Discussions By Condition: Medical Stories

Ovarian Cancer, Spanish healthcare system.

Posted In: Medical Stories 0 Replies
  • Posted By: craigfellows
  • February 27, 2011
  • 03:56 PM

Mum first went to our local health centre in Alora at the end of October 2010 she had suffered two weeks of stomach ache already, there were no other symptoms but she thought that she should get it checked out.
The doctor she had made an appointment was registered in the health centre as speaking English. On seeing the doctor is was quite obvious that she did not want to speak English and in the short time that mum was in the consulting room she did not receive an examination. The only concern of the doctor seemed to be blood pressure. She asked about mum’s medical history but noted nothing. She ordered a urine and blood test and quickly moved on to her next patient. The urine test results were instant and came back negative. She had to make an appointment for the blood test which she had five days later. We then had to wait ten days for the results.
On seeing the doctor the second time, mum had become quite swollen. The doctor said that the creatine levels in her blood were high and that mum was a little anemic. She examined mums stomach saying that she was quite swollen. We left the health centre with the advice to have another blood test and for mum to stop eating green vegetables. It took another two weeks to get the results of the blood test, during this time mum was in pain but could control it with paracetemol and ibuprofen. On going back to the doctor for the third time we were told that that again the results showed high creatine levels but this time the doctor seemed quite concerned. She said that mum would need to see a specialist in the Hospital Virgen de la Victoria in Malaga. The receptionist managed to get her an appointment for eight days later. On getting home from the health centre with the blood test results it became clear that tumor markers had showed up in the results which the doctor failed to inform us of.
At the hospital in Malaga mum was given an examination and asked about her medical history and of any cancer in her family. She was advised to wait until after the weekend and go to emergencies to be admitted for a CAT scan. The following week we went to emergencies with a form clearly stating that she needed to be admitted for a CAT scan but then spent ten hours in the emergency waiting room following the standard procedure of having a urine test, blood test, x-ray and ECG before being admitted. She gave her medical history on two occasions, both noted by doctors.
In the following three weeks, she was cleared by a specialist of having any tumors on her ovaries. They gave a clean bill of health to all other organs. A colonoscopy without any anesthetic which showed nothing in her colon as far as they could see but apparently she had a strange shaped colon and they would need to do a CAT scan. Almost three weeks after being admitted she received a CAT scan and was told that they had found a lesion on her Colon and fluid on her stomach. On December 30 they took her for a laparoscopy and the next day she was discharged from the hospital and told to come back on January 17 for the results. We managed to get an earlier appointment for January 14.
By the time of the appointment mum was now in considerable pain and could not control it. We saw an oncologist at the hospital on January 14, he asked for and noted her medical history and informed her that she had a tumor on her ovary. He did not give up the information that it was cancer until mum asked. He said that the cancer was localised and that most probably the best course of action would be three cycles of chemotherapy before looking to operate. He sent her away with a prescription for morphine patches and another appointment with a specialist the following week to discuss chemotherapy.
On starting the morphine patches mum was quite sick which we had been informed would happen and still in pain. The following day we went back to the specialist who informed us that we should cut another patch in half and gave her a prescription for an anti sickness drug. He also said that after speaking to his colleague, an operation may be possible before the chemotherapy.
A few days later mum was still being constantly sick and had not eaten for a couple of days. We took her to the emergency department at the health centre in Alora. We had to wait over two hours for a doctor to return in an ambulance. They gave her the anti sickness drug intravenously and the sickness stopped. The doctor there advices that we cut the morphine maptch down a quarter and go from build up the dosage from there.
Another couple of days later mum was sick again, she had diarrhea, incontinence and was so out of breath that she could hardly move. Again we took her up the emergency department where she was given anti sickness drug and glucose. I asked the doctor about cutting morphine patches and was told that this should never be done as it could lead to an overdose. After a couple of hours it was clear that mum was not improving and she was taken by ambulance to the Hospital Virgen de la Victoria in Malaga again.
She had to spend another ten hours in a wheelchair barely conscious going through the same procedures as before. Gave her medical history which twice was noted. We were then told that mum's kidneys were dry and was admitted to the observations ward. That night we received a call at 12:30am asking us to give mums medical history and asking whether we had ever discussed with her whether she wanted aggressive treatment or not.
She spent two days in the observations ward where she was told her kidneys were recovering before being move to a general ward for recovery.
The next day mum was still out of breath and after an x-ray was diagnosed with a chest infection, the doctor told mum that he thought this was most likely caused by the laparoscopy. They started to give her antibiotics. A couple of days later she was told she had a blood clot on her lung and they started to give her blood thinning injections in her stomach. At the point she was still unable to eat. Now, a week after being in hospital they stopped supplying her with food and drink and put her on a drip. Dad had mentioned that when his sister was treated for ovarian cancer in the USA, they had drained the fluid from her stomach and a couple of hours later a nurse appeared with stomach drain. Mum was clearly very distressed by the thought of having this tube put down her nose, she pleaded with me and the nurse that she could not do it but the nurse insisted and I was not even allowed to stay in the room to comfort her.
A few days later, mum had her sixty first birthday on January 28. She was moved down to the oncology ward and seemed to be improving. We were told that her kidneys were functioning quite well and the chest infection was clearing up. As she was feeling better we tried to get her out of the room in a wheelchair. As we could not always be there when the doctor came round we had often tried to find one after we arrived, this proved almost impossible, firstly the staff never knew where the doctors were and were unwilling to find out. The general rule that we kept on being told was that the doctor comes round in the morning and that is when you see him/her. I managed to catch him in his office to ask whether mum was well enough to go out in a wheelchair. Before I got a chance to ask, he said that he was very busy and did not have the time to talk to me. I ignored this and ask my question, thankfully he said he could see no problem with it.
When it came to getting mum into the wheelchair we realised that mum was unable to even move across the bed let alone stand herself. We asked the doctor for an assessment by a physiotherapist at least three times along with the interpreter who asked him on our behalf, He said she was not in need of a physiotherapist.
She was given a consent form to sign as they wanted to start chemotherapy the following Monday (January 31). On the Monday they did some tests and decided to start chemotherapy without a signed consent form. The chemotherapy seemed to go well. There was no sickness and only slight tiredness for the next couple of days.
On Wednesday the stomach drain was removed and she was allowed to drink liquids. We noticed that there appeared to be blood in her cafeter but did not think it was a problem as we could not be the only ones to notice it.
On Thursday the doctor came round and said he had expected to see her up and about by now, later that day she was told that she had another chest infection, they started to give her antibiotics again. She was upset and uncomfortable, the night staff had refused to move her up the bed or adjust her pillow although she had asked four times, this was a regular occurrence during her stay. Later that day she had terrible pains in her lower back and side which I told the nurse about before having to wait for almost two hours for pain relief which barely worked. She was given solid foods by the hospital that night which she was unable to swallow.
On Friday she still had the pains, became increasingly tired, weak to the point of not being able to lift her arms, felt very confused and spaced out. She was extremely depressed but could not even find the energy to cry. I informed the nurse of this and was told that these were all very common symptoms. That evening the staff noticed that her urine was not passing into the cafeter, two more staff members came into to try and drain what they thought was a blockage. Nothing changed and a nurse took mums blood pressure. Dad asked if there was a problem and was told no. Within another half hour her blood pressure was taken again and he was then told that mum was unlikely to make it through the night due to her kidneys failing. She was unaware of this. She died an hour later at at 12:30am.

She had initially died from a pulmonary embolism, from neutropenia and kidney failure, cause by ovarian cancer and secondary cancer of the lining of the abdomen.

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