OT: Just a rant about PCP and Onco

So, I contacted a doctor about getting a colonoscopy.
This was going to happen early last year, then covid happened.
They told me I needed to get another referral as mine was over a year old.
Okay, well my old Onco was the one that referred me last year.
So I figured since my Oncos are the ONLY doctors that have inquired of me if I wanted or had had a colonoscopy, I'd ask my current Onco.

Me to current Onco office: I'd like a referral for a C.
Nurse: You will have to get that referral from your PCP.
Me: Okay says I. (but inside I'm growling)
Me to PCP nurse: I'd like a referral for a C.
Nurse: Oh you'll have to have a physical first. (money grubbing SOBs)
Me: No, I don't need a physical, my Onco keeps tabs on me four times a year.
Nurse: No sir, you must have a physical before we will refer you.
Me: forget it, goodbye.
Me to the Onco nurse: Well, I guess I'm not getting a C. My PCP has never even asked about a C for me, only my two Oncos. Which means Dr P has. Goodbye.
Onco Nurse: Well, we'll do it this time, but you need to see your PCP for blood pressure and cholesterol checks.

NOTE: Who said ANYTHING about blood pressure and cholesterol.
I'm done........... procedure and MONEY.

I love Rock n Roll - Joan Jett

alephnull
I hear you, do you have a HMO or PPO or Medicare? It's all very frustrating.
I had never had a colonoscopy, until my PCP asked about it after my DX, in 2015. (Dx in 2012 at age 57), Then I asked my Cancer Center Oncology Doc, and he actually did not want me to get one, apparently, he was worried that the procedure might cause my prostate to rip or bleed or something. I actually overheard him say the consulting Urologist at the Cancer Center that "The patient has more to worry about than his colon". Yikes! That made me feel really bad.

So it was postponed until I got one done in 2017 and the result was 3 small cysts, no cancer there. Whew! It was recommended I have a follow up in 2 years. Here now almost 4 years later and my PCP is recommending another colonoscopy but is worrying because I have low Hemocrites and RBC (I am anemic). He referred me to a hometown Oncologist (one that I ran from 6 years ago because they could not fit me into their schedule to even see me for 5 weeks).

My PCP wrote a nice referral letter and gave me a copy. But the PCP office staff apparently did not forward or fax my records to the Oncology Doctor, who also does specialized consulting. I had the copy and faxed it to them. This time it has taken me 5 calls and no appointment yet. One nurse said she did not know who at the office had the copy of the referral. Perhaps it was assigned to their other office in the neighboring town. Another nurse told me my letter and lab records would have to be reviewed by one Doctor, (who happened to be on a two-week vacation.)

She said she (the nurse) could refer me to the Local Urologist in their Medical Group that performs colonoscopys. I told her I had Medicare and do not need a referral and would wait for the actual Doctors consultation and opinion. Part of the referral was to get advice from the Oncology Doctor about how they might raise my RBC level. She apparently had not even read my PCP's referral letter. She seemed bewildered. In any case they have two office assistants or nurses at two different offices(neither one was very helpful, one office even had only rated one star on Yelp and was said to be very “rude and uncaring”...I concur) Each nurse said they would set an appointment with "their" Doctor, now I am waiting to see which one calls first. I hope to be getting the consultation and then appointment for a colonoscopy sooner than later. Also hope they actually take Medicare patients!
Worn out Wings

Post Edited (Wings of Eagles) : 7/29/2021 3:51:08 AM (GMT-6)

Puh-lease...don't get me started...the medical system is trying hard...real hard to get their hooks into me...( insurance is too good)...my plan re the stroke( recent event) is to rely on their short term memory of me as a person...keep them apart from my other doctors...have as few appointments as I can with each one...but use them to get the medicine that I decide is proper...using the only weapon in the quiver...its my instinct and knowledge of my of myself and quite frankly this is pretty much the same as what i have done to to secure a happy marraige for forty+ year...shhh...bless my wife...Puh-lease......PS reference technique is not quite same with my wife... but you can figure out the the the difference...

I just had a colonoscopy last week. Because I'm on two blood thinners, I first talked my PCP into ordering the Cologuard test instead of a traditional colonoscopy. I took the test and it came back positive, so then she wrote me a referral for a colonoscopy. I had to withhold the Plavix and Eliquis, which put me in danger of a blood clot because of my stents and my ongoing afib.
The prep kept me up riding the porcelain throne almost all night, but the test itself was professionally done and a breeze. Propofol is wonderful stuff.
It had been 25 years since my last colonoscopy, and my father had colon cancer, so I was pretty stupid to avoid the test for so long.
Fortunately, though they found and removed 11 polyps, the results were benign. Dodged a bullet there!
My wife and I are on Medicare and also the Blue Cross/Blue Shield I carried over after retirement. It's expensive, but with the prostate cancer, treatment for atrial fibrillation, stent implantation, expensive medications, and some issues my wife had a few years ago, we may be approaching a million dollars in medical expenses for which we haven't had to pay a penny.
Money aside, though, having avoided complications as a Gleason 7 with a pretty good load of prostate cancer, as someone who had 85 percent blockage of a coronary artery discovered by accident, and as someone whose 11 polyps were benign, I'm feeling like a pretty lucky guy two weeks away from being 76 years old.
But, it's hard to avoid the feeling that there's still something sinister out there waiting to rear its ugly head.

Post Edited (clocknut) : 7/29/2021 2:23:05 PM (GMT-6)

Ken, last year I had an endoscopy and colonoscopy. The latter was clear so I am back on a 5 year schedule. The endoscopy showed a red area that was biopsied. I was given the same type of caution as you received and scheduled for a CT and gastric emptying study. All results were completely normal. Don’t get excited until you get the results.

Must be something going around HW.

I had a full body CT scan last month to check for circulation issues. No problem there, BUT a two large masses in my chest glowed brightly. No symptoms, but lots of negative possibilities. CT guided Core needle biopsy next week, and then we'll see. Sarcoma is a real possibility.

Scheduled September colonoscopy seems incidental right now.

Post Edited (garyi) : 7/29/2021 3:20:21 PM (GMT-6)

Gary, good luck with the biopsy

Tim G, you asked "@clocknut--How did your physician find an 85% coronary artery blockage "by accident" ?"
Actually we had know for some time that I had some degree of blockage, but I also had a lot of peripheral circulation that was helping. However, when we met with my electrophysiologist to talk about the bouts of afib I was having, he said my symptoms convinced him that it wasn't just a matter of afib, but that something else was going on. So, they did an angiogram and found the 85 percent blockage of the right coronary artery and also found that these were calcium deposits, not soft plaque. So, they had to do an atherectomy, drilling the blockages out using a tiny 200,000rpm drill, and implanting 3 stents. It worked out very well. So, maybe not really completely "by accident," but not what I was expecting.

@clocknut--Thanks for the follow-up. Interesting about the artherectormy with the drill. I've read that researchers are trying to find a way to use sound waves (similar to lithotrypsy for breaking up kidney stones) to break up coronary artery blockages. Like most us of a certain age, I've got heart issues (heavy plaque build up) but have been able to dodge the invasive surgery bullet so far.

The Twilight Zone, as our friend Zufus would say.

Gary, best wishes for your biopsies….hope it is nothing to worry about.

JNF said...

Gary, best wishes for your biopsies….hope it is nothing to worry about.

Thanks, Jack.

You too, logo, I think ;-)

logoslidat said...
Thinking...like...perfection...is highly overrated...thimk abut it

I gave up thiMking long ago....

“The man who thinks he can and the man who thinks he can't are both right.”

"I think I can, I think I can, I think I can..." ...."The Little Engine That Could."
An early turning point in my life when I won the book in the second grade