Wonder drug to the rescue

Sunday September 16, 2012
Gifford Pinchot State Park, Lewisberry, Pennsylvania

 

Thursday:

On Thursday night at 8pm his temperature goes up to 100.6.  They start the doxycycline and a few hours later his temperature returns to normal and remains there.  So glad we have been very careful not to over do antibiotics.  Now when he really needs them, they work!

 

Friday:

David’s white blood counts and absolute neutrophils have now gotten low enough that he is neutropenic.

His white blood cell count on Friday has dropped  to 1.7 and his neutrophils to .69.  He is on doxycycline for the infection but I am emailing his counts to Moffitt and that night his doctor at Moffitt talks with the hematologist here and neupogen is added.  

FINALLY the order is given for an injection of neupogen, the transplant wonder drug, which is administered at about 10pm.  This is the same drug he was given after the chemotherapy during stem cell transplant.  It is a man-made form of a protein that stimulates the growth of white blood cells in the body. It used to treat neutropenia, a lack of certain white blood cells caused by cancer, bone marrow transplant, or receiving chemotherapy.

With this I know he will turn a corner.   And he does.

 

Saturday:

By Saturday morning his White cell count is up to 6.7. (3.9 to 9.5 is normal).  The conditions for discharge as explained by the Infectious Disease doctor are normal White cell count and absence of fevers for 24-48 hours.  By Saturday mid day, these have been met and by later in the day both the hematologist and the infectious disease doctors say he can be discharged.   There seems to be no reason to think he can’t go home.

HA!  Not so fast.  It’s Saturday, that’s a week-end, things are even more disorganized on week-ends.  That seems hardly possible but it is true. 

 

 

Now there is a “hospitalist”. 

This is, as far as I can tell, a sort of made up job.  A hospitalist is a board certified doctor who doesn’t practice medicine but rather coordinates on behalf (supposedly) of an inpatient.  I won’t go into all the details which occur over an 11 hour period but suffice it to say that I am there until 9pm trying to get to the bottom of where is the hospitalist since that person is the only doctor who can discharge you and they only do so if all your other doctors agree.

  David’s doctors have told him that they do, but at 9pm last night after 11 hours of trying to find out what is going on, the hospitalist, who has seen David a total of once at 7:30 am earlier that day, decides to refuse to discharge him.  In spite of the fact that he meets all the criteria and the doctors who have all followed him (such as it was) for 4 days had agreed to discharge, this woman says no.  

Fear of fever flaring up is the excuse given.  And that’s just what it is, an excuse.  He’s been fever free for OVER 48 hours.  So I drive back without him.

 

 

I sure wish they’d let me testify about the problems causing rising health care costs. 

In the mean time, on Saturday while waiting to be discharged, they give him a second shot of neupogen obviously without first checking to see that at 6.7 his white counts are already normal.  Today, because of the second neupogen shot, they are at 20.5 which is twice the normal high.

But, I speculate that the hospitalist had forgotten about David later on Saturday, gone home for the evening and did not want to bother taking care of it until the next day.   This is what your insurance is paying for.  Unnecessary drugs (in this case at $300 a shot), and unnecessary over nights with all those accompanying costs.  Do we wonder why the system is going bankrupt??

 

 

Alls well that ends well?  At least for now.

The bottom line is that he is out of the Hospital of Horrors, feels very good due to his high white blood cell counts and has pizza for dinner.

 

 

 

 

We have found out first hand that nothing compares with Moffitt. 

They are simply amazing. I am bowled over by how quickly they responded to multiple daily emails I sent them and how they directed David’s care through out this ordeal.  Can you email your doctors and have them write right back??

David is safe and home due to their diligence and expertise.  We can recommend them without any reservation as having the very finest in care for cancer patients no matter where or when they may roam.  We feel we are part of the Moffitt family and we can call on them any time.  There is a lot of security in knowing that.  Choosing them was the smartest decision we’ve made in the past year.

 

 

The take home messages from our saga:

BEWARE the community hospital if you possibly can  for whatever your problem.
 
All doctors are not educated equally and some are “practicing” at your expense much more than others.

The Moffitt Cancer Center is what medicine in this country should be for everyone.