If the wheels on the bus go up and down; it might mean you just ran someone over

If I had posted yesterday my post would have been less than positive.  I am glad I didn’t post yesterday.  Today I received a very classy apology to a rather unfortunate incident.  I believe in sharing my experiences with blog readers in the belief that if one person can benefit from those experiences then it was worth sharing.

Lessons from today’s post.  

1.  Stand up for yourself.  Be your own advocate.

2.  We willing to share good as well as bad (don’t make it all or nothing)

3.  Keep mind open to 2nd chances; be willing to give that 2nd chance

Here is the “rest of the story”…

I sent this email (btw…great suggestion to do so) following a doctor visit.

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Dr. x (aka NewDoc),

I saw you this morning regarding my stoma. Since the exam I have been struggling trying to connect the NewDoc I met last week and the NewDoc I met today.

I was so impressed by you last week that I blogged in praise of you
http://lifeaftergastrectomy.com/2012/02/21/medical-updates/ ) I wrote…“he returned with another doc. I would say that it was a breath of fresh air walking into the room. New doc came over and expressed empathy and concern (before even looking at stoma). He asked me how I was holding up… He put his hand on my shoulder and assured me that he would help. Plastic surgeon told him that he had promised not to do silver nitrate at this exam. New doc maintained eye contact with me and assured me as well that he would not do silver nitrate either. He then examined the stoma…New doc said tube was still too small for size of tube channel and that this looseness was irritating channel and allowing bile to enter channel…New doc then suggests a new tube that will fit better and he can do it while I am there. Wow!

…New doc said that he would be taking over my care and that he wanted to see me in one week. He told nurse to let scheduling know to find room in his schedule to see me.”

I went on to blog…

“I am very pleased with the new doc’s manner. Just the perfect blend of compassion and professionalism. Since he is one of the senior docs, he also has a lot of experience. I am not dreading Thursday’s appointment quite as much now that he will be in charge. Amazing how a little warmth and compassion makes the medicine go down easier.”

Imagine my reaction when this morning the first thing you said to me when you entered the exam room was “Have we met before?” I was almost speechless. I told you that we met last Thursday when you were consulted by PlasticSurgeon….you still didn’t make the connection so I reminded you that you inserted a new j-tube and that I have been experiencing a lot of stoma granulation issues. You seemed to make the connection with your “Oh…okay, so how is it doing?” I wondered if you had even read my chart prior to the exam.

I told you that, although the fluids seemed to be slightly reduced, the pain had not diminished and the pain was still of serious concern. You looked at the stoma and then announced that you will be applying a silver nitrate treatment. I was convinced at that moment that you had indeed not read my chart and knew nothing of my case. While applying the silver nitrate (very painful) you acknowledged pain and paused for me to catch my breath before continuing. Afterwards you briefly discussed options related to the tube attachment. I explained that the current securement has resulted from trial and error with other options….including the disk option (blogged about that months ago). I mentioned that one of your suggestions (a button) had been considered and dismissed due to internal placement of my tube (I even blogged about that *sigh*). You dismissed this concern as well as the one voiced about being unable to wear the support/pressure brace if tube is placed how you suggest. Cut a hole in the brace you suggested – as well as in clothing (!?). I asked about the excess skin issue and you replied that you would be making a couple calls about buttons and attachment devices.

You told me to come back on Monday for another silver nitrate treatment. If you had read my chart you might have realized that I have had almost weekly silver nitrate treatments for several months with no improvement and increasing discomfort. You would have realized that PlasticSurgeon had been very aggressive with silver nitrate and it irritated the site rather than improve it (which is why you were consulted in the first place just last week).

Last week you had many other options besides silver nitrate/tube attachment. You talked about exploring long-term treatment options. I left encouraged and impressed. Today, it was back to the same song and dance routine (silver nitrate/tube attachment devices). I left totally discouraged and dismayed.

What happened in 7 days? Which NewDoc will I see on Monday?

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I received the following email today….very impressed with NewDoc (again) and I am open to continuing to remain his patient.  I look forward to “starting over” with him next week.

Dear Ms. Howard,

Please accept my humble apology for the anguish I have caused you. I spoke to our nutrition service after you left to explore a button device to replace the Foley catheter that you have been using. She will be in clinic on Monday so we can both evaluate the jejunostomy site. I recognize that this has been a difficult problem for you. I truly do want to try work with you and try to remedy the situation for you. However, I can understand you not wanting to see me after my rude behavior during Thursday’s encounter. I am sincerely sorry for upsetting you on Thursday.

NewDoc

It is an odd feeling this sense of self-advocacy.