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Doctor on VACATION !!

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  • Doctor on VACATION !!

    After being in a flare for over a year I was finally diagnosed in March of this year. Since then I’ve had instillations every week.

    Found out today my urologist is going on VACATION, for a week!! She asked if I thought I would have a problem with that week, Foolishly I answered “No, I can handle it.” Well, after I got home and started counting the days I panicked. What do you ladies do if your Dr. is not available or you are out of town and in a flare?? She's in practice for herself so she doesn't usually have anyone on call. I have a good supply of pain meds, but sometimes as you know they just don’t cut through the pain. I haven't taken her up on learning how to do the instillations myself yet.

    Has anyone had an instillation done in an emergency room, with a prescription from the urologist? The next question would be if you have, does the insurance company consider it an emergency, in other words will they pay for it. My insurance will not pay for another urologist because of their “referral” requirements. I can only have one specialist approved at a time!! .

    I'm not only worried about next week, but for "hurricane season" I do know during a hurricane evacuation (I live in the New Orleans area) my insurance will pay an emergency room visit for almost any good reason. As long as I have the prescription I’m not too worried if that happens, IF they will do it and on second thought will they honor an out of state physician's prescription.
    My Dr also provides me with her E-mail address for any out of town contact, especially for pain meds refills. We have our own set of problems during hurricane season !!

    Any encouraging words on learning how to do the instills myself would be welcomed.


  • #2
    I think it would be a good idea to find out who is covering for your uro while she is on vacation. If she's already gone, if you call her office number you will probably get an answering service, who will put you in touch with the doctor who's taking her calls.

    And when she returns, you can ask about learning to do your instillations. It isn't difficult after the first time or two.

    Warm hugs,
    Stay safe

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    I am not a medical authority nor do I offer medical advice. In all cases, I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.

    Anyone who says something is foolproof hasn't met a determined fool


    • #3
      As an IC patient, I always dread the summer months because so many doctors are on vacation or multiple vacations! I had one doc who seemed to be gone about every six weeks or so for a week at a time. I'd call usually when I was in the worst shape and be told, "Doctor is out of town this week" Geez.. if an IC patient is in a small town where lots of docs are solo practice, it can get really difficult. As June approaches, I always cringe! Doctors are people too and they need time off to be at their best, but sometimes they don't make good arrangements for handling patients like us. Just another fact of life with IC unfortunately............


      • #4
        View from the other side!!!

        I'm a medical assistant and work in a doctors office full time. I know it is really stressfull for some of the patients I work with when the doctors are out of the office. From our point of veiw, honestly you would burn out if we didn't get time off. It is very stressfull in my job, you have patients calling who would like answers to thier questions sooner than now. You also have patients calling in for refills on medications, including the patients who forget to get it soon enough and are out of a controled substance. Most doctors that are taking care of another doctors patient's are very hesitant about calling in heavy duty medications, because of the risks. Most patients are honestly needing help, and will not abuse medications. Unfortunatly there are those people in the world that will, and it is hard to know if a patient is or not if you have never seen them.
        My job is multi-tasking at least 3-4 things at a time, all the time, for a 10 hour shift. In the doctors office that I work in, the doctors work longer hours than I do. They come to work earlier, leave later, and usually have to round on patients in the hospital on thier days off. The only time doctors have any time for just them, is when they are out of the office on vaction.
        Sorry, I just went off for a while. All I'm trying to say, is that your doctor does honestly care about you. He just needs his time off to. I'm so sorry if that is the moment your body decides to turn on you. One thing you can do is make sure you give the doctors office plenty of time to call in medications, that way you don't get stuck with no medication and no doctor. Another thing you can do is find out from your doctor what to do, or who to call if you have a problem while he is out of the office. Most doctors do have an emergency plan for you, the trick is knowing what it is. Good luck!!!!! I hope you get feeling better really soon.


        • #5
          I noted you asked about instillations in the ER... the answer is generally "No." Many ER docs aren't that informed about IC, so they may not even believe it exists... and even if they do, they usually do not know what the treatment options are, and most have not even heard of an instillation.

          However, if you do end up in the ER a lot, I would discuss that with your urologist when she gets back -- the two of you can make an "emergency plan." She can tell you who you should call first when she's out of town, and you two can decide what to do should you need to go to the ER. The good thing is, she can probably arrange things with the ER (ie, put a note in your ER file) so that they will know to do an instill when you come in, and so they will have your instill "recipe" at hand. This method has helped many ICers get better treatment in the ER.

          And, I do urge you to learn to do your instills yourself so that you don't even need to worry about the ER's skill. It really is a lifesaver, and it is not as hard as it sounds. I was able to do it on the second try, and it's become second nature now.

          *Diagnosed with severe IC in 2004
          *Also diagnosed with PFD, fibromyalgia, chronic myofascial pain, IBS, migraines, allergies/asthma, dermatographism
          *Kept trying a million different treatments for all these things until I found what works, and I am doing okay these days with the help of a cocktail of medications and the InterStim, which was first placed in 2007. [I have had 2 revisions - one in 2010 when my battery died and had to be replaced, and one complete replacement (lead and generator) in 2012 after a fall on my stairs caused my lead to move.]
          *Current meds include Atarax (50mg at night), Lyrica (150mg twice a day), Xanax (0.5mg at night and as needed), Zanaflex (4mg at night), hydrocodone (10/325, every 6 hours as needed), Advair, Nasonex, Singulair (10mg at night), oral contraceptives, home instills containing Elmiron and Marcaine (as often as I need to do them).

          **I am not a medical authority nor do I offer definitive medical advice. I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.


          • #6
            Thanks to everyone for your advice. I called my Dr’s. office this morning and was told she left instructions in my chart for her medical assistant to do the instill if needed .What a relief. My mistake was not voicing my concerns for the week she would be gone on my last visit. She certainly deserves her vacations after dealing with me every week for the last few weeks.


            • #7
              Right now my Dr is out on Paternity leave, his assistant is on Maternity leave and one of the nurses is out on Maternity leave. I'm sure they didn't intend for all the babies to come at the same time. Only the nurse practitioner and the office staff are around, I brought the NP flowers when I went for my instill, she was totally frazzled, but still managed to squeeze me in .
              I was born with one ureta not attached to it's kidney, I've been poked and prodded for so long. I never had "private" parts. I had constant infections and took low dose preventive antibiotics into my teens.

              DX with IC July 1993 after seeing 3 different Uro's and finally switching Primary care doctors and affiliated hospitals.

              I have 2 beautiful daughters, the oldest has been in heaven since she was 14 when she was hit by a car The youngest is 20 now. She has had one UTI. She went into complete panic that she would end up like me. Now she has some idea of what the pain is like. Poor kid has been forced to know where every bathroom in Disney World is.


              • #8
                Hi Marilyn,
                Just want to concur with Jen that learning to do instillations is not hard. I've been doing my own rescue instillations now for 2 years & they have been a godsend. I can even wake up in a flare, do an instill & go to work just fine, with no one even knowing I started the day not feeling well Because of the instillations I only missed 4-1/2 days of work due to IC this school year!
                Hoping your week "off" goes well,

                I am not a medical authority nor do I offer medical advice. In all cases, I strongly encourage you to discuss your medical treatment with your personal medical care provider. Only they can, and should, give medical recommendations to you.

                New favorite quote: "God gives us only what we can handle. Apparently God thinks I'm a bad-ass" ~Author Unknown
                Source - Pinterest

                Current treatments:
                -IC diet
                -Elavil 50mg at night
                -Continuous use birth control pills (4-5 periods/year)
                -Heparin/Marcaine/Sodium Bicarb home instills at night 3-4x per week, more often if needed
                -Pyridium if needed,
                -Pain medicine at bedtime daily, as needed during the day several times per week
                -Antibiotic when doing an instillation to prevent UTI
                -Colace & SmartFiber to treat chronic constipation from meds, Fleet enema as needed
                -Dye Free Benadryl 50 mg at bedtime
                -"Your Pace Yoga: Relieving Pelvic Pain" dvd, walking, treadmill at gym
                -Managing stress= VERY important!
                -Fur therapy: Hugging the cat!