Big Medicine

My mother had her fourth round of chemotherapy last Thursday. Because she has been struggling with severe dehydration with this chemo, the doctor decided to change one of her meds since it was one she seemed to tolerate better when they used it during her treatment for breast cancer. We had high hopes that this would mean one less hospital visit but Monday morning she was lethargic and weak. So weak she could not stand. My father called the oncology department who recommended she go to the emergency room because they would not see her unless her doctor was there. She has ovarian cancer and, according to the hospital policy, she can only be seen by a gynecological oncologist. Never mind that she doesn’t actually have her ovaries anymore. Or her uterus for that matter. And her issue was not a gynecological issue, but a chemo issue. Her blood pressure was super low and while she wasn’t as severely dehydrated as the previous times, she still needed fluids. She wisely (in my nonmedical opinion) chose not to go to the emergency room. She is immunocompromised due to the chemo and the omentectomy two months ago. The emergency room is a good place to find new health issues for someone who doesn’t have a strong immune system. Eventually, very late in the day, my mom received special permission to be seen in the oncology unit, without a gynecologist there, to determine her blood pressure was scarily low (it was 63/54, for anyone who knows things about blood pressure). This is especially disconcerting for someone who’s blood pressure generally runs high. My mom was so weak she could not stand on her own, she could barely stand at all. But, she was going to be turned away from the oncology unit because she had a cancer in one of her “woman parts.” It was infuriating and unacceptable. How is this even a policy when, to my knowledge, no other type of cancer is treated strictly by a specialist. Yes, she should have a specialist overseeing her care, but for issues stemming from a reaction to chemotherapy should be seen by any available doctor. No cancer patients should be sent to the general emergency room where there is a higher possibility for infection. Even a common cold could become an issue for someone with a weakened immune system.

 

So, I am writing a letter to the head of the department at the hospital because this whole episode was totally unacceptable. The entity that manages the hospital recently bought 11 more facilities on the East Coast. Medicine is becoming Big Business and it is evident in how the patients, real human beings who are putting their very lives in the hands of the staff at these hospitals, are being mistreated. Part of my argument is how this particular type of cancer, because it is a reproductive organ of a woman, was singled out causing different treatment for a specific set of patients. Do testicular cancer patients have to be seen only by a urological oncologist? Secondly, I don’t believe patient’s should ever feel like a cog in the corporate machine when it comes to their health care. The hospital cannot think it is too big to fail because then it already has failed. Patients fighting for their lives should not also have to fight for proper medical care.

 

My mom is worried about the next two rounds of chemo because they are cumulative and will only get worse, not better. I tell her to focus on the present and not to worry too much about the future, but given how these things have been going, it is concerning. I hope her doctor is able to help her and to be there more for her, although she hasn’t really been thus far. I hope my mom is able to better tolerate the next two rounds of chemo and be done with cancer for good. Many prayers for a positive outcome.