Sunday, June 19, 2005

11/26/2007 I wrote an update to this letter here about the ultimate success of that terrible surgery.

Here is the letter that I'm sending to the CEO of the Cambridge Health Alliance regarding the experience I had with my surgery.

6/21/2005 - Update. I think I need to send a more watered down (or at least more brief) version of this letter. I think this comes off as "raving lunatic" versus "concerned consumer"

What do you (the general public) think? Raving Lunatic? Concerned Citizen? Crazy Drunk Lady Screaming on the Corner and Asking For Spare Change? It's more of an article than a letter.

Dennis D. Keefe, Chief Executive Officer
Cambridge Health
Alliance

1493 Cambridge Street
Cambridge, MA 02139

June 19, 2005

Dear Mr. Keefe,

I am a patient of Dr. Katherine Miller of the Union Square Branch of the Cambridge Health Alliance.

She recently sent me to see Sam Doppelt, Chief of Orthopedic Surgery at the Cambridge Hospital because of recurring knee problems. Dr Doppelt checked my MRI and not see anything conclusive that would explain the problems I was having. But my knee made a crunching noise when I bent it, so he felt the condition merited arthroscopy. I'm sure there was a more medical explanation for what happened, but as a layperson, that's the best I can do. In short, I went into the arthroscopy not knowing the extent of the problem.

Dr. Doppelt performed a right knee arthroscopy on me on Friday June 17 at the Somerville Hospital. And I have not seen, nor spoken to him since. He popped into the recovery room and gave me a smile and a nod. When I asked him what happened during the surgery, i.e. what he found and what was done. He said he'd talk to me later because I was too out of it to discuss it with him. He never returned, nor did he say anything to my mother who was standing right there.

I was rushed home from surgery with a prescription for Tylenol 3. Prior to the surgery, I told the nurse that Percocet makes me hallucinate and I needed something else. I assumed (wrongly) that I would get to discuss this with the doctor. If I had, I could have told him that Tylenol 3 is about as effective as a gumdrop to me if there was going to be serious pain involved.

Immediately after surgery, I felt mostly fine for several hours. I called Dr. Doppelt's office repeatedly to find out what had been done to my knee. Eventually a secretary called me and told me that there had been a tear in my meniscus and he "got it". I don't know if this means he actually repaired it, or snipped away the excess. The recovery time for either one is different, and it would be nice to know. (It's now Sunday and I still know almost nothing.) She told me that he has 40 patients to see on Monday, so I doubt I’ll be hearing from him then either.

The night after the surgery around 11:00 PM the local anesthesia wore off and I was in screaming pain. The medication they prescribed was not helping and my knee was immobile and I was terrified. I’ve been through major abdominal surgery (I had an ovary removed in 2002) labor and childbirth in 2003, so I think I have a pretty good grip on what constitutes serious pain versus “some pain and discomfort.”

Around 3:00 AM the morning of 6/18 I woke up my husband and asked him to find the post op instructions to find out of there was somebody we could call. According to the nurses I would be having "some pain" but this was profound, blinding pain. My husband found the 24 hour number for the Orthopedics department and the operator paged the doctor on call. The on call doctor called me shortly and our conversation basically went like this:

“This is Dr. Antounian. You paged me?”

"I had knee surgery today and now I'm in terrible pain. I have no idea if this is normal because the doctor didn't talk to me after the surgery."

"You have your pain medication?" He asked

"Yes they gave me Tylenol 3 but..." At this point he cut me off.

"There's nothing I can do for you."

Then he berated me for waking him up at 3:00 in the morning. Isn't that his job? I am an IT professional and I have gotten the odd phone call in the middle of the night and I would never treat somebody the way Dr. Antounian treated me. It was horrible. I was in excruciating pain and this guy's way of "helping me" was to yell at me for waking him up. He told me to ice it and wouldn't listen when I tried to tell him that I'd had a cold cryo-cuff on it since the surgery.

Then he hung up and that was that. Fortunately I felt a little better the next day, but I am not nearly as far along as I expected to be 48 hours after the surgery and I doubt that I will get to speak to Dr. Doppelt before my appointment on Wednesday. Is this pain, swelling and immobility consistent with the type of surgery I had? My right knee looks like a misshapen beach ball three days after surgery. Is this normal? I have NO IDEA! I don’t know what type of surgery I had. And when I tried to get an answer, I got yelled at by your on-call staff. I’ve been told repeatedly that the only person who can answer my questions is Dr. Doppelt and I think it would take a miracle to get a sentence out of this man before Wednesday.

How can Cambridge Health Alliance allow doctors not to follow up with patients after surgery? I know it’s not hospital policy. My mother had day surgery to remove a cataract at the Somerville Hospital a few months ago. In spite of a busy surgery schedule her doctor managed to spend five minutes with her afterwards to discuss it with her. She was given contact info for him and was told to get in touch if she had ANY problems. This lack of contact I received is inhumane and disrespectful to the patient.

Is it common protocol for on-call doctors to yell at frightened patients for waking them up? If Dr. Antounian doesn’t wish to be awakened at night, perhaps he should seek another line of work – like tree surgeon where most “patients” can be attended to during daylight hours.

I understand that an arthroscopy is not a big deal to an orthopedic surgeon, but most people only get their knees operated on only once. This assembly-line mentality is unconscionable. I'm sure that the hospital makes thousands of dollars per operation. Is it too much to ask that there be somebody there who can talk to the patient shortly afterwards? If the chief surgeon is too busy and important to discuss this with his patients in a timely fashion, you need to delegate this to somebody else. Is it too much to ask that your on call doctors are required to show a modicum of compassion to a frightened patient when they are on call in the wee hours of the morning? I would very much like a genuine response to these questions.

Sincerely,

Margaret

cc: Lorraine VanGetty

Katherine Miller, MD

14 Comments:

Anonymous Jay Levitt said...

Nicely done!

I have a friend who gets free health care from CHA, and we have both been utterly unimpressed with any of the so-called "care" to date; her doctor routinely misprescribes her meds, and recently missed an obvious warning sign from a test. You couldn't pay me to get surgery done there...

Sorry you had such a rough experience.

10:47 PM  
Anonymous Anonymous said...

I've had knee surgery (athroscopic) amd unfortunately the huge swelling and blinding pain is normal. :( I wish they'd have told me that too before I had it done. I, too ended up calling my surgeon at home in the middle of the night to ask for better pain meds. You totally have my sympathy!

7:51 AM  
Blogger Margaret said...

Cambridge Health Alliance is normally wonderful. I have insurance and I choose to go there, and my entire family (parents, husband and baby) go there. So, this should not be seen as a bad reflection on them. I'm sorry your friend has such a bad experience with them! It's easy to get appointments when you need them and I love all the doctors in Union Square, Somerville.

Orthopedic surgeons are a notoriously grouchy bunch. They're good at the surgery, and they're bad at the healing part.

8:01 AM  
Anonymous Jay Levitt said...

Now that you mention it, I ended up writing a similar letter after my carpal tunnel surgery in Virginia, though my experience wasn't nearly as traumatic. (Unlike you, I am an utter wimp about pain. I am a delicate flower.)

I experenced the same "assembly-line" mentality; I never saw him before or after surgery, and when went for a followup appointment (which I had to beg for!) after experiencing sharp pains, they brought me into the examining room 40 minutes before the doctor was ready, so that he could see patients "boom-boom-boom" (their words) at his convenience; meanwhile, the doctor was in the next office on the phone, tracking down an old resident of his so he could catch up on their lives.

My regular doctor wasn't available for a followup for three weeks (!), so this was his partner; after snapping to a staffer "This is ridiculous! He should see [his surgeon]!" he spent five minutes with me, told me to take Advil and get an appointment with my own surgeon, and left.

So you're right - must be an ortho surgeon thing.

8:35 AM  
Blogger Margaret said...

This is why I love Cambridge Health Alliance. There's been only one or two times when I couldn't get a same-day appointment with one of the docs. We've got a few that know us by now.

And I AM a big wimp about pain! I wanted them to put synonym for cat in my chart, but I didn't think that would be appropriate, so I told her to put "total wuss."

9:04 AM  
Blogger Be said...

Goodness, I hope that you do get satisfaction - there's no justification for that sort of treatment.

Anyhow, feel better; heal up well and soon.

3:50 PM  
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1:42 AM  
Blogger wms said...

sorry you had such a rough time. my experience with the cambridge health alliance has been a little spotty, but i deal because dr kathe miller at union square family health is simply phenomenal. my family and friends who also go to union square see some of the other doctors and give them good reviews.

12:40 AM  
Blogger Dr. K - Orthopedic Surgeon said...

I'm sorry you had to go through such a pain, but in the case with my patients I always see them before and after surgery and talk to them about the procedure and what to expect.

Unfortunately also, pain relievers only last a few hours, but I still would recommend morphine.


Godspeed on your recovery.

7:38 PM  
Blogger travis said...

This is the problem with health policies. They have to come up with ideal measures even for dentist in summerville sc.

1:25 AM  
Anonymous brian said...

Some doctors forget that are dealing with people, and this time you've had bad luck, but the important is that you are well.

Tree Surgeon Stevenage

10:28 AM  
Blogger Damon Tolles said...

Wow your post really opened my eyes on the mishaps that may happen when undergoing surgery. I'll try to tell my friend about this because she told me that she wants to get a threadlift on holiday. She says that she is nervous but is adamant in going on with the procedure.

9:21 PM  
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5:42 AM  

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