Friday, August 21, 2015

An open letter to my [Former] Primary Care Physician

Dear Dr. R,
I think you may notice very soon (if you haven't already) that I have stopped coming to your practice. Or maybe you will never notice and/or won't care (or maybe will even be relieved to not have to handle my objections anymore). Youbs

However, I feel compelled to tell you why I had to change doctors for the second time in three years. Somehow I think you won't really care, although nowadays you really should.  Let me tell you why you should care about your patients and what they think.  First, there are so many doctors in our neighborhood.  We don't have to put up with substandard care in Central Queens, because there are at least 1,000 doctors within a 3-mile radius, from which we can choose.  Secondly, in this era of social media, it's easy to let everyone know of our experiences.  As a matter of fact, recently on Facebook, a woman in our neighborhood contacted me and asked for a general practitioner recommendation.  I promptly told her to stay away from you, at which time she informed me that she had just made an appointment with your practice and when she heard my feedback, cancelled the appointment with you and booked one with another practitioner on your premises.

Let me tell you the reasons I have changed doctors.  I had a very nice general doctor at the other end of Queens Blvd but since she had moved from spacious quarters at 97-77 Queens Blvd, which she shared with another doctor, she was less able to provide me with quality care.  Her exam rooms in her new location were minuscule and there was no room for my wheelchair. She came up with a solution to give me the last appointment on Wednesday and I had to wait for all the other patients to leave so she could examine me in her waiting area in full view of her [female] office staff.  Despite this being a semi-private arrangement, it still wasn't ideal.  But at least this doctor listened to me.  However, she often rushed me; I sometimes smelled the scent of a pizza which had been dropped off earlier by a pharmaceutical rep, and I could understand her hunger.  As a matter of fact, I had to fast before every appointment for my bloodwork and I felt like going in the back to steal the pizza; thankfully, my wheelchair couldn't fit in the room where the pizza sat. You see, despite her giving me an 11:45 appointment, she was always behind-schedule and by the time she got to me, it was usually about 2:00pm.  I stuck with her until she got sloppy with callbacks and her staff member told me she would call right back one afternoon, and I learned later that she had already left for the day and didn't receive my message about a medicine refill until three days later when she returned from her weekend.  I hate liars, so decided it was time to switch.

I went from the frying pan into the fire.  Even though your office is right around the corner from my apartment, I was worse off with your practice.  First, I quickly learned of  your unavailability between appointments, even to pharmacists.  My pharmacist -- whom I have been using for 30 years -- complains that it is nearly impossible for him to call for a refill on a prescription.  Once, he was so frustrated that he told me he had given up.  So I sent my aide in person; she waited nearly an hour in your waiting area before she could even get the message to you.  And then you told her I had to make an appointment to come see you in order to get the refill. WHAT?? I had just seen you three weeks before so why did I have to see you again just to get a refill?  You never return phone calls, and this concerns me.  How could I have any kind of relationship with a doctor who doesn't return phone calls?

I happen to be a wheelchair user and can barely fit into your exam rooms.  Your "practice-within-a-practice" used to be a furniture store.  The practice owner took a large open space and built exam rooms barely big enough for a doctor and her patient, let alone a wheelchair.  For an establishment which opened post-ADA [American with Disabilities Act of 1990], this is unacceptable.

What is even more unacceptable is the fact that you insisted on GIVING ME A BREAST EXAM IN THE HALLWAY!!  You insisted that "nobody is looking" and was extremely annoyed when I expressed my displeasure.  And, speaking of breasts, why did it enrage you when I asked you for a prescription that I could use for a mammogram at Columbia Presbyterian Medical Center?  I have been going there for the last 20 years, and they are the only facility with a WHEELCHAIR-ACCESSIBLE MAMMOGRAPHY MACHINE !!  And yet, when you handed me a prescription for a local facility and I said I wanted to go to Columbia, you were positively exasperated.  Did I ruin a kickback that you receive from the local facility?  If so, I am sorry because I know doctors don't make as much money as they used to. Oh, and I did have that mammogram appointment in March but when I sent my aide to your office for the prescription, you refused to give it to her unless I came in.  Funny how you told me after my last appointment "see that you don't come back before having your mammogram." and now you won't give me the prescription until I come in.  What???!!!

But, my own exasperation reached a peak three months ago during my last visit.  I waited TWO AND A HALF HOURS in the waiting area until you called me.  Then, not one gesture of apology passed your lips, for having an 11:30 appointment and not seeing you until 2pm.  Might I remind you that I was fasting because I was having blood work?  By the time you examined me, I felt like I was going to faint, and you asked me why I couldn't breathe strongly enough when you examined my lungs.  How many times have I reminded you that fatigue is a hallmark of ALS, as well as weak breathing.? Once again, you told me I should be blowing up balloons for exercise.  Blow up balloons?  You must be dreaming.

Anyway, so after you make me wait two-and-a-half hours and I hand you two pages of carefully-typed information I need you to know -- like request for the mammogram prescription and explanation of why I need to go to Columbia, and full reports on every medical appointment I have had since I last saw you -- you rudely put it in my file without reading it and asked my aide to come into the room.  Next, you told the aide "I need you to talk to me because I don't have time for her [meaning me] to type out her answers on the machine".  I was floored;  I had just waited two-and-a-half hours and not once did you apologize for the delay.  And now you insist on speaking to my aide, who only repeated the questions you asked and I answered.  When my aide noticed that most of your questions were answered on the paper I gave you and pointed that out, once again you were exasperated. That was the last straw.  Such lack of respect for a patient is unacceptable.  I may be in a wheelchair and talk with an assistive device, but it is your job to deal directly with me.  Two-and-a-half hours is way too long for a patient to wait, and don't think I didn't notice that Russian-speaking patients who had appointments later than I did, were taken before me.

I gave you every benefit of every doubt, but you proved to be disrespectful, arrogant and a proponent of "my-way-or-the-highway" doctoring of 50 years ago.  You are not God and I don't have to put up with your bad behavior in this day and age of choice.  I have chosen another doctor who -- by the way -- apologized for making me wait 30 minutes in her waiting room.  I have an email which I can use to ask her questions between appointments, and request prescription refills.  I have already done so, and my prescription was at the pharmacy a few minutes later.  I am very happy with my new doctor and will not hesitate to recommend her;  I will continue to dissuade people from consulting with you.

Fern Ellen Cohen

Will I mail this to the doctor?  Probably not.  Because she will probably just stick it in my file without reading it, like she does with everything else I have given her.  She'll probably just think I died, or went to a nursing home.  Or maybe never notice that I'm gone, or maybe even heave a sigh fo relief that she doesn't have to deal with "the lady who talks with the computer".  Either way, she and I are done.

Monday, June 8, 2015

Walk to Defeat ALS in Manhattan and Ride for Life

 These photos above are of the 2015 Ride for Life, now in its 18th year.  The gentleman seated smack in the middle with the gray beard, is Christopher Pendergast who has survived with ALS for more than 20 years, started the Ride with a team of guys with ALS who rode their wheelchairs to Washington DC from Long Island.  Nowadays, they ride from Montauk all the way to Manhattan.  In the last couple of days, they pass through Yankee Stadium, home of Lou Gehrig, as well as Lou Gehrig's real home in East Harlem.  On the last day, they go over the Brooklyn Bridge, accompanied by a group of bagpipers.  The pictures above are of the closing ceremony which I attended with Louise Foisy and Lynette Wahid.  In past years, I rode from washington Square Park to Columbia University, a leg that the Ride decided to cut out this year to shorten the last day.  For 12 days, ALS patients ride their wheelchairs with walkers alongside them.  Some ride the whole 12 days, and some for a day or two.  But along the way, they are met by many organizations and schools full of children and teens who have raised millions of dollars.  The money goes to grants for respite care and equipment for patients, and to research.  For more information, go to http://www.rideforlife.org.  Christopher is married to Christine [yes, Chris and Chris] and she has been right by his side for several decades, as well as their son and daughter.  They have been a very active family for the cause.  Before ALS, Christoper was a science teacher in Northport, Long Island.

These pics above are of the 2015 Walk to Defeat ALS in Manhattan.  My team was small this year -- Lynette Wahid and Danielle Aquaviva, but we will be collecting donations through October.  My team -- Fern's Fighters -- will also walk in the Walk to Defeat ALS in Eisenhower Park on Long Island on September 19 this fall.  Once again, Danielle designed some cool tee-shirts. They did something different for the Manhattan Walk to Defeat this year.  Formerly, the walk started around the West Village -- like Charles Street -- and ended at West 55th Street.  This was a nightmare for people who came in cars, which they parked at the starting point and then had to get themselves from 55th all the way down to a spot about three miles away where they began.  This year, we started at about Houston Street and ended in the same spot.  Of course, you can't please everyone; there were complaints that the point where we turned around to come back was confusing.  And the pier [45] where the walk started had nowhere for Access-a-Ride to pull in.  So he dropped us at Pier 40 and Danielle called them to change the pickup point for the return to Pier 40.  I should also mention that they served the best ARTISINAL pizza at the end of the Walk.  I honestly don't know why more people don't join us for the Manhattan Walk.  In many ways, I prefer it to the Long Island Walk, especially since I can use Access-a-Ride and take my motorized wheelchair.

Fern's Fighters are registered for the Manhattan Walk and for the Long Island walk to Defeat, which will be on Saturday, September 19.  I would like more people to join us at Eisenhower Park in September, but if you just want to make a donation, go to this link   The new tee-shirt design, by none other than our team designer Danielle "Nellie" Aquaviva -- will be displayed soon.

Thursday, April 16, 2015

NewYork Winter, 2014-2015; Bad Karma All Around: Dad, Aunt Sylvia, Cold, and More.

First of all, check this out.  Some guy mentioned me in his blog and then posted the coolest pics of some of the architecture in my neighborhood.   Some guy by the name of Alan Rosenberg who came to visit me in 2009 loved my neighborhood and some of the remnants of pre-WWII architecture and wrote about it, in his blog [link above or click http://alanrosenberg.blogspot.com/2009/01/rego-park-ny.html ]  

Okay, so my last update talked about the losses of a dear aunt and a dear friend -- My Aunt Vicky and fellow ALS warrior Norma Steck-Hess.  But that's not all.  The same day [January 2, 2015] that my Aunt Vicky passed away,  the husband of my therapist also passed away.  Dr. L had been taking a hiatus since her husband went into the hospital for surgery, and then for a few weeks while he was "recovering".  Then she reported to me that he was "deteriorating" and she would need more time off.  It wasn't until mid-January that she emailed me and gave me the sad news that her husband had died.  She then said that she would probably return to her practice in early February.  She ended up further delaying her return to February 23, because she was not ready and wouldn't be able to "be present" for her patients.  As it turns out, I probably would have had to cancel a few sessions due to the weather, which has been "dangerously cold" according to the TV meteorologists.  My apartment was so cold, that we have been wearing hats and layers of clothing INSIDE. 
Okay, so this selfie was taken outside, which wssn't much colder than inside.  I was wearing my pink-framed reading glasses and my sherpa hat that ties under my chin.  And forgot to camouflage my freckled sun-damaged complexion.  This why I don't post pics of myself and don't take many selfies at all -- for various reasons, ALS has made me very un-attractive.

Then later in February,  I heard of the death of another aunt, my Mom's younger [and last remaining] sister in California.  My aunt Sylvia was the one my Aunt Vicky went to live with, when her own husband died.  My aunt Sylvia was 82 and she and I were not close when I was a child.  When I became an adult, Sylvia and I became closer and I found her to be a faithful confidante.  I know she loved me very much, and that is why she could not deal with my illness.  She called me on the phone in the early stages of my disease and could not understand what I was saying.  The shock was too much for her, I guess, because I never heard from her again.  I thought about her many times and considered writing her a letter because she wasn't techno-savvy and didn't have a computer and email.  But laziness and weakness got the best of me and I never did.  It always hurts when people from my past,  freak out from my ALS and completely abandon all contact with me because they just can't handle it.  I have learned to deal with more and more solitude as the years go on.

Here is a picture of my Aunt Sylvia when she was young.  The Vogel girls -- my mom Ruth, and her sisters -- Lynn, Vicky and Sylvia -- were all very beautiful.

But the bad karma doesn't end there.  Bad things seemed to be happening all over my "universe". My 87-year-old Dad was fainting and weak.  He went to the hospital and now is in a rehab facility -- aka extended care.  He hates being there and wants to go home, but he cannot live alone anymore and has to have round-the-clock home care.  He's not too happy about that either.  I can relate because I hated to have my privacy and space invaded by strangers too.  But I have a studio apartment and he has a house.  So he is in better shape than I am because he has a lot more space for another person.  Still, I totally understand.  It's a whole change in lifestyle for him and a new era.  My sister Haley has had to handle the logistics for him via an attorney, but I luckily served as a model as one who has been through the "spenddown" through a pooled-income trust in order to get home care.  Once that is all in place, things will feel a lot better, but it's a waiting game I am all too familiar with. All in all, it's an unfortunate situation that Haley has to handle it all herself.  This is not what we signed up for -- all children [in our case -- both sisters] should be able to share the duty of taking care of an elderly parent.  They call it the "sandwich generation"  but this sandwich is open-faced because I am a slice of the bread that is busy with the full-time job of taking care of myself.  Or is it the other way -- are the children the "bread"around the sandwich or are we the "meat"?

More still:  My friend Danielle lost her bunny Marley and about a month later, Marley's partner Phoebe.  This happens a lot with bunny rabbits; one half of a bonded pair passes away and soon after, the partner goes too.  The same thing happened with Nickels and Angel -- the bonded pair of my friend Deb several years ago.  Bunnies can die of broken hearts.  Another furry friend also passed away this winter -- Abbey  aka Cissy, the 18-year-old cat companion of my friend Louise.  I can't remember ever entering Louise's apartment without Abbey greeting me.  And the human world wasn't spared either -- besides my two aunts and my friend Norma, my friend Deb lost her two grandparents within weeks of each other.  I began to advise people not to come around me, because I was sure I was bad luck.  Danielle then came down with pneumonia last month...whew.

Here is my friend Danielle holding her bunny Phoebe.  They had just lost Phoebe's partner Marley, and Danielle was planning on finding another hus-bun for Phoebe, but then Phoebe passed soon after this picture was taken.  Danielle is bi-cultural like my nieces and nephew -- Jewish mom and Italian Dad.....thus the menorah and Christmas tree [just like at my sister's house]
And the cold!!  This was an especially bad winter, but the heat in my building never worked right all winter.  Now that spring is coming, the heater has been repaired, but we went through torture, often wearing hats and gloves in the apartment.  My building superintendent was fired by my board rather suddenly last month.  Since he is refusing t I spent about two months not going outside; Queens -- ever the forgotten borough -- was a sheet of ice and not good for navigating wheelchairs. AND, with the temperatures at record lows, I risked killing my brand-new wheelchair batteries. So now I am left with pent-up needs for medical and diagnostic appointments.  I guess I know what I will be doing in the coming months -- Access-a-Ride here I come!!

As winter comes to an end, Spring is starting to look much much better. Surinder -- my aide from India who is really into astrology -- says that I am moving out of this crappy karma in April.  Let's hope she is right

Monday, February 2, 2015

What Death Teaches About Life --Loss of another ALS Warrior and a Dear Aunt

Every time I lose someone to death, I am reminded of some very important lessons about life. One of the most important of these is the tenuousness of life.  In the eleven years since my diagnosis, I have personally known many who have died unexpectedly.  Some never seemed to be sick a day in their lives, and some had chronic illnesses and died of something else.  Some were older, some middle-aged and some young.  And that is why it burns me up when I hear "I don't know what to say to you because if I tell you the good things happening in my life, it might make you feel bad"  Not only do I not begrudge anyone happiness; but I also know that these people have to enjoy life now because you never know what will happen tomorrow. Anyway, Renee Lo Iacono said it better than I ever could, in her Huffington Post article "4 Things Death Teaches Us About Life" 


Around  the new year, I lost a dear friend and fellow ALS warrior.  Pictured above, Norma Steck-Hess was a special person.  For 30 years, she was an ER nurse at St. Luke's Hospital in NYC.  There are many theories as to causes of ALS.  One theory is that stress brings on the change in the motor neurons that triggers the disease.  I can't think of any job more stressful than an emergency-room nurse.  Anyway, for most of Norma's adult life, she was a single mom.  But in her 50s, she got married to Bob.  Well, she was diagnosed with ALS a year after they married.  Imagine finally finding love and marriage after retirement and planning a life of enjoying a new spouse and travel and relaxation, only to be diagnosed with a disabling disease a year later.  Norma became a good friend to me, befriending me at my first MDA/ALS support group meeting. I enjoyed many pleasant afternoons and even a Christmas celebration at her beautiful home in Flushing and when I had a problem with a mean VNS nurse, Norma wrote a letter that changed my life.  She knew the CEO of VNS and wrote a letter scathingly condemning the nurse's treatment of me, and lack of understanding of my disease.  From then on,  a sadistic nurse was eating out of my hand.  I was forever grateful to Norma and her support.  In the last few years, I didn't see her because she lost use of her hands and didn't feel comfortable using her eye-gaze device.  I actually suspect she fell into a grave depression.   I will miss her; all in all, she lived 15 years with ALS, which is above and beyond expectations [most patients lose their battle within 2-5 years].  I have learned an important lesson from her death, which is to never lose touch with anyone, even if they seem to be dying.  Yes, it's scary because eventually you will have to mourn them, but eventually if you live long enough, you will mourn hundreds of people, including some you never dreamed would pre-decease you.  I regret not making more of an effort to connect with Norma -- even with a family member -- after she stopped communicating on a regular basis.  Even a monthly card sent to her house expressing that I was thinking of her and praying for her, would have gone a long way.  I shortchanged Norma, but made a promise in her honor, to send more written notes and cards to people via old-fashioned snail mail.  Email is a great invention, but there are still people who cannot or will not use it.  When Norma could no longer use a computer, I should have made more of an effort to reach her, even if she could not reciprocate.

Another loss was my mom's sister Vicky[pictured above on the left; that's my mom Ruth at right] on January 2.  My mom grew up very poor.  Her parents emigrated to the United States in the early 1900s from Austria, and settled in Brooklyn by way of Minnesota. Thank goodness my mom was forever telling us stories about her family, and since I have a good memory, I really should write them down. Vicky was not my aunt's real name; her real name was Elsie.  But she changed it to Vicky and only as a young adult did I find out her real name and promised my mom that I would never tell Vicky that I knew.

Vicky died at 88 years old; my mom would have been 83 if she were still alive.  Basically, my maternal grandmother gave birth roughly every two years.  My mom once told me she only remembers her mom either pregnant or nursing.  And to my knowledge, all the babies were born at home.  My mom and I used to watch old movies together and one of the movies we loved was "A Tree Grows in Brooklyn" -- my favorite book by the way -- and there is a scene where Francie Nolan's mom gives birth at home and asks Francie to boil water and go fetch the midwife.  I was shocked when my mom revealed that she could relate to that scene, because that is exactly what happened in her own house.  They would send my grandfather and my mom's brothers out of the house and the girls would stay with my grandmother during labor,  but they would never stay for the birth.  The gaps in the two-year intervals of births, were babies who died.  I seem to remember there were two babies who were born alive and died as babies, and my uncle Sol died of leukemia at 12.  They say women were accustomed to losing some of their children back in those days, but I don't believe they ever got used to it.  The stress must have gotten the better of my grandma Frieda [Fanny], my namesake, because she died of breast cancer at 50 in 1948,  just weeks after getting her diagnosis.

Getting back to my aunt Vicky,  she was a longtime employee of the famous Roseland Ball Room, which is featured in many films from the 1940s and 1950s.  She never married until her 50s.  When I was 29, I learned that she gave birth "out-of-wedlock" when I was 10.  That explained why we never seemed to see her after that; she gave birth to the baby in a "home for unwed mothers" since single motherhood was a shameful thing in 1965.  Until then, I slept over my grandfather's house in Bensonhurst, Brooklyn many Saturday nights when my parents went out.  My grandfather's house also had the unmarried siblings of my mom living there -- my uncle Simpson, my aunt Sylvia and my aunt Vicky [and my aunt Lynn between marriages] because back in those days, single children -- even adults -- stayed with their parents when they didn't marry.  Anyway, I loved those sleepovers because the next morning, aunt Vicky would always make me pancakes with Log cabin syrup and then take me to Nelly Bly Playland, where we would go on the rides; then we would go to the local playground and swing on the swings.  Because Vicky was so pretty, all the men would hit on her, but she would tell me to go along with the story that I was her daughter so they would stop bothering her.

Vicky married in her 50s to a local policeman named H.  I never met him, but I saw pictures of him.  He was a good-looking gray-haired man who apparently was fighting his own inner demons.  Shortly after they got married, my aunt Sylvia moved out to Mission Viejo, California near San Diego.  My mom and I took a trip out there in 1987 to see my aunt Sylvia while I was still working at Aeromexico and had my flight benefits.  Vicky and H. had also moved close to her.  Years earlier, my uncle Irving had moved his family to Huntington Beach in Orange County, so he was the one who got Sylvia, Vicky and H., and later on my Uncle Simpson settled with the long-distance moves.   During that trip, my mom and I got to hang out with Sylvia and Vicky.  During this trip, he was in Brooklyn so I still didn't meet him.   I now know that alcoholism is usually a way of "self-medicating" an often-undiagnosed mental illness such as bipolar disorder, depression or even schizophrenia. In the 1980s H. was in recovery from his alcoholism.  Because he was a retired cop and worked as a security guard, he had a legal licensed gun at home.  And quite shockingly, he used that gun to commit suicide with my aunt Vicky in the next room.  Vicky was never the same after that.  Such is the pattern of suicide -- when the plan is in place, the patient seems to be in great spirits, and the ones left behind in the cloud of helplessness and shock, are left to suffer seriously.  Vicky moved in with Sylvia and mourned H. for the rest of her life.  One day after my uncle Simpson suffered a heart attack and Vicky, Sylvia and Irving came to Brooklyn to be with him,  I took Vicky to McDonald's on Kings Highway and she relived H.'s last morning with me, while pulling out of her purse a worn and tattered copy of H.'s typewritten resume.  I knew at that moment that she would never get through the trauma and would forever suffer from PTSD,  like an eternal veteran of a war none of us could never understand.

When I think of Vicky and H., I wonder how she lived so many years after he left this world.  Was it a blessing or a cruel curse?  and I think of Norma and myself, struggling so hard to outlive a death sentence imposed on us by a disease and the medical profession.  

Addendum:  I have since removed certain sentences from this story and used only the first initial of my aunt's husband.  I received angry comments from the daughter of H., accusing my aunt of some very disparaging acts.  When  changed the URL of this blog, all comments disappeared, and I found it best that this happened.  There are two sides to every story, and my side is that I lost a loving aunt, who -- like all of us -- was far from perfect.  But -- in the end -- this is my blog and it is written from my point of view.  Out of respect for someone who isn't here to defend himself, I made certain adjustments, but I am not obligated to present a view of my aunt which disparages her memory.