Sunday 21 February 2021

Hospital tribulations

 This post is a departure from my usual style of blog entries because it is a personal record of a series of unfortunate events about my passage through the New Zealand public health system during my treatment for prostate cancer.

The story started with the surgery to remove my prostrate in January 2018 at the Dunedin hospital. When sewing me back together the surgeon stitched the tube that drains the wound into me so securely that it required a further operation under general anaesthetic to remove the drain. Well, these things sometimes happen and I would have thought no more about it if only the surgeon had had the grace offer his apologies for a clear error.

I seemed to recover well until, in late 2020, my PSA readings began to rise and a consultation was scheduled with my urologist in November 2020. This was a different person to the one who had conducted the surgery and I will suppress their names so as not to embarrass them. The consultation was by telephone and lasted about 10 minutes. In principle I have no objection to consultations by telephone but they have the unfortunate effect of not leaving the patient to make notes conveniently. I have since learnt that a transcript is prepared by the consultant which contains useful information for the patient. It is a matter of policy not to use email to forward it to the patient and I did not receive a letter by regular mail. Instead a letter is sent to the patient's GP.

The main conclusion from this consultation was that I should go to Christchurch for a PET scan and the surgeon undertook to notify Christchurch Pacific Radiology for them to schedule an appointment. PET scans, by the way, are not funded by the public health system and I was fortunate to have some private insurance for the $3000 fee. I was told that I should hear something soon.

Nothing then happened for several weeks and in the second week of January I phoned the Urology department at Dunedin hospital. It was clear from the reaction that the consultant had not notified the radiologists and he had now gone on leave. A flurry of activity by a very competent administrator resulted in a PET scan appointment for me on 21 January.

Since the appointment was at 11.00am my wife and I rose at 4.15am that day to drive to Christchurch. It was a smooth journey until we reached Timaru some 250kms from Dunedin. Then we received a telephone call from Pacific Radiology to cancel the appointment as the radio-active pellet required had not been loaded onto the plane. This was a somewhat low psychological moment and we had to return to Dunedin with another appointment arranged for the following week.

The PET scan happened on 28 January. I was told that the results would be sent to my consultant and GP within a day or two, and I asked for a copy for myself.

Two weeks then passed and I heard nothing so made another phone call to the Urology department. They had received the results but would not give me any details. I was aware of a level of embarrassment when I said I had heard nothing from them - and they told me I would see the consultant on 8 March, and they would write to confirm (email confirmation again being impossible but, mirabile dictu, my GP would receive a letter).

A further week passed and still no letter so I made another phone call. More embarrassment and I was told the letter would be sent immediately.

The very next day I received a phone call to say that the consultant would actually be on leave on 8 March but they could offer me a phone consultation on 24 February. I agreed to this with some misgivings and after receiving assurances that all would be confirmed by letter. Possibly I was being alarmist but I had absolutely no idea about the seriousness of my condition and I was uneasy about having to react over the phone to some possibly challenging news.

The next day I received the confirmation that my 8 March consultation was arranged (the one that had been cancelled the previous day) but I recognised that this had most likely been sent before the cancellation.

I write this on 21 February and will update the saga as it continues to develop.

24 February: I waited patiently by the phone from 30 minutes before the appointment time of 1.40pm. No call. After an hour I called the Urology department to ask what was going on - and received the message that this was outside their business hours (mid-afternoon). Then I texted the Urology department, received no reply, and one hour and twenty minutes after the appointment time, still not having heard, had to leave. At 5.40pm the consultant called. The PET scan had been inconclusive and he recommended to just monitor the PSA levels and that he would write to my GP about the next PSA test.