Wednesday, December 10, 2014

The plot thickens

It does seem like my body is happy to be lowering the dose of the Fentanyl. Yes, there is pain returning, and yes, it is hard. I am dealing with it stoically, I think, because I keep telling myself that it is temporary.

Exactly how temporary, at this point, is up in the air. We've come upon a big hitch in the plan.

After leaving four messages, and also speaking directly with Dr. Davidson's secretary 10 days ago, it seems that my attempts at communication were put on a back burner, and the gas ran out. What do I mean?

At my appointment with Dr. Davidson, we left it that I would enquire with my pain doctor, Dr. Z, about whether or not he (Dr Z) will put in the request for the Cannabis, or if Dr. Davidson would. The difference being that I could be treated in Be'er Sheva if Dr. Z could do it, but if now, I'd need to be treated in Jerusalem by Dr. Davidson.

A few days after I saw Dr. Davidson, I saw Dr. Z. At that meeting, Dr. Z informed me that he isn't professionally able to submit the request. He doesn't have the right licencing to request Cannabis for a patient of his. OK, fine, so then I knew that Dr. Davidson would need to do it.

The very next day I called Dr. Davidson's office. No answer, left a message. No return call the entire next day. I called the day after that. No answer left a message. No return call the entire next day. I called two days after that. At that point I actually got to speak with Dr. Davidson's secretary, who is also like his right hand [wo]man, so to speak.

I laid it all out clearly, and had her repeat back to me what we spoke about, and what is needed. I reiterated that she should tell Dr. Davidson that he does need to submit the request for Cannabis (which, if you remember, can take up to 6 weeks to clear), that Dr. Z cannot do it. By the end of the conversation, I was quite sure that we understood each other. She repeated back to me exactly what I needed.

Then I waited. I waited for her to call me back saying that the request has been submitted to the ministry of health, and we are now in the six-week waiting period. The call didn't come.

I called her back, left more messages, with details this time on the recording. I needed her to know exactly what I am talking about so there is no confusion at all.

I finally heard back from her, after I had left three or four more messages; this being after we had spoken and gotten things clear.

She had this to say:

"Dr. Davidson received your directions, and has no problem following through with the plan to start me on medical Cannabis. In fact he had planned to, but did not get a chance to, and now he is out of the country and will not do any work until FEBRUARY."

....ummmm..... excuse me?.........

me: "I spoke with you over a week ago to move forward with this submission for the Cannabis request. Why was it not done?"

secretary: "yes, Sarah, I realize that. All I can do is profusely apologize that it didn't get done. To my regret, there are many, many things that did not get done before he left. You are right to be upset.

me: "Well, if he is simply out of the country, it doesn't really matter, because he can fax in what needs to be done, no? That is what he would do anyway, right? It's not like he physically goes to the ministry of health every time a patient needs a request for Cannabis. Why can't he fax it in? Or even you, yourself can fax- or snail mail- it in, that would even be quicker than February, no?"

secretary: "No, I'm sorry, that is not possible."

me: "Why?"

secretary: "That's just the way it is. I apologize again. I will make you a new appointment for February."

me: "Listen, you can't play around with this timing. I am weaning off of my narcotic medicine, and my pain levels are increasing. I understood that it would be 6 or 7 weeks, and in that time I'd reduce my narcotic medicine so I could start the Cannabis. What am I supposed to do until February?"

secretary: "It seems you will have to slow down the weaning process. Time it for the end of February instead of the original plan."

me: "Excuse me, but that seems just wrong on so many levels." (at least that was my intended snarky comment, not sure if it came across in my less-than- snark-able Hebrew).

secretary: again, I apologize. I am only trying to help. We'll see you in February?

~~~~~~~~~~ end of conversation ~~~~~~~~

Isn't this ludicrous? I mean, what happened, did he get arrested or something? Perhaps a family crisis, who knows. It doesn't make sense at all that he would have a trip overseas without any taking care of his business beforehand. Something is up, but until further notice, this is the situation.

I told Robert about it. He immediately suggested we get in touch with another pain doctor who was recommended to us through a good friend. This one is also in Jerusalem, in a different hospital. I thought that was a good idea. By the way- the wait to get into the pain clinics here in Be'er Sheva is three months minimum, so going private is the only real way.

OK, so the very next day I called that doctor.

The situation stands right now that I put in two calls to that doctor. They weren't answered; I left two [electronic] messages. Gonna try again tomorrow, and possibly leave my third message. I'll also try other extensions and see if I can get a person to answer.

I need an appointment (which will cost a bundle) and I hope he will be able to submit the request for a licence for me for the Cannabis.

Where does this leave me regarding weaning off the Fentanyl?

What is going ON here!?


  1. You situation indicates Israel's long-standing need for case managers throughout its medical world. Far too many patients are left to advocate for themselves while struggling to remain alive and/or functional. The socialized medicine of the kupat holim system leaves members in need of human bulldogs able to coerce medical professionals into providing the care they were trained to deliver in the first place. The situation could be saving the kupat holim system lots of money regarding medical services never rendered. It might be the reason that some doctors open private offices. so that they can deliver optimal care unimpeded by politics.

    1. I couldn't agree with you more. I do wish I had a medical manager, but unfortunately nothing like that exists here, as far as I know. And I have asked different organizations.
      Thanks for your input.

  2. A similar thing happened to me when I was sick with my lung thing. Just before my doctor needed to leave the country- without giving me my desperately needed perscription- I chased down my family doctor to make the other one give me the perscription before he leaves. I was in such bad shape, I could barely catch enough oxygen to sit upright. In their opinion, I wasn't dying, so I could wait.. It is infuriating.

    They are so understaffed and overworked, they're not set up for taking care of all their backlog before they fly off to different places.

    I'm sorry this is so frustrating and just crazy. February is only a few months away...

    are you able to function while you're weaning off or do you need to supplement with more painkillers?

    1. It's so true that if you aren't dying, you get put on that back burner, and it is quite a far distance for them. It is so easy to fall between the cracks in this system. It is so hard to fight for your needs. That is where I am at... well, at the moment I am not able to fight for my needs because I am getting ready for Shifra's BatMitzvah. But, the second doctor who I tried to get an appointment with isn't taking new patients. I have another idea, though, that is to call my new neurologist and ask for him to help me out with this. We'll see where that goes. Most doctors can prescribe Cannabis- only GP's can't, and psychiatrists can't.

      At the moment I don't need back-up medicine for pain, thank Gd!! My body is actually taking well to the weaning. It is encouraging. Pain levels were high at first, but I stuck with it and lowered doses twice more, and things are fairly stable. Pain is not worse- I feel I can handle it how it is now. I will do another dose lowering soon. It's time. As far as waiting till February, that's only when Davidson comes back. Only Then will he *submit* the request for the cannabis, then the waiting period is 6 weeks. That is the 6 weeks I am supposed to be in now, but it didn't start because the request isn't even submitted yet. That is what is frustrating.

      One day at a time.

      Gotta get this computer closed and my eyes also.

      Thanks, dear friend. Good night!