A NEW GUIDE

The knife man is out of my life for now.  His replacement, a fully qualified urological surgeon and a colleague in the same group of urologists was a good listener and easy to talk with.  During our first meeting on August 11, we agreed that the surgeons’ view of a complete cystectomy is very different from the patient’s.  Urological surgeons do many many prostate operations along with a few complete cystectomies while the patient experiences one unanticipated surgery.  So, my several questions were easily answered.  Then we had a good discussion about that May 24 surgery from which the new guide says I am recovering as anticipated. 

I did call attention to printed instructions I received shortly after the surgery as well as medical records that seemed to have some errors.  Those matters will be discussed at the next monthly meeting of colleagues.

(SIDEBAR: The apparently erroneous material was in three documents.

 1. A before surgery imaging request for multiple tests when all I needed was a chest x-ray 

2. A two-page instruction sheet from the surgeon's office that included erroneous instructions, which could have resulted in harm.

3. (Unsigned) report of the May 24 surgery, there was no mention of the spinal anesthesia…perhaps the result of using a template.  I suspect there are other errors that could result in harm to patients.) 

That new guide and I have an appointment Sept 8 and expect to meet every three months for the next year or two.  A week or so prior to each meeting he will request a CT scan and blood tests which he will use along with his own examination.  He will then let me know whether or not I have returned to cancerstan. 

(SIDEBAR: my PCP, a guide of 20 years, had arranged our first meeting (last Monday).  Shortly after that appointment was scheduled I received a call from one of the Knife Man’s worker bees who gave me a new offer: the choice of meeting with that replacement or yet another meeting with the Knife Man’s female physician’s assistant who seemed to not to understand my condition, did not give satisfactory answers to my questions and, for the previous six weeks had refused to meet with me let alone take my phone calls…. Choice was easy I chose the new guide.

I did find out that Medicare pays the surgeon a lump sum for the surgery and 90 days of post op follow-up.  Most likely, my choice resulted in the knife man having no more responsibility to follow-up. His costs are less as I had no more appointments with the knife man’s people and he doesn’t have to see me again.

Even though I am forgoing chemo, this Wednesday I see my oncologist.