Friday, April 9, 2010

If I Was Your Patient (God Save Your Poor Soul)

Note:Well, this wasn't supposed to post! It was a draft, but I hit the wrong button or Blogger farted, something, so here you go!

I want to clarify a few things to give a more balanced perspective of not just myself but of doctors too.

1. I do get along with doctors. Really. The current pulmonologist is a great example--we totally jive. I give her thank you gifts. She gives me hugs and kisses the baby. In fact, I'm going shopping for her, her colleagues and her stellar secretary this weekend. I am a big believer in rewarding kindness. Do you know in the corporate world something like 70%+ of managers don't say thank you to their staff? I hate that. I wasn't like that as a manager and I'm not like that as a person.

I know people suck. I try not to suck as a patient.

The pulmonologist before the current one, my first, took the time to write me a very sweet farewell note (and oh was I crushed when she left *sob*). That woman changed my life and health for the better. She used to say I was her most educated asthma patient and she would have her residents quiz me to see if they could trip me up. She also said I was one of her more severe asthma patients too. She's very well respected and I wonder if I got her to write me a note 'Pissed Off Patient does too have asthma, leave her be' if that would improve things?

I have an OB I can only see off and on due to insurance, who is fantastic. I've had several really great primary care physicians too although there was a dry spell there for several years where I couldn't find anyone who as a)sane and b)not a drug addict (that is not hyperbole by the way).

I've had long term relationships with physicians without drama. 8 years. 7 years. 6 years. 4 years. In short, I'm not drama queen enough to ping pong from doctor to doctor. This is a good sign I think.

2. I am a polite patient. I'm on time. I pay my bill. I say please and thank you. I phrase things as ideas or 'is this possible' or 'could we do this'. I could not breathe and I was panting 'Thank you' to the ER doc last week--unfortunately I don't think he heard me.

I am also a big personality with a long medical history and that can be a lot to absorb too.

If I don't agree with you, I might challenge you a bit but I mostly let it drop and revisit another time or I may try a specialist if I feel really strongly about it. I really don't want to get involved in protracted debates with anyone. I've had instances where my doctor didn't agree with what I needed and I had to wait them out. Which I did and it was fine, no one got hurt.

If you suggest a treatment plan and I don't like it, I'll likely still give it a chance and see what happens. I'm open and willing to work with people so long as they are reasonable. I go to the doctor precisely for their ideas based on their expertise. It does me no good to be stubborn just because they won't do exactly what I want. So long as there's some attempt to meet in the middle and the door is open to revisit things if their treatment doesn't pan out, I'm good.

3.I know I don't know as much as a doctor. I make every effort to be an educated patient. I research, I read, I think, but I run everything past my doctor because I know I don't have anywhere near the depth or breadth of education nor experience to make certain decisions on my own. But you can't snow me either and I've caught docs lying in an attempt to brush me off, thinking I don't know basic anatomy or physiology. I don't go back to them.

4. While I'm aware of my limitations, I do think my experience as a patient counts and I expect to be listened to. I intimately know the difference between a virus and a bacterial infection. If I ask for antibiotics, I need them. (Note this latest asthma drama, I refused them and was clear with the pulmonologist that this was a virus.)

I'm a little unusual in that I get excited when I get over an illness 'by myself'. I love it when I don't need antibiotics! I feel strong and healthy when I kick a bug's butt all by myself without a major asthma flare up. That never happened until Advair hit my lungs in the 90s.

You should see me flip with joy when everyone else gets sick and I don't get it, which is like, soooo awesome I have no words for it. I wish it happened more often. It's like "LOOK. That's my immune system actually WORKING over there!" Just thinking about it makes me giddy.

5.I'm an infertility survivor. If you have not spent any time reading infertility blogs, you are missing out. Don't mess with the barren bitches. We do it hardcore. I'm nowhere near as bitter as I used to be and I actively worked against becoming bitter while undergoing infertility treatments as I saw how damaging it could be to the psyche.

You know, the pro life movement targets infertility treatments, but I notice they don't have the balls to picket the fertility clinics. I've always said it's because they know better than to mess with desperate women who are shooting up hormones that induce pure rage.

We would probably rip their throats out and not even blink and I bet they know that.

Hardcore, people. Be careful with the infertiles.

You don't go through infertility without learning to ferret out medical information or read medical studies. You also get a little harder too and a lot more assertive. Once you gain those skills, you start having opinions and they don't stop when the In-vitro is done. I can't turn it off.

Truthfully, I wouldn't want to. More than any doctor, the single most important factor in improving my health has been me. Me doing the research. Me asking the questions. Me asking for tests. The truth is, doctors don't come to me volunteering aid, I go to them. It all starts with me.

6. I am a rule follower which means I take my medications pretty much exactly as prescribed. You can count on me to follow through. I'm not going to be the patient who refuses to conform to the treatment plan unless there are extenuating circumstances. Of which I will inform you about. Probably in too much detail because I want to thorough.

Hey, for a living I shipped chemicals that go 'boom' on your vacation flight to Florida (and if I didn't, some other company did. You have no idea what is under your feet on a plane. Dangerous stuff). Details matter when dealing with explosives and passenger air craft. I'm a little anal. Try to view it as positive. Think of all the people I didn't blow up.

Oh and if I screw up, I'll admit it and own it. I'll apologize too.

7.Lots of medical things have happened to me that weren't supposed to or that had weird presentation. I had an 'appendectomy' where they left my appendix intact. It looked exactly like I had appendicitis. Everything fit; the fever, the blood work, the pain. It was pitch perfect textbook appendicitis.

Only not.

It was a kidney infection--a super bug resistant to antibiotics. I totally do not blame the doctors at all. I would've thought it was my appendix too if I had been in their shoes.

Ironically, they all ran away and hid from me while I was in the hospital and wouldn't talk to me. And then they wouldn't give me my records,which I wouldn't have asked for if they would've just talked to me. I am pretty sure I hadn't scared them off with my horrid personality because a) I was a sweet young thang of 20 and b) I was too busy hallucinating on the Percocet they gave me to function.

I finally got the records by telling the surgeon's office I wasn't planning to sue them, they were just for my primary care provider. (Sometimes I wonder what they think they did so wrong, because they were really afraid of me and I don't see it. It seemed like an honest mistake to me. I was more pissed that they left my gut full of gas from the surgery and I couldn't fit into my clothes for a week. I had to use the motorized handicap scooter at WalMart to buy some sweatpants on the way home from the hospital. )

I then took the records to my NP and asked her to help me figure out what had happened, because no one had told me anything and it had been an emergency where I was alone with no family around. Beyond the fact that I still had my appendix and I'd had 3 days of IV antibiotics, I had no idea what had happened to me. The NP had to tell me about the antibiotic resistant bug!

That kind of shit happens to me all. the. time. It is just bizarre. So I don't take things on faith and I don't like pat uniform answers because my physiology is not wearing the same uniform.

You gotta be a good critical thinker if you're going to be my doctor--you have to know more than me (sometimes I've been kind of surprisingly underwhelmed in that area.). You need to want to work with me and partner with me. I will listen to you. I will thank you. I will treat you with kindness assuming you do the same for me.

But if you act up, play games or behave abusively, all bets are off.

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