Thursday, June 23, 2005

Letter writing runs in my family. The Somerville Journal published this heartfelt thank you to the Fire Department penned by my dear husband Rich.

I think I'm going to turn my bad doctor experience into an editorial for the paper and strip the names out.

Wednesday, June 22, 2005

Knee Update

Went for my post-op today. At first it looked like I still wouldn't find out what had been done to me. But the doctor turned up eventually and told me what happened. And the good news, is that I think Dr. Beauty Sleep is in big trouble for being such an unhelpful, unsympathetic bastard to me at such a dark time.

The pain on Friday night was from an effusion. This is a little gross, so don't' read on if you're squeamish. The cavity of the knee filled up with blood, causing major swelling and pain. This is very common side effect because I had a plica removed.

He did some other stuff and my prognosis is good. I should be back to normal in about another week. And his PA, Liz drained the excess crap from my knee and suddenly it was mobile again. She took about a pint of blood and joint fluid out of there with a big honking scary needle. And a prescription for Vicodin (a touch of locking the barn door after the horse escaped).. But I was happy to get it because the effusion can still come back.

It's kind of sad when the best thing that's happened to you all week is a needle the size of a banana going into the side of your knee, but it was still the best thing that's happened to me all week. Except for Eric singing the Macarena. He sings the "EYE EYE" part when he runs around naked after his bath.

The song goes something like this.
Humma dumma grumma numa duma Naked Baby
Grum Badda Badda dumma dada deeda Naked Baby
Humma dudda badda deeda dadda Naked Baby
HEY Naked Baby!
Eye Eye!! (sung by both parents and child)

I still walk like Igor, but it's a more flexible Igor than I was this morning

Monday, June 20, 2005

I'm writing book reviews for chicklitbooks.com. See my first "official" one here! There are some others of mine on their site that I sent as writing samples. But this one was the first one I did for a book they sent me.

SO happy about this.
Here is a recent e-mail I sent to the T regarding the escalators at the Park Street station.


Subject: Complaints
Mode: Subway
Line: Red Line
Station: Park St
Incident Date: 05/19/2005
Incident Time: 08:55 AM
Category 1: Escalator
Location Boarded: Davis
Direction: Inbound
Additional Comments:
The escalator at Park Street has been out of
service for months. When will it be fixed? I have to get knee surgery
soon and it would make my (and a whole lot of other
people's) lives easier if the escalator to Tremont street
were in service.

The elevators are filthy (as in there is usually an inch or
two of urine on the floor) and dangerous. So, they are not a
good option for anybody.

When will this be fixed, and why is it taking so long?


And their response:
Dear Customer:

Please accept our apologies for any inconvenience you experienced
because the escalator at Park Street Station heading towards Tremont
Street was not working. We are in the process of getting a replacement
controller for this unit. Until then, this unit has been deemed unusable
due to the heavy downfalls of rain we experienced during this past
winter and last month.

The condition of the elevators you described that are located at Park
Street Station is unacceptable. The Cleaning Coordinator has been
notified regarding this concern and will begin a complete investigation
immediately.

Please know that we value you as a customer and thank you for bringing
these matters to our attention.


Side note:
There will always be human waste in the MBTA elevators. There is nowhere else for the homeless to "go" in Downtown Boston. Unless they create more public restrooms in the city, people will continue to use any private space they can find. It also doesn't address the safety issue. I'm frightened of getting mugged in the elevator. They are cramped and unmonitored and anybody can watch for some particularly vulnerable person to walk in there. (Like somebody on crutches, or with a baby carriage).

Is this simple paranoia? Or is this a real concern?
I do write a lot of letters. I don't want people to think that they're all negative, so I'm posting a thank you a I sent to the Somerville Fire Department after the fire. My husband wrote a letter in a similar vein and sent to the Somerville Journal.

June 8, 2005

Chief, Kevin Kelleher
Fire Station Headquarters
266 Broadway

Somerville, MA 02145


Dear Chief Kelleher,

I am writing to thank your department for their efficient and competent service during a dryer fire at my house on May 31, 2005.

My husband and I own a condo in the oldest house in the city. Due to the quick and professional work of a skilled team of firemen, this historic house was saved. If they had not responded as quickly and efficiently as they did the house might not be standing today.

Please extend our gratitude to all of the firemen who responded to my frantic call that day. This experience confirmed my belief that the Fire Department is one of the most important resources that the city has. We are very lucky.


Sincerely,

Margaret and Rich

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