Thursday March 27, 2008 10;25 PM

So here's the latest really f-'d-up tale. Let me start from the beginning...

When I had scheduled Jim for his year-later follow-up visit with Dr. Horowitz, the endocrinologist who found Jim's tumor in his neck, I had asked if I could make an appointment to see her as well to talk about what's up with me....do I have a thyroid problem? Insulin resistance? Or am I just getting fat? For those of you who have never tried to get an appointment with an endocrinologist before, it's almost impossible. When the doctors at Deborah Heart and Lung had given up on finding Jim's tumor they told him to see one. He went through the entire list of doctors in our health plan. No one would even schedule him. One of them even said to him, "If the dcotors at Deborah couldn't find any tumor, the doctor won't see you." This just shows some of the ignorance of these people who work the phones in doctor's offices. If you can break through the front lines you're o.k., but trying to break through those lines is almost impossible. In the end, Horowitz was the only one Jim could even MAKE an appointment with, and even that took about 6 weeks to get. So I figured that Horowitz' office at least KNOWS me, and maybe I can get in. They refused to schedule me. They got really nasty too, saying something like, "Well, that's the office RULES...." so you all know me and you know what I had to say about that. Well, I refuse to go into that office anymore or even speak to those bitches, so I sent Jim into his appointment on his own.

When Jim went in to see her, he told her about how nasty her people had been to me and first she apologized and offered to schedule me, but in the meantime I managed to get an appointment with someone at Thomas Jefferson in Philly the second week of April, so thanks but no thanks. Next, she wrote Jim a script for him to get an MRI, but the script was extremely vague. It said something about "MRI of head and neck, to abdomen as needed"...plus it didn't say whether the scan was to be with or without IV contrast. Well, I knew that wasn't going to fly with South Jersey Radiology, but I tried to schedule it anyway. Sure enough, they said Horowitz had to be more specific. So I told Jim to call and straighten this shit out. Normally I would do it, but as you know, I'm not dealing with those bitches anymore. They mailed another script home, which was still fairly vague, but South Jersey Radiology said they'd take some preliminary info from us and then try to get more info from Horowitz themselves. So the woman is asking me questions about Jim.....Is he allergic to I.V. contrast? No. Does he have any metal in his body? OOOOPPPPPSSSS. I should have thought about that one before we even bothered to schedule this. Jim can't have an MRI....the "M" in MRI stands for Magnetic. He's got a plate in his jaw and a metal clamp holding his carotid artery closed. Then I said to the tech, "You know, there's a question of whether or not his vagus nerve has been cut. The surgeon who removed his tumor said it was, but there's nothing to that effect in his OP notes. A CAT scan is just going to show a mass, if there IS one. Wouldn't a PET scan be a better idea? You guys just recently got a PET scan machine, didn't you?" She said yes. And she said that by the time insurance would be billed for the three MRI's that Horowitz asked for, that would be the same cost as one PET scan anyway, so a PET would be a better choice.

In case you didn't know, the PET scan has been around for awhile, but there weren't many places that had the machines. Now they're popping up all over the place. The color pic of Jim's tumor on this blog came from the PET scan Dr. Jewell did on Jim during his consultation at Lahey last January. Lahey was unusual back then to have even done that- they didn't have them at South Jersey Radiology last year. But there have recently been articles in the local paper about JFK Hospital in Washington Twp getting one, as well as South Jersey Radiology in Turnersville, which is why I knew that South Jersey Radiology just got one.

So now I regret not going with Jim because I would have suggested that if we're doing a scan on Jim anyway, why not pick a scan that might show whether or not that nerve is cut. If you remember back to my account of Jim's first surgery, Dr. Jewell at first told me that he didn't have to cut any vital nerves....he just had to do a lot of damage pulling and stretching to get the tumor out completely, and it would take a very long time for Jim to get all of his functions back. About a week or so later he told me that he had had to cut Jim's vagus nerve right where it comes off the spine, which was why one side of Jim's larynx was permanently paralyzed. After Jim left Lahey and I got the hospital to send me Jewell's operating notes, there was no mention of a vagus nerve cut in there. Plus when Spiegel checked his larynx months later with a camera, we all saw both sides of the larynx moving. So what is it? Is the nerve cut or not? It might be a nice thing to know. Will the PET scan show that? I don't really know, but as far as I DO know, it's the most detailed thing out there, unless Horowitz tells me otherwise.

Then I had to break down and actually call those bitches at her office and explain what was going on. They said the doctor would call back. Yeah, right. I think I'll have to write a letter with the details, sign Jim's name, and fax it like I had to do with Spiegel's office when those idiots who answer the phone couldn't comprehend what we were trying to tell them. I'll give it until next week.