Diagnosis: A Case Of Jr. Mintosis
In an episode of Seinfeld, the characters Jerry and Kramer are seated in an operating room theater observing a surgery. Admittedly, I had not been paying attention to the episode to understand why a comedian and a hyperactive goofball would have been attending a surgery.
Being a “theater”, Kramer felt the need to have a concession, to eat while watching. His selection? A box of Jr. Mints, a popular staple in theaters, at least when I was growing up. Of course the two are carrying on a conversation, and carrying on, when a mishap occurs. A Jr. Mint candy flies from Kramer’s hand landing below into the patient’s surgically opened cavity, with the surgeon down below unaware of what happened.
While this was a comical bit, and it is highly unlikely that this would ever happen, mistakes can happen. Back in the 1980’s, mal practice lawsuits ran at all-time high threatening the extinction of doctors, no longer able to afford their insurance. Admittedly, things could go wrong during a procedure, either as it occurs naturally, and yes, sometimes negligence.
My diagnosis of Hodgkin’s Lymphoma, was originally diagnosed as a “common cold.” Now you may be wondering, “how the Hell do you mistake cancer for a cold?” And it makes sense. But here are the facts. Hodgkin’s Lymphoma is considered a rare cancer. Whereas your primary care doctors may recognize or suspect breast or skin cancer, Hodgkin’s is a lot more difficult to diagnose, especially if you are not looking for it.
Now, to be fair, I had only one symptom, a swollen lymph node. Under normal circumstances, we get them all the time. It all depends on how much they swell, but that is what they do when you are battling an illness. I felt fine otherwise, and was given an “anti-inflammatory” to help the node go down. Once the medicine was finished, the node flared back up, and some new symptoms began. Bloodwork revealed nothing. X-rays revealed nothing. Only when I allowed them to biopsy the lymph node, they found cancer, Hodgkin’s Lymphoma. Again, a rare cancer, and given all that I had to go through to get diagnosed, how could I expect my family doctor, with no special training in cancer, to have recognized that?
And if it were not hard enough for science and medicine to be 100% correct every time, there can be other factors that can confuse a situation.
For instance, my name. I am named after my father, exactly. With the exception of our title at the end of our name, I am a “Jr.”, our names are identical. I became aware of that with my first traffic ticket, as the officer forgot to put the “Jr.” to my name, and the citation ended up being placed on my father’s record.
While the mistaken identity was funny at the time, in the future, it would become a very serious matter.
Two Paul Edelman’s. Yes, our names are spelled identically. But clearly there are differences.
At a follow up appointment for my heart issues, due to my treatments for Hodgkin’s Lymphoma thirty years ago, I was asked about my smoking history. Immediately, I knew that they were looking at my father’s medical record instead of mine, one of the hazards of digitalized medical records through one system. It was easy enough to point out to them, because my father had mentioned he smoked for fifty-five years, and I was not even fifty years old. Confusing my record and my father’s record could be very problematic, each with our own extensive and extreme medical history.
Have you ever had one of these before? If the answer is yes, then you know of the worst possible pain imaginable, a kidney stone. You can see through the picture why they hurt so much, and depending on the size, determines how much pain, and how easily you can get rid of them. Sometimes, medical intervention is required.
In my case, the local hospitals did not technically take care of kidney stones. Instead, there was a “mobile unit,” that travelled from hospital to hospital. And depending where the unit was that particular day, if you wanted relief, that is where you went.
I was not happy about where the mobile unit was going to be, as I had a close family relative die there, and it was not known as one of the better hospitals in the area, but I needed relief. My stone was not going to pass itself, and I would need a “lithotripsy” to help eliminate it. Simply explained, they were going to “blast” the stone to miniscule passable pieces, a fairly routine process.
I arrived at 5am, first patient of the day at the hospital. I handed my ID and my insurance card over to the admin, who informed me that she would not be able to check me in because her computer was down. After some thought, she decided to photocopy my information so as not to delay my procedure. And then she came back, the copy machine was not working either. Now my horror. I was going to go back into a surgical room, no identification on me, and I was going to be unconscious. Fortunately, my doctor saw me before going in, and wrote very clearly on me with a “sharpie” my name and what was to be done.”
Once I came to, all I had to do was pass the remnants into a bottle for them to filter the contents to test the make-up of the stone. Wouldn’t you know, they flush the bottle down the toilet. I must wait until I have to urinate again, to see if I produce any more remnants. When I do not, I am discharged, unattended, to wait on the curb outside of the hospital for my ride to pick me up (as opposed to the ride actually being the one to check you out since you were under anesthesia).
Then, I come to find out how much trouble my name can actually cause, that I might just be mistaken for a dead man, my father. It turns out, I could get accused of voter fraud, if I do not use the “Jr.” after my name. Without doing so, that would indicate my later father would have voted, in spite of him having been dead for years, and it was actually me casting the ballot.
Between medicine and my namesake, I have a lot to keep straight. I am a strong advocate in health care for many reasons, mainly to help others who do not feel as if they have a voice. And often, it is by my example that someone else learns how important it is, to advocate for themselves whether it is for their care or other necessary support.
No one pays more attention to their medical chart than I do. I have a backpack full of all my documentation from my cancer diagnosis to when I first realized that what cured me, is also destroying my body. I really need to get it all put onto a thumb drive to make it more convenient.
But I learned advocacy in health care is more than just fighting to get the care you need. It is also about keeping your records, and your procedures straight. Imagine, your doctor tells you that you need to have something done in one part of the body, pertaining to a certain body system. Mentally, you prepare for that pending surgery. You are not worried about your doctor’s hands, he will do what he does best. There is a step though before you get to the operating room, between when you have the consult with the doctor and surgery day.
A clerk must enter and schedule the procedure… accurately. Since we are in the digital age, medical procedures are no longer entered by description, but by a code of four to six numbers. What would happen if one of the numbers being entered, was entered incorrectly? Obviously, you would have a different procedure scheduled. And if you did not notice it before the surgery date, you could be in a state of calmness that may not alert you to any questions that would bring this error to light. You go in for one procedure, and end up having something totally different done. Unless… you catch it first.
Mistakes can happen. I do not believe that any doctor or nurse gets into medicine to be negligent. But even if by accident, the errors can come at a high cost, perhaps the ultimate. You do not need to have a college degree to confirm information. Just a good set of eyes, and a healthy dose of suspicion. And if your gut is telling you something is not right, then deal with it. That is what advocating for yourself is all about.
Paul's Heart 