Sorry About That

I was trying to import posts from The Bad Mormon Handbook and Destigmatize Me. There was a glitch in the importer and it got stuck on a couple of posts. That wouldn’t be a problem except that led to at least 1000 email notifications. I am very sorry about that. I think that I have the issue under control. I hope so.

Sharp & Achy

I had my appointment with a physical therapist this morning to find out what I need to work on during pool therapy. My knee that I’ve complained about on here, on Twitter, and when talking to my family is actually unstable & inflamed. Where I can stand for 13 seconds on my right leg without touching my foot to the ground or falling, I can only make it 4 on my left. She measured both knees–the left was swollen. While doing some of the tests, she found a hot, swollen spot behind my knee. She recommended a “stim” treatment1 to ease the pain from the exam. It worked really well & the pain almost completely cleared up for about twenty minutes. The physical therapist also suggested I use the modality room after pool therapy if I ever felt like I was in more pain afterward.

The PT also told me that I was walking “carefully”2 and that I was locking my knees in a hyperextended position as I walked. She said that I probably did that, in part, to prevent injuries to my knees, but it is actually damaging them. The position puts all the pressure on my joints and doesn’t rely on the muscles. It ends up weakening the joint and leads to more injuries. She told me how to fix that on my own. The exercise for that isn’t unfamiliar to me, nor is the hyperextension issue. It was one of my early hypermobile to issues. I had to walk doing plies part of the time to retrain my legs to bend properly. 

To anyone who suggested I was a hypochondriac over this or other issues:3


That’s really all that can be said to absolute assholes. If you aren’t experiencing it and you aren’t examining or treating me, then you cannot say, at all, to me that you know that I’m malingering or having health-related anxiety issues. If you don’t know what’s going on or not going on, you aren’t in any position to judge me. 

  1. It’s electrical stimulation with a non-portable TENS machine. She put a small piece of fabric around my knee and the electrodes, then a brace-like thing around that. The brace filled with cold water, so that eased some inflammation while the stimulation went on. 

  2. She said it wasn’t a limp, but that I walked like I was going to fall. 

  3. Rachel. 

I Forgot to Mention

The assessment for what I need to work on in pool therapy is scheduled for tomorrow morning. Apparently, Dottie talked to the attending or to the resident and found out that I was actually telling the truth. The physical therapy people called this morning to schedule the appointment.

In true Dottie style, she had told them that I wanted the appointment in Madison, which would be an extra 12 miles away. Luckily, I got them to change it to a nearer location. I have no doubt that other things will be incorrect when I get there. C’est la vie when Dottie’s in your life.

Outlandish Medicine

I love when people who know nothing about my life or my health decide to negatively comment on them. Actually, no, I don’t. But I do tend to like telling them off. Maybe a little too much.

From Rachel of Nottingham:

Or perhaps Dottie is just sick and tired of your never ending requests for things, and your never ending appointments and can spot a time wasting, hypochondriac!

And IT IS outlandish that you have anything done, since you don’t work and don’t pay for anything.

Go Dottie!

First, we’re going to talk about Dottie and how this happens with every single patient that has to deal with her. When she used to be stationed at the nurses’ desk, she would not do her job. There would be four people in the little waiting queue for her. It would take an hour to be seen by her and many times she still wouldn’t finish the referral while the patient was there. Not because she couldn’t, but because she chose not to do her job. She would spend her time talking and complaining and just being a pain in the ass. When she would talk to the nurses, they’d roll their eyes at her. They don’t like the woman either. The referral person on the other side of the same practice was never disrespected in that way & she was almost always able to get a referral completed within minutes.

Dottie doesn’t deserve any praise at all.

Second, if I were a hypochondriac, it still wouldn’t be acceptable for Dottie to behave this way. If anyone was going to say no to the referrals then it would need to be the doctors who want them done. And hypochondria is a recognized mental health condition. It doesn’t deserve the kind of crap that people (like you) like to say about it.

People with hypochondria are people who believe that there is something wrong with them because of how their brains work, not because they just want to be annoying. They don’t choose to be the way that they are. It’s a condition that itself needs treatment. You would know all of that if you would bother to spend any length of time reading up on it before you started throwing it around to shame and disparage people. If you can’t have compassion for people with that sort of issue, knowing the anxiety that they go through every day, then that says a lot about you–none of it is good.

From the Mayo Clinic:

When you have hypochondria, you become obsessed with the idea that you have a serious or life-threatening disease that hasn’t been diagnosed yet. This causes significant anxiety that goes on for months or longer, even though there’s no clear medical evidence that you have a serious health problem. Hypochondria is also called hypochondriasis.

While having some anxiety about your health is normal, full-blown hypochondria is so consuming that it causes problems with work, relationships or other areas of your life. Severe hypochondria can be completely disabling.

Although hypochondria is a long-term condition, you don’t have to live your life constantly worrying about your health. Treatment such as psychological counseling, medications or simply learning about hypochondria may help ease your worries.

Third, I’m not a hypochondriac. I’m not making never-ending requests. The constant appointments you’re speaking of? No. Sure, I have more appointments than a really healthy person my age, but I’m not really healthy. I have actual health conditions–physical and mental. And they are, according to experts, not internet trolls, actually disabling conditions. When I talk about my health issues on my blog, which is my right, I am talking about what I’m going through as a person with chronic illnesses that have been diagnosed by actual medical professionals, not by internet trolls.

I have Ehlers-Danlos Syndrome. I have been diagnosed with it. I have been told that I have to be extremely careful about the things that I do because of it. People with it can have regular issues with sprains. It can also impact non-joint parts of the body. I may end up having to go through some form of physical therapy regularly for the rest of my life. That isn’t because I’m lazy and putting off working or because there’s nothing really wrong with me or whatever silly idea you have about me. The need for physical therapy is due to defects in my connective tissue that are a result of genetic condition. And when you have issues like EDS, aquatic therapy can actually be better because of the type of resistance that it offers. It lowers the likelihood of other injuries. From experience, it also hurts less in general.

Again, from the Mayo Clinic:

Ehlers-Danlos syndrome is a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls. Connective tissue is a complex mixture of proteins and other substances that provides strength and elasticity to the underlying structures in your body.

People who have Ehlers-Danlos syndrome usually have overly flexible joints and stretchy, fragile skin. This can become a problem if you have a wound that requires stitches, because the skin often isn’t strong enough to hold them.

A more severe form of the disorder, called vascular Ehlers-Danlos syndrome, can cause the walls of your blood vessels, intestines or uterus to rupture. If you have vascular Ehlers-Danlos syndrome, you may want to talk to a genetic counselor before starting a family.

You know the February referral issue that I mentioned in my post yesterday? That was the resident’s decision. Not mine. I went in for knee pain. She could tell there was something up with my knee, but she couldn’t treat it, so she wanted a specialist’s opinion. That’s what doctors are supposed to do. If they don’t know what’s going on, then they send you to someone who does. The knee pain was in part from a fall I had taken last year, but it was also due to weak joints from the EDS.

The need for the colonoscopy and endoscopy weren’t things I wanted to have done. They were things I needed to have done because the hematologist, the one I see for my IDA (iron deficiency anemia) and B12 deficiency diagnoses, was trying to figure out where the blood and iron was going.1 Part of why I haven’t called my gastroenterologist to get another routine endoscopy is that I don’t want to have one done. They are not fun experiences, but they are necessary. I take 80mg of a proton-pump inhibitor and I take maximum strength Gaviscon just to quell the acid & esophageal spasms enough so that I can fall asleep. That’s not exactly a fun thing to experience. 

This request for pool therapy is to stop the injuries that happen when I walk. I’m walking to get healthier. I’m walking to make my body stronger. I’m walking to lose weight. I’m walking so that I can cut down on all those appointments. This will build up the muscles so that they can help keep my ligaments and tendons from being damaged by the exercise. 

I requested one lab in the email to the attending. One. That was for parathyroid hormone. I requested it because I have a vitamin D deficiency. Hyperparathyroidism can both cause that sort of deficiency and can result from a long-term vitamin D deficiency. It can also raise the risk of fractures and may either be a cause or an effect of being obese. I asked for the test because I thought that if that was playing any role in this deficiency or in the risk of fractures that if I caught it soon enough, I could prevent future issues. If it comes back normal, then I’ll accept that and move on.

The other tests I requested at the appointment when the PTH request was left off were B6 and D.

In 2012, my Vitamin D level was 11.5. In 2014, it was 20. My D level from this year’s test, after I had been told to take another 2000 IU per day, was 22.9. The lowest that number is supposed to be is around 25. It is best if it’s between 30.0 & 74.0. Given my health history and my mom’s history of D deficiency and fractures, I’m supposed to try to get my level up to about 50 or 60. I’m trying to at least get it to the low end of normal so that my risk of fractures drops.

Several years ago I was also treated for a B6 deficiency by my neurologist at that time. I ended up taking myself off of B6 a few years later. I decided that I wanted to make sure that my level was high enough. It’s 6.2. Some people think it should be at least 5. Others say 7. I may start taking the vitamin again or I may not. I just wanted to make sure it hadn’t dropped.

Now, if you think that my other interactions with the resident since June were me being overly anxious about some real or imagined condition, it wasn’t. I had read the lipid panel, microalbumin, and A1C results. All were high. I was asking the doctor what sort of diet would help lower my cholesterol and A1C. I was also asking if Lavaza could be used instead of statins if medication was needed. I was also asking if the microalbumin, which is a urine test, could have been a false positive because I took it while on my period. Her answers? A Mediterranean diet would help, I’d need another appointment to talk medicines, and the microalbumin level could have a false positive if taken while menstruating. She also said I needed to exercise 30 minutes per day. My response to that was that I needed to do some pool therapy before I got back up to 30 minutes a day, especially since my knees are collapsing when I’ve been exercising less than 10 minutes per day. She said pool therapy would definitely help with that. I asked about the status of that referral. She said she’d get back to me. That’s the whole interaction that went on there.

None of the tests or referrals were outlandish in anyway. They were actually quite logical in nature. Now, your behavior, on the other hand, could be considered outlandish. You were rude and showed that you really know jack-shit about my health.

I’m sure that you thought you’d make me cry, but you didn’t. I laughed at it. A lot. I also added you to the spam filter so that your lovely behavior never again graces my comment section. If you don’t know how to behave like an adult, you can click that little X on your browser because I’m not here for this sort of childish behavior. Buh-bye now.

  1. The gastroenterologist determined after the scope that the iron wasn’t being absorbed through food because of the gastric bypass surgery I had in 2003. The surgeon had cut out too much of the iron-absorbing section. 

Inside the Dottie Matrix

Dottie is a referral clerk/specialist the family medicine practice that I use. Her job is to contact other medical practitioners about referrals to their services. This can range from other doctors to labs to physical therapy. The first time that I thought about reporting Dottie to her employer for not doing her job was about five years ago. Dottie has this odd way of doing her job, which is to not do it. Somehow she’s managed to keep a job for several years despite not doing it. Her co-workers would complain about her and she would get in hours-long verbal altercations with them within the earshot of patients.

resident and I discussing the pool therapy

The latest skirmish between Dottie and me is over pool therapy. Actually, it’s not even between the two of us because I refuse to talk to her. I have my mom do it on my behalf because she can talk to the woman and manage not to get riled up. Don’t get me wrong, even my mom doesn’t like her and gets pissed at her, she’s just able to not get flustered over that anger while talking to her.

Several weeks ago I had an appointment where I asked a resident to do a pool therapy referral. The resident didn’t remember to do the referral while I was at the office, so I contacted her attending when I got home from the clinic. The response from the attending was that the referral could be made. It then turned into a conversation with my resident1 over what could be done to improve my health and blood results, but the exchange with the attending did happen. Now, Dottie is saying that the attendings don’t make the referrals because they don’t see the patients, so she’s not sure if my story is even legit.

the response from the attending over my pool therapy request

response about pool therapy

In the weeks that I’ve gone without the referral, my knee’s condition has worsened. I don’t think that Dottie realizes how important the referrals that she’s making are. I’ve not only had this issue with her over physical therapy before,2345 I’ve had it with her over seeing a orthopedist6 and over a gastroenterologist for a colonoscopy and an endoscopy.789 When my mom called after her latest surgery to get a referral from UAB to the Heart Center over the chest pain that occurred after her surgery10 and Dottie didn’t want to make that referral either. This was a referral listed on her discharge papers. Dottie didn’t care.

uab resident back and forth
even in my gmail box

It wouldn’t surprise me if Dottie “forgets” to ask about the referral or “forgets” to do the referral after she finds out that it isn’t a bullshit referral. It wouldn’t surprise me if she claimed again that she was out of the office for almost a month. At this point the only thing that surprises me is when she actually does her damn job.

  1. not the same one who forgot to do the referral 




  5. Within around three hours of that tweet, the physical therapy office called to schedule the appointment. 


  7. In that particular case, she told me that I couldn’t decide what tests I need and don’t need. I told her that I wasn’t the only person requesting those tests be done on me. 

  8. As someone who’s had several endoscopies due to GERD since middle school and has to max out on acid reflux medicine, endoscopies are kind of a routine part of my life. It’s not outlandish for me to have them done. 

  9. I ended up being the person who called the gastroenterologist to find out if they took my insurance and calling her back to let her know that she could make the appointment with them. In other words, I did her job for her. 

  10. along with the blood clot in her lung 

Get A Location on That

Mom’s heel is doing much better than it was a few weeks ago. The last of her stitches were taken out on Thursday. She’s still banned from putting any weight on it for a few more weeks. But she’s healing pretty well. 

Dad started physical therapy a couple of weeks ago for his shoulder & is already doing better. It’s been awhile since he injured it,1 so he probably doesn’t think he’s healing quickly. But he doesn’t seem to be in as much pain as he once was. 

So the two treated dislocations are doing better.

That leaves my knee’s sloppy subluxation as the only one getting worse. 



No. No. No. 

I can’t go for walks with it like this. It gets worse every time I do. Even if the walk is only a third of a mile or so. That’s literally down the street and back. Not far at all. At first, I could pretend it and the knee-buckling weren’t all that serious. When the swelling and subluxation became obvious to anyone within ten feet of it,2 it became significantly harder. Of course, that’s mainly due to the actual pain, which has been pretty constant3 since last Monday’s walk

Pool therapy might help if I try to avoid making it any worse. That means actively avoiding the walks. Even with the pain, I want to walk. I keep having to remind myself that walking with the pain & injury could lead to permanent damag. Permanent damage could lead to surgery. So I’m waiting for my pool therapy referral & for my months-early rheumy appointment. Hopefully the PT & doctor will work some magic on me. 


  1. about as long as it’s been since mom’s last heel fracture 

  2. aka not all that close 

  3. and worsening 

Bad Blood (Vessels)

When I was in the lab, I told the phlebotomist who called me back (before she started) that both sides were equally bad. I guess she thought I was kidding, so she got a normal (non-butterfly) needle. She got so excited when she found a vein in my left elbow and she finished getting her supplies prepared. 

It wasn’t long before she realized that when I said bad, I meant horrible. She switched to the smaller (blue) adult butterfly and tried for the same vein on the opposite side. And guess what happened?! Nothing. Well, nothing except the pain of her digging in my arm with a sharp implement. 

She told me I was being nice & most people don’t behave that way when they can’t hit them. I told her I expect it on any draw. (I do.) I also told her that I would be her toughest case this week. It wouldn’t be a jump to say this month or this year. Even saying of the person’s entire career wouldn’t be exaggerating. 

People remember my veins. 

Anyway, she had another person come in & she found a viable one on my right hand. They told me to say go in the hand the next time, which might sound like good idea except that they really aren’t any better than any other spot. The only thing consistent about any vein on my body is that it will be a hard vein to stick. 

I just wish that phlebotomists & others who stick me would realize I’m not joking or taunting them about my veins. If they’d go into the blood draw in the mind frame that this will be hard & they need to be more cautious, it might take fewer people to do them.1

Anyway, I hope that they got enough blood to do the test. 

  1. This isn’t me speculating. You remember the part about people remembering my veins? When they do, they’re more careful & can usually hit them more easily.