment with them two weeks ago and told that my hospital neurologist, Dr. L, recommended an angiogram. I also signed a release form so they could access all my records, particularly directions relating to follow up care.

Turns out RFP doesn't have my records. So, the procedure was ordered based on my verbal instructions? What if I had asked for a boob job?

(Later on I learn that only 20% of Dr.'s instructions in an ER visit are retained).

Dr. L's office is called. Dr. L is in China. With no backup. And no, he's not calling in.


I need to look at my records. By the time I get back to Rex the Medical Records office is closed. They open up at 8:00 the next morning.

So, the next morning, bright and early and march over to the hospital. I feel like a detective. I find the medical records office, sign some paperwork and sit in the waiting area with my book until my records are delivered.

I review all 50+ pages of information. It's a little bit like reliving it. On one page I noticed the remark "The patient is pleasant and cooperative." Awwwwwww.

Finally, I find the follow up instructions. They indicate I am to have another angiogram. This leaves me where I was yesterday morning. What type of angiogram? The only person who can answer this is in China until the end of the month.

I walk from the hospital to RFP and bring them the records. This is so old school, walking records from office to office. Yeesh. One of the reasons I chose the primary health care provider I did was because they were associated with my hospital. RFP reviews the records and while they suspect that Dr. L was referring to a cerebral angiogram (I was right!) they want a neurologist to make that determination.

At this point, I'm fed up with Doctor L and his off to China with no backup so I try to make an appointment with a different neurologist who was recommended to me by a trusted friend. The first available appointment is September 30th (my appointment with Dr L was on the 29th). Yes, they can put me on a wait list in case there is a cancellation.

This whole experience raises questions about the patient's role in health care. I'm more than happy to take responsibility for my health and throughout this whole process I've paid quite a bit of attention to everything I've been told. I've also reached out to friends who are medical professionals for more information. Having said that, I'm not a Doctor and I also don't totally trust my recollection of any of the events that took place (follow up instructions in particular) when I was in the hospital (yes, despite pages and pages of blog entries about it). But, here I am, it seems trying to integrate information regarding my care.

Lesson Learned: Ask questions before you take off your clothes (to put on a hospital gown).

No comments: