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)”
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.
15 hours ago