{"id":280,"date":"2009-03-19T17:35:34","date_gmt":"2009-03-19T22:35:34","guid":{"rendered":"http:\/\/bekahcubed.menterz.com\/blog\/?p=280"},"modified":"2009-03-19T17:35:34","modified_gmt":"2009-03-19T22:35:34","slug":"medicine-schmedicine","status":"publish","type":"post","link":"http:\/\/bekahcubed.menterz.com\/blog\/2009\/20090319-280.htm","title":{"rendered":"Medicine Schmedicine"},"content":{"rendered":"<p>At lunch today, my dad suggested that perhaps my file at the University Health Center is flagged &#8220;Pain in the [deleted]&#8221;.  If it wasn&#8217;t before this afternoon, it probably is now.<\/p>\n<p>After all, my <b>real<\/b> Doctor&#8217;s office (where I see my Physician Assistants) has a slightly nicer flag that probably means the same thing: &#8220;Do not schedule for appointments less than 30 minutes long.&#8221;  I saw the flag once, a giant yellow banner at the top of my computerized information.  It lets the scheduler (and the PA&#8217;s) know that I&#8217;m going to be an involved patient.<\/p>\n<p>And I am an involved patient.  I consider myself to be the head of my health care team&#8211;whatever the physician may think of himself.  No one else knows my body, my mind, or my medical history as well as I do.  No one else knows all the information (and unfortunately, too many doctors would prefer I not give them all the information.)<\/p>\n<p>And since I&#8217;m the one who knows me the best, I deserve to be heard in the doctor&#8217;s office.<\/p>\n<p>Unfortunately, that&#8217;s not the way doctors always see things.  Too often, I see a physician&#8217;s eyes glaze over when I start detailing my past medical history and current diagnoses.  Too often, I get brush-offs when I raise a question about something the doctor tells me.<\/p>\n<p>I probably don&#8217;t have to be as upset as I am about today&#8217;s visit.  After all, he&#8217;s going to run the blood work I wanted him to do.  I would have been happy if he&#8217;d just run the blood work and said &#8220;Let&#8217;s wait for results before I tell you anything else.&#8221;  So why should I be so upset that he did what I wanted and then gave me all sorts of &#8220;free&#8221; advice.<\/p>\n<p>He was just being a University Health Center- type doctor, giving his patient what he thought she wanted to hear.  &#8220;Let me give you some self-help ideas to deal with your &#8216;dandruff&#8217;, &#8216;sleep problems&#8217;, &#8216;heartburn&#8217;, and dry skin.&#8221;  What he didn&#8217;t realize or bother to find out was that I already know how to handle dandruff, sleep problems, dry skin, and heartburn.  I also already know that I don&#8217;t have sleep problems or heartburn&#8211;and highly doubt that I have dandruff.<\/p>\n<p>I say I&#8217;m fatigued and tell him that I haven&#8217;t had a consistent sleep pattern &#8220;since this started&#8221;.  So he tells me to establish a consistent sleep pattern.  He gives me all sorts of advice to help me sleep better.  What he didn&#8217;t bother to do was give any answers for the problem I was there for&#8211;extraordinary fatigue that is keeping me from being able to perform my daily activities (working a job, keeping up with the laundry, and washing the dishes) DESPITE getting 7-8 hours of sleep every night.<\/p>\n<p>I tell him that I&#8217;m having chest pain&#8211;which I&#8217;ve had before.  I tell him that the chest pain is a stress response&#8211;I know it&#8217;s not heart problems (because I had a complete heart work up last year and got a clean bill of heart health).  I tell him that I&#8217;m worried because I don&#8217;t think I&#8217;m experiencing enough stress to warrant this extreme physiological stress response.  So he tells me I have heartburn and gives me advice for managing heartburn.<\/p>\n<p>I brought up the dry skin, mainly to make sure he knows I need to have my thyroid checked.  I point out that the dry skin has worsened even as I quit the job that had me washing my hands with drying soap several times an hour.  He tells me this winter&#8217;s been bad for skin and that I should wear gloves when I wash my dishes.  (Yes, I know.  But did you miss the part where I said I&#8217;m too tired to keep up with the dishes?)<\/p>\n<p>I don&#8217;t know why I brought up the itchy scalp stuff.  Probably because it hasn&#8217;t responded to dandruff shampoo&#8211;even though I was leaving the shampoo on for quite a while (10-15 minutes a pop).  Probably because my two PA roommates think it&#8217;s psoriasis.  Probably cause I wanted to make sure I didn&#8217;t miss anything that could be potentially useful in making a diagnosis of my REAL problem.  But the doctor took it as a serious problem and paid no attention to my assertion that dandruff shampoo had no effect on the itchy stuff on my scalp.  He insisted that I had dandruff&#8211;and that I ought to wash my hair with dandruff shampoo once a week for (get this) 15 minutes before rinsing it off.  Imagine that!<\/p>\n<p>I got what I wanted&#8211;an order for a complete blood work-up including TSH (thyroid stimulating hormone). I just wish I didn&#8217;t have to go through the frustration of THAT to get it.<\/p>\n<p>I miss my health care team.  I miss my PA&#8217;s who let me tell them my whole story before they break in with questions, who tell me what they&#8217;re thinking when they&#8217;re doing their differential diagnosis, who take my questions seriously.  I miss the team that already knows my meds, and understands why I&#8217;m on them.  I miss how they always ask me for any last questions before I leave.  I miss how they know to hand me a copy of my charts and laboratory values before I leave so I can put them in my personal medical file.  I miss my pharmacists too.  I miss seeing the same person every time I go to the pharmacy.  I miss being able to get my prescriptions filled while I do my grocery shopping.  I miss the pharmacy&#8217;s willingness to answer every question I have.<\/p>\n<p>I guess I miss my Blue Cross Blue Shield insurance.  Yeah, I didn&#8217;t have &#8220;free&#8221; visits to a clinic like I do with student insurance&#8211;but at least I got to see <b>my<\/b> team.  I might not have the flexible scheduling of on campus health care&#8211;but at least I had confidence that my health care providers were practicing evidence based medicine.  So there were more hoops to jump through back then&#8211;but at least then I was the head of my health care team.  Here, at the Health Center, I&#8217;m just another dumb student who needs to use more lotion.<\/p>\n<p>Medicine Schmedicine. Nothing worth stressing about, right?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>At lunch today, my dad suggested that perhaps my file at the University Health Center is flagged &#8220;Pain in the [deleted]&#8221;. If it wasn&#8217;t before this afternoon, it probably is now. After all, my real Doctor&#8217;s office (where I see my Physician Assistants) has a slightly nicer flag that probably means the same thing: &#8220;Do &#8230; <a title=\"Medicine Schmedicine\" class=\"read-more\" href=\"http:\/\/bekahcubed.menterz.com\/blog\/2009\/20090319-280.htm\">Read more <span class=\"screen-reader-text\">Medicine Schmedicine<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"ngg_post_thumbnail":0},"categories":[11],"tags":[],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/posts\/280"}],"collection":[{"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/comments?post=280"}],"version-history":[{"count":0,"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/posts\/280\/revisions"}],"wp:attachment":[{"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/media?parent=280"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/categories?post=280"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/bekahcubed.menterz.com\/blog\/wp-json\/wp\/v2\/tags?post=280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}