Monday, February 8th, 2010
Doctor's Incompetence We're going on 9 weeks of Coumadin treatment. I think it's been a whole week since I've blogged about it. HAHAHA

After my last ER visit last month I did change doctors. I was required to do so in order to get into the Coumadin Clinic. There were only 5 doctors who accepted patients under the age of 55 and (red flag) only one of those wasn't booked through June. I had to get in to see someone and QUICK so I made an appointment with Dr. Kimbell. (red flag) She didn't understand why I was there instead of at the Coumadin Clinic so I explained it to her. She told me that the 9mg I'd been previously taking was far too high a dosage. I was exceedingly thorough with her regarding my doses and resulting PT/INR numbers. She still insisted that 9mg was too high. She dropped me down to 7mg. My INR dropped form 5.4 to 1.3 in exactly 1 week's time. I will spare you the gnarly details of how I received my lab results and how incompetent her nurse is. :)

Last week, after the confusion of the previous week, the doctor called me herself with the results. She had them on Monday and called me on Tuesday. She told me I was subtherapeutic again--2 weeks in a row. This was the point last time when the hematologist sent me to the ER, New Years Eve remember? So after much coaxing on my part, she agreed that finishing off my remaing 2 days of Lovenox was a good idea and instructed me to up my dose and return on Friday for another blood draw. I did so, without hesitation and with trust. She was off on Friday so the lab results that were returned to her office weren't read and no new instructions were given to me. I continued taking the 8mg she instructed from last week. I got up at the ass crack of dawn today to go for my routine Monday lab testing. Oh, guess what, there was no order. Hum, wonder who screwed that up? What she told me to do last week and what she ordered were two different things. They recognized me, drew the blood and told me to call the office when I got home.

Of course as soon as 8am hit I was on the phone! I left an urgent message for the doctor. The nurse, Carol, who is filling in for Dr. Kimbell's incompetent nurse, is the one who returned my call. For once, I had someone on the phone who seemed to understand my frustration (she commented on her own about how I sounded) and empathize with the run around I'd been getting from the staff there. She was genuinely concerned for me and my health. It didn't take long for Dr. Kimbell to call back. I was very polite but honest with her in regards to my frustration. When she asked how I was doing I said, "Not good. How are you?" She replied with the same. After listening to her regurgitate all the same information in an unconcerned tone I began to get hot hot hot under the collar! I told her in a very polite tone that I was trying my very hardest to be nice and remain civil but that I was becoming very irritated with how all this is being handled. I explained that I was coming to the end of my rope. She began to spew the same crap I've been listening to. I explained, in a very severe tone, that I understood that Coumadin is difficult to regulate but there is no excuse for me to be going on week 9 without being therapeutic, let alone week 3 of being subtherapeutic. I continued to remind her of my ER visits and the hematologist who sent me because I'd been subtherapeutic for only 2 weeks . . . and now we're going on 3 weeks. I reminded her, also, of the remaining DVT in my right leg. I explained that I didn't want another clot, and that all this is putting me at high risk. She began taking note of my irritations, my tone, and my ability to think for myself and rationalize. I point blank called her out for having me do a lab on Friday with the express intention of getting me new dosing instructions before the weekend, but then being out of the office on Friday making it impossible for me to have gotten said dosing instructions. I even went as far as to tell her she was wasting my money on labs if she wasn't going to get the new instructions to me before the next lab was to be run. She continued to yadda yadda about time and the difficulty of Coumadin regulation. I then said, "Well, then how about we try to figure out why I can't be regulated on Coumadin because we both know it shouldn't be taking 9 weeks to do so." She said she's flag my file and get with my hematologist. I explained again that I'd been too see her twice already and had many labs run. I asked if she'd gotten the manila folder full of lab results that the hematologist had ordered for me back on New Years. She sounded surprised and had no idea what I was talking about. She said, "You brought it by my office?" I told her that I'd given it to one of her front girls who put my name and number on it. I further explained that I'd instructed them to have her nurse make copies and that I'd pick up my originals on my next visit with her on the 11th of this month. She had no idea what I was talking about but assured me that she'd look into it and get with the hematologist.

I'd forgotton to make my 6 mo follow-up appt with Dr. Narayan, hematologist, so I called and mentioned that Dr. Kimbell had "flagged me" to Dr. Narayan, whatever that meant, but that I needed to schedule my follow-up. The girl told me that the two doctors had already spoken with one another. I've still not heard back from Dr. Kimbell in regards to her conversation with Dr. Narayan.

So I'm back up to 10mg with another blood draw to be done on Wednesday. I'm becoming offended, irritated and just plain pissed off! I know there is a purpose in this. So I am trying to take this in stride, but it is becoming increasingly difficult.

I'm reading The Bait of Satan and am beginning to believe that I'm being tested. Ug!