19 responses to “Trust Me”

  1. Danya

    This is a TERRIFYING STORY. I can’t believe that this happened to you, ESPECIALLY not from another woman. I’ve experienced and come to expect this kind of treatment from male gynecologists (in most cases, never having had a period or a uterine cramp seriously diminishes the ability to empathize and assist someone who is suffering from them, although I’m glad to hear Dr. Kim is not like that), but to hear this from a female practitioner who presumably went into this profession to HELP women is unconscionable. I’m so glad to hear that you filed a complaint against her. I hope it’s taken seriously.

    The frightening thing is that, although this seems to be a problem most frequently with OB/GYNs and issues relating to women’s health, it’s not limited to us. It’s terrifying to think that the vast majority of people know little to nothing about their own health care and simply trust to their doctors to give them “THE ANSWER.” People need to come in as well informed as possible, armed with every possible question to ask their doctors. They should never be made to feel bad for asking or being “worried about nothing;” it’s the health care provider’s JOB to find the best solution for EACH, INDIVIDUAL PATIENT, which includes keeping them calm, being polite to them, and TREATING THEM LIKE A PERSON in addition to simply keeping them alive. Shame on Nurse Practitioner V.

    This is all very reminiscent of 19th Century novelist Frances Burney’s mastectomy in 1811, performed by “Seven Men in Black” without anaesthesia. A partial account can be found here: http://scribalterror.blogs.com/scribal_terror/2005/05/frances_burney_.html but is NOT for the faint of heart. When one of the seven men asked of his colleagues (while Burney was hidden under sheets, fully conscious and totally silent), “Who will hold this breast?” Burney sat up and replied, “I will!” and proceeded to explain in excruciating detail the exact extent of her pain and problems. Even then, the men didn’t listen to her wishes OR her needs. You’d think we’d have come a little further in 200 years.

    Sorry for the long rant. Y’know, I’m just going to go make this my own blog post. Do you mind if I link to yours?

  2. Jesse the K

    Arghhh.

    Lately I haven’t had the energy to complain, so I really appreciate your taking the time to call out Nurse-Midwife V on her shenanigans.

    And congrats on finding a rockin’ doc to work with. It makes such a difference!

  3. Tori

    At this stage in the day, I don’t have the energy I’d like to, so suffice it to say I’m hunting around for the “like” button here. ;)

  4. Kaitlyn

    Yay for doctors who respect you!

    Boo for the system that makes it hard to follow up on a mental promise to yourself to get a new one. I may have told a certain doctor who may or may not have an Ego who may or may not manage my pain that I hated him. To his face. Very scary until I had the prescriptions in my hand, because I loathe his smug face (probably some projection on my part) but he’s the only one I can see.

    Tricare (say that word to anyone connected to Western medicine and an “oh” comes out) doesn’t cover pain management because well, it’s Tricare. So if there are pain management specialists in town willing to take on my case (pain in my “female” area!), I’d need a different insurance or lots of money to see them.

    I’m glad you’ve got quick turn around on your referrals! I adore the referral person at my PCM, before Tricare made me come in to see my PCM (a nice guy) every time and made us stop er, backdating referrals because someone forgot what appointment number she was at… Anyways, a lot of nonsense this month referral-wise. Dr Ego (a specialist) referred me to PT. Tricare said nope, your PCM has to refer you. And then 2 referrals went out, one to a completely different place. No one knew why, but they had the official PCM and insurance paperwork. Of course, so did the correct place.

    I went in to my appointment yesterday planning to ask Dr Ego lots of questions. I ended up shouting and swearing at him. (damn) Whether it was intended as such, the appointment was an exercise in sadistic mind-fuckery. He spent the whole time telling me he wouldn’t do what “you want” re: pain and pain pills, because I’ve found a working combo that he didn’t prescribe and then he told me to talk to my mom about finding another doctor! And left the room. He came back in and stood there so calm and so… gah. And handed me a scrip for my mood stabilizers. And the requested pain medication. I asked my mom, “What just happened here?”

    My mom, however, is pure evil, I discovered that day. Guess who doesn’t *need* referrals because she’s so special?

    My insurance and my doctor are in the same place in my life – I cannot function without them, but god, I hate them.

  5. Kaitlyn

    Benefit about ranting about Dr Ego on the computer – only I know if I cry or get angry.

    Your story makes me hopeful for the future, when, as I told him, I’ll be getting a new doctor!

    (Less than 18 months until Tricare drops me fast. Unless I join the military…)

  6. Kaitlyn

    Thanks, Ouyang Dan!

    I don’t know the exact points. I’m a retiree’s dependent, off the base for many many years.

    I don’t know if there are any in the area.

    I’ll keep it mind and think about calling the base to find out, or maybe my case manager! I forgot about her, and she may know something! Thanks again!

  7. Quijotesca

    I’ve been having all kinds of problems in this area lately. I spent several months trying to convince a doctor that the pain I was having wasn’t due to anxiety. I’ve had anxiety problems for years and while I think it’s possible anxiety made something I had going on much much worse, I don’t think that’s my sole problem because I have a pretty good idea what anxiety does to me. It doesn’t stick around for a year and cause muscle tension for a year while I’m on antidepressants.

    I went to another clinic, and during the first visit with one of the doctors I saw, he spent time gushing about the antidepressant I was taking, which annoyed me because I personally don’t want to be on antidepressants for very long. That just rubbed me the wrong way because he was clear in telling me that he wouldn’t prescribe things like pain relievers or muscle relaxants, so it just felt wrong that he wouldn’t take my preferences into consideration, but really, that was just the tip of the iceberg. The next time I went up there, I needed him to refill a prescription I was taking, and he gave me that line about how he wouldn’t prescribe things because I thought I needed them and then proceeded to lecture me because I didn’t know the exact dosage of a medication I was taking. The kicker is he failed to listen to my explanation for why that was: I was only taking half a pill. He tried to prescribe just a two weeks’ supply because it could interact with something else I was taking and wanted to follow up, but since I only take half a pill, that was three weeks’ worth. He failed to listen to a few other things I said and corrected him multiple times. And, you know, I was the one he figured deserved a lecture. He also seemed generally disinterested in actually helping me and took more of a “wait and see” attitude which was not a great idea since I’d been in pain for about a year. I refused to see him again.

    The guy I’m seeing now seems OK. He actually noted I was taking half a pill on the medication directions and considering that not even the doctor I first discussed that with wound up doing that. It also turned out that there’s not much of a risk for drug interactions since I’m taking a low dosage, which is what I figured. I’d been on the same combination of pills for about a year at that point. Something might crop up later, but so far so good.

    I saw a psychiatrist who insisted all autistic people take anti-psychotics and changed my medication pretty much every time I visited. After Abilify gave me akathisia, I flat out didn’t want to try anything along those lines again. He wouldn’t take no for answer and prescribed something else. The strange part is that he seemed genuinely shocked when I exhibited withdrawal symptoms after he took me off Paxil. I refused to see him again mostly because he was prescribing this crap without even getting to know me. I later decided I’d had it with antidepressants, but at the time, they seemed helpful and all I’d asked him to do was keep prescribing the stuff I was already taking instead of pushing different medications based on his own flawed views. Some autistic people have really violent reactions to anti-psychotics, so his view was pretty dangerous.

  8. K

    @ Danya, unfortunately, being a woman does not a good gyn make. I’ve gotten blown off by both gynecologists who were male and female. But I still found better care under a male specialist. It’s like he knew he didn’t know what I was going through so he had to overcompensate. And who knew a guy doctor would be willing to prescribe boric acid (and knew why I was interested in it) but the lady gyn refused? Go figure.

    I can’t stand my current gyn’s nurse… She’s way too rush rush. Even the gyn herself, she’s rush rush too and I tell that office when I call, schedule my appointment for whatever time you’re less likely to be swamped, because I need extra time. So I go in knowing what I want to talk about & I have a lot of questions… Which seems to frustrate the hell out of her.

    And I can’t switch doctors easily because not enough in the area know about what I have. I’m getting tired of explaining it over & over again to doctors.

  9. Kaitlyn

    @ K “And I can’t switch doctors easily because not enough in the area know about what I have. I’m getting tired of explaining it over & over again to doctors.”

    Bingo!

    Which was why Dr Ego’s little stunt was so … grraugh. It’s hard to start over. For a doctor, he don’t know much. :P

    And even with all the records (a few pounds from each doctor), a new doctor will want to start anew, I fear, which is more time spent twiddling my fingers and screaming in pain.

    @Ouyang Dan – I called my case manager (I think she was supposed to stop working with me when I was 18 or 20 or something, but she mostly just tells me what I can do and helps Tricare speed up) today, and there are pain specialists in the area, so it’s something to think about. My PCM won’t have a problem with referring me to one, he’s such a nice guy. However, this week has been a bit much, I’m quite tired. So it’s something to shelve until spring break or next week or whatever. I just started PT and want to get that settled – settled as in not seeing him 3x a week! He’s Dr Ego Jr and much nicer than his father, but today’s session left me worse than when I came in (for no reason I can understand, as usual)! But PMs seem to focus on nerves, and I’ve been down that road (Lyrica’s side effects are fun – not being able to read, having the floor drop out from under you – and that just what I noticed and remembered!) so I’m not getting my hopes up. But it’ll be a new direction, and well, I do hate Dr Ego. (Not the first time I’ve shouted at him while crying.)

  10. Kali

    Oh ugh.

    I’ve had to explain every single time why I take my birth control the way that I do. I’m on the pill, but taken so that I never have a period. And every single time, it devolves into the explanation that having a period is hazardous when you have Ehlers-Danlos Syndrome, because it makes hypermobile joints even MORE flexible, which is serious bad news. I wonder how many times that is written in my file. I know I’ve had to tell at least a dozen doctors, and most of the time it results in a conversation where I have to convince a skeptical doctor that I know my rare genetic disorder that they usually don’t even remember learning about in med school better than they do.

    I wish I could get an IUD. I can’t have the hormonal type because straight up progesterone makes my bipolar and anxiety disablingly bad all the time (instead of being highly inconvenient and occasionally disabling). They don’t want to give me one because there’s that low risk of perforations, and the risk goes quite a bit higher when you have a connective tissue disorder like EDS. And add to that the fact that just having a pap done is excruciating, well, I’m not sure I’d survive having an IUD put in. At the very least, I’d end up dislocating several fingers due to clenching my hands into fists. (Pain problem not in the least made worse by the fact that local anesthetics work at something like 25% normal on me, oh no.)

    …which reminds me of the time they wanted to do a urological study – I can’t remember the proper name for it – where they insert a catheter and fill your bladder up by varying amounts and test what happens. The catheter is coated in lidocaine, the main local anesthetic we have. The pain was so excruciating that I couldn’t relax at all, so they couldn’t get anything resembling accurate reads on the test and the whole damn painful study turned up exactly nothing. I was so pissed off, because if they had made some alternate arrangement for local anesthesia (like injecting with lidocaine so I got a hell of a lot more), we might have actually gotten something useful. Instead, I have a bladder disorder they don’t really understand and can’t do anything effective about because I haven’t responded well to the medications they’ve tried on me. Small wonder that I stopped going to the urologist’s office and just invested in a lot of pads, eh?

    ~Kali
    http://www.brilliantmindbrokenbody.wordpress.com

  11. Kao

    I don’t understand the obsession American medical care seems to have with keeping women from having IUDs. I had a nurse prac — at a clinic that the awesome nurse prac at Planned Parenthood assured me offered Mirenas (my coveted BC method of choice) to nulliparous women — tell me there was zero chance they would give me an IUD unless I popped out a kid, because it “might hurt [my] womb.” Uh, what? Why would it be guaranteed to hurt me? Why does a slightly increased risk of expulsion mean I can’t get the method I want?

    I came in informed, I tried to express what I wanted, and instead I got shuttled into the bathroom to pee for… I don’t even know what, a pregnancy test? Either way, I couldn’t produce. Then I got shuttled into a room, waited forever, and the nurse prac just… bulldozed me. She wouldn’t even let me say that I was aware of the risks and comfortable with them – she literally just talked over me. I have facial pain that makes talking difficult; a surefire way of making me incredibly upset is to speak over me.

    She kept pushing me to try the Nuva Ring, even though my paperwork clearly stated that I had migraine with aura. I couldn’t even get a word in edgewise to point out that estrogen is a no-go because of that, since I’d rather not increase my risk for a stroke or blood clot, thanks. Then she pushed Implanon, ignoring that I have heavy periods and nasty cramps. It was so incredibly frustrating, since my face hurt and I kept having difficulty speaking, and they wouldn’t let my husband go back with me. The only bright side was that when I noted I’d had a pelvic done the day before at PP (literally), the clinic’s nurse prac didn’t try to examine me.

    I ended up on a progesterone-only pill, which I’m okay with, but jeez. Why do medical personnel not listen? Now I’ve got to call around and hunt for a facility to give me what I want, what I can safely have. I’m lucky that my insurance permits that, but it sucks spoons that I don’t have.

  12. Kaitlyn

    I haven’t had to explain the BC issue – I’m on Depo right now, and I think it’s messing with some chemistry – zits on my chest, oily hair – but no breakthrough! (I was on Lupron – hot flashes at 18. In summer. In Nebraska. In my aunt’s old farmhouse without central air. I slept on the vent one night, desperate. After Lupron, pills pills pills. At first with a placebo week, but then without. But the breakthrough got too bad.)

    So I haven’t had a “normal” period or cycle since June 2006. At my PCM, they ask every time when doing height/weight/bp, and it’s the same answer every time!

    I’ve been lucky in that I haven’t had to explain other doctor’s decisions that often. Two moments come to mind – I’ve had kidney stones (fun on a bun!) and I take 1000 mgs of Calcium a day, since I don’t make it anymore because… ask my endo! Anywho, it was “fun” (if painful, because GIVE ME DRUGS THERE IS A ROCK IN MY BODY) to see the look on the ER intake nurse’s face as she processed it. “You’ve had kidney stones and you take how much calcium?”

    The other – I went to the school clinic because I thought I had the flu and needed some tamiflu. Well, they need to know your medical history and all meds you’re currently taking. I forget what pain med I was on at the time (that was during the great time when the patches worked and I had little breakthrough pain. Unfortunately, I stayed on them for a year or so after they stopped working), but the nurse was like, “You do know this is addictive, right?” No, I know nothing about the medications I’m taking!

    I think it’s important to listen to your body (and ignore it when your body wants to sleep and your brain knows you have a test today) and know what medications are doing, but it’s also important to communicate with your doctors, either through an advocate or just practice. Writing a letter to Dr Ego… well that wasn’t a good example, but practice can help – they have “authority” in our eyes.

    Oddly enough, I had a short discussion with some girl in the school food court today about BC – she had to take some melting medication, and her companion was like why, and she mentioned BC so we got to talking. It sucks that we can’t know what will work with minimal harm right off the bat, but finding the right one is aces.

  13. Kaitlyn

    @Ouyang Dan – ouch! My PT was picked by Dr Ego (his son is the one doing the torture) but they are night and day in patient interactions.

    I’ve only seen him 3 times, and he’s been very receptive to me, especially yesterday’s horrible pain (tenge (sp?) unit, heating pad, and book for the last part of therapy… ahhh). He has done the leg yank thing, but he’s been very upfront – this is what I’m going to do, tell me at any time, we don’t want to overdo it. And no falling off!

  14. Quijotesca

    Ouyang Dan – Yeah, I think treatment is especially common when it comes to pain issues, which is hardly a good thing. I just don’t see why antidepressants are seen as more desirable than other medications. They create an actual dependency, unlike medications where an addiction is simply a possibility. I can’t stand antidepressants for long because they screw with my ability to concentrate. (A rare side effect. I’m so lucky!) I can, but not as deeply as I want to. I don’t have a “real job” right now, so I’ve been trying to focus on writing, but it’s really hard. I’m not gonna put it on hold for much longer than I have to.

    I went along with taking antidepressants again (not Paxil. Not doing that again) since I was pretty stressed to the point that I just couldn’t get things done. I didn’t really blame myself, but turning things down a few notches until things stabilized a bit seemed OK as long as I was in control of it. I really wasn’t thinking it would affect my pain any, so I’m kind of sick of the assumption that it’s going to take care of everything. I’m also doing some exercises, but that hasn’t quite taken care of it, so it’s back to trying to talk to doctors.

    I’m glad I’ve finally learned to put my foot down, but I really wish it wasn’t so difficult. It’s hard to tell when I’m dealing with someone who can be reasoned with or someone who’s just not going to budge. At this point, I’m trying to avoid a situation where I fight someone for months and don’t get much done. Well, that and I’d prefer someone who isn’t going to talk down to me or suddenly snap at me. That’s not really unreasonable at all and it sucks that I have to deal with that sort of thing.

  15. Jonquil

    “Kaitly: *big gentle hug* Oh, the books I feel I could write on Lyrica side effects, if only I could get through the side effects to concentrate long enough! LOL!”

    Oh, God, THIS. THIS. I swear I have what looks like ADHD thanks to Lyrica; I just can’t concentrate, and I can’t remember words (and I used to be the Goddess of Vocabulary) and if I couldn’t use Google as my external brain, I couldn’t remember quotations any more.

    I WANT MY BRAIN BACK SO MUCH. But Lyrica is the only thing* that’s done anything to make a dent in my chronic intractible migraines.

    * Well, there’s one other prescription drug. But I don’t feel safe specifying it. How sick is that, that I have to be cautious about admitting which *entirely legal* *prescribed by my doctor* medications I take?

  16. Jeanne

    Ouyang Dan,

    It saddens me that in 2010 there are still too many health care practitioners who don’t “get” that a big part of their job is to LISTEN to the patients. No matter how many spoons it takes me, I make every effort humanly possible to go into every health care appointment (doctor, dentist, physical therapist, whatever, etc.) as informed as possible… for my own protection.

    While it may take many spoons to do the research and preparation heading into each appointment, I have found that my time and efforts are (usually) rewarded. I say “usually” because I have most certainly run across the “Nurse Midwife V” type over the years and obviously it is INCREDIBLY frustrating to head into an appointment very prepared only to be ignored or talked over. :( :( :(

    Also, I have a HUGE problem with going into an appointment only to find I am seeing a stranger that I had no plans to see! That really ticks me off. If the doctor I had a scheduled appointment with (made months in advance) is unavailable, the office should call to inform me of this fact in advance! I should not be scuttled from one practitioner to another within a practice at random just because it’s convenient for that practice.

    If I am commuting to see the specialist my PCP referred me to, that is exactly who I expect to see. (This happened once when my endocrinologist’s office randomly assigned me to a nurse practitioner for follow-up on thyroid nodules for which I had gotten a fine needle biopsy). I have since insisted on being seen by my endocrinologist. I also told them I didn’t appreciate them switching me to someone else without notifying me in any way until I arrived to check in.

    When I take the time and effort to be prepared and informed, I expect to be treated with respect and listened to by my health care practitioners. When I get dismissed or talked over, I get furious.

    I have been known to file complaint reports about doctors. Like the time I was 24 years old and single (and not at all ready to be a parent) and a doctor who was looking at my medical history during pre-admission testing for a surgery to treat my endometriosis told me to “get pregnant” as a prescription to “cure” my endometriosis. THERE IS NO CURE FOR ENDOMETRIOSIS!! (By the way, Happy Endometriosis Awareness Month. Feel free to sign my endometriosis awareness petition linked on my blog. We’re targeting mainstream media to get endometriosis FACTS in the media and counter misinformation). ;)

    Sorry, I digress. So, I filed a report against the above doctor for prescribing pregnancy as a “cure” for my endometriosis. The pregnancy cure is an endometriosis myth. Even if pregnancy were a cure for endometriosis (which it is NOT!), that stranger doctor had no way of knowing if I’d be in the significant number of endometriosis patients who is infertile. What he said was so wrong and on so many levels.

    Anyway, any practitioner unwilling to deal with the very real issue of hormones affecting migraines is just plain ridiculous. I won’t even get started on that because this comment is getting pretty long. (Sorry. Gynecology issues can get me really fired up).

    I am lived with chronic illnesses for 28 of my 41 years. Endometriosis was the first chronic illness to affect me. I now have many other conditions as well. I have learned that I HAVE TO advocate for myself (and/or take someone with me on occasion to appointments/procedures/surgeries) because I can’t afford not to.

    It makes me sad that people like Nurse Midwife V just refuse to LISTEN to the patient. The patient knows his/her body best!

    Finally, Kaitlyn… I can empathize with you on the kidney stones. I have had 11 stones and they are not fun. I’m sorry for your pain.

    When I am unsatisfied with the care I receive, I either report the problem, switch doctors (if that’s an option), or both. I refuse to be dismissed or ignored. I know my body and if someone won’t listen to me, I get very upset.

    It saddens me when patients’ concerns or thoughts are dismissed. I’m sorry to hear about the story with Nurse Midwife V. Sadly, such incidents are too common.

    Patients truly do have to advocate for themselves. Doctors with 10 fancy looking diplomas on their wall can sometimes be arrogant and egotistical. Doctors who are highly recommended by others can do/say outrageous things to other patients.

    Patients shouldn’t have to spend so much energy to be heard… but it is important for patients to stand firm and demand that their healthcare practitioners listen. It is sad that there are sometimes no other options in a particular geographical area to switch doctors. I drive out of my way to see the specialists who listen to me and treat me with respect. It takes more spoons to commute… There is no doubt about it. For me, it’s worth the effort to drive further and see doctors who “get it”.

    Thanks for posting a great example of the anguish caused by a health care practitioner who doesn’t LISTEN to the patient.

    Take care,

    Jeanne
    .-= Jeanne´s last blog ..House Sends Health Care Bill To President Obama =-.

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