A Soap Opera: As the HMO Turns

Here's the latest episode in the soap opera that life around here has become:

You probably remember that Ed has been working part time for a grocery-delivery service because the awful economy has meant that his cabinetmaking clients aren't spending much money. On February 6, while checking out the back of a different kind of truck that he was to be driving that night for the deliveries, he gashed his forehead severely. He went to the local hospital's emergency department for stitches. The physician had him undergo a head computed tomography (CT) scan just in case there were internal injuries. There weren't, but the scan turned up a brain colloid cyst. These cysts are always benign, never malignant. But they are always located just where, if they are large enough, they can block the flow of cerebral spinal fluid, which can result in odd symptoms and even unexpected death because of high intracranial pressure.

Of course we were scared. We tried hard to get Ed's primary-care physician's office to get Ed a referral to a neurosurgeon, which is what the hospital suggested we do. (We couldn't just go back to the hospital and request to be seen by the physicians who treated Ed the night he injured his forehead, because that first visit to the emergency department was a worker's comp issue, whereas this brain tumor is not.)

But as I just now wrote only somewhat coherently to update a friend:

Grrr! Ed's physician's front office is incompetent! The doc looked at Ed's brain CT scan film yesterday, before Ed's appointment with him today, and saw the colloid brain cyst that the hospital emergency-department radiologist spotted 3 weeks ago. Today, the staff can't find the film! Idiots!

Ed was just now at the doc's office now for his postponed physical exam. These staff members are the same idiots who refused our request for a referral from the doc to a neurosurgeon before the originally scheduled exam date of February 18, which they rescheduled for today and said no referral before today, even though I told them it was regarding a brain tumor. If Ed were dying, would they have moved any faster? I doubt it. This is a #(*^$@ HMO.

So now Ed's doc has to call up the hospital to order another set of CT scan films stat, so that he can look at them with a neurologist. He told Ed (who called me during a break during his physical exam) that the cyst is "only" 3 mm and should probably just be watched at this point—no brain surgery to remove it for now—with Ed getting a new MRI scan once a year. But I want to hear this from a neurologist, dammit! The HMO is supposed to call Ed within a couple of days with arrangements for him to schlep halfway across Long Island (sigh—the local HMO practice facility doesn't have a magnetic resonance imaging [MRI] scanner or a CT scanner) to get a series of baseline MRI scans with (radioactive) contrast dye so that it can have plenty of info to compare against future annual MRIs.

I told Ed that if he didn't emphasize to his physician that a member of his front-office staff caused us lots of mental anguish by making us wait for 3 weeks for this appointment, despite my telling her about the brain tumor, that I was going to get on the phone and raise hell. The dimwitted staff member should have at least performed triage by putting me on hold for 30 seconds, telling the doctor about the situation, and then getting Ed in for an appointment before other patients with less scary ailments. Luckily for that staff member, Ed did what I asked, and the doc says that he'll get to the bottom of the situation. You don't let your patients sit around for 3 weeks in an agonizing knowledge vacuum. You just don't.

Anyway ... no brain surgery for Ed as of right now. Thank goodness.



Ed husband colloid cyst brain surgery EditorMom