My wife's boss performed an "Executive Escalation" on Monday or Tuesday and the paperwork started flying. As of last night, I was good to go. I had a slot available in Durham, the nurse at United Healthcare assured me I would be dialyzed in Durham before the wedding.

Today, I got a call from Carlos, the guy running my local Davita clinic and was told that due to my hypertension, the clinic in Durham would not be taking me.

You've got to be kidding me...First of all, just about every dialysis patient has hypertension. Second, I called Durham to confirm all this and the Social Worker there won't even take my call. I was told I should have the Nurse Practitioner at my home clinic call their doctor.

I leave you with the immortal words of Lt. Colonel Frank Slade:
Out of order, I show you out of order. You don't know what out of order is, Mr. Trask. I'd show you, but I'm too old, I'm too tired, I'm too fuckin' blind. If I were the man I was five years ago, I'd take a FLAMETHROWER to this place! Out of order? Who the hell do you think you're talkin' to? I've been around, you know? There was a time I could see. And I have seen.

Labels: Complaint, Davita, Travel Hassle

She asked why and protested a bit. She asked if it was because she pulled too much fluid off, which in the grand scheme of things is trivial. I wouldn't get rid of a doctor for something inconsequential like that. I told her that what she did put me in the hospital. She had no clue. I told her that I had discussed this all with her nurse Lisa and if she was out of the loop, that was just another reason why I didn't want her as my doctor.

I don't need to see a nephrologist every two weeks, if it was up to me, once a month or once a quarter would be fine, but if there's something wrong, he/she better be there and/or he/she better fix the problem. I think that's what pissed me off the most. It was painfully obvious that something was wrong with me and she did nothing. I demand a certain level of care and she didn't meet it.

I've been told time and time again that if I want to dialyze at that facility, I need to use Dr. Goel, but I won't put up with it anymore. Just before I left today, the Nurse in charge told me that if I was willing to switch my times (1st or 2nd shift), I could use the Davita Nephrologist. Apparently he's on the Davita payroll but he covers a couple Davita clinics.

Labels: Davita, Dr. Raven Goel, Monopoly, Nephrologist

They kept me overnight Wednesday so they could dialyze me Thursday mornning. Dialysis at the hospital went fine and they discharged me later that day with a whole bunch o' blood pressure meds.

Saturday I went in for dialysis and after about 2 hours, I started feeling nauseous again. I knew it wasn't the fluid issue, but I'm not a Nephrologist, so I had no clue what it could be. NEITHER did anyone else at the dialysis clinic. I had been dialyzing fine for 2 months and now suddenly I have a problem. I had been told I could get an antiemetic to keep from vomiting, but the nurse was reluctant to give it to me until I started dry heaving. I passed out soon after I received the drug and woke almost an hour later. The nurse told me because of the drug, I couldn't drive home and she asked me whether I wanted an ambulance, cab, or if I wanted to call my wife. I called my wife and she dragged the 3 kids out to pick me up.

I spent Sunday on the couch popping antiemetics and trying to keep from vomiting. I had asked to come in on Monday to take some excess fluid off, but the Nurse told me I had to come in for a full treatment (she was mistaken).

Spending the weekend thinking about the problem, I think it may be the Dialysis solution got changed. I seemed to remember the doctor making some off-hand comment about changing my solution recently (but with my memory, I couldn't recall when). I also seemed to recall that the hospital used a "1k solution" (the solution is refered to by it's concentration - 1K, 2K, 3K). So, Monday morning, I had a discussion with the Tech about my dialysis "bath" or solution.

According to my records, as far as Davita was concerned I was on a 2K bath. The tech couldn't tell me when it was switched. I asked if they kept records of when switches were made and she said "no", the nurse just makes a switch depending on the results from lab tests. I asked to see my chart and then I had issues with my fistula and the next 40 minutes were spent with two Techs and a Nurse trying to get it to work. Luckily, they failed and I was scheduled for an angioplasty Tuesday morning.

I say luckily, because they had me on a 2K solution and the Tech wouldn't change it without the Nurse's say so and the Nurse said he'd "look into it". When I got home, I knew I'd need help, so I called in reinforcements and my parents showed up a couple hours later.

The angioplasty went well and I went in to dialysis later that day. My Tech for the evening, who we'll call Sam, had set me up with the usual, a 1K bath. She hadn't looked at my chart, so she didn't know I was supposed to be on a 2K bath. Normally, that would be a bad thing, but I convinced her to leave it. The Nurse on duty told me she'd order a weekly potassium to confirm the problem. I asked for and was given my chart. Once I flipped past all the insurance info and got to the medical stuff, there, on the first page, at the top of the first page was this " ↑ Δ 2K" This was dated 3/17/09. According to the Tech, my dialysis on 3/17/09 would have been set up as a 2K bath because of that note. AHAAAAA. SO that's what sent me to the hospital. I looked further back and found that I had been switched to the 1K bath back on 1/15/09. I finished dialysis Tuesday night feeling normal again. Hallelujah.

The moral of the story is that some of the healthcare professionals around you don't care why you are becoming sick. They have no motivation to figure out what's wrong. They'll treat the symptoms and go their merry way. You have to learn everything you can about your treatment and be involved. They would have happily kept ripping me apart with each dialysis session until my monthly lab results came back. I am angry.

Tomorrow I will write about something scary I learned from reading my records.

Labels: Davita