What Next?


 

Some Drs have the bedside manner of a water buffalo, even when they’re smiling like an angelic kitten.

I can’t tell if they’re truly that oblivious to the havoc they reek, or if they’re actually so jaded that it just doesn’t matter to them anymore. If you’re ever in any doubt about the interaction between physicians and the drug reps, let me tell you that I watched mine being schmoozed as I left his office today in a shocked stupor over bad news about my heart. He saw me shedding tears during the visit, yet offered no comfort. He heard my questions about whether it was controllable circumstance or losing the genetic lottery that put me here, and gave me no real answer. He couldn’t even give me a genuine answer about what the information meant to me prognosis-wise. It was like you have this, you can’t do anything about it, take this pill or it will get worse no matter what. Gee. Way to be encouraging.

There was no acknowledgement of the 7 lbs. I’ve lost. He refused to see my blood pressure drop from 156/90 to 140/80something (my brain is a little fuzzy after all that) as an improvement. His exact words were, “It hasn’t improved. It’s still high.” Add to it that when I asked if continuing to lose weight and improve my BP would help, he said it won’t make any difference for the condition… it was completely demotivating. It was like well screw it, what the hell am I working my ass off for then? A person really starts to wonder how many patients leave a Dr visit with bad news that end up a suicide statistic as a result. I mean, shouldn’t they have trauma counselors for post-visit fallout? I’m normally very pulled together in my appointments, which is some work with the anxiety disorder I live with. Point being, if he’s used to seeing me in a good mood, interactive, and making sense, and has just reduced me to an indecisive, teary-eyed, distressed mess… maybe he should take a minute to repair the damage. Nope. Sent me on my way.

He wanted to start me on Beta Blockers to get my blood pressure down. Apparently I have cardiomyopathy, and left ventricular hypertrophy. All that means is a change in the shape of my heart that is reducing it’s efficiency to pump, and the ventricle is enlarged to some degree.. how much I don’t know. I remember hearing this number of 45% and my stunned brain couldn’t absorb whether he was saying that was what I was functioning at or how much it was reduced… but either way it pretty much means half capacity. I’m having a hard time swallowing that you can get that kind of accurate assessment from an echocardiogram, but have not yet spoken to an expert to know for sure. I’m having an even harder time swallowing the idea that I’m that diminished but functioning as well as I am. In fact, I feel better than I have in a long time in some ways. I will admit that I complained to my former physician at Kaiser about chest heaviness, feeling like I wasn’t getting enough oxygen circulating, and asking if it could be related to the heart palpitations I’ve had my whole life. She brushed it off and said I was just obstructed and gave me a refill on my Albuterol. I kept telling her it didn’t help with that but she didn’t seem to care. So I know something has been going on for a while, no question. I just can’t buy into this 45% bit.

Who tells a patient that they have no control over their health and then sleeps at night? He could have said yes, absolutely exercise and continuing to eat right as you are will improve your heart health… even if it won’t make the condition go away. Yes, it’s good that you are losing weight, great work! That’s part of a healer’s job, isn’t it?! He gave me no options, and even said “There is no natural solution.” Nothing to discuss… and on top of all that, didn’t even suggest seeing a cardiologist. Am I on crack, or shouldn’t a genuine heart condition warrant seeing a specialist? What did I miss here? This guy is so freakishly paranoid about blood pressure, it seems he will use any excuse to terrorize you into taking a Beta Blocker. I sat in my car and sobbed. I went home and cried some more. I had a meltdown that made me question whether I was going to make to it class today. I spent an hour on the phone with my father who, God bless him, has bothered to research this subject intently due to his own health disasters. He put it in perspective for me a little and agreed with me that the Dr’s presentation was crass and full of inaccuracies. I got further reassurance from my instructor after class, who told me he wanted me to relax. He’s right, of course. Stress is a genuine killer.

It’s amazing that my own physician, who is supposed to be making sure I’m in good health, did nothing but add to the stress I’m supposed to be avoiding. With a smile. It looked like a friendly exchange, if you’d seen it. The whole thing was bizarre. I felt more insulted as each hour passed through the day. At this point, I just feel like he’s a closed-minded idiot. His knee-jerk method of doling out meds for every twitch in a patient’s blood pressure is starting to get on my last nerve. I know why too. He lost someone. The thing is… THAT person was in renal failure. Of COURSE their BP was high. His friend’s death had nothing to do with what 90% of the people he’s treating are living with. You can’t practice medicine from that kind of a place. It makes you weak in communication and nothing resembling objective.

Oh, and by the way… my thyroid is NORMAL. Yeah, I had one result that was barely outside standard range a couple of months ago – first time ever. He wanted to put me on Synthroid “right away”, and I said no. I said retest in a couple of months. I had just come off a round of Medrol for a flare, and steroidal meds can suppress thyroid function. I told him that but he didn’t believe me. Well… it’s normal now, and a radically different reading. He would have had me on an unnecessary med and then adjusting it all over the place, trying to make it work, making me sick in the process! He’s like quick draw with the pill bottles, I swear. I’m beginning to think this is not the right Dr for me. I like something about his personality, I swear I do… but his views are not convergent with mine. I’ve had holistic, naturopathic oriented Drs in the past and it is a much better working relationship. I just don’t know if I can make it work with this one. *sigh* I’m trying. I really am.

I wasn’t as distressed by a Lupus diagnosis as this. Is that odd? Maybe because I already had a solid education about it by then. This came out of left field and flattened me. What now?  It’s no wonder there are so many lawsuits.

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About Tala

-Livestream Broadcaster - Active in Periscope & Busker -YouTube, Twitter, Instagram, & Facebook Pages www.talanoexcuses.live Advocacy for better quality of life with catastrophic illness & injury. Conditions I live with myself are my awareness platform: rheumatic autoimmune & neurological, women's heart disease Traditional First Nations (Native American) -Training: Tai Ch'i Chuan, medical terminology, cultural Medicine -Avid about hiking, camping, & outdoor adventure Special Interests: Natural health, everything from East Indian to East Carolina cuisine, 16th Century German fencing Favorite Travel Spots: Yosemite, Catalina Island, E. North Carolina, Northern CA redwoods/coastal rainforest ~I live as naturally as I can, stay on a whole foods diet (as in what I eat, not as in "a diet"), avoid as many synthetic meds as I can, and do not consume artificial sweeteners and most preservatives. If you're curious about why, see my posts.~ Periscope/Twitter ID: Tala_NoExcuses https://badges.wegohealth.com/ha-awards-2016.js?referrer=Owb2x2Nb8L81mhJHyfwGcg

Posted on May 24, 2011, in Uncategorized. Bookmark the permalink. 1 Comment.

  1. I’m pasting this for Donna Niforos. If anyone has trouble finding the Leave a Comment prompt, it’s at the bottom of the Blog posts – a little smaller and less obvious than my old format, but it’s there.
    Tala
    ___________________________________________________

    Some doctors are simply jerks. There, I said it right at the beginning. I worked with some doozies let me tell you but some of them, despite their demeanor, are incredible, knowledgeable doctors. They have great personalities, but come short because of a fear of getting attached to their patients. That is when nurses are supposed to step in. As a nurse we are trained to be that person who will put an arm around you and who will comfort you. When I was in nursing school, I worked in a doctor’s office to pay my bills. I had a patient who was elderly and had severe emphysema. At the time it was ok to smoke in a doctor’s office and this may shock you, but this doctor smoked cigars in the office. One of the medical assistants smoked cigarettes in the office and I was constantly hiding the packs she left around to attempt to get the idea across. Anyway, this dear man had such trouble breathing and he was to be led into the doctor’s own office, you know the one that has a desk and pictures of his family? As he walked in there was the doctor smoking his cigar. The room was full of smoke and now I was supposed to bring this patient into this polluted space? I don’t think so. I asked the patient to please have a seat near the assistant’s area and I went in and suggested that it would be harmful to have the patient in this room. The doctor was stunned. He didn’t get it! What the…? So I stood my ground, knowing full well I could soon become unemployed, but finally he said he would put out the cigar. I stayed persistent and said the room was unfit to use with an emphysema patient. And finally I prevailed and it was just a little thing to make the patient more comfortable.

    I have been in doctors offices where the medical assistants are very competant, they care and they are friendly. Had you been in an office like that you would have been attended to by a caring person who realized you were distressed after your visit. Had you been my patient I would have put my arm around you and asked you what was wrong. I would have listened to you and I would have had the doctor see you again. You might have had to wait a bit, but your problem would be addressed. That is what should have been done.

    Having said all of that, blood pressure is a big issue in healthcare. The more information that comes out the more doctors have learned that even a slightly elevated b/p causes damage to your body. For that reason they want and need to bring your pressure down. But having already dropped a significant amount from your previous visit, you should have been praised and encouraged for that and for the weight loss. And let me tell you that losing weight very often drops your pressure. So whatever you are doing, continue doing it. It is the same thing with diabetes. Having diabetes, type II, can easily be controlled by weight loss. As for type I, it is more difficult, but most doctors don’t really explain the damage that any type of diabetes can cause to your body. They forget that just because they know, the rest of the world does. That is why it should be encouraged to have a medical assistant give instructions on the proper use of a glucometer and while doing show, give the patient a little scare as to what could happen if they neglect to follow a diet and keep their blood sugar under control. More people die of the side effects of diabetes than any other disease I can think of. It takes its time slowly clogging all of your arterries and veins, and sooner or later the patient’s eyesight begins to decline. Some become totally blind. And why? Because lack of information that allows the patient and their family to understand exactly how serious diabetes and hypertension can be.

    This blog reminds me of an occassion where I was seen in one of the Doc-in-the-Box kind of office. You go in without an appointment and wait to see any doctor avaiable. I don’t remember why I was there, most likely another bout of bronchitis on a weekend. Anyway, as I was leaving a young woman came in. She was dishevelled and crying and the people who were the receptionists kept asking her why she was there. Many thoughts entered my head. Was she raped? beaten? did she just learn that someone died and she was having a problem coping? All of this could have been addressed with the simple act of kindness that the receptionist could have extended. There was more than one, she wouldn’t have left the desk unmanned. But instead she kept saying we have to know the nature of your problem. All the poor woman could do was cry. I was there, trying to make another appointment and I just stood wondering what to do. She was so very upset and I wondered if
    maybe she was contemplating suicide and was coming for help. No matter why she was there she wasn’t saying in front of anyone and the receptionist just kept repeated the blasted “what is the nature of your problem?”. I turned around and saw her walk back to her car. I tried to catch up to her and see if I could help her but she flew out of the parking lot. These many years later I still wonder if she was ok and I wondered what it was that was so upsetting to her. She sure didn’t get any help from the staff representing the doctors in the place. Their job is crucial, it is the beginning of the experience you are going to have at your doctor’s visit.

    Doctors without bedside manner. That is the issue. For the most part I have had good experiences. I don’t know if that is because I am a nurse, if I know how to handle them, or if I have simply been fortunate. Even the doctor who replaced my knees, has a terrible reputation for awful bedside manner. He is brilliant and he knows it, so I don’t get offended by him, instead I help feed his ego. He loves it! His usual visits include him telling you that either your case is simply too mild for his talents or he tells you that he is the only one who can help you. And so by stroking his ego, he sticks around loving the praises, and I get to ask all of the questions I want before he hurries out of the room. It is like interacting with a child. It is a rediculous thing to have to do, but it works. And quite frankly, it works with many doctors. I know that is a sad statement but it is true. There are the doctors who truly care and who have known me
    long enough that I get a kiss to begin my visit. They know my story, they knew my husband who always accompanied me to important doctor visits, so they are therefore very personable. One of my surgeons actually sent flowers to the funeral home when my husband died. To top it off, he is a great surgeon with incredible credentials. He does more than treat your problem, he recognizes that you are a person who will be effected by his recommendations and that your family will also be effected.

    So why aren’t all doctors like this? For the most part they are burnt out. I am not making an excuse for them, I am stating a fact. There is no excuse for doctors who do not treat their patients like a person with feelings. It is inexcuseable and I have seen patients leave offices without a clear understanding of their condition. That is bad medicine any way you look at it. There is no reason and no place for bad medicine. I am a fortunate patient, I have good insurance and good doctors. There are so many people who have none of that. I fear the new insurance that is suppposed to help us all, will not be the answer. I have researched medical coverage in other countries and most people are not happy with it. They may be able to see a doctor for “free” but believe me their taxes are paying for this “free” medical care. Not to mention the time they lose waiting to be seen. Free? What about the hours they have lost at work? Isn’t that part of the cost of their “free” medical treatment. I believe this isn’t the answer. I wish I had an answer. I think we need an incentive for people to go on to medical school. The government can help fund that and the overworked doctors who spend countless hours working might be less grumpy if they weren’t so tired. But when a student enters medical school he is looking at probably a quarter of a million dollars in education. He/she gets through their medical school and go on to intern where they work 18+ hours a day, skipping meals and catching a few winks if they are lucky. They are expected to attend to be patients and have a life? So many can’t cut it and it has been proven to be unsafe for the intern and the patient. More people die in hospitals not from people who aren’t qualified, but from doctors who make mistakes because they are exhausted. If the patient is lucky, a good nurse may catch them before they kill their patient from administering the wrong medication. That is another problem. Doctors order medications that need administration by a nurse. Sometimes the nurse will catch the error before they actually administer the medication, sometimes they won’t.

    Ok, enough. I hope I have provoked some thoughts that will prompt an addition to this message. If not, I have gotten alot off of my chest and I thank you for that.

    Donna Niforos
    ____________________________________________________

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