Wednesday, July 13, 2011

Rare Bird Stuck in Red Tape

This post was going to be written inevitably.  It was just a matter of time.

Let me just tell you that having ongoing medical needs and needing to be seen within the framework of the bureaucratic insanity that is the military medical system (thankful for my health care, though I am!  I really am!) is frustrating in epic proportions.

At this point we're in a holding pattern with the NIH.  I asked about the nodule on the carotid and they said, "Oh yeah.....  Well.  Come back and we'll scan you."  And I said, "But I'll freak you out with my scary breastfeeding infant again.  How about I wait."  And they said, "Ok.  We'll wait and then when you come back we'll scan you til you glow!"  Ok, so that wasn't exactly how the conversation went.  But the point is when Lainey is weaned we'll proceed with them.

In the meantime, it's our hope to find a local endocrinologist who can keep an eye on me as well--without us having to travel 3000 miles.  Why?  Well.  Because I need to be scanned at least once a year to make sure Tomas doesn't come back or show up in places he's not supposed to.  And because there is this other nodule (Tomasito) that needs to be watched.  And by the way, having one of these on the other side outside of the presence of a genetic mutation, from what I can glean from just reading, is kind of odd.  I have lots of questions.  And I'll wait to talk to the NIH folk, but if I can get information in the meantime I want to.

In order for me to go see an endocrinologist here, I need a referral through TriCare.

In order to get a referral through TriCare, I have to go see my Primary Doctor.

Except I don't have a Primary Doctor because my Primary Doctor left the clinic after the clinic said to him, "We think you're a great doctor.  How about you keep working with us, and how about as a bonus, you can do the same job for less money?"  And my Primary Doctor being the intelligent man and quality doctor deserving of pay that he is said, "Um...  NO."

Which means I have an "interim" primary doctor.  With very bushy eyebrows.  And he's ok.  But he doesn't know my history and he is NO Dr. C (Primary Doc).  For that matter, my Primary Doc had a lot of catching up to do once I went back to see him after my pregnancy, because after all, it was the doctor who saw me during Alaine's pregnancy that did all the initial diagnosing and referring.  He was a fabulous doctor and had stayed in the loop pretty well, so it wasn't too hard.

Really all I need is for SOMEBODY to type into their little computer screen that I need a referral to an Endocrinologist at the University of Washington so that I can then call the referral office and say, "THIS DOCTOR is the guy I need to see."  Seriously.  It's just a matter of a few key strokes.  (Which, ironically, is another spot of red tape.  I have to have the doctor make the referral, but the doctor cannot request a specific doctor.  So I have to wait for the referral to be put into the system and then I have to call the referral gods and say--Hey--I can't just see any Dr. Joe Schmuckatelly.  It has to be THIS guy.  And then they decide if they're going to honor my request or send me to Dr. Schmuckatelly.  So far they've been pretty great at working with me and I've only seen a couple of the Schmuckatelly varieties.)

So I call TriCare and I say I need to be seen.  And I give them my Sponsor's social, and my current phone and my non-existent alternate phone and my address, and my bra size and the length of my middle toe on my left foot and they look in their system.  I told asked them, "Look, can I be seen by someone who knows me?  Like the doctor who followed my pregnancy?"  

No.  

Ok.  Then.  What do you have with with my interim primary doc?  

Nothing for this calendar.  We'll transfer you to the clinic.

So I'm transferred.  I again give them my sponsor's social, current phone, n.e. alternate phone, address, bra size, and toe length.  And I say I need an appointment to get a referral.

Let me just say at this point that when I'm having these conversations and I am talking to these people who I know are just doing their job within the ridiculous parameters that have been set up but I'm nonetheless a littel frustrated that I get a perverse kind of pleasure at throwing them for a loop about why I need to be seen.  That conversation goes something like this:

"I need an appointment."

"Reason?"  

"I need a referral to an endocrinologist?"

*slightly confused tone of voice?*  "Ok.  Why?"

"Because I had a Carotid Paraganglioma removed from my Carotid Artery in February of this year at the National Institutes of Health in Bethesda, Maryland."

*stunned silence*

Then, "Ok Mrs. Roseberry, we have an opening next Monday."

Sure, I'll take that.

Guess what?  

It's not with my primary doctor, or my interim primary doctor, or the doctor who followed me for my OB care.

It's with a totally new doctor who doesn't know me from Adam (or Eve).  And he ISN'T my new primary doctor.  He's just a guy kind of connected to my non-existent primary doctor via clinic.

This will be fun.....  *maniacal gleeful giggle*





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