3. Email, Phone Calls, and the Power of Insisting

   Four weeks later, when the last Ciprofloxasin was in his mouth and he still had this pain, it was clear to us that the antibiotics hadn't worked.
   Worse, when an email to the doctor (our health plan's desired way of contacting one's physician) went unanswered, I made a number of phone calls to the doctor's office, the first of which resulted in being told, Ciprofloxasin is the best antibiotic for this condition. But had the doctor diagnosed the correct condition, I wondered? at which time I insisted he be referred to a Urologist: thinking it would be the same Urologist who two years earlier had related the news to us that he had prostate cancer.
   As with some health plans, doctors come and go for a variety of reasons. So, the Urologist we met with two weeks later was not the same doctor who had diagnosed his prostate cancer and subsequently referred him to the Radiation Oncologist who oversaw the radiation therapy.
   At the outset, we were both pleased with this new Urologist. (I accompanied him into the examination room.) The Urologist appeared confident and competent. (How does one conclude this in a first meeting I wonder? Naivete on the part of the patient?)
   Another urine specimen was examined; this time there was some concern about the fact that Ciprofloxasin had not killed the bacteria and that numerous pieces of protein (tissue) were in the specimen, along with some blood. While the Urologist did not refer us to the Radiation Oncologist at this time, he seemed to hear our comment that we suspected this might have something to do with the radiation treatments. Maybe I should have insisted. Definitely I should have been more cautious.
   The Urologist performed an in-office test: a cystoscopy (bladder scope) used to determine the health of the urethra and the bladder. We were out of our league; at the mercy of the doctor and his knowledge, diagnosis, and recommendations.
   The Urologist told us he had seen a growth in the bladder that could be a cancer or it could be something resulting from the radiation. Either way, he said, I need to do a bladder biopsy. It would be simple, an out-patient procedure, he assured us, at a local hospital. It should be done tomorrow.
   From that moment, we were in a race to get a lot of things done, and he wasn't feeling strong. Over time, pain wears one down; and he'd been experiencing a lot of pain for three months. Although he'd been prescribed Vicodin (Hydrocodone bitartrate and acetaminophen), it had not alleviated the pain.
   But we got it all done that day: visiting the hospital to complete their admission forms and make the co-pay, visiting a number of facilities to have lab tests performed, picking up more prescriptions at the pharmacy, and finally arriving home at the point of exhaustion. We had the help of a relative who did all the driving; without that help we'd have been in deep doo-doo.
   So, all we had to do now was get some rest and make it back to the hospital in the morning for the bladder biopsy surgery.
   Piece of cake.