Clinic Gatekeeper Problems

Well my colds have won the battle but will loose the war!

I have had 3 bouts illness since mid October. I took levaquin after the first one as it was a flu, I dont even think I was off the levaquin and I got the stomach flu as did my daughter and my husband. I had about a good week or so and I came down on thansgiving day, none the less, with a really bad head cold that in the end turned upper respiratory on me.

I could tell I had a sinus infection but thought an extra day of zithromax on an off day would do the trick. I was still on the fence as to wheter lung portion was clearing on its own when it took a very quick turn to the 'no such luck' side on thursday I waited to see if it was just a 'bad' day. On friday I was coughing horrid stuff out constantly, was completely whipped, and having bad pleural pain on my left side with each breathe=trouble for me.

I called the cf clinic (this is my 2nd year there) and left message on nurse's voicemail describing my symptoms and that I wanted to know when I could next be seen. As an explanation despite being larger this clinic only sees patients two days per month which is, in my opinion, ridiculous. They can get you in when you are ill supposedly but both times I have tried I had a problem. The one time last winter I had to see a NP which ended up being fine and she was on the phone with the doc etc but I had to push to get in and then this time. So the nurse called me back and says "I dont have any doctors or even the NP in all next week" so I ask what to do. While I'm waiting for a plan to hear what she can do she comes back with "well if it gets really bad you'd have to go to the ER" that's it, No but they can see you the week after (which is the holidays), No maybe we can RX you something...NOTHING. I was not pleased.

I said in as nice a way as I could muster "So I know I havent been @ this clinic long so I probably just dont understand how things work but it seems like I am only able to be seen two days a month and if I get sick between times then I am jsut out of luck" She confirms the way the clinic runs and follows up with sometimes she can get a doctor to see people in between their rounds, tehy work in the ICU too yada yada yada but there is always option of going to the ER. So of course I am still not impressed so I say "My understanding of this disease is that when you have an exacerbation it is best to jump on top of it quick so you are telling me that your best advice to me is to a-wait a couple weeks or b-wait until it gets bad enough I have hemoptysis and then rush to the hospital...either way just waiting for it to get worse". She counters with no you could got to the ER I just dont have anyone to see you and then starts saying *in a not so nice tone but not rude* well maybe I can wait until monday and page the dr to see if he can call you. I said "You know I am uncomfortable with this and I would really like the opinion of a doctor" she said she would page them to see 'see' if they could call me.

I am really not a fan of the nurse manager there--even before this but this concreted it in for me.

The dr calls about an hour later and I could tell by his questions that he had already reviewed and was still reviewing all my stuff whcih I was impressed with.

dr-so this has been a few days
me-no and explain the length and duration of the colds
dr-so then it turned to cf and not just a cold
me-yes about a week ago but it wasnt too bad and I thought maybe I could beat it but it took a sudden turn thursday
dr-any hemoptysis
me-yes I have had 3 isntances of streaking but I was 50/50 on where it came from
dr-sputum change
me-yes more and darker and thicker
dr-asks about peak flow
me-yes I havent had it up into my green zone since I started tracking it and sometimes I am not getting it into teh red zone

SOooo anyway the dr gave me the option of driving 1.5 hours (in a 1/2 blizzard no thanks) to come and be seen by him or we coudl get started on IV's right away today as I have been on the meds before and have a port so not a biggie. He felt given my symptoms we needed to start treatment immediately. UNLIKE the nurse who is a gatekeeper and doesnt listen.