I went for the GI consult. Office was very busy--staff seemed overwhelmed, and rather argumentative. Waited 45 minutes before a nurse took me back to do weight and vitals. Weight came in as 7 pounds lighter than primary care visit less than a month ago. I believe scale at primary care's office is roughly 4 lbs. heavy. So let's call it 3 lbs. It would be a nice trend. Anyway, the nurse said she was going to get the blood pressure meter. Minutes pass, a knock comes on the door, and it's the doctor. He's older than I am--yeah! Not to be ageist, but I think every doctor I've seen since moving to California as been at least 10 years younger than me. I take it back; Neuro-celeb is definitely older than I am.
Gastro-man's first name is Eugenio, but he has Robert, his middle name, embroidered on his lab coat. I haven't seen an embroidered lab coat in years--it seems very old school. Gastro-man actually read through my notes in their entirety, earning my undying gratitude. He felt my diagnosis of a virus in June was correct, and said it could have lasted 8 weeks. I didn't know a virus could last that long. He talked about how Copaxone opens a hole in your immune system.
He feels that the tenderness in my lower left abdomen is due to an injury to the muscle in the abdominal wall. That was a huge relief, though the healing process maybe very long. I was worrying that it was something much worse. However it is still a problem. He recommended I lay off the physical therapy exercises that stress the area. I am kind of loathe to leave off on the abs entirely, as I am trying to really strengthen the core muscles. Keeping problems in check with the lower back and the legs relies to a great deal on the abs and thighs.
I hate letting any area of my exercise regime go for any reason. Getting it back is so difficult. Maybe I can experiment with some other things? I hope to go to th water stretching class next Monday.
Of course, next Thursday, I am scheduled for a colonoscopy. I wasn't surprised when Gastro-man said he wanted to do one. I last had one in 2001, and in light of my recent troubles, he wants to make sure there aren't any surprises. I was ok with the concept, but did not expect to have it scheduled that soon. I was not asked if it fit in with my schedule--just ad to wait another 20 minutes, then handed paperwork with the date and instructions on it.
Then the nurse came back to finish my vitals. BP 127/95 after I was told I'd be missing 1.5 days of work next week. Then I was sent to the lab, where it took 30 minutes to give me a kit for a specimen. I'll have to stop back by the hospital on my way to work to drop it off...now to figure out how to handle the parking!
All told 2.5 hours at the hospital; 3 hours sick leave used. Next week, it'll be back on unpaid Family Medical Leave.
As always, I feel like I should never tell doctors anything. It doesn't pay.
Showing posts with label doctors. Show all posts
Showing posts with label doctors. Show all posts
Wednesday, September 12, 2007
Sunday, September 9, 2007
not really relevant
OK, crunching along here. Doing ok, in the walking and talking categories, but not great. We went to a plumeria show yesterday. Much walking around in circles, before deciding to purchase a plant. The plant doesn't look like much right now, but I have high hopes for fragrant frangipani.
Tuesday I go to for the GI consult. Oh goodie, another MD to break in. I was thinking about my mystery stomach complaint last week. I realized that the major problem began the first week in June. And I fell and fractured a rib the Sunday of Memorial Day weekend, i.e., May 27th. The bruising in my mid-section was pretty severe. There was pain, but it didn't bother me that much except for when I breathed.
The daily really severe diarrhea started around June 1. It was godawful. I lived on Gatorade, bananas, and rice. Just before we left for ALA and DC, on June 20, I caught a nasty stomach virus. It was dreadful, lasted around 4 days. I know it was a virus, because some of my staff had it first, then I gave it to The Boyfriend and my 83-year old mother. But everyone else had it about 24 hours, and then was fine. I apparently had it twice? Because 4 days after I recovered, I had to go on Immodium again. Did my body just start thinking daily diarrhea was normal?
It finally started to resolve August first. Solid bowel movements, yeah! I know it isn't healthy or "nice" to think or talk about such. But I need to document. I worry that all of this sounds like a mad woman, and that I don't really need a GI consult. But then, last Wednesday, September 5, I got to spend another morning of quality time in the bathroom. And another http://www.blogger.com/img/gl.link.gif1/2 hour of sick leave due to the inability to leave the toilet. Ick. I think I will never again complain of constipation (my old faithful). But I don't want to start any gods laughing.
The post title is referring to the two internal medicine M.D.s I saw in June. I am still peeved that they did nothing to help me. I still can't decide which one was worse. I'd say #1 because she didn't even examine my ribs, but #2 wasn't even concerned when the Xray she ordered showed a fracture. Didn't say anything about the trauma causing other problems. It was only because the pulmonologist said that it may have caused pleurisy, that it even ocurred to me to wonder if it damaged anything else.
Meanwhile, the tender spot (not Spot) on my abdomen that has hurt since December still hurts. It's another thing that doesn't bother me that much, but I've had the "don't ignore pain" lecture sooo many times. So I am not ignoring it.
I figure a GI consult has to mean more tests that my poor upset stomach will not enjoy! I read and hear about "Overtreated". The Boyfriend makes noises about medicalizing everything. But I feel like MS kind of sentences me to being hypervigilant. I have to keep watching every single thing, because I don't know where the next attack will come from. And my health history is just filled with weird things turning into disasters. Unlikely or not.
Some day I will do a crabby post on all the ways I test myself daily. I literally ask my body every morning, "How's it going?" BTW, I was able to stand on one foot for a count of 20 yesterday. That's very good. Maybe I'll again be able to put on underwear standing up. That would be a huge victory. Though it couldn't touch typing with four or more fingers. That's a dream.
Thursday, August 16, 2007
the new primary
Notes for Millen, 8/16/07
Here's my pre-visit notes, below. I scrawled on the bottom "arthritis, asthma, counseling." Im trying to think about the visit without having emotion color it to much. The doctor definitely has clinical detachment going for her. She had gone over my chart, and seemed to feel there was no worries.
When I explained that I am very nervous about medication changes due to the thing this spring with the sleep deprivation and psychotic episode, she was kind of dismissive. I should be careful, but it was unlikely. My health history is literally littered with unlikely events.
She tried to recommend an antidepressant for hot flashes. I told her I have been prescribed antidepressants 4 or 5 times in the last 10 years, for sleep and mood problems. They never helped at all. Oh well. I need some time to process.
=====================================================================================
Stomach problems--diarrhea frequent 5/5-8/1. Repeated viruses? Really bad in June--daily, Immodium. Seems to be resolving finally. Still some loose stools, but less frequent.
Pain in lower left quadrant since December 2006. Tender when doing PT. Recently some pain in lower right quadrant--fleeting.
In June, Poast said stomach problems could be MS, and to return in 2 weeks for follow up. First avail appointment with Millen was 2 months. Thought I should establish relationship with you. Toughed it out. Is it realistic to see you primarily, or should I go with one of the others? If so, recommendations?
Corey-Bloom not interested in discussing symptoms. In July, said to get a GI consult. First eliminate other problems.
Need new levothyroxine Rx.
Sciatica has come back. Pain and pins and needles, cramping. On hiatus from PT since bruising ribs in late May. Doing exercises/stretching at home daily. Real problems with fatigue. Knees weak first thing in the morning. Don't think I have the energy to do PT while working full time. Even using FML, it's exhausting.
Right foot--lots of spasms. Index toe curling independently. Some soreness still in the wound area, but not acute.
Lots of hot flashes some nights, particularly around menstruating, but other times as well. Hot flashes set off muscle spasms and neuropathy at times--very little sleep those nights. Already doubled up to 600 mg gabapentin at bedtime.
Email notes in advance? Sawires preferred.
Here's my pre-visit notes, below. I scrawled on the bottom "arthritis, asthma, counseling." Im trying to think about the visit without having emotion color it to much. The doctor definitely has clinical detachment going for her. She had gone over my chart, and seemed to feel there was no worries.
When I explained that I am very nervous about medication changes due to the thing this spring with the sleep deprivation and psychotic episode, she was kind of dismissive. I should be careful, but it was unlikely. My health history is literally littered with unlikely events.
She tried to recommend an antidepressant for hot flashes. I told her I have been prescribed antidepressants 4 or 5 times in the last 10 years, for sleep and mood problems. They never helped at all. Oh well. I need some time to process.
=====================================================================================
Stomach problems--diarrhea frequent 5/5-8/1. Repeated viruses? Really bad in June--daily, Immodium. Seems to be resolving finally. Still some loose stools, but less frequent.
Pain in lower left quadrant since December 2006. Tender when doing PT. Recently some pain in lower right quadrant--fleeting.
In June, Poast said stomach problems could be MS, and to return in 2 weeks for follow up. First avail appointment with Millen was 2 months. Thought I should establish relationship with you. Toughed it out. Is it realistic to see you primarily, or should I go with one of the others? If so, recommendations?
Corey-Bloom not interested in discussing symptoms. In July, said to get a GI consult. First eliminate other problems.
Need new levothyroxine Rx.
Sciatica has come back. Pain and pins and needles, cramping. On hiatus from PT since bruising ribs in late May. Doing exercises/stretching at home daily. Real problems with fatigue. Knees weak first thing in the morning. Don't think I have the energy to do PT while working full time. Even using FML, it's exhausting.
Right foot--lots of spasms. Index toe curling independently. Some soreness still in the wound area, but not acute.
Lots of hot flashes some nights, particularly around menstruating, but other times as well. Hot flashes set off muscle spasms and neuropathy at times--very little sleep those nights. Already doubled up to 600 mg gabapentin at bedtime.
Email notes in advance? Sawires preferred.
Friday, July 27, 2007
under currents
I saw the godlike neurolgist yesterday. Actually, she was almost human. Maybe it just takes her a long time to warm up. I've been seeing her for a year. My old neurologist in Philly was a great guy. I always looked forward to seeing him, because we would discuss politics and books. However, he apparently misdiagnosed me for like 8 years, which puts our relationship in a whole new light. I sometimes consider writing or calling him, but I know he is very busy and I don't want him to think I'm thinking of suing, or something...Still, I wonder about how and why. Medicine isn't really an exact science, and even really smart people make mistakes.
So, the San Diego neuro is about as much fun as sorting socks. But she's considered the best MS md on the west coast, and I am lucky she is here and took me. Being grateful is not my best role, and she is more than a little weird. Yesterday, we compared notes on how incredibly stupid administrators can be. In particular, how "negative" comments and questions can get you in heaps of trouble. So, we actually commiserated a little. It was nice, because I felt like she was accepting my intelligence as being equal to hers. I often feel like I have to prove my intelligence to doctors. I think they often end up thinking patients are kind of dumb.
I also always have to go through this thing about my pain tolerance. I have a very high tolerance for pain. This may seem like a good thing, offhand. However, it means I can not notice something is wrong until it's really pretty bad. Little things, like a new pair of shoes being markedly uncomfortable and I take them off after four hours to discover I left the cardboard shape holder things inside one of them. When I am in pain, I keep going. I walked to the ER when I was in labor before birthing my daughter. It took like 2 hours to convince them to wake up a resident to examine me. At that point, I was 9 cm dilated. A nurse told me most women are screaming by then. I just wanted to keep walking, because my back hurt laying down. You know they made me lay down.
Anyhoo, this scenario gets repeated endlessly: I see a doc that I don't know well. I complain about discomfort. They disregard it. A week later, something major is clearly wrong. (My old neuro used to always tell his students how I complained of discomfort after I had a stroke in my spinal column. "Beware stoics," he said.) I feel like I have to "break in" new doctors. Somewhere here, I'm trying to say that maybe I have broken in the new neuro a little.
Her big news is that Copaxone is now approved to go unrefrigerated for up to 30 days. Woohoo! Traveling just became ten times easier. Here it is, official. You see how trusting I am not--I double checked. She told me she found out Wed. (7/25/07) It was announced 6/6/07. I really thought Copaxone should have sent something out--they love sending me mail. This information was so useful, I can't believe they didn't share it. Well, it will make the trip next week a lot easier. Would have made the trip in June easier, but I can forgive them. Just think of the space this gives us in the fridge!
Anyway, she thought I was doing pretty good. Keep up the Copaxone and physical therapy. I asked her if she could recommend an internist with some experience with MS. I told her about my most recent experiences, waiting ten weeks for an appointment with my new primary care. She said the business with seeing inexperenced mds is part and parcel of managed care. She wanted me to go back to the baby docs and get a GI referral. I am going to try to wait it out and just go to the new primary care when I get back from my nephew's wedding. At least, that's my plan right now.
So, the San Diego neuro is about as much fun as sorting socks. But she's considered the best MS md on the west coast, and I am lucky she is here and took me. Being grateful is not my best role, and she is more than a little weird. Yesterday, we compared notes on how incredibly stupid administrators can be. In particular, how "negative" comments and questions can get you in heaps of trouble. So, we actually commiserated a little. It was nice, because I felt like she was accepting my intelligence as being equal to hers. I often feel like I have to prove my intelligence to doctors. I think they often end up thinking patients are kind of dumb.
I also always have to go through this thing about my pain tolerance. I have a very high tolerance for pain. This may seem like a good thing, offhand. However, it means I can not notice something is wrong until it's really pretty bad. Little things, like a new pair of shoes being markedly uncomfortable and I take them off after four hours to discover I left the cardboard shape holder things inside one of them. When I am in pain, I keep going. I walked to the ER when I was in labor before birthing my daughter. It took like 2 hours to convince them to wake up a resident to examine me. At that point, I was 9 cm dilated. A nurse told me most women are screaming by then. I just wanted to keep walking, because my back hurt laying down. You know they made me lay down.
Anyhoo, this scenario gets repeated endlessly: I see a doc that I don't know well. I complain about discomfort. They disregard it. A week later, something major is clearly wrong. (My old neuro used to always tell his students how I complained of discomfort after I had a stroke in my spinal column. "Beware stoics," he said.) I feel like I have to "break in" new doctors. Somewhere here, I'm trying to say that maybe I have broken in the new neuro a little.
Her big news is that Copaxone is now approved to go unrefrigerated for up to 30 days. Woohoo! Traveling just became ten times easier. Here it is, official. You see how trusting I am not--I double checked. She told me she found out Wed. (7/25/07) It was announced 6/6/07. I really thought Copaxone should have sent something out--they love sending me mail. This information was so useful, I can't believe they didn't share it. Well, it will make the trip next week a lot easier. Would have made the trip in June easier, but I can forgive them. Just think of the space this gives us in the fridge!
Anyway, she thought I was doing pretty good. Keep up the Copaxone and physical therapy. I asked her if she could recommend an internist with some experience with MS. I told her about my most recent experiences, waiting ten weeks for an appointment with my new primary care. She said the business with seeing inexperenced mds is part and parcel of managed care. She wanted me to go back to the baby docs and get a GI referral. I am going to try to wait it out and just go to the new primary care when I get back from my nephew's wedding. At least, that's my plan right now.
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