Thursday, May 06, 2010
I weigh 98 pounds
I weigh 98 pounds & have lost most of my teeth.
My apt, always dusty & cluttered, is coming apart. I sleep a lot.
It's been that kind of winter becoming a lost spring. Losing a spring is bad.
I've neglected my health. Particularly over the past five years. But that's not the issue.
When I was forced to present myself to the hospital last fall, I thought, things will happen now, change now. I put myself in the local medical system & figured I'd just have to take whatever happened. But in the process my prostate problem would be dealt with in whatever way it had to. I'd already found out I would lose all my teeth. I've had periodontal disease for year, used to be treated then I had to stop. But I'd seen a local dentist several times over previous few years, I knew the process for dentures, how long it would take once I began it. I wanted to find a different dentist & had located one I thought would be o.k.
It was bad that I had a primary physician only in name, had never gone to what I knew was a large LLC over by Trinitas. You had to wait month just for an initial appt. But I thought that would be taken care of as went through the prostate treatment. I'd looked over the HMO list, found some possible alternatives, when I knew my urolologist I'd call the HMO & switch the primary. Unfortunately, the attending physician at Trinitas wasn't on the list. I signed up with her when my HMO was changed in March.
While I was in hospital, I realized I could lean more on Gina, my friend from a few blocks away. She came to hospital nearly every day, it was close by. She brought magazines. juice, extra minutes for my phone. The night I was released - absurdly at about 8 pm because nobody at hospital was making a decision, she came with her boyfriend, Glen, & drove me on a couple of errands & home. I wasn't feeling bad with the Foley catheter - comfortable., actually, for the first time in months. The time in hoispital had stabilized me at least. Some of my appetite, for food & life, had returned - although I have to eat soft food. I do a lot of baby food type blending. & since I was referred directly to a local urologist group, I didn't need an immediate primary doctor referral, so I still had the option of finding a new primary with a smaller practice. The urologist might even recommend one. Unfortunately, the dentures would have to wait.
Then came the shock of finding out the urologist did not accept my HMO. He was the specialist who'd seen me in the hospital, & who the primary doctor I saw last Friday said she would have made a referral to. His office is an $8 taxi ride, & that only because the local taxi uses a zone fare & it's just past the city line. I walked home from there once, it's a couple blocks from the branch library.
My HMO listed only one eligible urologist for Trinitas, an ancient doctor with an office across town over a beauty shop. There was one in Millburn, a bunch in Newark. No matter how i thought it through, I could not work out a reliable way of getting to that doctor in Millburn. I looked at buses, checked with the local paratransit, triangulated the location with Gina's frame shop up that way. Only the doctors at University Hospital in Newark were reliably accessible. They looked like good doctors. I was aware that even a nearby doctor might do surgery at University, Beth Israel, or St. Barnabas, but I'd work that out when the time came. What I needed was a doctor whose office I could reach. Still, it seemed crazy that I'd have to go to inner city Newark when there were urologists all around here, in Elizabeth, Roselle, Union. Most of them affiliated with Trinitas.
I went with a University doctor. Had to. So the process began. But then it stalled. I got a series of bladder infections. I blamed the doctor's staff for not catching on to the first one, because I believed they had sat on a test result for at least a week, hadn't read it, & this is a busy doctor who probably needs to be constantly pestered & reminded by his staff. It should have been read & flagged. The problem, I concluded, wasn't that they were incompetent, but because the office was located at & was part of a giant teaching hospital in the middle of Newark. It feels impersonal because it is impersonal. The magazines in the waiting room tell you nobody gives it a thought. The whole freakin' city is impersonal. Unless you get off the bus at the wrong stop. Then it might become very personal. The local urologist was part of a group with several offices, & the staff there seemed much more focused & efficient, & probably were better paid.
I was losing energy, appetite, & hope. The best way to deal with my anxiety & fear is move things along. I felt like something had gone terribly wrong with the process. My time, my comfort, seemed worth little. Was it my imagination? My first visit to the new primary physician confirmed that it wasn't. She faxed a new referral to the urologist, along with a personal note that she wanted to be kept informed of my treatment there. Then, to be emphatic, she gave me the original of the note & told me to give it to the office staff the next time I was there. I did, yesterday, when I went to Newark for a 5 minute visit to deposit a urine sample. They hadn't even seen the fax, & looked at the note like it was the strangest request they'd ever received & of no use whatsoever. A request from a concerned primary physician - who knows I'm sickly & underweight, & see a psychiatrist for depression - that she wants to be brought into the loop. "She's serious about this," I said to the receptionist. "She was my attending physician at Trinitas." All the way to Newark yesterday, I kept seeing her sitting at the little table in the examining room in her office, looking up at me, & asking, "Why are you going all the way to Newark for this? I can refer you to Dr. M____, his office is near here." & my saying, "I saw Dr. M____, he didn't take my insurance. & neither did you. I would've seen you when I got out of the hospital. I signed you up when my HMO changed last month."
I'll add that this primary physician knows which bus stops at her corner, the exact number, & where it goes in downtown Elizabeth. I recall thinking in the hospital, "Maybe she just wants my business in order to grow her practice, but it counts for something that she wants at all, & wants it enough to know how to get there if you don't have a car."
"Why are you going all the way to Newark.....?"
I'm fortunate to have a full service hospital in this city. Most cities in Jersey have one. Newark has five, I think one is closing. Plainfield lost its hospital. I don't know what you do if you live somewhere distant from a hospital without convenient access to public or private transportation. I guess you're screwed.
"If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be." Thomas Jefferson
My apt, always dusty & cluttered, is coming apart. I sleep a lot.
It's been that kind of winter becoming a lost spring. Losing a spring is bad.
I've neglected my health. Particularly over the past five years. But that's not the issue.
When I was forced to present myself to the hospital last fall, I thought, things will happen now, change now. I put myself in the local medical system & figured I'd just have to take whatever happened. But in the process my prostate problem would be dealt with in whatever way it had to. I'd already found out I would lose all my teeth. I've had periodontal disease for year, used to be treated then I had to stop. But I'd seen a local dentist several times over previous few years, I knew the process for dentures, how long it would take once I began it. I wanted to find a different dentist & had located one I thought would be o.k.
It was bad that I had a primary physician only in name, had never gone to what I knew was a large LLC over by Trinitas. You had to wait month just for an initial appt. But I thought that would be taken care of as went through the prostate treatment. I'd looked over the HMO list, found some possible alternatives, when I knew my urolologist I'd call the HMO & switch the primary. Unfortunately, the attending physician at Trinitas wasn't on the list. I signed up with her when my HMO was changed in March.
While I was in hospital, I realized I could lean more on Gina, my friend from a few blocks away. She came to hospital nearly every day, it was close by. She brought magazines. juice, extra minutes for my phone. The night I was released - absurdly at about 8 pm because nobody at hospital was making a decision, she came with her boyfriend, Glen, & drove me on a couple of errands & home. I wasn't feeling bad with the Foley catheter - comfortable., actually, for the first time in months. The time in hoispital had stabilized me at least. Some of my appetite, for food & life, had returned - although I have to eat soft food. I do a lot of baby food type blending. & since I was referred directly to a local urologist group, I didn't need an immediate primary doctor referral, so I still had the option of finding a new primary with a smaller practice. The urologist might even recommend one. Unfortunately, the dentures would have to wait.
Then came the shock of finding out the urologist did not accept my HMO. He was the specialist who'd seen me in the hospital, & who the primary doctor I saw last Friday said she would have made a referral to. His office is an $8 taxi ride, & that only because the local taxi uses a zone fare & it's just past the city line. I walked home from there once, it's a couple blocks from the branch library.
My HMO listed only one eligible urologist for Trinitas, an ancient doctor with an office across town over a beauty shop. There was one in Millburn, a bunch in Newark. No matter how i thought it through, I could not work out a reliable way of getting to that doctor in Millburn. I looked at buses, checked with the local paratransit, triangulated the location with Gina's frame shop up that way. Only the doctors at University Hospital in Newark were reliably accessible. They looked like good doctors. I was aware that even a nearby doctor might do surgery at University, Beth Israel, or St. Barnabas, but I'd work that out when the time came. What I needed was a doctor whose office I could reach. Still, it seemed crazy that I'd have to go to inner city Newark when there were urologists all around here, in Elizabeth, Roselle, Union. Most of them affiliated with Trinitas.
I went with a University doctor. Had to. So the process began. But then it stalled. I got a series of bladder infections. I blamed the doctor's staff for not catching on to the first one, because I believed they had sat on a test result for at least a week, hadn't read it, & this is a busy doctor who probably needs to be constantly pestered & reminded by his staff. It should have been read & flagged. The problem, I concluded, wasn't that they were incompetent, but because the office was located at & was part of a giant teaching hospital in the middle of Newark. It feels impersonal because it is impersonal. The magazines in the waiting room tell you nobody gives it a thought. The whole freakin' city is impersonal. Unless you get off the bus at the wrong stop. Then it might become very personal. The local urologist was part of a group with several offices, & the staff there seemed much more focused & efficient, & probably were better paid.
I was losing energy, appetite, & hope. The best way to deal with my anxiety & fear is move things along. I felt like something had gone terribly wrong with the process. My time, my comfort, seemed worth little. Was it my imagination? My first visit to the new primary physician confirmed that it wasn't. She faxed a new referral to the urologist, along with a personal note that she wanted to be kept informed of my treatment there. Then, to be emphatic, she gave me the original of the note & told me to give it to the office staff the next time I was there. I did, yesterday, when I went to Newark for a 5 minute visit to deposit a urine sample. They hadn't even seen the fax, & looked at the note like it was the strangest request they'd ever received & of no use whatsoever. A request from a concerned primary physician - who knows I'm sickly & underweight, & see a psychiatrist for depression - that she wants to be brought into the loop. "She's serious about this," I said to the receptionist. "She was my attending physician at Trinitas." All the way to Newark yesterday, I kept seeing her sitting at the little table in the examining room in her office, looking up at me, & asking, "Why are you going all the way to Newark for this? I can refer you to Dr. M____, his office is near here." & my saying, "I saw Dr. M____, he didn't take my insurance. & neither did you. I would've seen you when I got out of the hospital. I signed you up when my HMO changed last month."
I'll add that this primary physician knows which bus stops at her corner, the exact number, & where it goes in downtown Elizabeth. I recall thinking in the hospital, "Maybe she just wants my business in order to grow her practice, but it counts for something that she wants at all, & wants it enough to know how to get there if you don't have a car."
"Why are you going all the way to Newark.....?"
I'm fortunate to have a full service hospital in this city. Most cities in Jersey have one. Newark has five, I think one is closing. Plainfield lost its hospital. I don't know what you do if you live somewhere distant from a hospital without convenient access to public or private transportation. I guess you're screwed.
