Trying To Get Ported (or Blue Cross Blues)

It’s Thursday, 28 days after The News.

Over the last couple days I’ve learned that Palo Alto Dental (PADF) Foundation and Palo Alto Medical Foundation (PAMF) are conspiring to cure me of nyctophilia. Just compare these two calls…

PADF: Hi Michael, this is Jane from Palo Alto Dental Foundation.
M&M: Hi Jane.
PADF: We have a cancellation so we can do your crown on Friday.
M&M: Great – let me get my calendar.
PADF: It’ll be at 8:40 AM.
M&M: 8:40?
PADF: Yes, 8:40.
M&M: Oooookaaaaaay, I guess I’ll see you on Friday….

and….

PAMF: Hi Michael, this is <unintelligible> calling from oncology infusion to schedule your infusion. You’re getting your port on the 18th?
M&M: Yep, that’s when it’s scheduled for.
PAMF: Let me see…we can schedule your infusion on the 24th.
M&M: Sounds good.
PAMF: The infusion will be at 8:15.
M&M: A.M.? (very hopeful she’ll say P.M.)
PAMF: That’s right, 8:15 AM.
M&M: (disappointed) with an 8:00 arrival time?
PAMF: Yes, 8:00 arrival.
M&M: (even more disappointed) Do I have to be awake?
PAMF: You can sleep in the infusion chair.

(Note to self: avoid providers with “Palo Alto” and “Foundation” in their names…)

Trying To Get Ported (or Blue Cross Blues)

Yesterday’s task was to schedule the mediport that’s needed before the chemotherapy infusions can begin. How hard could that be? During the infusion teaching appointment the nurse made it sound like a simple procedure done with local anesthetic.

So I called the number the nurse gave me yesterday, which apparently is for PAMF’s interventional radiology. (It seemed odd to me that interventional radiology would be involved, but according to this description at Hopkins Medicine interventional radiologists “treat a wide range of conditions in the body by inserting various small tools, such as catheters or wires from outside the body.” Aha, so this appointment is really to implant the infusion group’s shower-detection device, and while they’re at it they can also place the port.)

The person on the phone looked through my records and noted that the order indicated infusions were to start on the 17th. (Apparently everyone was told this except me. I just have a side-role chauffeuring the tumor from appointment to appointment). But the referral had a normal priority so they hadn’t gotten around to it yet. She said she’d send it over and to expect a call from a scheduler.

Half an hour or so later I got a call from a scheduler. She also noted that the request was for a mediport by the 17th, but said Sequoia Hospital is now requiring COVID testing prior to procedures even if you’re vaccinated. Alarm bells. Sequoia Hospital? Haven’t I been down this road before? Before I could ask what the COVID test delay would be the scheduler said “Oh, you have Blue Cross, I didn’t notice that…Sequoia’s not accepting Blue Cross now…let me send you over to the El Camino Hospital scheduler. “But isn’t El Camino Hospital also not accepting Blue Cross,” I asked? “They extended it to the end of August.” Ok, well that’s good.

While waiting to hear from the El Camino scheduler I sent a note to the medical oncologist’s office asking if the port could be done at one of their Ambulatory Surgery Centers (ASCs), like the ultrasound was moved from Sequoia to the San Carlos ASC. The reply a few minutes later was no – they don’t do ports (much like I don’t do windows, I guess). But they have three providers who do it for them and who are with Sequoia or El Camino.

By the end of the day I hadn’t heard from anyone, so this morning I called interventional radiology again. I want them to get that shower-detection implant “stat”, before I get another 7:30 AM call. I’ll wear my Apple Watch in the shower if I have to. I explained what had happened yesterday with the Sequoia scheduler. After being put on hold for a couple minutes I was told to expect a call from “Cinderella” (no that’s not her real name. I’ve changed it to protect the guilty). I was also told that if I got a call from anyone else like Sequoia or El Camino Hospital it wasn’t them. Well isn’t that kind of obvious? I must be missing a subtlety here.

A short time later I did indeed get a call from “Cinderella”, who was able to schedule me for 11:30 at El Camino Hospital. Yay, I can sleep in! “You’ll need to fast for 8 hours prior.” Again? This is why people lose weight when they get a cancer diagnosis. “Please arrive by 9:30.” Okay I can sleep in a little. “And you’ll need someone to drive you home – El Camino changed and now requires all procedures to be done under sedation.” And that means I need to Uber there. So much for sleeping in. How is it that the medical profession can take a perfectly reasonable 11:30 appointment and twist things around so I’ll need to be up by 8?

Those of you keeping track of my calendar (I assume no one does – I can barely manage it these days) might notice that the 18th is the day after the first infusion was supposed to occur. Which is why the call at the top of this post took place – everything’s pushed back a week thanks to the squabbling between Blue Cross and the hospitals. (Actually PAMF oncology infusion wants to wait 2-3 days after the port is placed to allow things to heal, so there wasn’t any way the 17th was going to happen. But that doesn’t make as good of a story.)

More Than Just Treating The Disease…

As I wrote earlier I had a great chemotherapy teaching session on Tuesday. The nurse who did the session is another example of the wonderful people at PAMF. Demonstrating that here’s a little detail she entered into the appointment notes:

We had spent a minute or two talking about Caper-the-cancer-magnet and her experiences at Sage Veterinary (a well-regarded practice that the nurse was also familiar with). But I never imagined Caper would end up in my medical records. I suppose I can look forward to showing off pictures of Jasper and Caper at future appointments 🙂. Maybe while playing with those labs 1-2 days before chemo. (I wonder if they have chocolate labs?) She did not however enter into the notes that I would like chemo with a side of hair loss.

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