Persistant Infection in Leg

[DawnCt1]

I went back to the first post.

1. Your doctor wanted you to take the most effective medication, which you refused, due to cost. A cheaper but less effective medication was prescribed.

2. Your doctor told you to STAY OFF YOUR LEG! Again, you did not follow directions.

I'm not disputing that you feel you have valid reasons for not following treatment orders, but your actions do have consequences which have delayed your recovery....which is not your doctor's fault.

What are you going to do if you DO see an ID specialist, and he/she ALSO says that your only option is the more expensive drug and complete rest? Why should your first doctor think you'll be more compliant this time around?

So, WILL you be willing to follow treatment orders now that you've seen that you aren't getting better doing things your way?

Call me cynical and I am sure I will be flamed for being "insensitive" , but anyone who posts that "they go to the mat" for other family members but do not do what is required for themselves, seems to be seeking attention because this is just not reasonable behavior.

 

[KadysMom]

Call me cynical and I am sure I will be flamed for being "insensitive" , but anyone who posts that "they go to the mat" for other family members but do not do what is required for themselves, seems to be seeking attention because this is just not reasonable behavior.

I agree!

 

[mcco5543]

Hey Diser's that's another topic entirely!

Let's focus on staying on top of the OP and see if we can't get her to an ID Dr. ..... Although I'll admit, she doesn't seem to want to go...I'm not sure 'its a lost cause yet! I will nag until I feel like there's no point anymore.

 

[froglady]

I was just responding to all of the posters who were dumping on her doctor.

There's a more than likely chance that her doctor DID do a phone consult with an ID doctor, and was told that the first course of treatment was the only one that would insure an optimal outcome. The ID doctor and her primary care doctor might have concluded that since she was noncompliant with the treatment, she would continue to be noncompliant, so a visit would be a waste of everyone's time.

It's up to the OP to convince her doctor that she is scared enough to comply this time, and if an ID doctor comes on board, she WILL follow advice.

We're only getting her side of the story; as a retired nurse, I've seen the other side - Patients who get admitted over and over again because they don't follow through (for whatever reason) with discharge and medication instructions, then complain that it's the doctor's/nurses'/hospital's fault when things go downhill...in this case, the possibilty of a lost limb, or worse.

 

[yeartolate]

One doesn't "need" permission from their Primary physician to see a specialist. They are not your parents!

Actually, depending on your insurance you may ---- if you want it to be reimbursed.

Most insurance I have had required referals to every specialist except OBGYN.

 

[froglady]

Actually, depending on your insurance you may ---- if you want it to be reimbursed.

Most insurance I have had required referals to every specialist except OBGYN.

Which is why her condition is not getting better. Her insurance would not pay for the optimal medication for her condition, and she would not/could not pay out of pocket, so a less effective treatment was used. Then, she was unable/unwilling to follow orders to stay out of work for two weeks. Then, when she chose to go back to work, she did not elevate the leg enough to keep the infection from spreading.

NOW, it appears that her doctor seems to be reluctant to send her to a specialist, as she refused the initial treatment plan. The OP is going under the assumption that her insurance company WILL pay for the extremely expensive medication if a specialist orders it.

The problem is that unless she is also willing to stay off her leg, the more expensive medication still might not clear up the infection. At this point, it's hard to tell if the infection hasn't cleared due to the medication, or due to her activities, or a combination of both. Unless her doctor, or even the ID doctor, can convince her insurance company that a different medication is the only answer, they may still deny it.


My previous statement still stands.

 

[Tiggeroo]

A good nurse in an infectious disease practice should be able to get your insurance to authorize the more expensive meds. It may cost a bit more but it won't be any where near paying out of pocket.
Like I said, dh was on home iv therapy for around three weeks. This was actually cheaper then the prescription pills because it was billed to my medical insurance not my script plan.
His leg was red and had pain for over six weeks. It did continue to improve once the right meds were prescribed. It was required that they run a culture also, even when the vancomycin was working to be sure it would continue working. Also he was told that if he stopped the meds too soon and the infection continued to be there it could become immune to the effective antibiotic.
I am telling you that when dh was in the hospital when it ws very bad he was delirious, had extremely high bp,severe chest pains and a raging fever. When this stuff goes unchecked it is scary.
He had to go back to work too soon also. But he was always home to do the twice daily iv therapy, stopped worked often to elevate his leg and kept walking as per dr.

 

[MELSMICE]

Call me cynical and I am sure I will be flamed for being "insensitive" , but anyone who posts that "they go to the mat" for other family members but do not do what is required for themselves, seems to be seeking attention because this is just not reasonable behavior.

No flames from me - ITA!

 

[DawnCt1]

Actually, depending on your insurance you may ---- if you want it to be reimbursed.

Most insurance I have had required referals to every specialist except OBGYN.

But after the fact, I can't think of ONE physician that wouldn't provide a referral for a regular patient if they insisted. It happens all the time. There is a point where one has to take care of themselves and not worry about "permission".

 

[DawnCt1]

Hey Diser's that's another topic entirely!

Let's focus on staying on top of the OP and see if we can't get her to an ID Dr. ..... Although I'll admit, she doesn't seem to want to go...I'm not sure 'its a lost cause yet! I will nag until I feel like there's no point anymore.

Oh OOOKAAAYYY! PLEASE, PLEASE, PLEASE OP, please go to an ID doc, please, please...with sugar and honey on top! This is just too silly.

 

[mcco5543]

I'm trying to be genuine..no need to mock me ..

 

[yeartolate]

But after the fact, I can't think of ONE physician that wouldn't provide a referral for a regular patient if they insisted. It happens all the time. There is a point where one has to take care of themselves and not worry about "permission".

I cannot either - but I oinder if the internist is constrained by the fact that she hasn't followed a treatment protocol.

Our ID docs are pretty busy (read way overworked) and they will probably not see a patient until they are failing customary treatment (or if they are critically ill). THey are happy to give "roadside consults" - they are more than happy to discuss findings and current plan of care ith the primary without seeing a patient. They have never refused to see a patient, but it does take away from their time with patients who really want their help and are willing to be compliant with a regime.

The bottom line is that the OP (because of unwillingness to be compliant) may have to shell out some cash up front to get the care she wants .

10 years ago I went to a specialist for an ankle problem. I got appropriate referrals, but they were initially "lost". THe specialist visit, xrays, injections, walking cast were all refused . Since all were prescribe and done by an MD which they thought I didn't have a referral for, all was refused. (almost 1500 bucks) . Luckily both internist and orthopedist had referally letters and it got olved quickly. But I could have been royally screwed.

 

[DawnCt1]

I'm trying to be genuine..no need to mock me ..

I know you are and I didn't mean to hurt your feelings. My irritation is not directed towards you. I just look at pages, and pages of excellent advice followed by excuses and I say to myself, "what is the point?" And then I have to answer the question, What IS the point? The point may be to get a lot of attention. I don't know.

 

[mickeysaver]

Deleted.....drama's over

 

[Eeyore'sthebest]

Maggie I am so glad that they are going to refer you to someone. I remember when my DSis was bad. She was out of the hospital for a week and they told her she had to come back to work. She was in crazy amounts of pain and the leg looked just as bad.
I have a good friend that is a hematologist. I try to never ask for any sort of guidance/advice but I did for my DSis. She basically told me that this can stay with her for years. And believe it or not, its been almost 3 years now and there are days where her leg still hurts if she over does it.
And I swear Maggie that everything you are typing mirrors my Dsis. So with that in mind, unfortunately this is not going to get dramatically better in the short term. Good luck with everything. Keep us posted because I really think most people do care.

Oh and seriously contemplate renting an ECV for Disney. You will have so much more fun without having all the pain. Go on the disabilities board and there is a link with different vendors. They can deliver one right to your hotel room.

 

[luvwinnie]

PLEASE make sure you get that referral today!
Do you have a fever still?

 

[Tiggeroo]

You won't need a referral if you go in thru an ER

 

[mickeysaver]

Deleted.....drama's over

 

[DawnCt1]

She offered to get Dr. O to come talk to me, but I declined since she told me that she had already discussed it with him and there wasn't much new that he was going to tell me anyway.

IShe had spoke with Dr. O about my concerns.....I guess again, who knows maybe for the first time today.....and he thinks that I should see ID.
So, now I am waiting for info on a referral. With my insurance, if I see a specialist outside of OB/GYN or Dermatology, I must have a referral, or the bill is all mine.

More thoughts beyond the update.......
My personal doctor has NEVER spoke with ID about my case. The doctor that took care of me in the hospital was in practice with an ID doc, but they only see patients in the hospital, which is a shame, because Dr. Austin was really great. My doctor's office knows that I have done everything possible to be compliant during the course of this illness.

I am not seeking attention, but guidance from "friends"......as in real life, some friends are nicer in the way they give advice than others. It's obvious who in this thread has been genuinely concerned. I appreciate the input. Hopefully, I will get in to see the ID doc soon and be able to get past this nasty infection. Maggie

I honestly am happy that you will be seeing an ID physician. Let me recommend that you make the appointment and go. Fight with your insurance company later. Secondly, next time the nurse offers to get the doc for you, say absolutely, right here and now! If I seemed abrupt, it was because you had gotton great advice and you needed to act in a timely manner. Going to the ER would have been more than reasonable. Take care. I hope you are back on your feet soon!

 

[mcco5543]

Maggie,

I'M SO RIDICULOUSLY HAPPY AND PROUD THAT YOU STOOD UP FOR YOURSELF!! you deserve it girl!!!! I really am sorry if you ever felt attacked by me, I tried the sympathetic gentle suggestion tactic and it wasn't working very well. So I've hit the scare you silly tough love tactic, but believe me there IS ONLY LOVE behind it. I want all my fellow Diser's to be well! Keep us posted and keep putting the pressure on your Dr. for that ID appointment and refferal. The other Diser's are right..Doesn't matter if the referal technically has to come before the appointment. It IS AN EMERGENCY and they WILL see you. I know i've done it plenty of times. I promse. Just get the name of the ID guy and have your DOCTOR call it in and keep being foreceful! YAAAAAAAAAY MAGGIE~!