Monday, September 1, 2008

WTF (Day -4)

I never thought I would be sitting down to write this, but I am jaw-droppingly shocked at what we found out today.

This morning our rounding doctor, Dr. Andersson, came to see us and we had a short list of questions prepared for him. Most of them centered around Ann's daily blood test. Why was one number a little high? What did he think was causing it? The kind of thing that doctors probably sleep walk through, most of the time. Not because they don't take the questions seriously but, because they are probably pretty easy to answer. However, he really was a very nice man and seemed genuinely interested in answering our questions.

Almost as he was leaving he made an innocent comment that completely altered the entire trajectory of the day. I'll paraphrase how it happened.

"So you are going to be finished with chemo tomorrow", he said to Ann.

"What do you mean?" I piped in. "We have three days of ATG coming up."

"No. Your orders are for only for busulfan and fludarabine. There is no call for ATG in your orders."

Ann and I disagreed with him and that lead him to call the charge nurse and ask her to pull Ann's chart and orders. We both looked over the documents and found the orders and schedule that Ann had signed in clinic with Dr. Kebriaei Thursday when she consented to the treatment plan. Those called for three days of busulfan and fludarabine and three days of Rabbit-ATG then the transplant. Ann's signature was there as was the doctor's, just like the copy we had been given and I had filed at the apartment.

The only difference was that on this copy the Rabbit-ATG had been crossed out and the word "error" had been added. I asked Dr. Andersson why the ATG had been omitted and he was at a loss. I could tell from the color of his face and the way he casted about trying to answer me he was embarrassed.

Presumably Dr. Kebriaei had made this change for a good reason, and I want to give her the benefit of the doubt. But omitting us in the decision making process is bordering on the inexcusable. Because this is probably Ann's final shot at beating this we argued very vociferously for the strongest chemo regime that Ann could tolerate. A reduction in the amount of chemo would see to make it less likely, not more, that this transplant will be a success.

I have to ask myself what the point of us signing our consent was?

Update:

I should add that Dr. Andersson promised he would find out what ws going on and have answers for us in the morning.

6 comments:

Ronni Gordon said...

Too bad it's a holiday. I have gone through very confusing hospital situations when my doctor is away, and probably lots of them are gone for the three-day weekend now. I hope you have succeeded in reaching your doctor, or if you haven't been able to, that you will be able to get through tomorrow. Perhaps the "error" is an error. If not, there is, hopefully, a good explanation. Hang in there!

Nancy said...

Hang in there Chris. This is all very taxing on you and Ann. Don't let it get to you. Hopefully, there's an explanation or they'll fix the error. Hopefully, the hurricane will only be a storm in a few days and the bone marrow will arrive safely.

In the meantime, breathe!!! love, n

Nancy said...

Hang in there Chris. This is all very taxing on you and Ann. Don't let it get to you. Hopefully, there's an explanation or they'll fix the error. Hopefully, the hurricane will only be a storm in a few days and the bone marrow will arrive safely.

In the meantime, breathe!!! love, n

Susan C said...

Breathe. You will resolve this.

Anonymous said...

I am so happy that both of you are so proactive and with it to catch this. Needless to say, anytime you "catch" something (especially as major as this) it makes you feel uneasy and like you can't completely let go. I am sure this will be resolved by the AM.

I hope you can do something relaxing that distracts you somewhat from this.

We are pulling for you guys-
Lea

Y Bar Ranch said...

All I can say is you are your only true advocates for proper care, and our medical profession is amazingly haphazard. Good catch. The squeaky wheel gets the grease. Be a bad patient. Question everything. Read everything. Ask questions. Stay on'em.

Best of luck!