Thursday, May 29, 2008

And then there were none... (the final specialist visit)

This is part of my appointment today with what used to be my “heart specialist” who had not seen me in over a year and a half.

Dr. N. (who by the way I called “Child Killer” to the staff, after reading about his making a 16 year old with a diagnosed failing valve and ventricle wait SIX months for a follow up appointment to talk about treatment): I made this appointment today to go over the upcoming tilt test.

Dr. McClung: Actually, I made this appointment because after almost a year and a half you still would not make a follow up appointment.

Dr. N.: Well, there were some tests done….

Dr. M: And, since those tests are over a year old when I was still fencing, I think they are about as useful as a doctor taking a medical test done BEFORE Christopher Reeve had his accident and planning treatment on it a year AFTER his accident….don’t you?

Dr. N: Well….the strip shows no “erratics” (they did a two second strip before he came in).

Dr. M: But it does show double beats, back beats…..

Dr. N: Those are all considered within the normal level.

Dr. M: Did you get the strip from the ER from Dr. G? That had quite a few erratics.

Dr. N: You were at the ER, I received no notification.

Dr. M: Odd, since MY GP got full notification, and since the hospital is only a few feet away (his office is 50 feet from emergency room – across the street).

Dr. N: Do you get chest pain?

Dr. M: Yes, two to six hours a day.

Dr. N: Well, that shouldn’t be happening with erratics.

Dr. M: But if you notice that my HAND is blue, that indicates lack of oxygenation, and since the heart IS a muscle, then lack of oxygen COULD cause pain, could it not?

Dr. N: Yes, but you shouldn’t be on a beta blocker.

Dr. M: That was prescribed by Dr. G. because looking at the visit schedule (the initial visit over a year and a quarter ago…and nothing), he could not confirm that I was under the care of a heart specialist, as the oxygen, erratics and other readings he was seeing indicated I should be, so he prescribed it himself. We found that as the heart beats slower, the more erratics appear and the more it hurts, and this masks that pain.

Dr. N: That is not indicated. Dr. G. is JUST some ER physician who has had ONE year! (What he meant was one year specialization training in heart – he has done ER work for MANY years and my GP worked with him and under him and respects Dr. G. greatly).

Dr. N: Unless you have been seen by Dr. R, Dr, V. or Dr. I (all who share an office with Dr. N) then you can’t say that you have a heart specialist’s opinion!

Dr. M: In your ENTIRE practice, how many patients have you had with MSA?

Dr. N: (pause)…none.

Dr. M: Dr. G. has seen to quote “hundreds of autonomic heart failure progressions” and he says that my heart produces enough volume, it is the vascular constriction which will cause strokes and death.

Dr. N: There is no way with that heart you could have a stroke.

Linda: There have already been TIA’s.

Dr. N: Who confirms this?

Linda: (she makes a list finishing with the top neurologist at the hospital who she says, “saw a seizure, an “R” seizure”)

Dr. N: A REND Seizure (something with neurological), which means that the effects last longer than 24 hours which is what determines a TIA. (meaning the effects can last days or forever). Do you have any swelling in your ankles?

Dr. M: laughs….keeps laughing as Linda pulls off the sock to show the foot swollen with blood that is simply seeping out under the skin.

Dr. N: “That’s not heart related! That is the micro-capillary system!”

Dr. M: “So when half of my body is one colour and the other half the other, that is the micro-capillary system?”

Dr. N.: Yes.

Dr. M: “And that is also where the clots and stokes occur, isn’t it?

Dr. N.: Well, yes, but only in the head.

Dr. M.: “And as you can see, 60% of my visible body has a compromised micro-capillary system….is it then not too great a leap to assume that parts we CAN’T see, like parts in the brain, might be compromised as well?”

Dr N.: Well, yes, but that has nothing to do with cardiology.

Dr. M: Well, who then DOES take care of the micro-capillary system?

Dr. N: Uh…no one! (Dr. M gives him a look) Well, Neurology, they have everything to do with the head.

Dr. M: Well, they don’t seem to be doing that well.

Dr. N: I talked to Dr. Atwell-Pope (groan from Dr. M) and I think that Neuropsyh unit would be a good thing.

Dr. M: (sighs) The Vancouver Neurology department admits that I have permanent peripheral damage to my neurological network, which may be degenerative, they admit I have autonomic failure which they hope is peripheral, other experts have confirmed central autonomic failure as well, you can see in my hands my level of oxidation or talk to the hospital and you think that the NEUROPSYCH unit would better my quality of life?

Dr. N: (aggressively) The Doctor in charge would know how to handle you. Anyway, we are here about the tilt table.”

Dr. M: Actually, the tilt table will only prove that I have orthostatic hypotension (a type of autonomic failure), is that not correct?

Dr. N: Well….

Dr. M: You use nitro to accelerate the process and you want to observe if there’s orthostatic hypotention, is there ANY other use for a tilt table test?

Dr. N: No…..We are doing it because Dr. Atwell Pope requested it.

Dr. M: Actually I requested it nine months ago, but you YOURSELF, doctor, verified that I had orthostatic hypotention, in fact EVERY doctor has verified it EXCEPT Dr. Atwell Pope. One made a little chart and everything, do you want me to have it sent to you? YOU verified it on our first visit.

Dr. N: Rushes to file, flips it open, read the letter (which by the way he wouldn’t tell me the results that day, much as he didn’t tell me any results of blood pressure he took today) and turns, “Well there was a drop in pressure.”

Dr. M: Is ANY treatment going to be initiated from this test?

Dr. N: No.

Dr. M: Then why have it?

Dr. N: (a bit angry and sulky) Now the angiogram, that could have been useful?”

Dr. M: Is that the one where you drip liquid metal through my heart?”

Dr. N: Yes, you never did it.

Dr. M: (Yes, I know, which is why he refused to see me!) I did not have that because no one would follow the medical protocols which are in the medical journal article I gave and is sitting IN THAT FILE (points to his file). When you want to follow protocol and call for an anaestheologist, I will do that test.

Dr. N: (turns to face away) That’s NOT going to happen!

Dr. M: So, what CAN you offer in treatment?

Dr. N: I can give you a two week event monitor.

Dr. M: Okay

Dr. N: Even if it is AFTER the event, you need to push the button.

Dr. M: So it doesn’t record unless I push the button?

Dr. N: No, and if you have a seizure, or (getting quite excited), If your heart stops completely! Remember to push the button.

Dr. M: (thinks to herself: “If my heart stops completely I will have a lot more things to worry about than a damn button”) Okay, the central autonomic is the one that sends electrical to the heart, correct? And we do know that I have at least two A/V nodes.

Dr. N: No, we don’t have that verified.

Dr. M: Excuse me?

Dr. N: (getting puffy) Until I run a catheter from your groin INTO your heart we do not KNOW how many A/V nodes you have…….but the holter tests (24 hour tests), show that you have heartbeats which originate from the opposite ventricle.

Dr. M.: Which means I have P.A.T.

Dr. N: That hasn’t been completely VERIFIED

Linda thinks: (“What a little puffed up hair splitter, just to try and be RIGHT”)

Dr. M: Okay….Well, when the beats become too erratic, Doctor G. at the hospital has offered to admit me and put in a pacemaker to keep me alive. Is that okay with you?

Dr. N: (Gets a bit haughty): “Well, that works, though you can tell Dr. G. that once you are admitted that I can put in the pacemaker.”

Dr. M: (Stares at Dr. N). I’m sorry, but I would be going in for a PACEMAKER because my heart wasn’t working, I’m SORRY but I DON’T HAVE TIME TO CARRY NOTES BETWEEN YOU TWO when you are ONLY 50 YARDS away!”

Dr. N: ……I need to see another patient! (Leaves the room)

Dr. M. goes to the front counter to the admin person. Who says, “I think you are getting a two week monitor…it will be at the Jubilee.”

Linda says I was slightly loud at this point.

Dr. M: “Oh is that what CHILD KILLER, I’m sorry, that’s just his only RateMD name, is Dr. N sending me to the SAME hospital that he just told me was full of doctors who are under-trained and incompetent?”

Admin: “Ahhhh, I don’t know, it may be another department.”

Dr. M: “Did you know (apparently the ENTIRE floor including his colleagues and all the people waiting could hear me), that when a doctor FAILS to comply with the standard protocol for a procedure after being shown it, not once but twice that it constitutes grounds for a complaint AND action from the college of physicians?! (I was talking about his refusal to treat due to the needle phobia)”

Admin: “Ahhhh……”

Dr. M. Wheels off, “What a DICKHEAD! A year and a half for a fucking tilt table test he confirmed at our first…and only meeting! And he has NO patients with central autonomic failure? And HE is the expert?”

Dr. M – aka Elizabeth was going through what is known as grieving, or rather through my ANGER stage because now I have….no specialists (since my complaint with the college of physicians on various breaches of protocol by Dr. Atwell-Pope not limited to patient confidentiality disclosure when she gave personal information beyond the test results to the TECHS in Vancouver – the college does not allow any complainant to be treated by the doctor they are complaining about, and since there are only 4 or 5 neurologist with hospital privileges in Victoria, that will be…well, difficult)

Did I want to come and write another “Hell Specialist” visit, or the fact that I lost my voice (gee, I wonder why!). No, I want to write about good things, but now at least, I know that Child Killer….I mean Dick Head….I mean Dr. N is not likely to do anything since he feels he is always right unlike Dr. G who said, “we are starting you on a very, very tiny beta blocker because….with your autonomic system we literally have NO WAY of knowing how your body will react. Then after we see the results we can see if that IMPROVES your quality of life or not.” Do you understand why I like Dr. G. better than, Dr. N and his: “I don’t feel you should be on beta blockers because I didn’t prescribe them to you. And no I have no experience with autonomic failure but I will remain acting as the ONLY authority on you as a human being.”

Well, I promise, unless the fever returns a happy and cheerful post tomorrow. The bad news is that now I currently have a) no treatment plan for the future, b) no accepted plan for dealing with increasing pain, c) no specialists and d) a GP who WANTS specialist to instruct him on how to proceed and while I like that he calls them “The FUCKING specialists in this CITY!” I still think doc, it is time to take a risk and go solo. Because quite honestly, you are all I have.

23 comments:

A Bear in the Woods said...

I think your response to the evil and stupid doctor was pretty mild, considering his provocations.

yanub said...

MD is over here, and I read her this part:

Dr. M: Is ANY treatment going to be initiated from this test?

Dr. N: No.

Dr. M: Then why have it?

She joins me in cheering you kicking your specialists to the curb.

Dr. Child Killer's intruction to "push the button" is priceless. No wonder no one I know has ever had useful information from a holter monitor. I didn't really realize they were supposed to "work" that way.

SharonMV said...

I'm not going to talk about the "evil and stupid doctor" as this will surely bring out my long burried rage against specialists who think they are gods. I've dealt with it in regards to myself, but I am very angry & frustrated about what is happening to you.

Work with doctor G - get him to do whatever he is willing to do to help you. And you've got a good GP who wants to help. My internist (my primary care doctor)kept me going & took care of me for years & never gave up on me.

I don't know how much of the problem is because of the health care system - trying to find & get to see specialists other that these doctors from hell. some of the problem is that Specialists don't want to work or even see outside of their own little boxes. Even those who are not basically malevolent & capable at their jobs have this problem. But some capable & mere mortal specialists to help deal with your cardio & neuro care must exist and there must be some way to get you access. A scathing letter to the press? A petition from the Friends of Elizabeth"? I don't know, but with all our minds working on it, maybe we can find a way.

The other problem is that you have something rare. Which means it's hard to get dxed & not many doctors know anything about it. Did you know that doctors in med school have been taught that they will never see a case of CVID in their entire career? But at least we know that you have something rare & the kind of doctor you need. There are going to be doctors (albeit, not many) who specialize in this rare thing, who have actually seen & treated patients, written papers, etc. So we have to find out who these doctors are & see if there is some way of consulting them. Someone who wants to see an unusual case. Through correspondence, telephone, computer videio conference. Maybe have some of your test results reviewed.(Maybe your GP could request copies of the nerve tests you had). Maybe even see them in person for a consultation. Find out if there is some neurology conference where there are papers on this topic.

By the way, I'm still outraged!

Sharon

Lene Andersen said...

He wants you to press the button when YOUR HEART STOPS COMPLETELY?!??? That made me laugh. The rest was like falling down another freakin' rabbit hole. What is it with Victoria? You only get the incompetent doctors with delusions of grandeur there?? Well, Dr. G. excepted, who sounds wonderful.

You're right. It's time for your GP to give up on assistance from specialists. The two of you (with Dr G) have a better chance of giving you some decent quality of life. Thank god, by the way, that you are as resourceful as you are. Otehrwise, that quack could've killed you.

Neil said...

If it's any consolation, the definitive test for Alzheimers is a biopsy of brain material. That's not done until both brain and heart cease functioning.

It's a royal pain when the doctor's ego gets in the way of his practice, isn't it?

Get thee hence to another city if necessary, or to the Mayo clinic or something similar. Talk to your GP and see if he can get you referred someplace that might a chance of understanding and treating you.

FridaWrites said...

Elizabeth, dear, I'm so sorry about your treatment. Your doctors apparently not only undertreat or mistreat a lot of their patients, but when people question their authority, then they see them as a psychiatric case? If only more people would question them, if only they would stop seeing themselves as gods. How can they claim to know everything if they haven't encountered MSA before? I'm feeling a lot of anger on your behalf.

What hubris, to deny you medication that obviously helps and that does regulate heartrate, only because he was not the one to prescribe it! GPs often prescribe beta blockers.

If he's putting you on a 24-hour monitor, it should record continuously *and* record events when you push a button. The other kind of monitor is an event monitor only, which can be worn up to 30 days. My concern is that doctors may assume that every time you push the button you're pushing it for the same thing, and not realize that you're pushing for any symptoms, not paying attention to the worst of it. Your GP may also be able to order a heart monitor and may pay more attention to it--I don't know if they can do that in Canada or not, but my GP has.

Lene Andersen said...

p.s. I've seen my share of specialists with a god complex (although I think yours take the cake) and can I just say? Reading about you running circles around this moron and effectively hoisting him upon his own petard was one of the most satisfying experiences of this year. Thank you.

Crip Power!! ;)

Gaina said...

<<--is beating head on the keyboard with fury and frustration.

Can Dr G and your GP get together? At least if you've got the two doctors you like fighting your corner, it's somewhere positive to start.

If the doctors in your disctrict can't help you then I think you've got every right to get them to find a doctor who can help weather they are in Canada nor N.America.

em said...

A cheerful and happy post will come, this is the one you needed to write today. I feel enraged reading what happened, enraged. And you did a wonderful job in proving that creep wrong at every turn and I cheered at the part where you asked if the test was going to make any real difference in your life. But dammit, you need a specialist! Is there research that needs to be done to find one? Can I help?

saraarts said...

"(aggressively) The Doctor in charge would know how to handle you."

EEEEEEP!

Very chilling.

cheryl g said...

Fucking asshole with a god complex!

It is time for your GP to step up and do what needs doing. Maybe he can work with Dr. G.

I am very disturbed that all these specialists are gung-ho on the neuropsych unit but can't tell you how being admitted there will help. You have a doctor admit that the results from that unit are "dicey" yet they all push for your admittance there. Seems to me they just want a guinea pig and having you in a locked ward provides them that.

You are definitely competent to make decisions about your treatment so they need to work with you and quit playing the "I am a doctor so I know best" card.

Grrrrr... I want to come over there and kick ass and take names. I also want to figure out a way to get you to a doctor/specialist that will actually do some good - even if that means having you see someone in the U.S.

rachelcreative said...

It's no wonder conditions like yours are rare - most people would not have the ability or resources to fight their corner and get passed off with second rate care and diagnosis.

Good for you and Linda kicking ass. Absolute cr@p that asses need kicking.

Hoping you're not whacked from the experience.

Neil said...

Im curious; you referred to a teenager having to wait for six months to discuss possible treatment, but you also refer to Child Killer. Putting 1 and 1 together and coming up with Pi, I can't resist asking the question "Did the teen die before receiving treatment?"

I hope that your not-so-excellent adventure with the cardiologist doesn't cause any more crashes, health-wise.

Happier note: I brought your latest post card (from Ryoan-ji Temple rock garden) to work, and my coworkers are impressed with your taste in cards. They also agree that the photo sticker makes you both look even younger than you are.

Zen hugs are always appropriate! and many are offered now.

Neil

Tammy said...

Good for you for sticking up for yourself. I found out early that if you allow the doctors to bully you, they most certainly will. Why is it that when people have some form of position of power, they always seem to bully those who they consider "weaker" or some how "less than"? I'm just speechless at the treatment you received YET AGAIN! Unbefreakinglievable.
Pffft. Don't worry about "cheery", you post what you feel and are dealing with. That's why I love reading your blog. The raw honesty.

Elizabeth McClung said...

Bear in the woods: I do too, I mean, no treatment for over a year? What kind of treatment is that?

Yanub: Yeah, it is so very hard to say no, but Linda says I am very good at asking questions to cut through the "bullshit". It just took me a year before I realized I COULD...MAYBE say no to something medical and I wouldn't go to hospital jail.

Holters record for 24 hours but I guess for two weeks you have to push the button AS the event occurs, and for me I get chest pain, feel that I am losing beats or there is a sudden "AHHHH!" feeling, at which point I would push the button and get...nothing! And if my heart stops, I am pushing 9-1-1 on the phone. Geez!

SharonMV: Yes, well, I think I will try to get my GP who HAS a relationship with Dr. G to see if he can get some questions answered and some possible treatment things done or pushed forward as possibilities since my GP wants the "expert advice" and if Dr. G says okay, I could, I dunno, have treatment of something!

The problem is that tomorrow a report is coming out from the college of physicians saying "Doctors of Victoria, stop dropping all terminal, cancer and complicated patients" - now, how many complaints do they have to get before they issue a special report for just ONE city in the whole province?

I like your idea of teleconferencing, at least to determine if the doctor and I are a match before flying out to someplace like chicago. I think we will try to fundraise (aka - sell our stuff) and then find the RIGHT doctor to get a second opinion and hope that they can explain to me what is going on, what is the likely progression and what are the forms of quality of life treatement. Isn't that pretty much what you want/or have gotten for your condition?

Lene: Yeah, I would have laughed too except....he was serious. He is also the doctor who told me to try and MAKE myself pass out repeatedly when he orderd the holter test ("becuase then it will show up on the holter test" me: "Yeah, but I'll be in the hospital?")

All the training hospitals and conferences are in Vancouver so yeah, we get people who want to retire or be the BIG FISH in the small pond - I mean, we are the capital city and have 4 heart specialists?

Neil: that's the definative test for my condition too, brain autopsy and slide of sections of the brain.

Yeah, it is just, I WISH I was a car mechanic and he brought his car in and I would take it apart and never call him and when he came back I would let him know it MIGHT be available in....15 months (hey, that's how he treats humans!)

Lene: Well, turns out the Jubilee knows ALL about him as I got a call from them regarding the two week test this morning and they were laughing so hard at some of his statements. I think they are more "realists" over there.

Gaina: I know my GP and Dr. G have worked together before so I think my GP might be able to "approach" Dr. G for his opinion on treatment options - that is what I am going to pitch as the idea to my GP next week. I don't think as an ER doctor/head of ER I can like...book appointments or see him directly

Yes, I agree, I think I need to find out how much funding I get repaid for a trip to seattle, Chicago or the Mayo.

Em: Thanks, I really didn't want the write the post becuase I was SO angry, I mean, this man didn't have the human decency to book an appointment to treat me and that is my LAST specialist, now I have NO one to treat me. And I am NOT better and the whole thing sort of hit me and made me sad and angry and so I wrote it in one go and writing takes out some of the poison, I find. So I will have a happy post today (what could be worse...no, I shouldn't ask that!)

Saraarts: yes, both Linda and I picked up on that it seemed that "controlling" me (and my BIG mouth) was far more important to a lot of people than, I dunno, HELPING me.

Cheryl: Yeah, I mean, he works in a street and drug clinic, if he can help people get off the street surely he can extend that to helping someone rather ill have a better quality of life (or I can just score some drugs in the waiting room, whichever).

Yes, if they could just tell me what they expected in clear terms from the Neuropsyh ward then I might consider it - or the proof they have that I have "conversion" - but for example, if I take IVIG, I will want to know, WHY I am taking it, WHAT are the expected outcomes and WHAT would be a good result, WHAT would be a bad result and what are the liklihood of both - this is supposed to be a SCIENCE, right?

Time for that legal name change to actually become sisters? since I HAVE US citizenship (which probably means the IRS is searching for me as we speak).

RachelCreative: I think you are saying that maybe there are more people who have the condition but who have less support and thus are just shoved in a box of easy classification. Which I think is true. I was a bit well, ready to bring down the gates of hell, but I am all better now!

Neil: Here is a secret, when medicos play mind games with me, I play it with them - I know that this doctor has repeatedly delayed very SIMPLE tests, in fact I was told by the Jubilee dept today regarding the two week monitor that if Dr. N believes that my heart even MIGHT stop, I should NOT be getting that test but advanced to further and more advanced test and treatment immediately. I know from on line comments of others that tests have repeatedly shown time sensitive need for treatment to avoid death and had Dr. N wait months and months before even a follow up to explain the test. It was our opinion that if he operated, and a patient died, he would consider that to be the patient's fault. And when I called him Child Killer, non of the staff were phased at all (meaning that it is likely not one but several children have died under his care) - the cases I know, the person on line never followed up to say if thier child had died. But, considering for example, I was denied a test for seven months becuase his staff had booked a test, not notified me and then blamed me for "non-compliance" when I didn't show up and refused to book any more tests, like heart scans. Now, if that is common practice, how many people are dying becuase of "non-compliance" or delayed tests. Quite a few.

I am glad the post card was a hit and I refuse to acknowledge that I am older than the post card makes me look! Unless that is 17 in which case, yes, I can legally drink!

Tammy: I did learn late after too much bullying, but I did learn that if you ask questions which sort of imply that the doctor doesn't REALLY know what they are talking about, then you get all sorts of concrete information becuase they immediately challenge you back and to do that they have to provide data - which is often the only way I have of finding out what the results of the test they did 15 minutes ago was. So yes, I am a wee bit wearing, but then, with him, I don't have God on call waiting so I am not as puffed up as he (I don't think God is either!)

It also was the first time I heard a "professional" specialist slag off not only the head of an ER department but other doctors at the hospital as well. Becuase I "believed" their opinion when Dr. N.'s was all that mattered. Woah!

Lene Andersen said...

Hi, me again.

"The Doctor in charge would know how to handle you."

Handle you?? Not handle IT, not handle the CONDITION, but handle YOU???

I can see why. Clearly you are a challenging patient who needs HANDLING!

(I'm going to let it go now. Well, at least try to let it go)

Anonymous said...

what a piss poor additude....

SharonMV said...

Yes, I finally got some treatment that helps and only 8 years later. Actually, we have different insurance since Dennis has changed jobs & they have been really good about paying for the IVIG which is very expensive. But if you've got CVID, it's the only treatment medically recognized. Still some people have to fight their insurance companies and those on medicare have trouble getting it.

I'm short a few specialists that I need, but mostly because I've been too sick to go get the lesser problems sorted out. And Mr. big -name research immunologist left me by the wayside, so my internist has taken over ordering my IVIG. As I already had it set up to have treatment at home, this has worked out. And she increased the dose, which he wouldn't do. But I may have to go up to UCLA & see an immunologist there - when I'm better (ha). Most helpful to me has been learning from other people with PIDs(primary immune deficiencies) in an on'line group. And info from IDF (immune deficiency foundation) for the basics. And lots of searching online & reading articles.

Sharon

Neil said...

Elizabeth, I sorta hate to admit it, but you look about 16 or 17 in the photo. And Saint Linda looks closer to 13 or 14. If either of you really looks like that photo, I'd be carding you very carefully, and I wouldn't believe Linda's ID at all.

Now, go work with your GP and get referred to Vancouver at the very least. In Saskatchewan, if they can't treat you here, Medicare will pay to have you treated in another province, or even the US if necessary. Especially during a nurses or doctors' strike.

Now, on to happier times. More weekend fun? I MAY end up buying a shop vacuum tomorrow; for that I'll need the bicycle trailer - I took the child seat out of it a few years ago, and it'll hold a couple of hundred dollars' worth of groceries. LOTS of room for hardware!

Cheers and hugs,
Neil

Raccoon said...

That sounded so frustrating. Did you tape it?

How has your research been going in getting to a doctor stateside? Have you been able to get a hold of copies of your medical records? Can Dr. G. get copies?

I've got my tickets & my hotel; now I just need to pack...

And figure out where I want to go once I'm there, tourist-wise.

Heather said...

Couple of more things to factor into the medical idiocy that you're documenting.

Many doctors are basically mechanics and get through med school on the basis of strong memorization skills and the ability to function while sleep deprived. As well, the medical community has a strong aversion to acknowledging and dealing with their mistakes. (This is a phenomenon that gets studied academically but doesn't seem to translate into making changes in day-to-day practices.)

The cardiac care system is designed to deal with middle-aged or older men. It doesn't deal well with young women. (A friend of mine had a congenital heart problem and had had multiple surgeries as a child. She got treatment from a major cardiac care facility only after she asked for her files to be transferred to another city. By then it was too late. She died after a too long-delayed angioplasty. I suspect you and she would have gotten along like houses on fire though she leaned more towards dragons than skulls. And she'd recognize the whole turning purple thing you do.)

Keep on documenting the "treatment" you're getting: it's wearing you out but it's keeping you out of the neuro ward and forcing the doctors to have a tiny tiny moment of cognitive dissonance. Not to mention that it's giving your dialog writing skills a work out.

Dawn Allenbach said...

*hugs you*

Fucking dickhead!

Sea said...

wow... and many Americans are rallying for the same type of health care.. they know not what they wish for....