Read this story of a man who attempts to find adequate medical care during the COVID-19 pandemic as the clock ticks and he struggles to breathe.
In December 2019, Bob’s breathing became very labored. Since he was a long-term smoker, often trying to quit, his primary doctor ordered a screening CT scan of his lungs. After a few days of worry that he had lung cancer, Bob received a phone call from his doctor’s office with the verdict that he did not have lung cancer and the obligatory warning to quit smoking due to mild COPD findings. Much relieved, Bob cut back on his cigarette intake.
However, Bob’s breathing worsened during January and February, despite daily use of two inhalers to reduce his symptoms. During the week that his state-issued COVID-19 stay-at-home orders, he went to a local urgent care facility because he could barely breathe at all. A chest Xray revealed that his left lung had partially collapsed, unable to expand when breathing. Since his temperature was 97.5, the facility physician ruled out COVID-19. Bob received prescriptions for antibiotics and anti-inflammatory drugs. Two weeks later, a follow-up Xray revealed that the lung was no longer collapsed and he was proclaimed cured despite his unmistakable wheezing and strained breathing.
As directed, Bob followed up with his primary physician, who prescribed nebulizer treatment to clear lung passageways and reduce COPD symptoms. Bob then asked to see the results from his CT scan in December. An expression of shock fell over his primary doctor’s face as he read aloud the report findings of significant inflammation in his left lung. At this point, Bob received a referral to a pulmonologist (a specialist who treats lung disorders). Amid the pandemic restrictions, the office staff at the referred pulmonologist reported all the practice doctors suspended accepting new patients due to COVID-19. Nearby pulmonary practices reported similarly.
After Bob fell down an entire flight of stairs due to weakness from being out of breath, he scheduled another appointment with his primary doctor. Bob received an order for a specialized CT scan to rule out a suspected blood clot in his lung. After several more days of worry about a blood clot amidst ongoing concern about contracting COVID-19, he learned that no blood clot was detected. His doctor offered another referral to a pulmonologist, who happened to be accepting new patients. During the consultation visit, the specialist coldly told him that the most recent CT scan revealed a blockage in his left lung that could be cancer. The specialist also noted that the CT scan months before showed suspicious findings of inflammation. Bob needed to get a bronchoscopy, a scope to view the airways in the lungs. That procedure was scheduled two weeks later.
Since Bob’s father and brother died of cancer, Bob’s anxiety about his worsening breathing intensified. Bob called several hospitals and pulmonology practices to schedule a sooner date for his procedure. Staff members repeatedly told him that the earliest appointment, even to have a telehealth consultation, was two months in the future. During this time, Bob sought counseling to ease his stress. Unfortunately, his sessions with a detached, distracted therapist via telehealth, only heightened his anxiety as he feared both COVID-19 and the diagnosis of lung cancer.
A few days before his bronchoscopy, Bob received orders to obtain a COVID-19 test, which was negative. On the morning of his procedure, Bob grew very anxious as he pondered the procedure, the additional risk of COVID-19 infection at the hospital and a cancer diagnosis. He waited alone in the surgical waiting area for two hours because his wife was not allowed to accompany him. The attending nurse refused his request to call his wife and offer an estimate of when she needed to pick him up after his surgical procedure. After several hours, his wife contacted the hospital to inquire about pick up time and to request that the surgeon call her as promised. A few minutes later, the pulmonologist quickly rattled off his findings on a poor cell-phone connection – probably not lung cancer, but a severe lung infection. Biopsy samples would be sent to a teaching hospital for analysis. The nurse who wheeled Bob to his wife’s car kept looking at his wife — through her mask — with a concerned, sympathetic expression. Relieved to hear it was probably not lung cancer, Bob slept soundly for the first night in two weeks.
The next day, Bob received lab results through his hospital portal account. Wading through piles of unfamiliar medical terminology and researching them online, Bob learned that, among other findings, he had a staph infection in his lungs. This type of infection, usually associated with skin boils, can become quite serious when it attacks lungs, and can eventually lead to sepsis, a potentially fatal condition. Immediately, Bob called his pulmonologist’s office to obtain an explanation of the lab findings. After wading through a phone tree, Bob left a message with his doctor’s assistant. When he received no return phone call for a couple of hours, he tried again, this time reaching the assistant. He asked if the doctor or representative could call him to explain the findings and scheduled a follow-up appointment for over a week in the future.
When Bob did not receive a phone call from the pulmonologist, he contacted his primary doctor via the patient portal to explain the lab results and question the need to see an infectious disease specialist. Immediately, the primary doctor responded that Bob needed to ask the specialist, who, of course, ignored Bob’s phone calls.
In the meanwhile, Bob learned that one of his co-workers had contracted COVID-19 weeks before. As each day ticks towards Bob’s specialist appointment, his breathing worsens.
To be Continued
Story told with Permission
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