Esophageal Stent, Stool Softener & a Substandard Physician

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Our last update ended late Friday 04/17 with esophageal cancer (EC) combatant Diann Pearson (a) lying uncomfortably in a dysfunctional bed in Jackson Memorial Hospital (JMH) South Wing Room 614B, suffering from weeks of incessant coughing caused by a bronchoesophageal fistula (BEF) it took her JMH treatment team weeks to find, and (b) praying for relief from both…

All through Saturday 04/18 Diann’s coughing worsened as we waited for someone – gastroenterologists, oncologists, surgeons, et al – to step up and offer a fix for her fistula. No physicians offered anything new that day, and by evening Diann barely had the strength to hack up the thickening phlegm coming from her lungs. Fortunately, an alert young nurse named Angela Bravo recognized that albuterol inhalation might ease her suffering, and recommended same to the unknown doctor dictating Diann’s destiny from a distance that day. The resulting respiratory treatments proved to be a merciful miracle, and with that and a dose of dilaudid Diann made it through another night.

On Sunday morning 04/19 her CT scan scheduled for Saturday was finally performed. A few hours later a thoracic surgeon named Daniel Nguyen MD showed up with his apprentice. The senior surgeon was taking the long road to explaining why surgery was not an option for Diann when three more medical types with “Surgical Oncology” (as I recall) stitched on their white lab coats came in and lined up behind him. They whispered amongst themselves briefly, then Nguyen said he’d get back to us and they all left. He never did.

The GI (gastrointestinal) emissaries we’d been promised on Friday made their first appearance on Monday morning 04/20. We asked several questions of a friendly, bright and eager young gastroenterologist named Fernando Calmet, who assured us he’d return in a few hours with his superior and some answers. He did: A professionally poised and to-the-point Dr. Amar Deshpande gave us straight answers to direct questions, and was the first to commit JMH to implanting an esophageal stent to stop part of everything Diann swallowed from leaking into her left lung. He promised us the procedure would take place on Wednesday 04/22, and suggested Diann do her best to rest and relax until then.

Originally scheduled for 7:30am then moved to 9:30am, transport finally showed up to roll Diann down to see the anethesiologists in the JMH DTC (Diagnostic Treatment Center) 3rd floor waiting and recovery room at about 11:15am. A caring lady Dr. George (?) noted a “gallup” in Diann’s heartbeat, and ordered an electrocardiagram (EKG) before allowing Diann to be taken at around 12:45pm to the operating room where a team of three gastroenterologists – Amar Deshpande, Patrick Green and Leo Arosemena – would implant her 10.0×1.8 centimeter (3.9×0.7 inch) stent.

As instructed, I returned to the recovery room looking for Diann at 2:15pm. I was told everything went fine but the anesthesiologists were keeping Diann under observation for a while, and I should come back when they called me. As I turned to leave I ran into two of the GI doctors who had performed the procedure – Arosemena and Green. Like Deshpande, Dr. Green proved to be a straight-shooter in answering all the questions I had for him.

It was approaching 5:00pm when I finally got the call to join Diann in the recovery room. There the compassionate anesthesiologist George (?) told me Diann’s heartbeat became irregular during the procedure and she wanted another EKG to be sure it had returned to some semblance of normal. It had, and by 6:30pm we were back in room 614B for the night.

Thursday morning 04/23 we worked through some seemingly never-ending nutrition and hydration issues, then our much-appreciated friend from North Carolina Linda Seagle came to spell me so I could go home, get some work done and maybe sleep in a bed for a night. That was not to be the case, however, as later that afternoon Diann called and put me on speaker with a “hospitalist” who attended medical school in Colombia named Angelica Rocio Jimenez. We had never heard of Dr. Angelica R. Jimenez before then – and I wish that was the case now: Her command of the English language was questionable, and her sole concern seemed to be getting Diann discharged as soon as possible. I told her I would not allow that to happen until (a) she’d been on enteral feeding without complications from the stent for at least 24 hours, and (b) we had consulted with two physicians who actually knew something about her condition – those being Amrita Desai and Rafael Yechieli. I then rushed back to the hospital on our scooter through a rainstorm to make sure the below-average rated Angelica Rocio Jimenez MD didn’t put Diann on the sidewalk with her TPN tubes hanging out.

Once I arrived, I changed into two hospital gowns and hung my dripping-wet duds around the room to dry. I could find no comfortable position to sleep in the chair (again) that night – but I took great comfort in the fact that Diann’s cough was all but gone, and only some old back and new neck and ear pains kept her from sleeping peacefully through the night. At one point she was even snoring!

When dawn Friday morning 04/24 finally arrived, I put on my still-damp clothes and headed down to the JMH cafeteria for two large cups of dark roast to go. I then placed calls to Drs. Desai and Yechieli, and watched a tear come to Diann’s eyes as she slowly sipped her first cup of tea in many, many weeks. Dr. Deshpande and company came by to say good-bye later that morning, and encouraged her to drink clear liquids, then juices or formula, then soups and slowly work her way up to pureed foods. Her chemotherapist Dr. Desai scheduled a follow-up for next week, and her radiation oncologist Dr. Yechieli dropped in to encourage her to live each day to the fullest until he sees her again in June. By noon our checklist was cleared, and all that remained was for Diann to be discharged.

Thanks in no small part to her D-list doctor du jour Angelica Rocio Jimenez, Diann’s JMH patient discharge papers were long and from some perspectives laughably full of errors, e.g.:

  • Her “Discharge Instructions” were to follow up with a non-existent primary care provider.
  • Her “Scheduled Clinic Appointments” included chemo and radiation treatments that were suspended.
  • Her “Diagnoses This Visit” included multiple mythical references to dehydration (at least upon arrival).
  • Her “Prescriptions…” included lactulose – a stool softener – “as needed for constipation”.

Diann Pearson has eaten no solid foods since January, has survived on an all-liquid diet based on Ensure Plus since February, and her bouts of diarrhea these past two months have been eclipsed only by her coughing fits. So who in the world would send her home with a prescription for STOOL SOFTENER?!?

Dr. Angelica Rocio Jimenez, that’s who… The same doctor who sent her home Friday afternoon with a prescription for a pain reliever that no pharmacy – CVS, Walgreens or Jackson’s own – could fill. And the same doctor who the JMH South Wing 6th Floor Nurses Station spent all day Saturday (04/25) trying to locate, and who was equally difficult to reach by the CVS pharmacist who was also trying to help Diann get her pain medication. Our frustrating experience is alarmingly consistent with these online reviews of Dr. Angelica R. Jimenez MD:

  • “Called all three numbers listed for Dr Jimenez. Reached a personal cell phone and the other two numbers brought me to someone who stated they had no idea who the doctor was.”
  • “Rush and hurried to the max… makes fun of patients to their faces… laughed at pain.”

It is now 11:00am Sunday morning 04/26, two days after her discharge. And thanks to Dr. Angelica Jimenez MD, Diann STILL does not have her pain medication.

Pray for Diann,

BDaddy

P.S. It is now 12:30pm Sunday 04/26 and our friend Linda Seagle just returned from taking Diann first (a) to the JMH South Wing 6th Floor Nurses Station to pick up the corrected prescription they were finally able to extract from D-List Doctor Jimenez then (b) on to CVS to get the prescription filled. On the “corrected” prescription Diann’s name is misspelled and her DOB is wrong, but the CVS pharmacist mercifully filled the prescription anyway.

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Her Caregiver

Her Caregiver

Help Diann Pearson (DP) beat Esophageal Cancer (EC) with a monthly donation towards her medical & living expenses while she gets chemotherapy, radiation, surgery and other medical treatments for cancer of the esophagus.

One thought on “Esophageal Stent, Stool Softener & a Substandard Physician”

  1. I’m just angry at all the confusion when at the hospital. When not being looked after by the same doctor, every time there is someone new it all needs explaining all over again. Makes you feel unimportant and neglected. It’s crap!

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