Ambivalence

Preparing to see a new doctor is frustrating.  In addition to filling out mountains of paperwork, I have to guess which aspects of my medical history the doctor will deem important.

Will he want copies of any of my prior lab work?  Which of those tests might matter?

Will he want my guesses about what’s going on, or should I keep my thoughts to myself unless asked?

Will he want to know about discontinued medications as well as current meds?  He should, since two or three of them are pertinent to the situation.  What if he doesn’t ask?  If he does, will he want exact doses/dates, or just the med name and approximate dates?

How I long for the days when I had only one doctor and saw him only for my physicals & the kids’ well-child visits.  I liked going in for a routine check-up and being told, “You’re healthy.  Come back in two years.”

Alas, those days are gone.  While I’m thankful that people have selected medicine as a career, and I’m grateful to my physicians for their help, I am weary of needing to see doctors.

So very weary.  I’m tempted to cancel my upcoming appointment with yet another specialist.  If it weren’t for the threat of getting a “non-compliant” label, I never would have scheduled the appointment.  On the other hand, what would be the point in asking my doctors for their expert help and then ignoring their recommendation?

Some days I find myself asking, “What did I ever do to deserve this?  Why does my immune system hate me?”  Then I cancel my little pity-party and get back to figuring out how to cope with this situation.

I want this appointment to go well, so I need to be prepared (unless I call the whole thing off, in which case I need to be prepared to explain that choice to the referring doctor).  Although I don’t want to go, I probably should.  To that end, in addition to gathering information, I’m reviewing some of the things I’ve learned in the past few years about doctor-patient interactions.  It feels like I’m cramming for a test:

know why you’ve been referred (Dr. Grumpy)

remember that doctors are human, too (Jill of All Trades)

small-talk matters (Dr. Synonymous)

ask, “what else could it be?”  (Groopman)

provide the information doctors need (Medical Interview)

Letter to Patients With Chronic Disease

There’s certainly more, but with any luck, this will get me off to a good start with this new doctor.

Patient Perspective on Refills

Med renewal appointments are supposed to be quick.  How hard can it be to verify that everything is okay, then write a new prescription?

Although I’d love to have my pharmacy fax my doctor about my prescriptions, doctors want to periodically examine the patient before authorizing more refills.  It doesn’t take very long reading medblogs to realize that there’s a reason my doctor won’t okay refills over the phone (or fax).  Maybe something has changed and the dose needs to be tweaked.  Maybe the medicine isn’t effective, so a different one needs to be tried.  Medblogs are great for learning the reasons that doctors offices do some of the things they do.

It’s one thing to read about it in theory, it’s another to experience it.

At a recent appointment, I asked for a renewal on two prescriptions.  Simple, straightforward.  That was the whole purpose of the appointment; I figured it would take five minutes.

One medicine is a headache prophylactic that I’ve taken for three years.  As usual, my doctor asked about headaches.  Normally I say there have been none, then he writes the renewal.  This time, however, I mentioned that I’d been having headaches, but figured out that it was due to the muscle relaxant I’d been taking.  I quit taking it, and have had no headaches since then.

While this was good news in obtaining a renewal on that med, it threw a wrench in the works for the other medicine that I wanted more of.

That second medicine was to treat a rash.  That rash was thought to be from a medication interaction.  If you start taking a new medication and subsequently develop a rash, then it makes sense that the med might have caused the rash (especially when it’s listed as one of the med’s possible side effects).  It also makes sense that discontinuing that med would make the rash go away.  If you discontinue the med, but the rash continues to get worse, then maybe the rash was caused by something else.

I knew that, but I don’t care.   I don’t care what the rash is.  I don’t want to know.  I don’t want to go to more doctor’s appointments.  I don’t want to have more tests.  I don’t want to incur more expense.  I don’t want another diagnosis.  I am done!  All I wanted was for my doctor to write a prescription so I could refill my meds (so that I can have little round scars on my legs instead of ugly bleeding sores).

Apparently, good doctors care what a rash is, even when the patient would rather not know.  I don’t want to go to more doctor’s appointments – but I have a referral and the appointment is already scheduled.  I don’t want to have more tests – but the doctor will probably want to run some.  I don’t want to incur more medical expenses - but all of this is going to cost money.  I don’t want another diagnosis - but it looks like I’ll walk out of there with one anyway.

Last week I checked in at my FP‘s office expecting my doctor to renew two prescriptions in a very quick appointment.  He did write those prescriptions, but that half-hour appointment wasn’t quick.  This is incredibly frustrating.  Request for med renewals aren’t supposed to be snowball appointments.

Keeping My Thoughts To Myself

We’ve all heard that old joke, “Doctor, it hurts when I do this…”  The doctor responds, “Then don’t do that!”

We laugh, but I’d sure like to see that thought process expanded.  If a medicine is thought to cause adverse effects, why is the solution to add another medicine in hopes of controlling those adverse effects?

Off to the pharmacy I go:

Three weeks later: