Tag: stupid doctor


Jesus, Wheelchairs, and Radiology

15
March

On Saturday, I fell. No big deal, right? I wouldn’t have thought so, except that when I fell, my left foot slammed down on the ground. My toes started bruising almost immediately, as did many other places that didn’t even hit. My mom tried to get me to go to the ER, but I didn’t want to. Going to the ER generally leads to a 3-4 hour wait, a possible trip to radiology (isn’t always a guarantee for me), and then a rude dismissal from the staff (about an hour and a half after being taken to the back–if I even get that far) because I’ve ended up wasting their time.

‘My foot would get better’ was my initial thought.  I fall quite a bit, and usually I’m okay within a few days.  Instead, by Sunday, the bruises and swelling were worse, as was the pain.  I was also having some stiffness in the joints that connect my toes to my foot.  Still, I didn’t go to the hospital.

On Monday morning, I called the UAB Clinic folks so that I could see my family doctor (or another family doctor in the clinic).  Well, I just so happened to call on the day that at least 2 of the doctors who were scheduled had decided to take a sick day.  (I’m sure they didn’t just decide to take a sick day, and that they were actually sick.)  So, they were too busy for the staff they had and couldn’t see me.  Instead of saying that they would see me another day, they told me that I needed to be seen ASAP.  Well, before they could say where I could go, they had to know what insurance I had.  I told them it was Medicare & Medicaid.  Apparently, none of the walk-in clinic are into the whole Medicare-Medicaid combo, so the only other place to go was (cue dramatic music) the ER.

The ER on a Monday is not the best place in the world to be.  It isn’t necessarily the worst, but it’s pretty damn close to the worst place you could be in town.  I went in and, after filling out a form where I put the symptom as “left foot & ankle”, was immediately triaged, which wasn’t necessarily a good thing.  From the first nurse in triage, everyone ignored the foot part of the symptoms and just focused on the ankle.  I thought it was weird that they would do that, though I don’t know why it would surprise me.

After being triaged, I sat in the waiting room for another 3 hours.  I got to people watch, which was fairly entertaining, but not exactly what I wanted to be doing.  There were some interesting people there.  A guy was sitting across the room, under one of the HD televisions, laughing and talking to himself.  My dad and I tried to figure out what to call the guy.  (Please don’t tell me that it is rude to talk about people in a waiting room.  This can sometimes be the only source of fun when you’re in a waiting room.)  We debated between Charlie (for Charles Manson), Jesus (for, well, Jesus Christ), and some others that were related to the guy’s main look–long, wavy-ish dark brown hair, a dark beard, and a look of being in touch with something “else”. We ended up calling him Jesus. My dad thought the guy was probably just crazy.  I thought that he was probably high, but might also have some craziness.  I regretted referring to him as Jesus later, because though I thought that Jesus might wear acid wash jeans and a matching jean jacket, I didn’t think he’d wear sneakers.  (Jesus would definitely wear sandals.)  There was a group of people that we (and a lot of other folks) paid attention to as we waited.  It was a group of about 10-15 people, who, among other things, were very loud.  The security guards chastised them at one point for being so disruptive.  They tried to bum-rush the back to see their friend, who had apparently been beaten up.  Of the five or six people that were part of that rushing past the door when it unlocked for one or two to go back, only two were allowed to stay back there.  Apparently, the ER rule of two visitors per person was lost on the group.  Though this group of people had gotten there at the same time as me, they left about an hour ahead of me.  The only employee that we ended up watching was one of the security guys who’d rolled me into the ER.  He was confiscating any wheelchairs that had been abandoned, even if the person was in the bathroom.  I made sure to hold on to my wheelchair.  (I’ve learned that the staff doesn’t take hurt feet very seriously if you’re not in a wheelchair.)

By the time I was finally allowed to go back to a room, everyone who’d been there before me was already either seen and discharged, seen and waiting on a diagnosis, or had given up on the process and had gone home.  Several of the people who’d come after me ended up being seen before me.

When I got to the back, they kept talking about my ankle, even when I showed them where on my foot I hurt.  I found out that x-rays had been ordered about 2 hours earlier, but that there was a very long wait for the whole hospital to get seen in the radiology department.  (I didn’t understand why they couldn’t send people to one of the other connected facilities [via the tram] that has a radiology department, but apparently that wasn’t a possibility.)  The doctor, who I saw for a grand total of ten seconds, just told me that it was taking forever to get the radiology department’s attention.  A few minutes later, a radiology tech (or someone from transportation) took me down to the department.  I, then, waited for about 10 minutes for someone to wheel me into the room for the x-ray.

The x-ray was done on my ankle, which I was really perturbed by, but I couldn’t get across to anyone that the brunt of the fall had been “absorbed” by my foot.  (I had, by this time, learned that you never give too much information on those little sign-in forms.)  So, after the x-ray was done, I was taken back to my room.  There had been a shift change in nurses while I was in radiology, so I met my nurse at about the same time that the nurse practitioner came in to tell me that my ankle was fine.  My father and I gave him a weird look that should’ve given him a big clue that my ankle wasn’t the part that was really hurt.  (This is why physical exams, which had never taken place, are important in diagnosis.)  He asked what was wrong.  I said that my foot was the problem.  He said that he would check the x-ray again, but the ankle x-ray usually shows the foot.

That is what a standard ankle x-ray shows.  That little area of where the foot meets the lower leg.  That probably hasn’t changed since I first started getting ankle x-rays over 10 years ago.  That kind of view doesn’t show the part of the foot where the toes (phalanges) meet the foot (metatarsals).  It barely shows any part of the metatarsals at all.  It shows the tarsals, aka the ankle.  If an ankle x-ray was the same as a foot x-ray, then there would be no need for calling them different things on forms and there would be no need for different views.

Well, the nurse practitioner, who was sure that the x-ray showed the right part of my foot, was proven right–though, this happened while he was out of the room and with no input from any other medical professional.  I could’ve complained and refused to leave, because I’ve done that before, but it generally ends with the doctor or a supervisor coming in and defending the position of the staff member who made the shoddy call.  (Generally, it is a call made by a doctor who hasn’t been attentive or this particular nurse practitioner–I think he may have been part of the team that made the decision with my mom’s first ankle break to send her home over the weekend, even though she couldn’t bear weight.)

Now, I know that nurse practitioners can do a lot.  And I know that they are generally really good at their jobs, but this guy didn’t do an exam and acted like there wasn’t really anything wrong.  And his end diagnosis?  My foot is bruised and I have a sprained toe.  I’m not exactly sure which toe is sprained, since 3 of them have been in a lot of pain and 1 has been in a bit less pain than those 3.  Only one hasn’t had any kind of pain, bruising, etc.   On the discharge orders, I was told to take Tylenol for the pain, because I guess it works better for pain than Tramadol.  (That was sarcasm.)  I was also told to follow up with a family doctor.  The discharge orders were signed by the same doctor who’d spent 10 seconds talking to me, and was also the same doctor who (on the day my mom had to come back in with the first broken ankle) had written me a prescription for Ibuprofen (can’t take NSAIDs) and spent 10 seconds with me and all of the other poor end-of-the-spectrum pain cases in the same room.  Of course, that day I didn’t get an x-ray, which I kind of feel like I didn’t get yesterday–except that I know that I did get one, even if it was the wrong one.

The Huntsville Hospital ER has really gone to shit.

Comment » | General, How I Met Your Neighbors (aka An Overactive Imagination), Rants, Sickness and Health

It’s Not All in My Head

23
February

I’m sorry but I must disagree with your assessment of the visit. I took a full history, reviewed available records and did a complete rheumatologic physical exam (which I know is more detailed than most). I ordered appropriate labs and all they are returning normal and negative for rheumatic disease. I am aware that you have musculoskeletal pain and I acknowledged that but I have no treatment for chronic undifferentiated pain syndrome. I have been practicing for > 30yrs and this has allowed me to be more efficient in my evaluations that most. Again , I would recommend that your MD have you evaluated by a pain specialist.

The exam wasn’t complete. Going through the motions isn’t a complete exam. The appropriate labs probably wouldn’t be back by now, since it generally takes more than 36 hours to get lab results back on anything other than simple tests. Pain is not the same as inflammation and it isn’t the same as all of the dryness going on everywhere. The syndrome that he mentioned in the email, which wasn’t mentioned at the appointment, is (from what I can tell) a somatoform diagnosis–meaning that it’s all in my head. So basically, I hurt, feel like crap, etc. because I’m a nutter.

The last time that a doctor diagnosed me with a somatoform illness and stuck with that diagnosis was when I was 13 and I was having problems with my gallbladder. That doctor thought that I was just really anxious and causing the stomach pain. She continued that stance after the surgery to remove the gallbladder. So, I don’t really take stock in doctors who outright say that it is all in my head. And if it were a somatoform issue, then you know what the treatment is? Therapy and anti-depressants. What have I been going through on near-constant basis since I was 16 and off-and-on since I was 13. Yeah, those two things.

Now, it could be that I’m just crazy, but I really don’t think so. (I know that’s supposed to be part of the whole diagnosis with the problem.) I just don’t think it’s possible for me to fake this much stuff. I think it’s more likely that the doctor is just an arrogant ass who didn’t care to look into what might be going on.

4 comments » | Confessions, Rants, Sickness and Health, So Damn Special

Sometimes People Suck

21
February

Well, today was the much-hyped trip to Birmingham for my new rheumatologist. Unfortunately, it was a bit over-hyped. I got there early, and was taken back right away. That part was pretty cool. My mom went with me, which was a nice change of pace. There was no checking of vitals, which was a little concerning.

Mom and I waited…and waited…and waited. Eventually, the doctor came in. He asked a few questions, frowned at the incredibly thin records (explained below), had me change into a gown while he left the room, had me sit on a table that was about 18″ off the floor (too close for my legs), barked out orders about how to breathe for him (2 deep in and a few shallow–no breathing out, no real listening), looked at my eyes for a minute, did strength testings on my hands, checked a little of my range of motion, looked inside my mouth for a second, told me I didn’t have Sjögren’s (or Lupus or any type of inflammatory arthritis), said he was going to order some tests, said that I should see other doctors instead of rheumatologists, was uninterested that I’ve been having near-fainting spells lately because my heart is getting more out-of-whack (I know he’s a rheumy and not a cardiologist, but still…), told me that for those spells I should see a neurologist (which given that they’re related to pulse & bp is kinda nuts), and left. Five minutes. Those five minutes that I had traveled for 2 hours to Birmingham for. Those five minutes where he told me that anything I had previously been told was true was now considered invalid. Those five minutes that I’d actually kind of looked forward to since I figured I might actually find a rheumatologist that spent more than 5 minutes and actually listened. Those five minutes were basically ones that I wished I could have back for the next hour and a half, as I went from crying to stunned silence to horrifyingly bad migraine with a numb cheek (which happens with some of them).

I cried when I was handed the lab sheet from the nurse. I lied and said I was fine to her. I cried as I went down to the admitting office. I cried as I filled out the information. I lied and said I was fine to the receptionist, too. I cried when I was having blood drawn, which freaked out the phlebotomist. (She hit the vein on one stick and didn’t leave a mark, so kudos to her.) She tried to get me to calm down. My parents tried to calm me down, too. I sat in the backseat and cried until we got to the Rest Stop. I finally told my dad what had happened, though my mom might have told him earlier, since I hadn’t really been much for talking for a while. I was almost back to my normal semi-melancholy state by the time we had lunch in Cullman.

I tried to remain a bit more positive on the rest of the ride home, and when we got home, I promptly made a list of every doctor that I could remember seeing since I was a small child. I found the addresses and phone numbers, and I found the fax number for some of them. I then found the rheumatologist’s email address and sent him the list. I also wrote a letter to him.

This is Janet Morris. I saw you today at the UAB Highlands Clinic. You commented that you didn’t have any blood work or any medical records other than what UAB’s Family Medicine Clinic in Huntsville sent. I have attached a list of every doctor that I have seen since I was about 6 years old. I would have gathered the medical records, lab reports, x-rays, imaging studies, etc. that I had done over that time period, but I didn’t have the money to pay each doctor for a copy of those records. Your office, on the other hand, can request these and get them for no charge. I have also attached the blood results from a blood test that was run by ************, my neurologist, in June of 2010.
I don’t know if you were having a bad day, if you were upset at the lack of records, or if you are normally that short with patients, but it seemed like you felt like I wasn’t worth spending any time checking. I know that it makes your day harder when patients don’t have a complete history with them, but that doesn’t seem like a reason to spend 5 minutes and automatically dismiss their history. You didn’t bother asking if I had anything more than dry eyes or joint pain before telling me that I didn’t have Sjögren’s, Lupus, or any kind of inflammatory arthritis. I have dry mouth, anhidrosis, and a rash that comes and goes pretty regularly. I also have a normal temperature at 97 or lower, unless I’m upset, sick, or go without water or eyedrops for more than 1-2 hours, at which time my temperature goes to 99 or 100. The fainting thing that you recommended I see a neurologist about was actually due to my heart rate going to the upper end of its normal level (which is typically between 95 and 145 bpm) or my bpm going up to about 100/140, which is far from its normal level of about 100/60.

As my list shows, I have seen multiple doctors over the years. Some have found problems. Others have been dismissive towards me. I had been going to see ****** who thought I had Sjögren’s, Fibromyalgia, and Joint Hypermobility syndrome, but he recently started acting like I was a waste of time, so I thought I’d try UAB’s Rheumatology department.

If you could at least try to get the records and look them over, I would appreciate it. If this is just another waste of time, then I’m sorry, but please at least try to figure out what is going on before you completely dismiss me.

I doubt that the letter will do any good except maybe brand me as a total nutjob or a hypochondriac or something, but I am so sick of going to doctors and having them just ignore me or say, “Go somewhere else.” It would be one thing if this was a rare occurrence or if this had happened in town, but this happens at the majority of places now. It happens with specialists, some of the UAB family medicine doctors, and (worst of all) when I go to the ER. (The ER likes to put me with the drug-seekers or just give the minimum care.) I am pretty much at my wit’s end when it comes to this kind of stuff.

Oh, and when we got back to Huntsville, my mom had my dad go by Sonic to get the Red Velvet Cheesecake Blast that I had asked for for my birthday. (It had been forgotten before, so we figured today was as good a time as any.) When we got there, the Sonic person said that they were no longer making them, but they made a Red Velvet shake instead. (No cheesecake or whipped cream.) So, the one thing that I had asked for for my birthday was not available.

Today, for lack of a better word, sucked for me.

2 comments » | Alabama Weirdness, Confessions, Family, General, Rants, Sickness and Health

The Idiocy of a Medical Professional

27
July

I got a call today about my sleep study results. Apparently, I have “mild to moderate sleep apnea” and need CPAP. They gave me some of the basics on my sleep apnea: 10 apneas/hour and 89% oxygen saturation. I’m also asymptomatic. Now, I did a little research. While 5-15 apneas constitute mild sleep apnea, you should typically have 85% or lower saturation. For CPAP to be used in mild cases, you should have something else…SYMPTOMS. I don’t meet the qualifications for the damn machine that they’re going to make me wear for 2 weeks. UGH. And the thing is that I have to wear it for those 2 weeks to appease this idiot of a man. I have to wear some stupid machine because he has different standards than freaking experts in the field.

And what about the fact that it can take HOURS for me to fall asleep? Oh, well, he didn’t diagnose that problem. Or that I never actually seem to be unaware of what’s going on in the middle of the night when I try to sleep at night? He didn’t address that. My brain does not shut off at night. This is not sleep apnea stuff. This is circadian-rhythm disorder stuff. Of course, I can’t tell him all my symptoms for that because he’ll chastise me for not wanting to sleep “normal” hours. (Personally, I think it’s BS that people HAVE to sleep at night. If my body was programmed to sleep in the day, then who can say that that’s wrong?)

And you know what’s really bad about this whole thing? If I don’t have sleep apnea bad enough to require this treatment, then I’m being treated for no reason. Then, if I have a circadian-rhythm disorder, and I’m not being treated, I have to endure rudeness about my sleep-wake schedule AND I might possibly be on psychotropic medications that I could be taken off of because I might not actually be as insane as was previously detected. (Delayed sleep phase syndrome can commonly be misdiagnosed as mood disorders and schizophrenia.)

1 comment » | Mental Health, Rants, Sickness and Health

I’m back, I’m back

26
June

Sorry I disappeared. I tend to do that when I’m depressed or manic or something really crappy, but I’m neither. I can’t really explain the feelings I’ve had lately, I guess they’re just run of the mill human ones that people go through on a daily basis. My mood has only been an issue when I’ve been in really bad pain or really tired.

I disappeared to start because I was reading. Then I started staying up at night and sleeping during the day. I found out, by doing this, that I was in less pain and had less of a mood issue than I did by doing the whole normal circadian rhythm stuff. (My therapist and new neurologist think this is a bad idea.) I also found out that my mom was lonely, and that she liked it when I stayed up but stayed off my desktop (the laptop is okay because she can still see me). Well, staying off the desktop keeps me from the internet, so I had to choose between my mom’s well-being and the internet…as I often do, I chose my mom. (She’s sleeping right now.)

I have new doctors and diagnoses. First, the new psychiatrist. Well, actually, this is my second time around with her. She was my psychiatrist before the wonderful people from the A&M Social Work department decided to go to that psych appointment and scare/agitate me so bad that I almost got locked up in a ward. She’s pretty nice, but she believes that my psychiatric problems would all get so much better if I lost weight. When I tried to explain to her that this was a lot more difficult than she could imagine because of my PCOS, she was like, “Well, if you lose weight, that’ll clear up.” That could be true, but it doesn’t make it any easier to lose the weight, when part of the crap that causes that is what makes me keep on the weight to begin with.

Second new doctor: new neurologist. Actually, he may be a repeat of one I saw when I was in high school and my hands were always shaking. (Before I went off the deep end.) He did a neurological work up on me, and determined that:

1. My twitches that I went to the past neurologist for are either myoclonus issues or are because I’m just almost going to sleep and they’re waking me up. I think it’s probably the former since they can happen when I’m wide awake.
2. I have myelopathy (possible spinal cord injury/problem). He doesn’t know what is causing this but he sent me for an MRI on Monday.
3. I may have sleep apnea. He referred me to a sleep specialist.

This brings me to my third new doctor, who actually isn’t a new doctor. He’s my old pulmonologist. He has me scheduled for a sleep study and from what he heard of what I said, he thinks I have obstructive sleep apnea because of my “loud snoring”. The thing is that I don’t snore loudly. When I snore, it’s very quiet. And he’s already determined that he will treat this issue that we don’t even know that I have with a CPAP machine, which is just absolute crap because I’m not going to use one of those things. I would rather use one of the alternative treatments IF that is my problem.

I’ve had to go off my Depakote. Actually, I’m doing that today. Instead, I’ll be on Lyrica to prevent my migraines. Of course, aside from the fact that the Depakote had quit preventing migraines, its ineffectiveness was causing me to twitch like crazy. I was also gaining more weight on it. (I had a time where I wasn’t gaining weight in the past few years, and that time was when I wasn’t on the Depakote.) I asked the headache neurologist to put me on Tegretol. He of course chose Lyrica instead. This will probably help the pain, which is what I should hope for, but honestly, I was kind of hoping that I’d get put on the Tegretol since I know that in my family it helps the problems and it causes weight loss for us. Lyrica tends to knock members of my family out and causes weight gain. I don’t need those side effects.

Also, because my wonderful Part D insurance won’t cover Frova when I have migraines, I had to ask for a different migraine treatment (the Lyrica is just for prevention). My doctor has decided on Maxalt, which is probably going to do the same thing that the Imitrex did…cause my face to get cold, then hot, then cold, while the pain gets worse, difficulty seeing, plus the horrifying pressure until I cry and have to go take something that causes me to fall asleep so that the pain that the treatment causes will go away. I don’t want to take Maxalt. I want to be able to take the Frova, but of course, the insurance company knows best what to put me on for migraines.

Comments Off | Mental Health, Sickness and Health

Anger Issues?

6
May

I found out a gem of a comment that my (former) psychiatrist wrote in my chart after my first visit with him. Apparently, in that one session where he was supposed to do a quite long and intensive psychiatric evaluation, he spent 5 minutes with me and determined I had anger issues and severe anxiety. Given that I have a pretty good memory of the session, since this was before I was on Risperdal, all I can really recall is me giving a brief rundown of how bad my depressive symptoms were, telling him I needed a better anti-psychotic, and that I was wanting to come off of the Depakote since I had gained so much weight on it. He had put me on Effexor and Risperdal, then told me I could come off the Depakote because I was “on too much medicine”. (I was on the Depakote, Klonopin, Effexor, and Risperdal.) He then sent me on my way, only billing for a med check.

According to my therapist, in the next session he claimed to do a psych evaluation, which is crap because he never spends more than 5 minutes with me. He always tells me I’m on too much medicine. He ignores me when I tell him which symptoms are worse, and tries to get me to up my Klonopin, even though I’ve told him that I can no longer take it because it knocks me out. (Besides that, I don’t feel I need it because I haven’t had a full-blown panic attack in almost a year.)

He also said that I had the symptoms for Borderline Personality Disorder (which I had previously been diagnosed for, but I did not tell him I was experiencing any of the symptoms for it at the time of any of the appointments) and I guess this is his justification for not paying attention to my ACTUAL problems. Ugh. I didn’t really have any anger issues towards him until I found out about him going through my old parts of my chart to come up with his present diagnosis. Hasn’t he ever heard of actually doing the work himself? Yes, it takes a while to do a psych eval, but it was in his schedule and he would have been somewhat compensated for it.

2 comments » | Mental Health, Rants

     

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