Showing posts with label specialists. Show all posts
Showing posts with label specialists. Show all posts

Friday, August 2, 2013

DON'T listen to your body!




As is so often the case, this post is something I adapted from my personal journal, which I will admit often amounts to a load of complaining. But keeping a journal is one of the sure symptoms of writerhood. I have had many a person sit down with me over the years saying "I want to be a writer", meaning they want to make effortless money and be an instant best-seller (it can't be that hard, can it?). One of the first things I ask them is, "Do you keep a journal?" Normally I get a blank look, a why-would-I-want-to-do-that expression, as if a journal must be written on pink Hello Kitty stationery with scented lavender ink.

Mostly people merely take stabs at writing, brief ones. Then they sort of run in terror, realizing that they will actually have to put their work "out there". As a friend recently told me about her own former ambition to write, it just got buried under the mundane tasks we all must undertake in the course of a day.




All this leads to something else. (Which is what I seem to do in this blog, though I can't tell you why. Steinbeck leads to Travels with Charley leads to why people treat dogs like babies.) So this is about my never-ending, awful sort-of-relationship with doctors, who have been poking and prodding my sagging old body for a year now trying to figure out why I am having this persistent, nagging, sometimes severely disabling pain.

It's getting in the way of jumping in to preparing my novel The Glass Character for publication (which I wish I could enjoy more). This is what I wrote this morning:

"I want to get the medical stuff over with, which it should be next week when I get told there’s nothing wrong with me again. I have a theory it’s a low-grade infection, but I doubt if he will give me anything for it, will likely say “it’ll go away on its own” when I have been in pain for nearly a year now. They said the same thing about the infuriating ear symptoms which I’ve now had for 13 months. Things do NOT “go away on their own” in many cases, but doctors now let things fester for so long they become ingrained and chronic and really WON’T go away. We then have a "nuisance patient", a hypochondriac completely obsessed with imaginary illness. But someone has commanded doctors from “on high” not to prescribe antibiotics. They’ve swung from one ridiculous extreme to the other, and in both cases it’s to get you out of the office FAST."






So how many specialists or procedures HAVE I been exposed to? Let me count the ways. Gastroenterologist (God, these things are hard to spell). Gynecologist. Ultrasound. Colonoscopy. Ultrasound again, because they couldn't find anything the first time, and now urologist/cystoscopy (can’t ever remember how to spell that one). I have also been to a nephrologists and an otolaryng-whatever-it-is. All uselessly. Each person takes a part of the body, and they are never co-ordinated or put together in any way. They’re not supposed to be. Each body part must get sick in its own way, and if it gets sick outside of certain strict boundaries, then you’re not sick, or at least that part of you isn’t. If you have a condition such as a bladder infection and only have three symptoms out of five, then you don’t have a bladder infection and will not be given antibiotics.

Oh, antibiotics! Like Valium in the '70s, doctors handed them out like candy until relatively recently. Patients wanted something to relieve their fear and distress about being sick. They wanted to come away with something. Doctors wanted them the fuck out of their office so they could go on to the next patient. So they went home with a prescription.






Then all of a sudden, we are being told WE were wrong to accept all those prescriptions for all these years. WE were wrong to seek a fast and easy way out of disabling symptoms. We should have just put up or shut up, because there was probably nothing wrong with us anyway.

Suddenly, in spite of everything our doctors had been telling us for decades, antibiotics were just wrong.



It still comes at us from every side, ads on TV with cute but shaming slogans like, "Not all bugs need drugs." It's a kind of finger-shaking admonishment to the public, because for God's sake didn't we create this situation to begin with? The public, being weak and self-indulgent, demanded antibiotics so vociferously that they created a race of Superbugs which are now resistant to medication.


We have rendered antibiotics almost completely ineffective. How does that make us feel?

Doctors had to stop acting like free vending machines for this seductive candy because "someone" ordered them to, some medical association or other. "It will go away on its own" became the new mantra. This got patients out of the office nearly as fast as "Here, take this prescription for amoxycillin".

Now, you can have pus running out of you and feverish red inflammation and strep throat (and my granddaughter, then three years old and running a fever of 104, might have died from it: my daughter, a dragon when she needs to be, INSISTED she be prescribed antibiotics, which cleared it up completely in two days), and the doctor will not prescribe antibiotics. Once again, the crushing weight of shame is applied to us as she tells us something we have already been told 100 times. "Patients ruined antibiotics by taking them too often. It will go away on its own."






There are two things my doctor never prescribes: antibiotics and pain relievers. When I told her I'd had significant and even severe pain for a year, pain that sometimes prevented me from functioning well, she said, "Advil is the drug of choice."

"But I've been taking Advil for a year now and it has no effect at all."

"Try Tylenol."

"I've tried them all. None of them work."

"Advil," she said, a little testily.

"Can't I have anything stronger?"

Oh, it's the facial expressions, the bodily shifting, the "I know I'm dealing with an addict cadging drugs" manner that gives it all away.









"Advil is the drug of choice." (Meaning: if Advil doesn't work, I am having the wrong kind of pain and need to set it straight. Or else I'm lying.)

Another time she asked me the doseage I was taking and I said something like 800 milligrams. "That's too much," she said. "But the lower dose doesn't do anything." "Always take the correct doseage or you'll damage your kidneys." But the "correct doseage" wasn't doing any more than the so-called overdose anyway.

I have enjoyed good health for most of my life and have stayed away from doctors whenever possible, so I can hardly be called a hypochondriac unless such a damning stereotype can develop in a  few months. I hate taking pills, and it does not occur to me to abuse prescriptions. I have dreaded developing some sort of vague but persistent, painful medical condition that no one can get to the root of. And now it's here. My own theory - and who gives a shit what I think anyway, it's only my body - is that this is a low-grade bladder infection which has been flying under the radar for a year. But doctors refuse to see it that way. "Your urine test is normal," my doctor said, furrowing her brow and sitting back in that "get out of here and go directly to the psych ward" way. If my urine test is normal, I cannot have a bladder infection and have to go home and behave myself.









Over and over again I hear/read the same advice from people: Listen to your body! If anything feels amiss, go see your doctor immediately! I am here to tell you that you won't be in her office for long. Your symptoms will have to escalate until you are in severe enough pain to wait months to see a specialist, who will tell you there's nothing wrong anyway. The cancer diagnosis won't come until it is far too late to treat it. Then you will be asked, "For God's sake, why didn't you DO something about it?"








Is there nothing you can do? Why are you stupid enough to ask? Take Advil, which should get rid of all your symptoms. It's the drug of choice.

Friday, December 28, 2012

Blood work




 

They should install a little tap on the inside of my arm. That’s what I’ve heard people say. I never thought it would apply to me until a few years ago when it became apparent that, for health reasons, I was going to need “blood work” done (and just what does THAT mean?) every three months or so.

 

It’s an art to tap the mysterious underground streams that throb inside us, and not everyone can do it. My life is besmirched and besmutched by botched attempts that left deep bruising and yielded almost no blood at all, as if I were a human turnip or had somehow turned to stone.

 
 

I’d be happy to keep all my blood, thank you. Especially now that I am no longer a prison of the Moon Goddess that makes us all run out and buy tampons every month. Science needs but a few cells, likely, but always takes what seems like tanks full of it.

 

I don’t know what it is, but I’ve had some sort of revelation. Or something. For years I had my “blood work” done at a local lab I could walk to. Seemed like a good idea. But over the years the service got worse and worse. At least every other time, and eventually every time, the technician couldn’t find a vein. They slapped, they smacked, tied the rubber thingie tighter (though one dithering lady who seemed on the verge of hysterics insisted on tying it loosely around my rolled-up sleeve “so it won’t hurt your skin”). Then they’d jab. Jab jab. Oops. Pull out, turn around, jab some more. This is what it must have been like for Victorian women on their wedding night.

 

 

Then they’d get “that look”. Anger mixed with panic. Anger at ME, actually – they’d usually say something like, “Do you have this problem all the time?” or “Your veins are so tiny!”, or something that made me feel equally swell.

 

My veins wished they could apologize.

 

The worst was when they had to bring in a second person because the first one just couldn’t do it. Then panic ensued, with technicians running jerkily back and forth like something out of a silent movie. I hit rock-bottom a few months ago when, unable to get blood from either arm, they tried to get it out of the back of my hand. It hurt like hell, took ten minutes of agonizingly slow drips, and yielded about a thimbleful, which is probably all those lab fuckers need anyway.
 

 

I don’t know why I didn’t think of this before – maybe I assumed it was one of those geographical cures that’s never supposed to work – but one day I thought, hmm. I thought, WHY DON’T I TRY ANOTHER LAB? Surely all technicians can’t be this incompetent, this panic-stricken and unsure of themselves, not to mention insulting to their clientele’s veins.

 

So I did it. A little uneasily, I cracked the door of a clinic that looked pretty much like the old one. Surprisingly, the waiting room wasn’t choked up with unhappy-looking people in winter coats: I was able to go in right away. As a last-minute decision, I decided NOT to say anything about my “problem veins” or my miserable lack of success as a dispenser of my own blood.

 

I was cool.



 

Cool in the hands of the technician, an older woman with a no-nonsense manner.  I relaxed like a dog under the care of a good vet. The whole thing was over in 30 seconds, and I never even felt the stab.

 

So easy it was, it was almost pleasurable, which I know is a pretty perverted thing to say in this age of vampires.

 

OK, I said, fluke. HAS to be a fluke, or maybe this particular technician is a blood-drawing genius. But the second time, with a different one, it was just as laid-back and painless and FAST. No waiting for the agonizing drip. . . drip. . . drip. . . of  blood being tapped by a needle stuck in the wrong way, at some bizarre angle arrived at by corkscrew-like drilling.

 

It seems like we have a Land of Incompetent Blood-Tappers and a Land of the Other-Type-Thing. The bloodletting today was just ridiculous. She didn’t even say “make a fist”, and I did not feel the brief stab of entry at all. In fact, by the time she finished, I wondered when she was going to start.

 



 

It’s a mercy, for lately the frequency of the drilling has only intensified as new medical “issues” have come up, some of them scary as hell. I shouldn’t think the worst, of course. But I’m suddenly in that netherworld of clinics and waiting rooms and pee bottles and tiny circular bandaids and seeing specialists who may or may not turn out to be special.

 

I have another test next week involving not peeing for several hours, the sort of procedure pregnant women go through all the time. When I was pregnant, the doctor stuck his ear on my stomach and got more or less the same results. But now science must look inside me. Deep inside me.

 

Any time I’ve had a health crisis, which is not often, I would always feel silly when I got the test results back: no, we couldn’t find anything. Part of me wishes they WOULD find something. I crave the drama. But I also hate to be sick. Even having a cold makes me resentful.
 

 

After a most intimate probe in yet another specialist’s office the other day, I was assigned a colonoscopy in February, quite soon actually, meaning my case is of “moderate” importance. In other words, I’m not quite at death’s door from internal rot, but nor am I doing this just for an afternoon’s entertainment.

 

I’ve heard all sorts of things about this procedure. My husband had one done 30 years ago when preparation involved taking  twelve boxes of laxatives the night before, followed by lying helplessly on your stomach with no sedation whatsoever while they Roto-Rooted your insides. I hear now it’s easier, but the preparation takes five days. Fortunately you’re stoned out of your mind while they do the drilling, which I honestly look forward to.

 

But the thing is. . . some part of me, an insistent part, sometimes whispers in my ear, you might really be sick. They don’t do all this shit to a well person, do they? Or maybe they do, to rule it out.
 

 

How would I feel about that? I have to confess that a part of me leaps at the possibility of death with a sort of dizzy joy, like a dog reuniting with its master after the war. It reminds me of that Buddhist saying, “Throw down your earthly garments and run to me.”

 

It’s subversive even to think these things, let alone write about them. And yet, I do think them, pretty much daily. I look at my life and I have to conclude that it hasn’t exactly turned out.

 

Not like I thought, not as I wanted, no not at all. I look at others who have “made it”, who have succeeded and live in a world of stimulating company and conversation, while I sit there knitting.
 


 

I look at authors who’ve won the Giller, the Booker, the Nobel. Well, why not go right to the top while you’re feeling this bad. While I sit there looking at form letter rejection slips from wormy little backwater presses that won’t even give me the time of day. I look back and see years, and years, and years, hundreds of these humiliations, followed by yet one more masochistic attempt, the faithful dog too idiotic to know when to give up.

 

So why do we live? We’re set in motion, and it’s assumed from then on that we WANT to live. Why? Aren’t we sort of stuck with it?
 

 

I guess I live for the wrong reasons. I live for other people, which is also known as “codependency”. It’s a no-no and I must stop it and only live for myself, a self so tattered and shredded with disappointment that I am sure it won’t hold together as the sole reason for staying around.

 

The other thing that sneaks into my mind is this: you know it’s going to happen. I’ve seen six friends die in the past few years, from illness, accident, suicide. Some were younger than me. I have no idea what happened to them, where they went, what happened to their essence. I guess they just stopped. I guess WE just stop, and then there’s nothing. Ever. Or just a few atoms of memory in the minds of others that, too, will eventually stop.

 

So why scramble so hard to keep all this going? It’s assumed that life is an unalloyed good. It’s assumed that happiness is everyone’s natural state, and if you’re unhappy you have a “disorder” and have to take medication for it. What is "assumed" is generally a crock of shit, which is one of the themes I keep returning to in this blog.
 

 

Personally, I have always walked through life feeling like an accident. Due to the helpful information conveyed by my much-older siblings, I know I wasn’t planned, and am pretty sure my mother wanted an abortion. My father talked her out of it by saying, “You wait and see, he’ll be a genius, smarter than all the others added together.”  I’ve felt like a sharecropper here on earth, in this reality, which is why I try so fervently to transcend it with music, with writing, any way I can.



And yet, the Great God Accomplishment still looks down on me, shakes his hoary head and says with a tender smile, "No."

 

Our lives are supposed to be a priceless gift from God and all that, even if we feel like shit a lot of the time. Pain is the norm for an awful lot of people, and endurance their only choice. Even though I’m not supposed to because it makes me codependent, I DO live for other people. I live because I have this idea – I need to think it’s true – that if I died, a few people would feel it. Not many; perilously few. But those few matter immensely to me, and I don’t want to inflict pain on them. I have done enough of that already.

 

 

Friday, November 30, 2012

Why are doctors such a bunch of assholes?



This is the last day of November, which really should be the "cruellest month":  T. S. Eliot was obviously out of his poetic little mind to say it was April. This day is sort of special, and sort of not, because it has now been 22 years since I had a drink. I have to confess I was afraid to write about this before because I thought that, by some far-flung chance, a publisher might see this and conclude I was a drunken sot and completely unreliable. You can't write about your triumphs because they will do you in ever time.

But on to the topic of the day: otorhinolaryngology, or something like that. My problem goes back many months and still isn't resolved. In June of this year we had a very enjoyable week of holidays in San Francisco, but on the last day I started to feel not-so-good, achy and weak, as if I was about to get the flu.




On the plane home I didn't feel so hot either, but as we started to land, oh God. Both my ears began to shriek with pain, as if someone was driving screwdrivers into my head from both sides. It takes about 35 minutes to land a plane, from that first subtle feeling that you're dropping in altitude to the reassuring thud of wheels on the ground. So the agony went on and on and even increased. "Try swallowing," my husband said, as if it hadn't even occurred to me.  Try to patch a gaping war wound with a bandaid.

The really distressing thing is that I never did have that "pop" that indicates the pressure has been relieved. The pain went on for at least an hour after we landed. There is something truly excruciating about an earache, like a whistling icy wind blowing across a bad tooth. L'angoisse, as the French call it.






Feeling rotten and weak and sure I had the flu, I dragged myself into my doctor's office and left about a minute and a half later. She took out one of those ear thingies, looked in both ears and said, "They look fine." I mentioned flu and she said, "Oh, no, it's not flu (with a patronizing smile). It's just a summer cold."

Months went by. I was completely over my "summer cold", but alarming symptoms remained: every time I yawned or swallowed, there was a noise in my left ear, not the "crackle" described by medical web sites but cannon fire on the side of my head. I could not imagine going back to the doc and having her tell me "well, don't yawn or swallow then" (like the old joke: "Doctor, doctor, I have a terrible pain when I do this." "Well, don't DO that!"). Worse than that was a new symptom: whenever I talked, which I can hardly give up altogether, I heard a buzzy, distorted sound on the left side of my head, like an old speaker with a loose wire or a radio not tuned in quite right. This wasn't from the outside, obviously. It was the sound of my own voice feeding back inside my head. It was also very loud.




Months went by. It wasn't going away in spite of my doctor's instructions to hold my nose and blow. It was worse, in fact. I went to a walk-in clinic and saw another doctor who took out the ear thingie, looked in my ears and said, "They look fine." Then she sat there impassively until I left.

More months, more annoying racket in my head. I was SURE something was wrong in there, this COULD NOT be normal! I went back to that second doctor and she told me to hold my nose and blow, then  finally, with considerable arm-twisting from me, referred me to an ENT specialist in New Westminster, about an hour and a half drive from here.

After still more months of discomfort and cannon-fire, my appointment finally came up. I did not have a good feeling about it. I was pretty sure I would be dismissed again. When I entered the office, I was in a time warp. All the medical equipment seemed to go back to the 1950s, antiquated, as if it should be in the Smithsonian. I had to fill out one of those forms, and one question was about medication, so I wrote down what I was taking. It never occurred to me not to.


 


The doctor, an old impassive Iranian guy who looked like he never smiled, never once made eye contact with me and seemed both bored and annoyed. I told him about my symptoms. He looked inside my ears with that little ear thingie and said "they look fine". His assistant stuck a little rubber probe into each ear. The right side was OK; the left side was just excruciating. I tried to tell him about it and there was no response.

The hearing test was normal, which was both a relief (I don't want to be one of those "EH?" people) and distressing: I knew that if I could still hear, he would soon dismiss me.  As a matter of fact, I had better hearing than almost anyone else in my age group. I was not really surprised: when I'm under stress my hearing becomes so hypersensitive, I can hear a watch ticking across the room, loud enough to keep me awake at night.

Fine,  I have better-than-normal hearing. That means I can hear the cannons and buzzes much more clearly!

The doctor's bored look had hardened: his impassive face had turned to stone. With one last gasp, I tried to tell the doc about my annoying, even infuriating symptoms. He said I should hold my nose and blow, then sat there not looking at me. I kind of went, "Ummmm. . ." In an irritable tone, he said, "Everything is fine. You can go."





I had some thoughts after this big letdown. One, I am not a woman of childbearing years. Older women usually get short shrift because subconsciously, they are not perceived as being "productive" in their natural, God-given function of spewing out babies. Two, I made a terrible mistake in filling out the form: I was honest about the medications I am on.

I am not saying this is conscious - or maybe it is - but when he saw the word "lithium", I think he just crossed me off the list of people to be taken seriously. Lithium equals manic-depressive equals fruitcake/hypochondriac/delusional old bag.

Do you think I exaggerate? My first impulse is to be honest in almost every case. Of course there are a few exceptions, but mainly to spare people's feelings.




But have you ever noticed that with most people, a lie goes down much better than the truth? For one thing, a lie can be tailored any way you want. You can unmake and remake reality, bend it and soften it and take the sting out of it, or - best of all - make it so that it flatters the person you're lying to, even if he's a total asshole.  So , yes, yes, yes, we believe you because it's easier on us, the lie is much more palatable.  There are many advantages to this policy, and much more of it goes on than we consciously realize.

There are sub-categories, of course, including the lie of withholding information. This is the one I definitely should learn to practice, particularly with doctors, who are some of the most heartless human beings I have ever encountered. Don't tell me it's because *I* am being difficult. I bend over backwards to accomodate these bastards and they let me down almost every time.




Result: after 5 1/2 months, I still have the cannon-fire and the loose speaker-wire buzzing inside my head, and it's quite possible I will have this for the rest of my life. If you go from doctor to doctor, well, guess what that makes you? One of "those": meaning those crazy old ladies who are so lonely that they will feign illness to get any sort of attention.

I have no idea what to do now.




I deleted the last paragraph of this post because it was just too angry and bitter, though in my mind it contained some truths that badly need to be told. Trouble is, they're pretty unpalatable the way they are and need to be dressed up.  And I'm not too good at that. My attempts to be honest have gained me exactly nothing except a one-way ticket to that prominently-marked door in every medical office. The one with the four-letter word.


Thursday, February 10, 2011

Nephrologist: say it three times, backwards







The surprising thing about being, so help me, 57 years old (as of yesterday: happy birthday to me!), is that your insides age just like your outsides. Or maybe a bit more.

You can't see in there, and if you're not having any obvious problems, you can (wrongly) conclude that everything is chugging away normally.

I seemed to be chugging away normally, except that my doctor (not the one I complained about a few posts ago) noticed an elevation in something called creatinine. Oh dear. Creatinine isn't a good thing if it's elevated. It was, in fact, elevated just a tiny bit, but this particular doctor, being a specialist and a nitpicker, decided to refer me to another specialist who turned out to be an even bigger nitpicker.

This was Dr. Schachter, the nephrologist.

Nowadays, instead of doctoring the whole person, most docs choose one part of the body and study it furiously. There are advantages and disadvantages to this approach.

The advantage is, these guys really know their stuff. Though I didn't know Dr. Schachter and didn't at all know what to expect, I was amazed at how thorough the exam was: far more thorough than the cursory open-the-mouth-and-look-at-the-horse's-teeth thing I have come to expect once a year from my family doctor.
The not-so-good thing is that, in focusing on only one body part, you can forget about all the rest, or not put it in the context of the whole person.

This guy, the nephrologist, had done a dizzying battery of tests on my blood and urine, stuff I'd never even heard of, but that didn't matter because he knew what it was. And he knew all the right questions to ask. He asked a lot of them. This might have got my back up, since some of it was pretty personal (I'm kind of attached to my kidneys), but for some reason it didn't.

Maybe it was bedside manner, a kind of professional concern that is missing from most medical care these days. It's as if doctors are afraid their patients will get attached to them or, even worse, trust them. This is why I often have that shoo'ed-out feeling with certain of my doctors. When you're feeling anxious about something and have it brushed off as hypochondria or sheer foolishness, it hurts.
When you hear horror stories of blatant misdiagnosis or doctors who overlook serious disease completely, it makes your hair stand on end.

This guy, however, well, for some reason I felt completely comfortable, and who knows why. For one thing, he was very (very very very) young. I swear these guys get younger every year. It could be that med schools are finally telling these guys and dolls to please, please consider the whole person while you're focusing so fiercely on those kidney-shaped organs on either side of the torso.

I noticed several other things about my visit. One was that the office, almost brand new, had been built so close to the exit of the Skytrain station that I blew right past it and couldn't find it. The hidden message seemed to be: don't rely on your cars so much, folks, it ain't healthy. Or maybe the property was cheaper, I don't know

Another thing: the waiting room was full, and the average age of the patients must have ranged from 85 - 90. Most of them looked in rough shape, as if they spent most of their time in waiting rooms. One very elderly woman had one of those oxygen thingies on a pole, and she had to wheel it around with her.

I was the blushing young flower of the group at 57. It was strange. Yet, in spite of how ill everyone looked, there was lots of joking and laughing going on, mostly about the indignities of the procedures. I saw this as a form of valour, of not just enduring serious illness but finding a way to transcend it.

After poking, prodding, listening to this and that, and tapping me all over, Dr. Schacter talked to me about my kidneys. They were in pretty good shape at this point, but pretty good didn't mean perfect. I was surprised to learn my blood pressure is somewhat elevated. Ye gods! My body is ageing. So what's happening to this piece of meat inside my skull?

Looks like I will be returning to this oddly-located office at intervals, but I don't mind. Dr. S. is a real sweetheart, the kind of person who makes older women proudly exclaim, "My son, the doctor!".

And the place has one other advantage. It makes me feel so young.