GYNs won't do a visit

zsazsa1
zsazsa1 Member Posts: 568 Member

I started to lose weight the week before I began the rituximab for the indolent lymphoma.  BTW, my counts improved greatly after the first dose, so clearly, it works for me.  So naturally, my first thought, when it became evident yesterday that I really was losing weight, was that I had better start with an internal check, to look for recurrence.

No one in the gyn onc group at Hartford would see me.  They are too afraid of a patient coming in with coronavirus.  I explained that I am not sick, and have been completely self-isolated at home.  Still, they would not see me.  Same response from Yale.

I understand completely.  All medical personnel are putting their lives at risk to see patients, from the senior attending in the ER right down to the lowest level janitor there.  I would have had a tough time choosing how to handle it, since I was in primary care, and would have been putting my life on the line to continue to see patients.  But to me, this seems excessive.  This is not an infectious disease risk, I'm not sick, I'm self-isolating, if I go anywhere, I'm wearing an N-95 mask and gloves, and I do have a serious life-threatening malignancy.  The receptionist and tech whom I dealt with at the oncology lab are still working, how can the GYN oncs simply say that they're not seeing patients?  I mean, weight loss is a significant sign, and the first thing to do is to check for a local recurrence with an internal exam!

It's a bad time to be sick.

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Comments

  • MAbound
    MAbound Member Posts: 1,175 Member
    edited March 2020 #2
    Two way street

    This is so scary and just crazy to just stop treating anything other than coronavirus. It will just result in a lot of collateral suffering and pump up the death toll. In some ways I can understand it because doctors offices could be prime locations to pick up an infection. Oncology patients are at particular risk. It's a real Catch-22, but you'd think there'd be some commons sense involved to set limits and make exceptions.

    Do you have a back door to get past a receptionist to your oncologist, like a televisit? Have they abandoned their patient portal? I really don't see how they can close themselves off completely from people in the middle of treatment. They should still have some options.

  • LisaPizza
    LisaPizza Member Posts: 358 Member
    I agree with MA. I don't

    I agree with MA. I don't consider this to be elective or nonurgent medical care. I wonder if there's any patient advocate position who could possibly help.

  • Donna Faye
    Donna Faye Member Posts: 427 Member
    edited March 2020 #4
    One is at their mercy

    It seems no one was prepared for a pandemic! I had to talk to my onc on Monday by phone. She prescribed the Megace/Tamoxifin for me. I have called Walgreen's daily to get. Today finally asked to speak to phram and she says there is no ok from onc for both meds. So, called the clinic and was on hold for 20 min. but finally spoke to nurse who is calling the pharm to see what the problem is. They have the scrip for both and meds in stock but cannot give to me??? I fear we are in for some rough months ahead as everyone tries to figure this out. ZZ, I hope you can be seen soon. You do not need this stress. Thinking of you as we battle on.

  • zsazsa1
    zsazsa1 Member Posts: 568 Member
    edited March 2020 #5
    I understand their fear.  But

    I understand their fear.  But this is so low risk for them, and a significant issue for me.  They basically just pulled up the gangplank on patient care.

  • MAbound
    MAbound Member Posts: 1,175 Member
    edited March 2020 #6

    One is at their mercy

    It seems no one was prepared for a pandemic! I had to talk to my onc on Monday by phone. She prescribed the Megace/Tamoxifin for me. I have called Walgreen's daily to get. Today finally asked to speak to phram and she says there is no ok from onc for both meds. So, called the clinic and was on hold for 20 min. but finally spoke to nurse who is calling the pharm to see what the problem is. They have the scrip for both and meds in stock but cannot give to me??? I fear we are in for some rough months ahead as everyone tries to figure this out. ZZ, I hope you can be seen soon. You do not need this stress. Thinking of you as we battle on.

    Megace

    When I was on Megace, it had to come from a special compounding pharmacy rather than from my regular pharmacy (RiteAid). I don't know if that was a requirement from my insurance to cover it or an issue with a regular pharmacy. It was shipped to me at home in a mini cooler during the summer because it is very temperature sensitive and I had to be home to sign for each delivery. I don't know about Tamoxifin, though.

  • Forherself
    Forherself Member Posts: 1,018 Member
    One of the problems

    Is a severe shortage of protective gear.  I think they are saving it all.   In Washington State our local Family Practice group is actually asking for dinations of masks and white lab coats gowns etc.   Not easy decisions to be made right now.  Especially in the bigger cities.  Providence hospital is even asking  for volunteer seamstresses to make masks.

     

  • jan9wils
    jan9wils Member Posts: 209 Member
    edited March 2020 #8
    This sounds serious to me. I

    This sounds serious to me. I agree with MABound that you try to contact your Onc through the patient portal.

  • CheeseQueen57
    CheeseQueen57 Member Posts: 933 Member
    edited March 2020 #9
    MAbound said:

    Megace

    When I was on Megace, it had to come from a special compounding pharmacy rather than from my regular pharmacy (RiteAid). I don't know if that was a requirement from my insurance to cover it or an issue with a regular pharmacy. It was shipped to me at home in a mini cooler during the summer because it is very temperature sensitive and I had to be home to sign for each delivery. I don't know about Tamoxifin, though.

    Not the case

    With me. I get both Megace and Tamoxifen at my usual pharmacy

  • Donna Faye
    Donna Faye Member Posts: 427 Member
    edited March 2020 #10

    Not the case

    With me. I get both Megace and Tamoxifen at my usual pharmacy

    New pharm

    Not sure what the real problem was as the clerks I spoke to were clueless! However, I can email my doc and she got it all smoothed out and I can pick up tomorrow. It may just be that I am a new customer and not completely in the system but all good now. 

  • MoeKay
    MoeKay Member Posts: 495 Member
    edited March 2020 #11
    Good luck in getting an answer

    zsazsa, good luck in getting a response from your oncologist through the patient portal, a phone call, an email, a text, or whatever other method of communication you have at your disposal.  It's crazy that your oncologist would become unavailable while you are experiencing significant problems and in active treatment.  Your doctor has to provide you with some direction on what is in your best interests here. 

    The issue you're experiencing was just discussed on the nightly news tonight.  See:

    Cancer patients forced to delay treatment over coronavirus concerns

    https://www.nbcnews.com/nightly-news/video/cancer-patients-forced-to-delay-treatment-over-coronavirus-concerns-81041989653

     

  • So sorry zsazsa, but that's wrong

    I would understand if they had talked with you on the phone about your weight loss, and then told you they thought ther risk to YOU was greater than not seeing you at this time.  But to reverse a doctors first importance is the patient and not THEMSELVES is really disgusting.  If you feel the weight loss is significant, please call all channels to talk with someone.  And if you continue to see these doctors in the future, really tell them how they abandoned you by not offering any contact.  Hugs Nancy

  • MAbound
    MAbound Member Posts: 1,175 Member
    unknown said:

    So sorry zsazsa, but that's wrong

    I would understand if they had talked with you on the phone about your weight loss, and then told you they thought ther risk to YOU was greater than not seeing you at this time.  But to reverse a doctors first importance is the patient and not THEMSELVES is really disgusting.  If you feel the weight loss is significant, please call all channels to talk with someone.  And if you continue to see these doctors in the future, really tell them how they abandoned you by not offering any contact.  Hugs Nancy

    A bit harsh

    I don't know if I would be quite so harsh on the doctors. In terms of their calling to treat the sick and do no harm, one has to bear in mind what the loss of each one who dies from this virus would cost everyone in the long term. There aren't enough doctors, especially specialists such as the ones we need, to begin with. It takes an extrodinary person to have the gifts and the drive needed to become a doctor and they are not easily or quickly replaced. Their actions are not necessarily about self-preservation, but a safe-guard to make sure they are still around for the long term. 

    The other point to consider is that their ability to continue treating with surgery, chemo, or radiation may not be the right way to go under current circumstances because of what it does to a person's immune system. Ours is a slow growing cancer, so suspending or delaying treatment may actually be the safer option to maximise the odds of survival. Hopefully, as everyone gets a better handle on this virus and PPE suppllies become more available, they'll have some ability to start prioritizing and treating patients for issues besides this virus. That can't happen quick enough, but in the meantime, I agree that it would help a lot if these doctor's didn't just abruptly cut everybody off to fend for themselves. There are options for remote care and they should be used.

  • zsazsa1
    zsazsa1 Member Posts: 568 Member
    edited March 2020 #14
    They offered me CT scans, but

    They offered me CT scans, but I had a normal PET/CT a month ago, as part of the workup for the lymphoma.  I really need to start with an internal exam, and since my entire household of 3  is on utter and complete isolation, and I would come in gloved and masked, it is absolutely NO risk to them to do an internal look.  Everything in medicine, and in life, is a risk/benefit issue.  We take a risk every time we drive anywhere, but the benefit of convenient and quick transportation outweighs the risk of an accident.  In this case, it appears that the GYN group decided that their infinitessimally  low risk of contracting coronavirus from me, outweighed the very significant risk to me of not finding a local recurrence early on.

    It's called medical abandonment.  I'm stunned, to say the least.  Meanwhile, other medical workers at far, far greater risk keep on bravely going into work, heroes every one of them, from the attending physicians right down to the janitors.

    I eat what I want, and weigh myself daily.  The weight loss seems to have stabilized, I hope, at about 5 lbs less than I was a week ago.  Hopefully, it's much ado about nothing, at least for me.

    Stay safe, everyone, and STAY HOME!

  • barnyardgal
    barnyardgal Member Posts: 272 Member
    edited March 2020 #15
    I'm so sorry. I understand

    I'm so sorry. I understand the worry the health care workers have, but it does seem wrong in your situation. Can you do a video visit for starters? I was supposed to have a 3 month chrckup next week but since CT and blood work is fine my gyn onc is doing a video chat. 

  • zsazsa1
    zsazsa1 Member Posts: 568 Member
    Ha ha ha!  Honestly, if I

    Ha ha ha!  Honestly, if I could get hold of a speculum, I would do just that!  And maybe I CAN get hold of a speculum.

  • zsazsa1
    zsazsa1 Member Posts: 568 Member
    When I went in for a

    When I went in for a rituximab infusion, I also was seen by the nurse practitioner.  I explained to her the need for an internal exam, she called the GYN/ONC group, and they got me in today.  Normal internal exam.  So I can put the UPSC on the back burner, and concentrate on the splenic marginal zone lymphoma, which now is causing hemolytic anemia.

  • Armywife
    Armywife Member Posts: 451 Member
    zsazsa1 said:

    When I went in for a

    When I went in for a rituximab infusion, I also was seen by the nurse practitioner.  I explained to her the need for an internal exam, she called the GYN/ONC group, and they got me in today.  Normal internal exam.  So I can put the UPSC on the back burner, and concentrate on the splenic marginal zone lymphoma, which now is causing hemolytic anemia.

    Praise God

    Thankful your focus can remain on the immediate issue.  Also thankful you were seen promptly!  

  • Molly110
    Molly110 Member Posts: 191 Member
    zsazsa1 said:

    When I went in for a

    When I went in for a rituximab infusion, I also was seen by the nurse practitioner.  I explained to her the need for an internal exam, she called the GYN/ONC group, and they got me in today.  Normal internal exam.  So I can put the UPSC on the back burner, and concentrate on the splenic marginal zone lymphoma, which now is causing hemolytic anemia.

    What a relief that you got

    What a relief that you got the exam you needed and that the UPSC can stay on the back burner.  I was shocked to read that you had trouble being seen when you had a serious concern. I know my care team is still seeing patients. I think about them and the women who are still in treatment so often and feel lucky that I finished chemo in January before COVID-19 hit the US hard. I have a bunch of post chemo questions for my gyn/onc and nurse practitioner, but since my questions aren't at all urgent, I decided to wait until the next time I have a check up. When everyone in the building is risking their lives, it doesn't feel right for me to ask them about hair regrowth. 

  • TeddyandBears_Mom
    TeddyandBears_Mom Member Posts: 1,814 Member
    Molly110 said:

    What a relief that you got

    What a relief that you got the exam you needed and that the UPSC can stay on the back burner.  I was shocked to read that you had trouble being seen when you had a serious concern. I know my care team is still seeing patients. I think about them and the women who are still in treatment so often and feel lucky that I finished chemo in January before COVID-19 hit the US hard. I have a bunch of post chemo questions for my gyn/onc and nurse practitioner, but since my questions aren't at all urgent, I decided to wait until the next time I have a check up. When everyone in the building is risking their lives, it doesn't feel right for me to ask them about hair regrowth. 

    Molly, if you are comfortable

    Molly, if you are comfortable asking here..... Lots of ladies will gladly answer. Congrats on finishing treatment!  Now, be kind to yourself and give yourself time to heal.

    Love and hugs,

    Cindi

  • zsazsa1
    zsazsa1 Member Posts: 568 Member
    Molly110 said:

    What a relief that you got

    What a relief that you got the exam you needed and that the UPSC can stay on the back burner.  I was shocked to read that you had trouble being seen when you had a serious concern. I know my care team is still seeing patients. I think about them and the women who are still in treatment so often and feel lucky that I finished chemo in January before COVID-19 hit the US hard. I have a bunch of post chemo questions for my gyn/onc and nurse practitioner, but since my questions aren't at all urgent, I decided to wait until the next time I have a check up. When everyone in the building is risking their lives, it doesn't feel right for me to ask them about hair regrowth. 

    Molly, the most important

    Molly, the most important thing for you to do is to totally self-isolate, you and your household.  Get someone to drop off groceries for you.  No one in your household should go shopping, or come into contact with anyone else, other than in your household.

    My last chemo was I think the last day of February.  By mid April, I had a significant 5 o'clock shadow with hairline look - I think that's when I stopped wearing hats.   Now, about 14 months after chemo, I'd say hair is about 6 inches.  At first it came in quite curly, but now it's just got its normal slight wave.  Pretty much same as it ever was.