Saturday, March 28, 2009

The mammogram chronicles – part 4: Gaming the system

As I was writing my latest post for The mammogram chronicles, I began to wonder if maybe I should have accepted the doctor appointment. If the breast clinic’s own doctor recommended that I get one, perhaps I could get a mammogram a little quicker. I called the breast clinic back on Friday (apparently they do take calls on Friday) to find out.

The clinic opens at 7 am. I called at 7:10 and was scheduled for a callback at 8:30. Miraculously, someone did call back at about that time. I said I had been offered a doctor appointment but that I had declined. I then asked if I had accepted the appointment and the doctor recommended a mammogram would that improve my standing in the queue and I could get one quicker? The nurse confirmed my understanding – no.

I then said it was a pretty sad state of affairs if you had dire symptoms and really needed a mammogram you had to wait so long to get one. She then said if you have very suspicious symptoms, like a lump, they get you in faster. But general soreness (including my sore shoulder), she said, is usually due to hormones, and although it’s good to get a mammogram, soreness is not considered serious so you have to wait (and wait, and wait).

A friend of mine was going through a tough divorce and wanted to talk to a therapist or counselor. The last I heard, the wait for mental health care for an adult can be a year or more. (By the way, pills are the preferred Swedish solution to mental health problems. Counseling and therapy are considered too messy and too expensive.) There is an emergency number you can call to get a couple emergency sessions with a mental health specialist. “I called the emergency number and told them I was suicidal,” my friend said. “I’m really not, but I knew it was the only way I’d get in to see someone.”

When I was showering this morning, I think I felt a lump.

Thursday, March 26, 2009

The mammogram chronicles – part 3: Learning the rules

I’ve had unexplained soreness in my shoulder the past couple days along with a sore breast so I’m getting a little anxious about scheduling this mammogram. After having waited two months already, I figured I would not be getting an appointment before the end of the three-month scheduling period (the magic date is April 28), so I called the breast clinic today (the callback was scheduled for 1 pm. They called at 1:25) to find out the procedure for scheduling a mammogram in another health care district so I would know what to do come April 28.

Apparently there are two care options: Free Choice and Guaranteed Care. The Free Choice option means if I find a clinic that will take me before April 28, my district will pay for the mammogram but not transportation. The Guaranteed Care option, which kicks in after April 28, requires my district to schedule a mammogram for me somewhere in Sweden (I don’t know if it covers Europe), presumably within 3 months after April 28. They also pay for transportation. So it looks like I should get a mammogram somewhere in Sweden no later than July 28.

I was a little confused. I thought I couldn’t arrange a mammogram on my own before April 28 unless I paid for it. The nurse said because there was a “stopp” in the queue and since I had already waited so long I could use the Free Choice option. (In Swedish, “stopp” can mean anything from a blockage, to a bottleneck, to, in this case, closing the queue completely. She didn’t explain what she meant and I didn’t ask.) Why hadn’t some one told me this two months ago? They are so eager to keep health care money within their district they will jeopardize patient health to do it!

She then offered me an appointment with a doctor next Tuesday and explained that the doctor visit usually followed the mammogram, but since I had been waiting so long, I could see a doctor next week. I asked what the doctor could do for me and she explained if there was anything suspicious the doctor could look into it (a biopsy, I suppose). But isn’t a mammogram usually the next step if the doctor detects anything suspicious? Yes, she conceded. So this visit is actually backwards? Yes, she said.

Well, I know my breasts are sore and lumpy and that my shoulder hurts. So not a lot to be gained from a doctor visit, which would also cost $37. I declined.

I said I would try and call the neighboring city to see if I could schedule a mammogram there. She mentioned that that city also has a queue, but I decided to try my luck anyway. I called the central health care referral number and asked for the locations and phone numbers of mammography clinics in the city. The receptionist referred me to the central hospital and gave me the number to the x-ray department. Of course, it was the wrong – mammography is its own unit – but the person in x-ray was kind enough to give me the correct number. When I dialed, I got a message: telephone hours are Monday –Thursday 8-10, and Monday and Tuesday afternoons 1-3.

Guess what I’ll be doing Monday morning at 8:00 am!

Sunday, March 15, 2009

How DARE they!

On Friday there was an article in the newspaper about the rescindment of proposed bonuses for Volvo’s top managers, and that SEB, one of Sweden’s largest banks, had backed away from a bonus proposal for its top management.

My question is how dare they? How DARE they?! These businesses are not exactly robust, and these proposals shouldn’t even be on the table!

I’m shocked how socially and politically tone deaf these boards of directors and top managers are, and I’m truly surprised that unions and ordinary people aren’t protesting in the streets about such outrageous behavior.

Who are these people?! And how did they get so out of touch with reality?

Wednesday, March 4, 2009

The mammogram chronicles – part 2: Is it worth it?

On February 2, I tried to schedule a mammogram. I’m still waiting to get an appointment.

A few days ago, a reporter interviewed a woman who is a part of my health care region on the radio. About a year ago, they closed the health care facility in her area and she now has to go to the main central clinic for a mammogram (the same one where I’m still waiting for an appointment).

She lives about 80 kilometers from the clinic. She was saying if you’re dependent on public transportation, it basically takes all day to get to and from the clinic, not to mention the cost of train and bus tickets. She said that she and several women she knows have decided to skip mammograms in the future (and take their chances).

I know how she feels.