A BroKEn sysTEM

Today was glorious –warm with the sun shining.

I thought, “I’ll go outside and work in the garden.”

Sure, I will. I bent over to pull a weed and had to grab onto the porch railing to prevent myself from becoming an embarrassing example of stupidity. Vertigo in one or another of its dizzying manifestations has been my unfortunate identifier for some time now.

I went to my new doctor about two months ago with a detailed description of what was identified by previous physicians as orthostatic hypotension and benign postural vertigo, not one malady but two. I get to use the word comorbidities here. We came up with a plan.

The plan was for me to seek help from physical therapy for the latter and to wear a Holter monitor for a bit to eliminate or identify any cardiovascular issues with the former. Someone from the cardiologist office would call me about the Holter monitor. OK.

I’ve been going to physical therapy. I think that it is helping. I use the word think because becoming dizzy, short of breath, etc. are symptoms of both. For a while I could truly say that the symptoms were intermittent, but no longer … more mitten than inter.

So, I waited to hear from the specialist to whom I was referred to have a Holter monitor fitted. I waited for almost a month. My ability to carry on normal activities was declining rapidly. “dizzy dame” was not at all inappropriate.

A “patient” patient was also correct but the patience was wearing thin. A month seemed a bit long to wait.

I called my doctor’s office. Was it something I had failed to do that was holding up my access to this test? They assured me that I would be contacted “any day” now. “Any day” passed, so I calmed my umbrage and I called the specialist. They had no record of a referral for the device. I could only get a Holter monitor if I saw the cardiologist and the first appointment available was in late June. Are you kidding?

That seemed odd, since my PCP was the one ordering the device. Did he have to get the approval of the cardiologist? Approval from the cardiologist? I was under evaluating who second guesses the physician the doctor’s plan would have to go through. I had worn one of these devices in the way-back time when they were huge and didn’t remember having to wait at all.

Back to the primary doctor. The response was “There must be some mistake, someone will call you.” No one called.

Last week I got a letter from EviCore, a firm that is hired by Excellus to evaluate whether or not I should be allowed to have a Holter monitor. Luckily for me, this company, located somewhere in the southern U.S., decided that I could have one. Apparently, there is something special about me because my spouse, who purchases the same health insurance as I do, got a Holter monitor within five minutes of the doctor telling him that he would need one. No referral, no waiting, no scrutiny of what the doctor wanted. The nurse went to a supply cupboard and got one. Actually, I have permission to get a cardiac event monitor which is a bit different from a Holter monitor. Who made the change? The guy at EviCore?

So two and a half months after one was ordered, I got a phone call from the cardiology department to report mid-May to get not a Holter monitor but a Holter event device with instructions to wear a shirt that opens in the front.

But wait. Want more of the source of my frustration? My spouse had a referral to another specialist and again, no one called. I followed up with the primary care doctor who said that the office would look into this. The next day I received a call from the specialist and made the appointment.

This morning we received a call apologizing for our long wait and telling us that the specialist had not received the original referral. The primary care doctor’s office would help us set up an appointment with the specialist. When I told the nurse that we had an appointment this Thursday, her response was “the system is broken”

It sure is. The trick is to not have it break me or my spouse.

Ann Ferro is a mother, a grandmother and a retired social studies teacher. While still figuring out what she wants to be when she grows up, she lives in Marcellus with lots of books, a spouse and a large orange cat.