At A Loss ...

I have never seen such a lack of empathy as I have in the past several months. It seems like doctor after doctor is pushing my mother away because her health problems are just too serious for them to deal with (or there are too many of them to remember.) Friday, I went with Mom to her primary care appointment with Dr. V, and it was bad from the beginning. The nurse was nice, joking with us and saying that she hoped Dr. V's attitude was better than it had been at her last appointment. (We mentioned something to a different nurse at the previous appointment, who tried to help us get answers from the doctor, so word evidently got around that we weren't happy with Dr. V's bedside manner.) Then, the doctor came in and was instantly on the defensive. Mom first asked for the results of the blood work the doctor insisted on last time (testing for some pretty serious stuff), and the doctor immediately dismissed her, saying that they only had a limited amount of time and wouldn't be able to talk about everything, so to just tell her what Mom considered important and they would address that.

It was obvious that someone had spoken to her about how she didn't address all of the things that my mom talked about in her last appointment, and it was obvious that she had no intention of owning up to her mistakes. It was also obvious that she no longer considered the bloodwork important enough to talk about first. She knows Mom's long list of health issues, and is aware that she's struggling with several of them right now. Everything Mom spoke to her about during the last appointment was important. We both just sat in silence for a second, not believing what we heard.

For the second time, Mom said that the severe shoulder pain she's been having since a fall a few weeks ago was important. She repeated that she had a previous injury, a torn rotator cuff, and that's what it feels like; the pain is sometimes so bad that it makes her feel like vomiting. She told her that she has to hold her elbow close to her side to be able to lift anything, and that she has been babying the shoulder as much as possible - not lifting anything heavy, etc. This is all info she gave Dr. V at her last appointment, which was never addressed.

So, after talking to Mom about her shoulder, she painfully tested her range of motion and ordered x rays, but only after asking if any x rays had been done on her shoulder recently. (This baffled us. X rays would have been done had the doctor addressed that during the last appointment, and Mom wouldn't be requesting them had they already been done.) Then she suggested that Mom stretch her shoulder to regain range of motion, keep her elbow close to her side, and that she shouldn't lift anything heavy. Somehow I don't think that will be a problem ...

She also said that someone ordered the wrong test as part of her lab work last time, and that she would have to make sure they did the right test this time. We believe this was a mistake on her part, because of what the lab paperwork states from the last visit. The correct tests should have been for the various types of Hepatitis, so Mom asked her to clarify which one (we couldn't remember the different causes for the different types of Hepatitis.) Dr. V's reply was blunt and didn't answer the question: "Hepatitis B is Hepatitis B. They ordered the wrong test." Mom asked again what the causes were, and she did answer the question, no less bluntly than her first answer.

After telling her that she had written the requests for x rays and new lab work, Dr. V stood up and started walking toward the door. She didn't ask if there was anything else Mom wanted to discuss, so I asked Mom if she wanted to ask some questions about the medication she had been prescribed last time (as well as some she asked the doctor about, but wasn't addressed) which made the doctor pause. Before she could even answer, though, Dr. V was walking out the door. Of course, Mom said she didn't want to talk to her about it, because, let's be honest, who would want to continue a conversation with a doctor that makes you feel completely uncared for? As the doctor walked out, Mom answered "No, I don't think so. She already made it clear that she doesn't have time for that, " as I agreed. Dr. V nodded and said "Yeah, the nurse will be right in," and closed the door.

I'm in the same healthcare system, and it's my understanding that after your first primary care visit, which is usually 45 minutes to 1 hour, the time frame decreases to about 30 minutes per visit. Dr. V spent between 10 and 15 minutes in the room before rushing out. There's no reason the appointment should have gone the way it did.

It so happens that this new medication the doctor switched her to (from a med that was working, but the doctor didn't approve of because it's highly addictive) makes her unsteady on her feet, sleepy, and makes her feel "drunk." The medication makes it impossible for her to drive, adds to the possibility of her falling, and makes it even harder for her to work productively to make some kind of living. In other words, the medication is making things worse, and she won't be able to see a specialist for another three months. 

The same nurse we spoke to at the last appointment came in with Mom's paperwork, made it very clear that we were not the only ones having problems with Dr. V, and that even the staff was being treated the same way we had been treated. She suggested some different options Mom could try, assured Mom that it was her right to find a different doctor, and was very apologetic. We thanked her for all of her help and told her what a good nurse she is. She was obviously busy, but took the time to talk with us and attempted to help.

All in all, I'm at a loss, here. Should Mom just wait three more months to see a specialist she's needed to see since last November? Should she attempt to find another primary care doctor within the system now, who may or may not be able to prescibe her medication while she's waiting to see the specialist? Should she find a new primary care doctor, which could also take months, after her specialist appointment? It's so frustrating to start over completely with a new doctor, no matter how much better they are, when they aren't yet familiar with your extensive and complicated health history.

I know this is a long winded post, but I'm just at a loss for what to think, say, or do at this point.

Wishing you wellness,
Chelsea

Pharmacies, Shmarmacies, and What To Do When Your Doctor Leaves You (Or Vice Versa)

Things to do at the pharmacy while waiting on your prescription:

1. Do crossword puzzles. When it becomes boring, try to do them upside down or involve the people sitting around you. Mom and I used to do them all the time while waiting for her radiation appointments.
2. People watch. Make up stories in your head about where people are from, what their job is, and, of course, what kind of medication they're getting.
3. Start conversations with strangers. They're often relieved to have someone interesting to talk to.
4. Don't wait. Drop your prescription off and go run errands, or better yet, get a sno cone! Our favorite is the Snowflake Factory in Arlington, TX!

So, not long ago, Mom had an experience with a doctor that ultimately made her decide to switch. The doctor was completely inappropriate during a visit and rude over the phone while giving bad test results. Mom had already had issues with one of the nurses on her staff (a different can of worms,) and I had encountered another doctor at the hospital who, after I explained to her that I felt she had been really rude to me in an emergency situation, referenced Mom's doctor and said, "She's my colleague - she wouldn't say anything bad about me. She knows I'm not rude." Insert nasty smile here. 

Mom spoke with her primary care doctor, who said she would refer her and get the proper tests done as quickly as possible. You have to stand up for yourself and your well being. If a doctor is unprofessional or doesn't seem to have your health in his or her best interest, you have the right as a patient to speak up and find another doctor. When you do that, you also have to follow up to be sure the proper documents have been sent to the new doctor, and that appointments have been scheduled. Sometimes, you have to take charge of the system. It's hard work getting good healthcare!

A few days ago, I had a follow up appointment with my new primary care physician. She had prescribed me a bunch of meds for Fibro and anxiety that not only made me feel worse, but were meds that I just didn't want to be on day to day. When I went back, I let her know how the meds made me feel, and that I didn't necessarily want a daily med for pain or anxiety. I asked if she could prescribe something for when the symptoms get bad, and she was happy to. I thanked her for being so thorough - asking lots of questions - and for caring about my health and pain level. She smiled and said thank you, then paused and said, "You know I'm leaving, right?"

Sigh. Of course she's leaving. I found a good primary care doctor who knows about Fibro, is caring and inquisitve, and she's leaving. So, I asked if she knew anything about the doctor who would be replacing her (and, jokingly, if they were any good.) I now know that the new doctor is a woman, about the same age as my current doctor, with experience in hospitals and family practice. She's nice, as far as I know, and I'll have to wait to see what her bedside manner is like. Just asking a few simple questions gave me some peace of mind about the changes in the near future. It's early in the game, and I can always choose another primary care doctor if this one isn't a good fit. Everyone has a hard time living up to my first family doctor, anyway, who treated my mom as a teenager, and treated me throughout my childhood and adolescence. That man was a great doctor!

I guess what I'm saying is - it's okay to change doctors if you have that option, and if your current doctor moves on or retires, ask questions about their replacement, or for referrals. It may take some work on your part, but it's worth it to find a doctor who truly cares for you.

Wishing you wellness,
Chelsea