Monday, July 20, 2009

What a difference a doctor makes!

Quick recap on BR's bladder issues.

BR has been having a lot of bladder pain, cramping, and urine leakage from his urethra despite having a suprapubic catheter. We saw a urologist last Wednesday who refused to do anything for BR other than deflate the catheter balloon down to 10cc, and that was at my suggestion. She insisted on a whole bunch of tests that were going to take weeks to execute.

Last Friday, BR's urinary tract infection (UTI), which the urologist has diagnosed but did not treat, had flared up so badly that we couldn't wait any longer, and called the urologist to see if the urine culture had come back. The office was closed. No warning. No notice. No antibiotics for BR. We asked the answering service to please page the doctor, but they didn't hold out much hope.

We decided to call the other urologist on BR's referral to see if they could help. The office was closed, but the scheduler was able to get BR an appointment for Monday morning. We jumped at the chance to cut ties with the first urologist, but that still didn't fix the immediate problem.

As a last resort, we got an emergency appointment with BR's primary care clinic. His doctor there had prescribed antibiotics in the past even before getting a culture -- using the test to validate treatment, rather than delay it. Unfortunately, BR's doctor was also on vacation, and the doctor covering his patients saw the referral in the records and wanted to contact the urologist before doing anything. We told his nurse that the urologist was the worst doctor ever, and we shouldn't hold our breath waiting to hear from her. Two hours later as the office was getting ready to close, they finally gave up waiting and decided to do their own urinalysis. The doctor gave us a Cipro prescription, and we were on our way.

BR's bladder pain and cramping improved over the weekend, but the leaking didn't.

This morning, we saw the new urologist. He took BR's full medical history and listened to the problems we were having. He recommended a cystoscopy as the best way to figure out what's going on inside BR's bladder. We agreed and scheduled one for early next week. He also recommended trying one of the medications that can control bladder spasms. Without hesitation, he gave us a four weeks supply of Enablex from his stash of samples and told us to start taking them right away. If the problem was gone by next week, he'd still do the cystoscopy just to validate the results.

I'll say it again. What a difference a doctor makes! I took great pleasure calling the first urologist to cancel all the tests and follow-up appointment. Worst. Doctor. Ever.


suejan said...

Try again!Bladder infections drive me round bend. Now take a Trimethoprim every day and no infections for 4 years now. I have 1 1/2 in my balloon also flipflow so no bag.

Herrad said...

Hi Steve,

Excellent work well done in getting asnother urologist that treats you well.


steve said...

Hi suejan - Thanks for the hints on Trimethoprim and a flipflow valve. Once we get the diversion issue cleared up, we will definitely look into flipflow. Sounds like a much more natural bladder program than a free-flow bag. It'll let BR wear short pants again, too!

As an alternative to Trimethoprim, I've been reading a bit about Mandelamine to help control recurring UTIs. They both go on the list of questions for the next visit.

Hello my darling Herrad - I like being a member of the medical team, and that's how the new guy makes me feel.

Richie said...

We have had such a mixed experience of doctors. I am so glad that we have now got a very bright and very committed general practitioner who we can talk to on an equal basis. (To be honest my previous experience of GPs in Amsterdam has been very positive)
At the moment the two specialists we see from the rehabilitation centre are very nice and very supportive to both Herrad and I.
Medicine is more than science and it is bad practice not to take the human element into consideration. Some doctors are shockers.
I hope it stops hurting soon!

Cranky said...

Steve - so glad you got rid of the first stinker urologist and found a replacement that treats you like part of the team.

Anonymous said...

Way to go Steve!!!I hope this Doc is a good one and will listen to you!!!You are the greatest, and your patient is pretty great, also!!!!!

Kim said...

Woo hoo! I am so happy that you have a caring, competent doctor. This is truly good news.

Steve, I promise to update my blog this week. The All-England Summarize Proust Competition version is that things are peachy and we're on the waiting list for a baby :-)

love to you both,