Wednesday, April 04, 2007

Patient from hell? Insecure and confused doctors? Or yes to both?

Doctors, doctors, doctors; in life you can’t avoid them, but if they are incompetent or just hung over they can kill you. This was why I switched doctors. My previous doctor, Dr. W, delayed over a month after I started passing out to do a basic blood test. Then I found out that he had previously almost killed two other patients. One of those patients was my father. See, with Dr. W. a lot of people like him because you say, “gee, I’d like a bit of valium to help me sleep” and he gives you a prescription for 100 (a kind of “please don’t come too often” message). I was sort of appalled the day after I asked him NOT to give me a large prescription he gave me a prescription for 100 extra strong painkillers AND 90 valium (this to a person he knows has tried to kill herself twice with pills – of course in the UK, I would get like a dozen pills, so trying to overdose took way too much planning and became kinda pathetic with 12 valium, 8 painkillers, some vitamin E, some children's cold syrup, etc, so as yet, not successful. But with 190 pills? Bingo! P.S. - much better now.)

The problem with Dr. W. is that he would say stuff like, “You should really get a test for xxxxxx” but then he would never order it, or the next time, or the next time; he just kept plum forgetting, no matter how jovial and jokey he was. And his jovial demeanor fell off the day he got the blood tests back and asked me “What did you do when you first passed out.”

“I came to you.” I told him.

“And the next time?”

“I also came to you, and then again and then four weeks later YOU decided it was time to get some blood taken.”

He turned with a bit of snarl, “I am getting real sick of your attitude.”

My father, a couple years previously, had kept coming to him the same way saying, “I have pain in my side.” Now, my father has very high pain threshold; even as an adult trying to give him a back massage was pointless as I would be almost stabbing him with my fingers and he would say, “Are you going to start?” So for my father to admit he felt pain at all was unusual. I was in the UK and become very concerned as time went on and on and nothing was done, I asked/begged him to go in and REALLY explain that he was in pain (still driving transit buses eight hours a day). Dr. W. gave him some pain killers I think which worked not so great. One of the times he went in to say, “I really am in pain!” a locum (temporary doctor) was there instead of Dr. W. The locum ordered a series of tests. When the test came back, my father, who was driving, was contacted by his supervisor by the doctor's office to proceed, with his bus, to the hospital where an emergency team was standing by because an internal organ (I believe his gall bladder) was rupturing as it had been infected for months. The emergency team took him right into surgery. They were surprised as he stopped the bus told his passengers another driver would arrive and walked over to them (in their experience someone in his condition would be in so much pain being able to move at all should be nearly impossible).

So as Beth slides into rapidly declining heart and life functions (with a structurally sound heart), was this the man I trusted my life with? No.

I found a sports doctor who was interested, Dr. M. Only she didn’t talk a lot (like a few dozen words a 15 minute visit). But she got me an appointment (in two months) with an internal medicine internist. Then she seemed to just stop. I would ask for certain tests; she would write it down, nothing would happen. Then in the visits she would say things that were a little disconcerting like looking at the test results and picking up the Holter Monitor result and saying, “Oh, well, I can’t understand these result sheets.” (and I’m thinking, “Well, pass it over and I’ll go over it with you.”). After a conversation with her Monday and this morning she is firmly determined to NOT collect any more tests or data on the heart or thyroid on the basis that “the specialists will do that” even though, I do not, as yet, have an appointment even months away with a heart specialist. Plus, when I give her information, she has stated things like, “You can’t know that.” when I told her my heart aches at the end of the day if I don’t get enough rest (like a sore muscle). “Okay,” I said, “Something right here hurts at night when I go to bed and hurts more during arrhythmias and in the morning I don’t feel it aching.” So, not collecting “hard” data through scientific tests, nor is she collecting data from the subject.

What is she doing? She is focused on “other issues” specifically whether I could have malaria or if I am suffering from heavy metal poisoning. She seems convinced that I take pills in secret and often asks me every time I come what pills I take (I have and only ever take daily: 1 Echinacea to ward off colds, 1 Acidophilus to aid digestion, 1 birth control pill for hormone regularity and a ½ of the minimum dose of the NRI antidepressant Reboxetine which I have been on for 4 years or so from the UK). She has decided that Reboxetine must be poisoning me. This seems an odd choice. I have no job. I have no money. I have no mobility. I fall down multiple times a day. I pass out a few times too. Because of that I cannot drive, I cannot go places or exercise in a pool unaccompanied. I have no prognoses, I am slowly continuing to degenerate. I am in a wheelchair. This has all occurred in a matter of 10 weeks or so. Normally, would this be the time a doctor would be PRESCRIBING anti-anxiety and anti-depressants or the time to TAKE THEM AWAY?

Additionally she has taken away the valium which I use once or twice a week if I wake up and can’t sleep (since if I don’t sleep 8-9 hours overnight, I can’t get out of bed for more than an hour or so) and replaced them with an anti-anxiety medication and an anti-depressant sleep medication. Both of these have as their most common symptoms: dizziness, nausea, excessive sleep, fatigue, muscle tremors. These are my symptoms without pills (or on pills that have NO side effects). So, if I take the pills and I am dizzy a lot, does that mean I am getting worse medically or “just a side effect” or rather – why would anyone prescribe multiple pills which have common side effects which mask or replicate the problem you are trying to detect (which is why I have touched neither pills)? She did offer an anti-depressant which is contraindicated for anyone with a heart condition specifically arrhythmias. This drug (Maprotiline) in control groups, 74% of patients have side effects (my drug 4%) of which the main ones are: Dizziness, drowsiness, fatigue, Hypotension, tachycardia, other arrhythmias. Does that sound familiar to you, because it does to me. Forget the heavy metal toxicity theory and someone find out if anyone has been slipping me Maprotiline because that covers at least 80% of my problems (and is yet the only thing I found which creates the “mystery three heart problems” I have, Hypotension (you pass out because your pressure drops), Tachycardia (your heart races too fast) and other arrhythmias (SVT’s and SVE’s please raise your hand!).

So tremendous stress, removal of the “safe” anti-depressant and Linda is leaving next week to fly off to do training for the government leaving me to crawl around in the house as best I can. Now, I have to ask, does that set up sound like the doctor’s creed of “Do no harm” or rather what I will ask next time I see Dr. M. (while Linda is away); “What is going through your head? What is your plan....is there a plan?”

To put it bluntly, if I wanted to be in human medical experiments I would have signed up so I could have been paid. But, I guess you get what you pay for (up here, nothing). What I don’t understand is why there isn’t a doctor rating system like there is the professor rating system so we could check our GP and see how competent/incompetent are they? What percentage of their patients do they kill? And special markers if they “don’t believe” in things like people having medication for mental health (who considering someone still kills themselves every few minutes in the US, and I see those as preventable deaths, I place those views heavily in the “idiot not doctor” category). Don’t get me wrong, I went to a doctor who tried to give me Prozac for everything, including one time when I had a cold and a cough – prescription: prozac (“probably came on due to stress”). But when I was in my early 20’s I was diagnosed with bipolar disorder, OCD, anxiety, anorexia and psychotic breaks. Currently I take ½ of the minimum dose of a single NRI anti-depressant. Do I sound like a person who is “addicted to being mentally ill” or a person who has strived for a balance in which there are ups and downs but a minimal guardrail to prevent thing like say: multiple weeks of reoccurring suicidal thoughts?

Sorry to dump my garbage on you but I have to wonder if I am the only one, to find, in times of great distress, when not dealing with the common cold or bad PMS, to find the GP, the person we expect to either know something, know someone who knows something or has the ability to research something (they did go to a school for many years learning this right?), completely out to lunch? Or worse, finding that the worse you get, the more perplexing you get, the more hostile they get. My therapist (yup, got one of those too, that’s how I keep my meds so low), says that first, I tend to be “very intense” which can be threatening and second, that my condition, in its complexity, threatens the very self-image of doctors: that they know what is going on. So the more complex and difficult the progression of my illness/illnesses, the more they may want to dump this on someone else’s lap, and if they can’t dump it on another doctor’s it is “wait for the specialist, they will deal with it, goodbye, please don’t call back again soon.” I know I may seem very critical and part of that is the frustration of constant pain and being on oxygen and crap like that but come on......malaria!?

Anyway, I don’t expect to be blogging any more about what is going on with me and the medical system because......nothing will be happening for several months (though my doctor did say this morning I should go to emergency if there was a problem. “And have them transfer the data to you?” I asked. “No no!” she said quickly, “The ER doctors will look and make the decisions”). So onward and upward to the next blogs about fashion and fencing and feminism and I’ve run out of f-words, oh there’s one, and fumbling-towards-ecstasy (I’m trying to cut down on swearing), and maybe some fun (but also likely fear and some feeling funky).

11 comments:

kathz said...

I can't really think of much to say in response to that - except that yes, doctors can be pretty useless (luckily not all are). But I wanted to post a comment and say hello and that I'm still reading your blog and hoping things get better. (Oh, and as it's nearly 1.00 in the morning here I'm a bit tired - perhaps that's another reason I can't think of anything to say.)

jim said...

I do not know what to say that I have not said before.

I suggest you carry your epee and the first nurse you see....flick her in the ear. This is a warning to the doctor!

Sober @ Sundown said...

I like Jim's suggestion.

I hope you find a solution soon.

Kate J said...

The trouble with the health service here - and I guess in Canada too - is that if you get a good doctor it all works brilliantly... but if you don't, and you try and complain or whatever, the whole system closes ranks and whichever way you turn you're fucked, basically. You're a 'difficult' patient, the patient from hell indeed... especially if mental health comes into it anywhere, however marginally. Anyway, if anyone can get through this, you are probably that person.
Oh yes, and I'm reading Zed and think it's brilliant.

hazel8500 said...

I wish you lived in Vancouver, cause I would refer you to my doctor. After 15 years and several doctors, three provinces and a few dozen experiences such as you've described here I finally found someone who not only says I think you should have this test done... but actually orders the frikken thing. And when I say to her I feel like... my shock system is over worked can you check my adrenal functioning? She says of course your internal warning system acting up again?

Uh yes as a matter of fact.

The medical system in this country is so unbelievably out of tune with patient needs it makes me sick. ( literally)

But worse is the horrible attitude of doctors I've come across who cannot believe that I just might be the only expert in the world on my own body and what I have to say about wtf is going on in here is worth paying attention to.

I dont think this is a helpful comment I guess I just wanted you to know, I know THEY SUCK!

BUT it is possible to find a good doctor. Use your connections, ask people about their doctor's in the Victoria area, put together a wish list of the type of doctor you want and see if anyone can refer you to a good one. Thats what I ended up doing and thats how I found my current doctor who i love and who btw wears kicking boots to the office.

A fan who wants you to feel well enough to write that next book!

Hazel.

Wiccachicky said...

That's annoying. I hate doctors for just this reason - I have never really had much luck with finding a good one who really listens to me. I mean, really - I think people who are in tune with their body and know it well (like you would as an athlete) really can have a lot of qualitative data that makes sense but doctors don't listen to it. Instead they order tests and what not only to find "nothing" and then say it's all in your head. At least that was my experience with my stomach condition - 10 years of saying I was in pain and finding ways to deal with it before someone actually diagnosed me and got it right. Annoying!! I hope you find some help soon, but until then, pay attention for yourself - keep a journal of symptoms. That really helped when I finally got the diagnosis.

GayProf said...

When in college, I worked as a secretary at a hospital. If I ever had any delusion about doctors' abilities, that would have quashed it out. Most of the time, they are just punching the clock. The really terrible ones are happy to pump their patients full of drugs so that they will simply stop talking.

There were, though, good doctors (by my estimate 1 out of 6). Try to keep searching. In the meantime, I will wait for your next fashion entry.

Daniel, the Guy in the Desert said...

It sounds like you need your own advocate with the doctors.

Elizabeth McClung said...

Thanks again for the support or at least comments - I was hoping for more horror stories - I think a friend of mine is correct in saying this doctor may feel over her head and is just covering her butt in making sure no one can say "but you didn't look for..." while passing everything else on to the next level - anyway, I am through with that - on to party! Party! Party!

belledame222 said...

gahhh.

if you really want more horror stories you can always check out Liz, I expect--she had some doozies.

i'm just thinking: goddam, and here i was grass-is-greening Canada all this time...crap

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