More kidney stuff, sort of...

Or, how NOT to run a medical office.

Remember way back in April when I went to Georgia Health Sciences University for a transplant evaluation? The day that I went, I had just taken the last dose of a course of Cipro to get rid of a stubborn UTI that had been hanging on since February. That was my fourth course of antibiotics and since I don't experience the telltale symptoms of a UTI, I assumed I was "cured". About a month after my evaluation, the transplant coordinator (my new best friend) called me and said that GHSU wanted me to get clearance from a urologist before they would place me on the transplant list. They would make the referral and they would also pay for it. No problem.

I got a letter from a urology practice here in town stating the date and time for the appointment but it was at their facility that's 40 minutes away from me. They have an office that's 10 minutes away so I called them and changed the appointment to the closer office. I arrived on the appointed day and time with all my paperwork filled out, plus a list of my surgical history and all the other doctors I see (I think we're up to 15 now) and a list of current medications.

First battle; insurance coverage.

She: We need your insurance cards and a picture ID.

Me: Not for this visit, it's being paid for by GHSU.

She: So I should put you down as a self-pay patient then?

(Which part of being paid for by GHSU did you not understand?)

Me: No, it's being billed to the party that referred me.

She: I don't see that in your chart, do you have a copy of the order?

(Why, yes I do, and you had one too but I bet somebody just threw it away.)

I hand her the order from GHSU and she says she'll just put it in my chart.

Me: You can take a copy for the chart, but I'd like my copy back for my records (so that when I see this on my insurance statement, I can protest it).

She: If you'll just have a seat, someone will be with you in few minutes.

A few minutes? Is there a rupture in the time/space continuum when you get inside a doctor's office? It is now 9:35, care to guess when I saw the inside of an exam room? Not until 11:30. The first thing the nurse wants is a catheterized urine sample. Okay, fine, I'm all about the catheter. So she steps out of the room to get supplies. When she comes back in, she gets right down to business.

Me: Whoa! Could you wash your hands please?

She: I washed them before I came in the room.

Me: And you've touched two doorknobs and God knows what else. If I didn't see you wash them, then it hasn't been done.

(Were you absent the first day of Nursing 101?)

She gets her sample and then it's another 20 minutes before the doctor makes his grand entrance. It was almost worth the wait; he's tall, slim, in good shape and I suppose he's attractive if you like the soap opera doctor type. His hair is just a little too perfect and his teeth almost certainly have veneers. He proceeds to grant me a five minute audience in his presence and then says "I'll clear you for transplant". Okay fine, that's what I was here for.

I figure I'm done and I don't ever have to see him again so I jump in with both feet.

Me: I'm sorry if I sound critical but do you know what time my appointment was scheduled for?

He: No, I don't.

Me: It was at 9:30 and it is now noon. I don't have a terribly important life but I find that unacceptable. If I wasn't going to be seen until 11:30, then the appointment should have been scheduled for that time. I could have gotten a lot done in two hours.

Bless his heart, he never flinched, never smiled, he just got the thousand yard stare. At least there were no excuses about "emergency", etc. It was really more of a take it or leave it attitude. So I go on my merry way figuring I probably will never have to go to that office again.

Whoa pardner, not so fast! Fast forward three days when I get a call from one of the office nurses saying that the urine culture had come back positive for bacteria. Lo and behold, they're calling in yet another prescription for Cipro. She assures me that this will fix me right up, I'm not so optimistic, it hasn't fixed me right up the last four times I've taken it. I dutifully trudge off to the pharmacy and start taking the antibiotic. Over the weekend, I do some research, talk to some friends in the medical profession and come to a decision.

First thing Monday morning I call the urologist's office back and make an appointment for a cystoscopy. Fortunately, they can see me the next afternoon at 3. The procedure itself was quick, easy, not painful at all, and not the least bit erotic. I take a guided tour of the anatomy of my lower urinary tract. Everything is as pink and healthy as you could want, no abnormalities whatsoever and no signs of chronic infection. Hmmm, what a puzzlement. The doctor asks when I went through menopause. When I tell him, the lightbulb goes on.

This ongoing (or recurrent) infection has nothing to do with my urinary tract and everything to do with my hormones. The quick explanation is that since I'm not producing much estrogen, my system is more base than acidic which makes it the perfect environment for wayward bacteria to grow and hang out. So now I have a script for Estrace cream and an appointment for a recheck in August, we'll see how that goes.