Wha? Doctors that seem to know what they’re doing? Twice in one day? Get out!

So it seems my iron levels are up again. I’ve finally rebounded from my little stint with anemia and my iron levels have gone back into the stratosphere. What I find interesting is that in the last six weeks or so, I’ve had a plethora of blood work done. First, because I went to the primary care doc and complained of rapid weight gain and feeling cold all the time. That was his cue to check thyroid, after I suggested to him it might be my thyroid. I was right, the thyroid numbers were off. Which got me handed off to an endocrinologist. He couldn’t figure it out and did do much. The primary care doc wanted me to get a physical and ordered a bunch more tests. I reminded him to order an iron panel. Good thing I did. Way high again. Time to go back to a hematologist again. Thyroid levels were even more way off. Send a message to endocrinologist, who responds back – follow up in 12 months. Really, are you kidding me? I think that’s code for “go get a second opinion and maybe somebody else can figure out what’s going on, because I sure can’t be bothered.”

I really didn’t like, no, make that despised, the hematologist that I saw last time. He was dismissive, arrogant, smug and overbled me. Worst of all, he contradicted whatever my hepatologist (who I think is a rock star) said. I had been avoiding this d-bag for months, and now that my iron levels were in the stratosphere again, I had to find somebody who would give me the “Mother May I” to dump some blood. Ah-hah, a review on Yelp from someone who has Hemochromatosis who raved about a doctor. Small world, she’s in the same office as Dr. Smug.

Side note to any doctors who might be reading this. You might hate Yelp, but until you come up with a better system to find a decent doctor, shut up.

You surely know me well enough by now that I have no problem breaking up with a doctor and dating his roommate, which is just what I did. It didn’t seem to surprise the office staff that I was cheating on the first doctor.

Best move I made in a long time. She actually had 21-st century training in hemochromatosis and I got the feeling that I wasn’t her first rodeo. She even pronounced it correctly. Matter of fact, reviewed what went wrong last time and how to tweak the treatment. Talked to me like I wasn’t crazy. There is hope!

To top it all off, as I’m parking the car in front of the Medical Center, I get a call from Rock Star Hepatologist office: “Dr. F saw your lab tests. He wants to see you right away.” Uh, oh. You mean to tell me that after all of these other docs who looked and my abnormal test results and blew me off, Doc RockStar paid attention? I haven’t seen this guy in a year, and he’s watching my lab tests? Dang! There’s a reason I think he’s a rock star, he’s that damn good. This guy is probably has a patient load three times what the other guys do, sees patients in a 300-mile range throughout the state, and yet will call you at home on a Sunday to answer an email, not to mention will testify in court on your behalf.

Of course, the downside is that finding a time slot to see him is tricky, I have to wait eight weeks, or hope for a cancellation. Hopefully my iron levels will be back to normal by the time that rolls arounnd and he’ll have nothing but positive things to say about my health. Glad at least to see that there’s some doctors out there who don’t blow off the hard cases, and have my back.

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Don’t make me lie to you.

So I ended up in ER today. I didn’t want to be there. I wanted to be at my primary care doctor’s office, or even  the urgent care office. I was perfectly capable of getting myself to those places, except those places weren’t open. It was Martin Luther King Day, and apparently it’s not allowed to require medical help on a holiday.  Except at the Emergency Room. So that’s where I ended up.

A few days earlier, I had taken a nasty fall and really banged myself up. I was alright, or so I thought, until 24 hours after I went tumbling down the steps of a bus onto hard pavement my spine decided to file a complaint. It went on strike and refused to work. My back decided to take the day off.

After getting a lecture from an Endocrinologist about osteoporosis last week, I had two goals in seeking medical advice: Pain management and checking for fractures and breaks.

After almost two hours of hanging out in the waiting room, I finally see the doctor. The first words out of his mouth were “When was the last time you had a tetanus shot?”

Really?   I didn’t step on a nail, and wasn’t there because I had cut myself. I had hurt my back. Where does a tetanus shot come into the picture?

I told him it was irrelevant, that I had a vaccine reaction (check my chart under allergies – it’s right there), and that I settled my case with the Department of Health and Human Services. He shut right up and changed the subject.

I’ll never really know, nor would this doctor ever admit it, whether he changed the subject because he thought he was seeing the “crazy-lady-in-a-tinfoil-hat” patient, but his tone changed right after that. He did his job, but I could tell he wanted me to move right along.

Mentally, I was slapping my forehead and saying “stupid, stupid.” Why didn’t I just lie to him? When was my last tetanus shot? Why, a couple of years ago, I think.  Why does this doctor deserve the truth if he’s trying foist something on me that I don’t need? Would the doctor have thought of me differently if I had given him that answer, rather than giving him reason to believe that I had a mind of my own? I suppose I’ll never know. I have to figure the only reason that I wasn’t offered a flu vaccine is that they were fresh out of flu shots.

As far as the conversation with the endocrinologist went, he was gung-ho for me to go on osteoporosis-preventing drugs.  Now, I agree with him, my tests have indicated that I am pretty well on my way to having bones as strong as pretzel sticks at a very young age (relatively), but we differ on treatment and prevention.

This doctor is relatively new to my story, but I’m sure he doesn’t realize how profoundly my health, finances and life were affected by bad reactions to pharmaceuticals that were supposed to make my life better. Skeptical doesn’t even begin to describe how I approach a new medication.

Just because the Flying Nun raves about how cool and stylish her bones are thanks to modern medicine, doesn’t mean I’m about jump on that bandwagon. I told the doctor that I would research it and we would discuss it. He reluctantly agreed.

In my research of Fosamax and his friends, I found that a common side effect is bone and joint pain. Wait. I already have bone and joint pain. I’m not signing up for an extra helping of that.  So, diligently doing my homework, I discover that a version of Strontium is approved in Europe for osteoporosis and is 10 times more effective than the Fosamax gang. It’s available by prescription only in Europe, why isn’t it commonly prescribed here in the US?

Yes, you guessed it. Money. It seems that Strontium is a mineral, like calcium is.  No pharmaceutical company has bankrolled the clinical trial necessary to get this on the menu.  Big pHARMa can’t make any money selling  a mineral, which they can’t patent.  So there you go. Mr. Merck and friends would rather have you take something far more expensive and dangerous.

So, what will I tell the doctor about my decision on osteoporosis treatment? Sure, give me the prescription. I’ll never get it filled, and take the generic strontium (which is easily available) instead. I’ll let you believe that I complied with you and the pHARMa agenda.  When it comes time to recheck my bone density levels, let’s see what the results say.

After that, will I lie to the doctor?  Probably. They don’t like it when patients think for themselves.

Are your ears broken?

One of the things I love about my job is I get to go to some interesting places and meet some interesting people. Last week, I worked at a medical conference. Doesn’t matter what type of medicine, once these guys (and gals) are out of their familiar environment, they become completely helpless. Sad, really.

I’ve often felt, and you may have felt too, that doctors don’t listen. On more than one occasion, something I’ve told them has gone in one ear and out the other, or ended up in my medical records completely twisted around.

My little stint at the medical conference last week proved that doctors aren’t listening to a thing you or I say. Indeed, their ears are really broken. It seems that at the registration desk of this conference, certain people were entitled to a sweatshirt. Or as they were referred to, a “fleece.” Seems someone messed up on the fleece-ordering task, and the more popular sizes ran out quite quickly. By mid-morning, only Extra Large Fleeces were available.

So, as I was checking in these learned men (and women), I’d say something to the effect of “Sorry, we are limited on sizes. We only have Extra-Large. Would you like one?”

Invariably, every single one of them said. “Oh. Do you have a Medium?”

What the heck did I just tell you? “Sorry, only Extra-Large.”

“Then I’ll take a Large, then.”

WTF is wrong with your ears? Do you hear yourself? Apparently not.

If you can’t be bothered to listen to someone giving you one of those coveted fleeces, you must not bother to listen any of your patients. Which is something I knew long ago. This day just proved it. None of them listen. They don’t have to. They’re “doctors.” Now hand over that fleece.

It’s a genetic defect, not a character flaw.

Hey Dr. Specialist, don’t you dare call me fat, lazy and weak until you have completely reviewed my medical background. If I’m in your office for a problem with my bladder, treat THAT, and don’t tell me that I need a personal trainer twice a week and I should lose weight.

The fact that you even noticed hemochromatosis on my chart and the comments that you made, told me that you’ve never seen a patient who actually had it, and that the only thing you know about it is outdated information that you learned decades ago in med school. If you had, you would know that the primary complaint is weakness, then fatigue. It’s a GENETIC DEFECT not a character flaw.