Another VA horror story

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Gunner59
Regular Member


Date Joined Nov 2008
Total Posts : 110
   Posted 6/21/2009 6:08 AM (GMT -6)   
Saw this article while catching up on the news this morning. As a retired GI, it really gets me riled up that crap like this happens to my brothers in arms, especially ones fighting this darn disease.

www.msnbc.msn.com/id/31470106/ns/health-the_new_york_times/
Age 48 at diagnosis
3 Jul 08 PSA 27.21
Biopsy positive 3+3=6 on 9 of 24 punches
Bone scan clear
22 Sep 08 Laproscopic Radical Prostatectomy and bilateral pelvic Lymphadenectomy
Gleason 3+4=7 after prostate removal, lymph nodes clear
Stage T2B
PSA at 3 months=undetectable
6 month PSA still 0


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 6/21/2009 9:31 AM (GMT -6)   
And what country did these vets fight for? Couldn't possibly happen here in America, we take such good care of our vets, lollll. Though not really laughing.

There should have been criminal charges in this case, the doctor should be in jail for long term, lose his medical licencse for life for starters, and many radical changes should take place so that could never ever happen again.

The patient, a brave vet, should be taken care of from this point on with the best medical resources available, and compensated well, very well, for the rest of his life.

What a disgraceful story


David in SC
Veteren, US Navy
Viet-nam Era
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10 doubled in 3 months, new test in six weeks, then possibly off for salvage radiation
 
 


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 6/21/2009 9:57 AM (GMT -6)   
This is what makes wonder why Americans want government run health care. If they cannot do it for a small population, how in the world do they expect it for all Americans?

Since they use so many foreign docs at the VA I wonder if this guy was in the program for getting an American medical liscence. Yikes!
Forum Co-moderator - Crohn's Disease:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/21/2009 10:14 AM (GMT -6)   
While I am certainly not a proponent of government run healthcare, this is appears to be a case of a poorly run unit, not a systemic failure. There are plenty horrible private docs, I am sure. It is a combination of a horrible incompetence and vets that gets our blood boiling with anger and reported in NY Times. Other similar cases could go a lot quieter. Just underscores the importance of choosing your doc carefully.

On a separate note, I dont believe Americans want government run healthcare. I think it is being forced on us be a minority for political reasons. Our healthcare is not broken, just expensive. Lets figure out how to fix that without rationing care.

Greg


montee
Regular Member


Date Joined Mar 2007
Total Posts : 315
   Posted 6/21/2009 10:14 AM (GMT -6)   
AMEN! Some people think that same group who now has a bankrupt post office, Social Security, Medicare can run a health care system.
diagnosed sept 2006 @ 54 years old, live in Georgia, gleason 3+4=7, (r) lobe only

psa 4.7 (psa rose 1 point per year for 3 years, urologist said still under 4 and no concern. If I can find out about PSA velocity, why didn't he know!)

Told not to have surgery at Dana Farber as cancer had already penetrated prostate, in seminal vesicles, would have positive margins. Would only treat with radiation and HT

RP Emory Atlanta December 2006. Path-negative margin, negative lymph nodes, negative SV, both Lobes involved, 40% gland involved
multifocal perineural invasion, Gleason 3+4=7

Fully continent 2 weeks post catheter removal

1st psa April 2007-<0.04, 6 mos-<0.04, 9 mos <0.04, 1yr <0.04, 21 mos <0.04, 2 yr 0.04 (rising?) 27 mos-0.05


KeyWestPirate
Regular Member


Date Joined May 2009
Total Posts : 60
   Posted 6/21/2009 1:38 PM (GMT -6)   

This just emphasizes the point I've been hammering since my first post on this site, hoping to catch the attention of the newly diagnosed:

            Choose Your Treatment Provider Carefully!!  

There are a LOT of Dr Kildares out there  (incompetent, but great bedside manner), and not just at the VA.  Unless the patient dies on the table, no one in the OR is going to speak up.  They know who shouldn't be there, and gossip among themselves, but the information doesn't leave their immediate circle.

You and you  alone bear the ultimate responsibility for the quality of your care, and you alone will pay the price.   You SHOULD be able to assume that your treatment provider is competent, but that is sometimes not the case.  PCa is not a mis-dagnosed sore throat, or a few poorly done stitches for a laceration.  The consequences of a poor choice can be life-altering.

 In a few years you won't have the choice option, you will be assigned a doctor, kind of like playing the lottery, but you'll bet your life instead of a dollar or two.

 At least the guy wasn't doing RP's:

Nurse Jackie:  Doctor, I think that's a bladder, not a prostate, that you just pulled out.  Boy, is this guy going to have a continence problem!

The  support for government run health care comes from dreamers who think we will have the same high quality of health care we presently enjoy, except it will be "free". 

  Nothing could be further from the truth.  What we WILL do is subsidize people's poor life style choices (alcohol and drug abuse, smoking, and obesity), diminish the quality of our care through a variety of dis-incentives, and reward incompetence by lowering the bar for all providers.

Wealthy people (and members of Congress) will find good care by going outside the system as they do in Canada, England, Costa Rica  -and probably everywhere else a government run health care system is in place.  The rest of us will take what we are given, and like it. 

 The only ones who will benefit will be   Dr Quaak and "workers" in the vast DMV-Post Office-IRS like bureaucracy that will be created to filter our money.

 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 6/21/2009 2:50 PM (GMT -6)   
Thanks for posting this Gunner.  Our veterans should have the best of care and not the dregs.  Unfortunately, that is not the case.  I know that we have to do something about our healthcare system in the USA, but having a government run system is not the answer.  There are lots of good medical personnel in our VA system and we shouldn't paint the whole bunch with the same brush.  However, there are systemic problems in how things are done.  I hope we can find a better solution than to turn it all over to the government.  David (USAF Vietnam era vet)

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 6/21/2009 4:08 PM (GMT -6)   
David,
I agree there are some good people in the VA system, but they are hard to find and they are swamped.
Forum Co-moderator - Crohn's Disease:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/21/2009 7:25 PM (GMT -6)   
It is worse than that, but you may want more information.

Here is a link to the New York Times article which broke the story
http://www.nytimes.com/2009/06/21/health/21radiation.html?_r=1&hp
and the the story in the Philadelphia Inquirer
http://www.philly.com/philly/news/20090620_Feds_see_wider_woes_in_VAs_cancer_errors.html

Most shocking is that the VA realized that they couldn't competently staff a brachytherapy unit and so they contracted with the University of Pennsylvania to do it for them. The radiation oncologist, Dr. Gary Kao remains on the staff of the University although according to a spokesperson "he no longer sees patients."
According to the Times; The"cancer unit at the hospital, one that operated with virtually no outside scrutiny and botched 92 of 116 cancer treatments over a span of more than six years — and then kept quiet about it "

So, while you scream about government incompetence, you might add something about private universities acting as government contractors.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


MMMNAVY
Veteran Member


Date Joined Jul 2006
Total Posts : 6927
   Posted 6/21/2009 7:45 PM (GMT -6)   
Is U of Penn a private university or State uni?
Forum Co-moderator - Crohn's Disease:_All comments have the caveat contact your local health care provider.

I will find a way or make one. –Phillip Sidney 1554-1586

All that I am and all that I shall ever be, I owe to my Angel Mother.

The Bucket List- Have you found joy in your life?  Has your life brought joy to others?

Make sure your suffering has meaning…


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/21/2009 8:28 PM (GMT -6)   
The University of Pennsylvania is one of the Ivy League schools and is private. Penn State University is the largest public school in the state.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/22/2009 10:59 AM (GMT -6)   
Thoughts from the advocacy groups...By Mike Scott at the InfoLink
 
 
Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 6/22/2009 3:40 PM (GMT -6)   
It's a badly written news article - leaving a lot to the imagination that's unexplained.  VA hospitals and medical care for Vets have been considered substandard in this country for at least the past generation, but the bad management and lack of oversight - by the VA - at the Philadelphia hospital in question should indeed be considered criminal and the physicians and nurses and anyone else involved should lose their licenses and be prosecuted.  Not all physicans and medical professionals working in VA hospitals and caring for the soldiers and Vets are bad people, though - and those of you tossing the bricks probably need to be reminded of that.  The distortions regarding the proposals for health care reform in this country add nothing to the conversation - they just allow bitter folks the opportunity to blow-off steam wastefully. 

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0

 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25394
   Posted 6/22/2009 3:46 PM (GMT -6)   
The VA situation to me, is no worse or better than it was in my days. When I came back from Nam, I was at one very good VA hospital in the Boston area, and a very bad one, of all places, in Philadelphia (1971). I remember very good doctors and very bad doctors. We don't want to generalize and throw out the baby with the bath water.

The bad ones need to be weeded out, and prosecuted if found guilty, no doubt.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 832
   Posted 6/22/2009 7:29 PM (GMT -6)   
Isn't there enough bad news on this web-site already without having to read stories like this.  I wish more constructive things would be posted...
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