My History

On Friday we drove the 3 hours to Edmonton for a dermatological exam of my left temple where my family doctor (FD) had removed a large mole about a month ago. Biopsy came back as skin cancer and the idea was remove more tissue to be sure it hadn’t spread. My understanding was the procedure would be done that day and included an exam for other spots my FD has no time to look at.

Unfortunately, this dermatologist had a clinic to run, intended to operate later and was gracious enough to freeze a bump on the end of my nose that appeared suddenly a few weeks ago. And then he was gone. At the front desk I was told to await an appointment convenient to their schedule. AKA “you do a six hour drive for ten minutes of my time and then do it again for this simple operation which will be booked in the AM so next time will also include an overnight hotel stay.” No consideration for the patient? You bet.

Had my FD read my medical record, first she would have removed the mole a year ago when I asked and she said it was “nothing.” To be fair, she is my second doctor at this clinic, (there is only one clinic in this district). Though my former doctor works in the same clinic, there is no cross-talk between doctors so you have ONE doctor. If that doctor is on vacation (mine was gone over 3 months in a row last year so when my prescriptions ran out and I had to get renewals from my cardiologist) you in theory can have any of the other docs IF they have time but they will know nothing about you–or should I say LESS than my FD knows about me? .

So, not knowing I’d had moles removed, she wouldn’t know that there was a dermatologist who had already treated me and knew my record.

This morning I called yesterday’s dermatologist’s office and cancelled any further contact. Will book my other dermatologist, or maybe I’ll forget it.

Below is a letter from the heart surgeon who fixed me twice, to my cardiologist who is in very infrequent contact. Not sure why with a department full of them at the U of A hospital. Probably because I have only ONE cardiologist?

My idea here is to write down my medical history here because I KNOW medical people don’t read my history or don’t believe it. Also, someone close to me said today I didn’t have my “story right” so I want to get it down before I’m erased by everyone. This is what the reliable surgeon sad about me and I’ll fill in details in later posts.

April 21, 2016

RE: JOHNSON, Scott PHN# 

I reviewed the recent CT-Angiogram on Scott. Although there was very slight enlargement of the aortic root and aortic root pseudo-aneurysm since October 2014, the overall appearance to me does not look very bad. As you will recall he has an ultra-complex history- I originally operated on him back in 2008 to replace his aortic root. Prior to this he had congestive heart failure with severely reduced ventricular function with an ejection factor of l5%. We had also performed a four vessel coronary bypass. He did well with this for a period of time. However, he had an MI in 2010 and had a bi-iliac stent and internal iliac embolization in 2010. In April of 2014 he had a myocardial infarction again and was found to have severe aortic regurgitation and aneurysm of the ascending aorta. Prior to surgery he developed renal failure and a cardiac arrest and had been resuscitated. He had hepatic failure as well as renal failure. He has been a long-standing heavy smoker with a 50 pack year history and has emphysema and chronic obstructive lung disease as well as hypertension and peripheral vascular disease. He was also morbidly obese with a BIvfl exceeding 40 kg/m:. We re-operated and replaced his aortic root and he gradually got better from this.

In 20I1 he was diagnosed with stage 3 colon cancer and had a lower anterior resection followed by chemotherapy.

Obviously with all of the risk factors that he has, any of further surgical re-intervention would be highly risky. I would just recommend a repeat CT-Angiogram in I years’ time.

 

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Comments

  • thesmallc  On July 18, 2016 at 7:49 PM

    Hi Scott. I am sorry you’ve been dealing with so much the last few years. Wish you received better support from your medical team. It is so against what their protocol is supposed to be? How can they be allowed to treat their patients that way? What a system! Know that we are here to listen and to offer some level of support. Please keep us posted about how things progress. I am hoping for the best outcome possible. And I hope your wife is doing well.

    • scottx5  On July 18, 2016 at 10:40 PM

      Hi Rebecca, it’s amazing how completely dis organized the medical system here is. In 2013 an extensive report was issued by the Health Quality Council of Alberta on continuity of care. Last week they issued an update to announce that nothing had been done and, as a result, they were reissuing the same recommendations. There are a bunch of patient advocacy groups “working on” changes, but it’s all just words. Strangely this province spends 30% more on medical care than the next highest province.
      We will be moving to the city soon so, in theory, we will be nearer the edge of the back of the woods and might get better care–not likely. All I can do it see my Cardiologist once a year for a CT and review of my meds. Well, not actually see her in person but by letter. (After using the word “fuck” incident in a moment of frustration speaking with her receptionist I have to stay away). The Oncologist it supposed to be a 6 month check-up except she can’t get the colonoscopy office to return her calls, so we may have to give up the cancer thing altogether.
      Alberta is a very bad place to be sick.

  • Rebecca  On July 19, 2016 at 12:59 PM

    Scott I applaud you for your efforts to document your story on your blog. It may not seem like a big thing at the time, but the information may be used in ways that you cannot foresee – and perhaps ways that might help other people if it doesn’t help you directly. I also hope that moving closer to the city will give you better access to care. I have read reports that those who live more than 2 hours drive from a major cancer center have worse outcomes.

    • scottx5  On July 19, 2016 at 3:01 PM

      Thanks Rebecca, used my heart report to build an example of how sloppy medical care here is. Reading it, a person might get the impression that I have chronic problems that might be of interest to my doctors but besides an ongoing prescription there is no continuity of care. It starts at the clinic level but the whole system is broken. Doctors that work in the same clinic here won’t talk to each other about each other’s patients because, just like customers at a car dealership, us patients “belong” to a particular doctor. I’ll write more about this in my blog. My cancer experience has been the same.

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