A Tale of Two (or 3) Doctors June 11, 2009

“It was the best of times, it was the worst of times…”  -Charles Dickens

It has been a while since I wrote of my medical stuff. Probably some sort of psychological avoidance issue. Or possibly because of the amount of time that I have been dealing with it of late, the last thing I’ve been wanting to do is write about it. But there have been some new developments so I feel obliged to share them. 

As soon as I was adequately recovered from the last angiogram, I began intensive work with my chiropractor-2-3 times/week. The work was hard, deep and usually left me feeling pretty crappy for the next day or so. The good news was, that we were seeing some definite, although not permanent, improvement. We at least felt that we had honed in on the root of the trouble. The bad news was that we weren’t really sure what she was doing that seemed to help and if her work would/could have any permanent effect.

Also, my last 2 doctors, neither of whom do I respect (see May 21 post “A Bitch of a Week”), suggested that my problem was caused by my pain medicine and not the other way around. Although this seemed completely illogical to me, I was so desperate, that I think I was open to hearing just about anything. So, when they suggested I get off my pain meds, I was at least willing to give it a try. My fear was, what if I get off the meds and the pain is still there only now I get no relief, have no safety net?  That concerned me, especially since getting off the drugs is a long drawn process which need to be undertaken with great care so as to avoid or at least ease withdrawal, which can be a very painful experience on its own. Also, neither of these doctors told me how I should do the withdrawal and neither referred me to another doctor who specializes in helping people wean gently off of narcotics. I was, yet again, alone in my journey.

So, I started calling around to different clinics or programs that were designed to help people kick their drugs. Only problem was, I wasn’t nor am I a drug abuser. Evidently one has to be a hard core addict or as rich as Miss Lohan or Spears to get any help. I was told point blank by 2 different admissions directors that they weren’t the place for me because I am simply dependent on my medicine to feel well, not addicted in order to get high. Damned if you do, damned if you don’t. I did speak with one facility that would have happily helped me to part with a great deal of my money for the privilege of spending 28 days away from my family, attending NA meetings, etc. 

Surprisingly, my playing around on the web landed me right at the internet doorstep of the most amazing perfect e-match of a doctor that I could imagine. Her website described someone who was the doctor equivalent of tall dark and handsome. Dr. Gayle was western trained and she is an M.D. Her field of specialty was gastroenterology (a girl after my own spleen), and internal medicine, but she had also studied with a medicine man on a Native American reservation and she became open to other ways of healing. She then learned about other healing modalities and now runs a completely integrated practice. She is well known in her profession and highly respected. She treats the body, mind and spirit  as a whole and considers herself a partner with the patient to figure out a way to health and wellness. Imagine that! AND her practice is about a 20 minute drive from my house.

I called her office and was able to get in last Tuesday. And what happened next was truly amazing. We sat, I spoke, she listened. She took some notes and asked a few questions, but mostly she just listened. And then she stated quite simply and matter of factly, that she had a pretty good idea about what could be causing my pain. Just like that. At the end of our meeting she looked me directly in the eyes, put her hands on my arms and said, “We will figure this out.” And I believed her. 

We all have a very large muscle that runs up the length of the torso, connecting at the hip and up near the diaphragm (the very diaphragm from where the median arcuate ligament was cut in my original surgery), called the iliopsoas muscle. Her thinking (which was confirmed on examination) is that this muscle has been in chronic spasm since the surgery, likely as a result of the body trying to protect itself from the trauma of the surgery. She said that it would account for all of the pain that I have described to her-the squeezing inside my body, the wrapping, the burning-all of it (other than the normal aches of being a grown up and having 3 kids and living in a stressful world). But not only that, she actually has a plan for dealing with the muscle. She told me that we have to break the cycle of the spasm and re-teach the muscle that it doesn’t need to be that way-that it can simply relax now. Not only that too, but she has a plan for breaking the cycle and that is through the use of magnesium injections which cause muscles to relax. 

So, last week I had my first injection. I won’t say it was a pleasant experience, because it wasn’t, BUT at the end of the treatment, my pain was gone–GONE!. And for the nest several days I woke up without pain. It was truly amazing. She wouldn’t venture to guess how long the relief might be, planning several more injections-once a week for the next month and we’ll take it from there. I still take my meds because A. I can’t just stop them and B. there is no expectation that one shot is enough. In fact as the week has gone by, I have felt some pain creeping back in, but I am taking much less medication than I was even a week ago. I am scheduled for another injection this afternoon. 

It’s too early for me to claim victory-way to early, but for the first time in a very long time, I actually feel hopeful…

More to come.

nufced

a bitch of a week May 21, 2009

I had a plan. I had a whole week’s worth of posts about bitches. So much for plans. I have had doctor appointments every day this week up until today. The first one was on Monday with a the director of digestive medicine at one of our BIG local university hospitals. He shall remain nameless. What a waste of time. Rather than explain, I shall post a letter I wrote to him the next day. It pretty much explains the outcome of that appointment. Tuesday and Wednesday were spent with my wonderful chiropractor who beats me to a pulp, but could possibly be the only person out there that is actually helping me. Only thing is that after she works on me I feel pretty lousy for the next 24 hours. So I have not written this week since Monday’s post because, quite frankly, I have been exhausted and just plain old not feeling like writing. Oh, and the wonderful doctor put me on yet another pill which had me feeling like I had just drunk a six-pack all day yesterday.  No more of that for me. One bright light in all of this is that I have found a new doctor that I am seeing next week, a doctor who has a background in western medicine, but has studied eastern and Native American healing practices and takes an integrated and holistic approach to healing. I am hopeful that she will be a turn in the road for me. 

Following is the letter that I wrote.

Dr. R:

I came to you Monday against my better judgment at my husband’s insistence because you are supposed to be the best. I have been to countless doctors, and went with the slim hope that, in you, I would find someone different, someone who would listen, really hear me and help me to put my trust in you. That outcome did not occur. 

What I got instead was a bright eyed intern with no experience, to take notes on my story, not history, mind you, but story, one of pain and suffering for my family as well as for me for 2 1/2 years. She then, through her own filter, told you details of that story.  Based on that you made several diagnoses.  While you insist that you “got” my story, that is, frankly, impossible and for you to insist, is arrogant.  More importantly, when I agreed to the appointment, I expected to see you, renowned “Director, Digestive Disease Center,” not a student.  I am NOT a textbook to be studied by a student. For that, I am angry that I wasted my valuable time and money.

To begin, you stated that my surgery 2 years ago, was likely unnecessary.  What possible good could come out of you telling me that at this point? To further decrease my trust in doctors, in whose hands I put my trust and very life? To tell me that I needn’t have suffered these past years?  Furthermore, based on what evidence can you even make this claim? You have not seen any of the tests used to make my diagnosis.  You did not see or examine me at the time. You do not know that the pain with eating did, indeed, disappear and despite the fact that I was left with ongoing pain, it was of a different sort, perhaps, even likely, caused by the surgery itself, the very surgery that may indeed have been needed. There is countless documentation that surgeries lead to adhesions which can cause many complications including pain, as well as other problems such as damaged nerves. 

I had no choice but to resort to pain management as my doctors all told me they had no idea of the cause of my new ongoing pain. Not one of my doctors EVER mentioned adhesions. The pain that I have suffered for 2 years, the squeezing, wrapping, contracting, burning pain, which was only relieved by narcotics and neurontin could be caused by what then? The pain that only began after my surgery, the pain that was and is like nothing I have ever felt before.

Perhaps now, at this point, your diagnosis is correct that the medications have made things far worse for me, but that does not change the pain that had been with me since the surgery, the pain that had nothing to do with the original abdominal pain, the very reason for taking medication in the first place.

You, like many others, sent me off with your certain diagnosis, a slip of paper for more drugs, and taught your intern that that is the way to practice medicine. Why should I trust or believe you any more than all the others? You offered to me no support in the way of finding a doctor to help me with the next step, despite the fact that you say you have had other patients in the same position.  You have left me, feeling vulnerable, to again, on my own, navigate the world of doctors out there to try to find one to assist me with the withdrawal. I have been doing this for 2 1/2 years. Doctors seem to give you their opinion and then send you on your way. It is shameful.

When I tried to call you to follow up with further questions, you were short and dismissive.  You certainly have done nothing to build patient/doctor trust to allow me to feel that taking the step of withdrawing from my medicine is the right thing despite the obvious anxiety that any patient would feel given this information. You were quick to inform me that you are not my psychiatrist.  That is for certain. I would never consider going to a psychiatrist with such a dismissive manner as your own. 

Despite my negative feelings for you, I am willing to and planning to take your advice to at least see where I am without the medications, as my own research has confirmed some of what you have told me and because I am desperate to have my life back to be a  mother to my 3 children. By the way, you did not even acknowledge my 3 1/2 year old sitting so patiently in the room with us. 

Be advised, however that I have already made appointments with 2 other doctors and that your services will no longer be needed by me. I hope the young lady that you taught that day has other, more compassionate doctors to study under and she learns more from them than from you. 

I do not expect a response to his, because honestly, I’d be surprised if you even read this far. I’m sure you never hear this from patients because they are taught to believe that doctors are gods, however, you are human, and fallible. I do, once again, feel like the medical system is failing its patients, certainly this one. With each doctor visit, my already low trust is further reinforced. 

With deep disappointment,

Lesly M.

nufced