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Inferior US Medical Care

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I am so damned frustrated. As I may or have not mentioned previously, I developed a seroma by my incision about day 10 post-op. I had it drained three times sucessfully using a syringe (once in my hotel room, twice in the doctors office) before I left Brazil, with the instructions that I follow up with my family doctor on Friday (and probably on Monday as well, since it needs to be drained every 3 days or so until it's healed).

So I head to my PCP's office on Friday, and ask her to drain it. She refuses to do so, saying that it's a liability issue for her. After making a couple of phone calls, she says I'd need to have a CT scan, be admitted to the hospital impantient and have a drain surgically placed in me, and have to stay in the hospital (for 5? 15? 30?) days until the seroma is healed. Needless to say, this plan is asinine. I'd have to go through all that here in the US for something that could be done by a nurse in a hotel room in Brazil? Needless to say, I wasn't on board with that plan. I told her I'd check around and get back to her. Of course, this same doctor didn't even know what a seroma is, so it didn't inspire confidence. When I pointed out that a nurse did it with a syringe in a hotel room in Brazil, the nurse said, "well this isn't Brazil." My response? "Well, that doesn't say much for the US, does it?"

So all weekend, the seroma has been bothering me. I emailed Dr. M (the surgeon) and asked him what will happen if it doesn't get drained. He says that eventually it will drain on its own by creating a tear in my skin, and that it will be a breeding ground for infection. Not what I wanted to hear, and all of sudden this makes the issue more pressing.

So this morning, on the suggestion of some other people on Dr. M's yahoo group, I called a wound care clinic. Even though they list "surgical incisions" on their web page, they say they won't touch it unless it is an open wound. I tell them if I don't get it drained, it will be one, and I am trying to prevent that. They tell me it doesn't matter, they won't touch it in any case. Great.

In desperation, I call my original surgeon's office. She left BTC (Barix) years ago, and is now with the bariatric program at a local hospital. Her receptionist tells me that she doubts that Dr. Choban will drain it, since I had the surgery done out of the US and she won't want the liability. She said she'll ask anyway, but is sure the answer will be no. She asked about where I've been following up with - I told her I followed up with BTC for the first couple of years, and then after that, it was impossible to make an appointment for follow-up (they'd always tell you to "call next month when the appointment books are open"). So she says, "oh, so you've been non-compliant with your followup?". Uh, no lady - it was impossible to make an appointment. Big difference.

So the situation is looking bleak. I'm tempted to hurry things along by puncturing the seroma with a syringe myself, so some of this fluid can leak out, and so I can control the size of the hole, and so I can keep the hole meticulously clean to prevent infection.

It just makes me really sad that doctors, who have taken an oath to "do no harm", will let a person suffer because of "liability issues" - no, it doesn't matter if the wound gets infected and I die, as long as their hands are clean. Maybe I've just been spoiled by Brazilian medicine, but this US attitude makes me sick to my stomach. Literally.

Dr. M says that the seroma will never resolve itself on its own (most seromas get reabsorbed by one's body after a month or so) because of the hernia repair mesh. I'm not sure where to go or who to ask next. I'm truly left holding the ball on this one, and I'm angry, and upset, and extremely frustrated.

On the bright side, I weighed in this morning at 349, so I'm down 35 lbs. in 20 days. Not bad. :)
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On January 29th, 2008 03:21 am (UTC), (Anonymous) commented:
the seroma
This may sound terribly naive, but could you just go to the emergency room of a good hospital and beg for mercy? Jancd
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On February 7th, 2008 01:55 am (UTC), (Anonymous) commented:
Don't leave us hanging!
Are you okay? Have you performed surgery on yourself?
[User Picture]
On February 7th, 2008 02:03 am (UTC), swampkitty replied:
Re: Don't leave us hanging!
Actually, no - I'm not OK. I went to the ER last week, and they refused to treat me, again, because of "liability issues". The seroma popped on its own, and now my incision is dehisced (sp?) and infected. The surgeon in Brazil told me to have my doctor run tests on the fluid to check for infection and to see what kind in order to know which antibiotics to use, and to also go to a wound care clinic if it's open, but the PCP's office refuses to do it, again because of "liability issues". They told me I'd have to go back to the ER. So it's back to the ER again for me tonight, with an active infection and my incision split open, where they are going to treat me or else I'm going to throw a hissy fit and call in a lawyer.

The sad thing is that this all could have been prevented if the PCP just would have drained the damn thing with a syringe in the first place. :(
On February 7th, 2008 06:51 pm (UTC), (Anonymous) replied:
Re: Don't leave us hanging!
Wow, this has been a mess, hasn't it! Hope your visit to the ER takes care of the problem tonight. Please let us know what happened. We are praying for you and your recovery. Is eating becoming easier? Jancd
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