Tuesday, November 27, 2007

just hope you never get really sick

Almost twelve years have passed since I had a heart attack. I was a 43-year-old woman, and because of that, I was seriously mis-diagnosed. After a series of tests, the G.P. I was seeing remained clueless. When he finally asked me if I was "having problems at home" and if I wanted a prescription for a tranquilizer, I told him what I wanted was a referral to a doctor who could figure out what was wrong with me. Fortunately, he referred me to Dr. Razak Kherani, a caring, compassionate cardiologist, then affiliated with the Elyria Memorial Hospital. It didn't take Dr. Kherani any time at all to figure out what was wrong with me. The episode I described to him: intense pain under my left arm that radiated up into my neck and shoulder and left me writhing on the floor in agony, was clearly a heart attack. Couple that with my inability to climb even a single flight of stairs without stopping to catch my breath, and, clearly, I was in trouble.

After he examined me, Dr. Kherani invited me back to his office for a consultation. He would prefer to get me into the cath lab that very day, he told me, but regretted that we would have to wait through the weekend for that. He made the arrangements for the following week and gave me a prescription for nitro tablets. When I had to take one of the tablets, and it relieved my pain, it all became real to me.

My trip to the cath lab showed that one of my arteries was, indeed, 99% blocked. Dr. Kherani immediately performed a balloon angioplasty. I watched on the monitor as the team worked on me in the cath lab, and found it surreal and fascinating. If my relative youth had masked my coronary artery disease, it also helped in my recovery from the procedure. And, really, I was a model patient during my rehab. No, really, I was. They ran an article about me in the local newspaper, with a photo showing me and my golden family, walking down a leafy, sunlit street.

I saw Dr. Kherani every six months for the next couple of years. What a wonderful man, what a compassionate doctor he is. Each time, he examined me, then invited me to his office, where we chatted. He knew where I worked, and how my kids were doing in school. Dr. Kherani was pleased with my progress, and let me know it. He clearly cared about me. I don't think I am exaggerating to say that he saved my life.

Time passed, and, of course, I backslid. We moved to a new town where instead of being within walking distance of the hospital, we didn't even have one. When the familiar pain returned, I found myself in an emergency room in Akron, forced to deal with whatever cardiologist was on duty that day. His name doesn't matter, but I will say that he belonged to The Heart Group, a large group of cardiologists who seem to have a lock on all the heart patients in several surrounding counties. Another trip to the cath lab showed no blockage, and I received virtually no follow-up care. I was, however, given a prescription for a statin, to help maintain healthy cholesterol levels, and so had to have periodic blood work done.

Several years went by, until during a phone call to the doctor's office for a new prescription, my file garnered some unexpected attention. As I gave the woman on the phone my information, she was amazed to see how much time had passed since my last appointment. "Honey, you need to come in and see the doctor," she told me, and set up an appointment for me. He didn't remember me, and I didn't like him any better than the last time I had seen him. I decided to switch doctors. I could see someone closer by, I thought, and he couldn't be worse than the cardiologist handling my case. Well, as I said The Heart Group has a virtual monopoly in this area, and I ended up with another one of their doctors. While he isn't any worse, he isn't any better, either. It is amazing how impersonal and indifferent both of these men seem.

Since I switched to this doctor, my annual appointment has been in the fall. Accordingly, I called his office earlier this year to schedule an appointment. The doctor's secretary was incredulous that I expected to get in any time soon. "We are now scheduling for (six months out)," she told me. "Well, perhaps I should just see one of the other doctors, then," I told her. "Oh no," was her response, "their schedules are the same." "What a racket," I replied. "Schedule me whenever you can, then, but I will need a refill for my prescription before then." "That's not a problem," she reassured me. "Just give me a call when you need it."

My supply of pills has dwindled since then, so I called her yesterday for a new prescription. She cheerfully offered to call it in to the pharmacy of my choice. I waited until today to pick it up because I didn't want to make a needless trip. Do you think my prescription was at the drugstore waiting for me? Of course it wasn't. I made another phone call and reminded the secretary that she promised me just yesterday to phone in my prescription. "I think you have to have a blood test first," she told me. "Let me check. Yes, you need a blood test before your prescription can be renewed." I was sorely tempted to ask her when she intended to share that information with me, but instead took a deep breath and made arrangements to have my blood work done later this week.

Hopefully, soon, I will be allowed to purchase the medication I need. I am not getting my hopes up, however. How I miss Dr. Kherani and his kindness and concern. The doctors in The Heart Group would do well to take a page from his book and remember that the assembly line of half-clothed bodies they briefly see in their examining rooms are actually people they need to look in the eye and treat with respect. I'm not holding my breath for that, either. I'll let you know if I get my pills.


Ben said...

A harrowing account of some very tough days. We need to work harder to find you a good heart doctor.

anne mancine said...

Think Dr. Kherani would take me back?

Julie said...

you know, as infrequently as you would have to do it (once a year maybe, as a check-up), i don't see that driving into elyria for an appointment would be all that terrible. you know? it's just an hour.

and if you needed urgent care, you could always be stabilized nearby, and then transferred out there, where a real, good doctor is!

Julie said...

an additional comment--there are very few things as maddeningly frustrating as dealing with doctors, their aids, insurance companies, and pharmacies to get prescriptions that you're dependent on for your quality of life, if not your life itself.

the worst thing about it is the way that it is a hassle-filled rigamarole every time, and so even when you're not actively pursuing getting your medication, you're despondently worrying about the next time you'll have to do it...

anne mancine said...

Oh, Jules, it makes me very sad to think that you are "despondently worrying" about your medication all the time.

I told Dad that I know people who live in this area who drive to the Cleveland Clinic for treatment all the time, and I even know someone who goes to Columbus to see a specialist, so maybe I should give Dr. Kherani's office a call. I could probably get in there sooner than the appointment I currently have with the goofball here.

Bryan said...

It always amazes me how many medical professionals don't err on the side of caution and let such things slip by. I don't know if you were still living here when this happened, but your former/my mom's hairdresser was told by a skin cancer specialist that the spots on her abdomen were nothing and essentially said to "come back when you have cancer." Well, she got a second opinion and she did indeed have skin cancer.

The last time I saw my oncologist, I was still contemplating moving to Dayton, so I asked him what my options were. One was that he could refer me to someone near Dayton or Cincinnati (Cincy would have been just as far a drive as the Cleveland Clinic is from Elyria). Another was that I could have a CAT scan done near there, then send the films to him and drive up for the appointment.

The third option, which I'd have preferred, was that he could schedule my CAT scan at the Cleveland Clinic main campus in the morning, and I could meet with him in the afternoon. Then I'd just have to take a Friday off work once every 6 months (and even less frequent than that, in a few years), drive up after work Thursday and spend the weekend at my parents' place.

Obviously it's a moot issue now, but I was glad to hear he could be so accommodating. I had just assumed I would have to do all my checkups in Dayton with a new doctor.

anne mancine said...

Bryan - No, I didn't know that Robin was diagnosed with skin cancer. Is she going to be okay?

Bryan said...

It was a few years ago, and I think she just had the spots removed with surgery. As far as I know she's OK now.