my medical saga

Patient Relations
Valley View Hospital
Las Vegas NV

Dear Sir or Madam
Just a few minutes ago, I spoke with a young woman in your offices named Corey regarding my concerns about some possible errors in care that may have occurred during my stay at Valley Hospital facilities during the second half of 2006. Some of these issues are still dependent on unfolding events. It was her advice to write a letter offering as complete a picture as possible of the issues that concern me, and the events that are (or may be) connected to these issues.
I'll organize this letter by starting with what seems to me the “largest” of these issues, and proceed to the more minor. But I must also stress that it is the final, (the most “trivial”) issue, that is of most pressing concern to me, because I am currently receiving care that I consider satisfactory for the larger issues, but none for the relatively minor issue of side effects caused by phenytoin.

What may be the largest issue is the possibility of an incorrect diagnosis of the initial cause for my hospitalization, an event that has been characterized as an ischemic stroke that occurred on August 27 of 2006. This diagnosis was first made at Spring Valley Hospital, where I was initially admitted, and apparently confirmed when I was transferred to Valley View a couple of weeks thereafter,

A recent routine X-Ray, however, has indicated the presence of a spinal cord lesion that may be responsible for some, or perhaps all of my symptoms. I am scheduled for a bone scan on the 20th to determine more about my SCI.

As no one ever advised me whether any of the previous imaging that was done ever confirmed the existence of a brain bleed, I am currently unaware of whether or not a stroke actually did occur, though this of course is a topic I will be exploring with my primary physician at our first opportunity.

The second issue of concern is a urethral blockage I've been dealing with since my catheterization at Valley View. My symptoms (erectile dysfunction, issues with urination) were at first taken as prostate-related, but that apparently is not the case.

I know for certain that UMC's records will show that my sensitivity to latex was part of my record from my date of admission, yet I suspect that a latex catheter may have been used, and may have given rise to these issues. These issues are currently being treated to my satisfaction, and so are not the reason for this letter.

The last issue is perhaps the most trivial, but is of the most concern to me, as I am currently going without treatment for it. While hospitalized at UMC, I was placed on Dilantin, and, though I did go for a lab to monitor my phenytoin levels after about 3 months, it seems that no doctor familiar with my case ever reviewed these labs. As a result I was re-hospitalized with phenytoin toxicity in January of 2007, with my vital signs depressed to life-threatening levels.
After my release from the hospital, I began to experience sensitive gums and gum growth, and found in my own research that gingival hyperplasia was a frequent side effect of dilantin.

I know I was never asked if I had ever had gingivitis when my medical history was taken; and no doctor informed me that dilantin carried such risks for patients with gum disease.
As my Clark County medical card is of no help with such issues, I spent some months trying to find a facility that could extend appropriate and affordable periodontal treatment, to no avail.
I recently availed myself of dental services through the Bridger Health Center; the dentist there gave me a needed filling but told me I need a deep cleaning and probably gum surgery from a periodontist.
My mouth is full of bridges and caps that I paid for out of pocket about ten years ago when I was working. When I become eligible for Medicaid in February, 2009, my only affordable option will be to have everything extracted and to purchase dentures. I know that this is not the course any dentist would recommend.
Currently, my rent takes better than half of my disability check, and the rest disappears to simple expenses like food and utilities. I've applied for subsidized housing, so in a year or so I may be better able to finance such services, but for now, there's no wiggle room in my finances at all.

The above are not my only health issues, I am also in treatment for depression, and am in discussions with a specialist regarding what course to take with regard to my hepatitis C. Since the only treatment for hep C is a lengthy course of Interferon, which tends to exacerbate depression, I am hoping to clear away the more minor health issues, such as my periodontal problems, as soon as I can, so that when I consider my treatment options, I'll be dealing with a somewhat smaller cloud of anxiety.

Thank you very much for considering how I might best find assistance,