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Old 12.02.2019, 20:43
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Ending a relationship with a doctor during treatment

Hi there, could anyone advise me what the practice is with regard to finishing with a doctor?

I'll spare you the sordid details of the medical problem... but, the background is that, I went and saw the doctor recently. He suggested a treatment of three iron injections based on test results from June. I went for the first treatment and a nurse (I'm guessing) was training the receptionist in phlebotomy (great!) and it took a good three goes to find the vein. After half of the dose, it started to hurt and they stopped. I had a swollen, black patch on my arm where they injected into the tissue and not the vein. The colour is still there, over two weeks later.

This unpleasant experience has not been shared with the doctor, however, I wrote in German and cancelled all further appointments, sent it recorded, and asked for June's test results. The letter arrived on Tuesday for the Friday appointment.

They have now written to me, asking me where I was for my appointment. Effectively, they have completely ignored my letter. Can I do the same to them?

Is this good practice? How do you terminate a doctor's relationship during treatment in such circumstances?

I love living in Switzerland. And just when you think you've got the hang of it all... stuff like this happens. Trouble is, as well, his prognosis is more than likely wrong as my medical problem is more likely to be an auto-immune problem but he never explored that and this debacle has slowed up treatment. I am very disappointed and still have the issue to unravel.

Many, many thanks
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Old 12.02.2019, 21:01
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Re: Ending a relationship with a doctor during treatment

Umm, you simply tell them that you want no further treatment?

Tom
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Old 12.02.2019, 21:24
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Re: Ending a relationship with a doctor during treatment

That's what I thought I could do. But they've just ignored it.
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Old 12.02.2019, 21:32
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Re: Ending a relationship with a doctor during treatment

Did you consent to having a 'learner' do your injection ?



Also, why an injection and not an infusion ? And was it in your arm or in your bottom ? Normally an injection is put in the fatty part of the bottom or lower waist, and the infusion goes in the arm.


For infusions, it can bleed. That's bruising. That can happen. And yes it hurts and takes a long time to heal.


As for ending the treatment, normally the quickest way is to find a new doctor and ask them to request your files from your old doctor. Do you normally have a 'House doctor'. ?
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Old 12.02.2019, 21:32
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Re: Ending a relationship with a doctor during treatment

Send a brief, polite letter including a photocopy of the first letter you sent, and of the "registered" slio, and their letter, and say that it seems they wrote to you before having taken note of your letter, and asking them to please send you the blood results.
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Old 12.02.2019, 22:01
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Re: Ending a relationship with a doctor during treatment

During my 8 years living in Switzerland I came to a conclusion that inserting catheter into the vein correctly is not a strong side of Swiss healthcare. I had a surgery last month and they tried to insert a catheter 4 times in 4 different places (on the my both wrists and my both forearms) and ended with children's catheter in the crook of my arm, although it's not a recommended location during a surgery. In all the 4 locations where the insertion failed I had huge bruises afterwards.

So, I'm not surprised that in OP's case they din't insert the catheter correctly from the first try. I'm having iron infusions myself from time to time and it also happens to me sometimes. But I'm surprised that they've noticed that they have been doing it wrong only after half of the dose. I usually feel pain right after they let the iron infusion flow and they immediately stop it and reinstall the catheter in another arm. They also come to check the catheter and my state every few minutes to make sure everything is ok.

I wish the OP will find more professional doctor's office for future infusions.
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Old 12.02.2019, 22:04
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Re: Ending a relationship with a doctor during treatment

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For infusions, it can bleed. That's bruising. That can happen. And yes it hurts and takes a long time to heal.
In my case only incorrectly inserted catheters cause pain. If everything is done correctly, I feel only slight discomfort when they install a catheter and slight coolness in the crook of my hand when the liquid stat flowing. Nothing more.
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Old 12.02.2019, 22:28
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Re: Ending a relationship with a doctor during treatment

I've been receiving iron infusions for close to 20 years and this has happened to me a few times. And it's not because of lack of capability on the nurse's part: veins can burst. Yes it's painful and burns like hell, but it's not the end of the world either. In my case, it also takes absolutely every doctor or nurse to find appropriate veins and it's not unusual to have to start twice or three times until the injection works properly. Whether that is because Swiss doctors or nurses are generally less capable of doing this right or whether it's just the way my veins are, is up for debate. I'd say the latter is more likely.

That said, if you are not happy with the experience, just cancel your appointments, don't go again and look for another doctor. Simples. You need to give consent to the new one to ask for your files from the previous one.
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Old 12.02.2019, 22:35
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Re: Ending a relationship with a doctor during treatment

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During my 8 years living in Switzerland I came to a conclusion that inserting catheter into the vein correctly is not a strong side of Swiss healthcare.
Swiss are no worse than anywhere else, i.e. in general, few people can do it with my veins on the first try, here, or in any other country.

At Lugano hospital, it was well known that they needed to get somone up from anaesthesia to do it of I needed a new drip feed!

Tom
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Old 12.02.2019, 23:29
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Re: Ending a relationship with a doctor during treatment

I've been "gepikt" more times than I care to remember. One lady can do it almost without me noticing, but then it's pretty much all she does all day and a blind one armed monkey couldn't fail to find one of my veins. For infusions they always flush with saline first. Some do a small amount slowly and some the whole syringe in a second.



Anyway to the OP, if they've sent you a fine for the missed appointment, just write again to say there must have been some mistake as you already had cancelled. I wouldn't bother with registered mail. Or call them.

I hope you didn't pay for the failed infusion.
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Old 12.02.2019, 23:36
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Re: Ending a relationship with a doctor during treatment

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In my case, it also takes absolutely every doctor or nurse to find appropriate veins and it's not unusual to have to start twice or three times until the injection works properly. Whether that is because Swiss doctors or nurses are generally less capable of doing this right or whether it's just the way my veins are, is up for debate. I'd say the latter is more likely.
Sounds like you have what my UK GP descibed as "deep set veins". I've been told this in 3 countries now, and my Swiss doctor won't take blood from me. She sends me to a clinic in town to get an expert to take blood samples.

To the OP, what happened to you can happen to anyone, but if you haven't had this problem before, you may have just been unlucky on that occassion. I wouldn't let it put you off a course of treatment that you apparently need.

It happened to me the first time I tried to be a blood donor in the UK. 4hours later, I fainted and was taken to hospital because the black bruise was from my wrist to arm pit.
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Old 13.02.2019, 05:59
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Re: Ending a relationship with a doctor during treatment

Somehow I totally mis-read the title.
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Old 13.02.2019, 07:41
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Re: Ending a relationship with a doctor during treatment

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Somehow I totally mis-read the title.



You would !
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Old 13.02.2019, 08:16
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Re: Ending a relationship with a doctor during treatment

I have roll veins and very opaque skin and it is always a torture to find the vein for any nurse. I'm always bruised and the bruises stay for about two weeks. No big deal.
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Old 13.02.2019, 11:54
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Re: Ending a relationship with a doctor during treatment

When a new procedure is done for the first time, of course, the patient will feel nervous, even if they have had their arm poked many times before. New substance, unknown effects on this very person, etc. So putting a trainee nurse on a person who is doing iron injection for the first time is not a good idea.
To a doctor's practice, nurses and experienced patients it's all straight forward and clear, but to new-comer everything can be scary. And it's not an easy job finding a vein on a scared person.

I have had an experience almost 100% similar to OP's, hence my brief drivel on the topic.
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Old 14.04.2019, 12:11
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Re: Ending a relationship with a doctor during treatment

I wanted to thank everyone for their help with this topic and to give you a quick update. I wrote again to Doctor #1, as suggested, and was very clear that I wouldn't be attending another appointment. The doctor's office did then send me my test results so they must also consider the matter now closed.

In terms of the "bruising", unfortunately, it is still there and is a result of the iron infusion being injected directly into the skin. Doctor #2 says it is pretty much a tattoo and will take several years to go. Fortunately, most people will think it's a bruise - it's pretty large ca 10 cm long and 6 cm wide - so I guess you could say I've been relatively lucky.

Thanks again.
CW
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