Monday, May 10, 2010

Dignity is Fragile, Like Exam Table Paper

I saw a new doctor for the first time this week. Woo!

I find myself saying that she is "just a pcp" or "just an internist" as if her lack of a specialty makes her less-than when that is the exact opposite of how this doctor makes me feel. And oh, how she makes me feel. It's like whiskers on kittens and not being condescended to, raindrops on roses and being respected, brown paper packages tied up with string, being treated like a whole person is my faaavorite thiiiiiing!

I haven't had a proper primary care physician (pcp) in years. Every time I'd find someone my insurance would change or disappear altogether. In my recent dealings with specialists and ERs, they have no idea what to do with someone without a pcp. It's apparently the hot new accessory, so I just had to have one.

Unfortunately it's no longer a simple matter of picking a name out of a book. I'm not a healthy person, or a meek one. And I have the internet, which so many doctors seem to resent. I need someone to coordinate my treatment and help me figure out what else I need to try, who else I need to see and what other tests can we run. I need someone who will speak on my behalf to the specialists and ERs and various government agencies. I want a woman, needing a change from the string of crappy male doctors I've left in my wake, and she needs to be accommodating, patient and no-nonsense, because I just don't have the tolerance or energy for anything otherwise. I need a doctor who realizes that she doesn't know everything and is willing to listen to me when I have concerns, questions and suggestions. Because I will. I want a doctor who will help me navigate my healthcare options without bossing me. (I just became aware of the idea that doctors are not the boss of me and in fact, I am the boss of them. It's a revelation to say the least.) I knew that my expectations might be difficult to meet so it might take a few tries before we found someone I liked. I also knew that I might be wasting what few energies I've had lately on interviewing doctors whom I would never see again, because this time I was not going to settle out of desperation, frustration or exhaustion. This time, I was going to wait for the one.

My resourceful boyfriend found a super local doctor on yelp, and the reviews were great. He called the office, had a long talk with an administrator about important things like if the office had air fresheners and how late of an appointment we could get. They answered his questions and booked us for a week out.

So, the pressure was on. And I was feeling stressed. I kept bringing up the upcoming appointment with my so patient boyfriend, who let me go over and over what I needed to get out of the appointment, what I wanted to express to the doctor, how much he should talk, or when he should talk, what we should bring, and what I should wear. Though he did cut me off pretty quickly with that last one. On the day of the appointment I even had a panic attack. I was slightly irritated at something small, I can't even remember what. And it just started to blow up. I started crying and breathing hard. But as soon as I realized what was happening, I stopped everything, sat down and focused on breathing slowly and deeply. I thought of nothing but my breath, and all distressing thoughts were acknowledged and dismissed. It only took a few minutes to pass, thankfully. Overcoming those out-of-control feelings and regaining control over my body left me feeling really strong and confident, so much so that my pride endorphins got me through the walk to the office totally unscathed.

Oh yeah, it's in walking distance. Sweeeeeet.

As soon as we got into the room with her, I knew: This. Doctor. Is Awesome. She was very thorough and really listened to both me and my boyfriend. She didn't interrupt once. She understood that I have run the gamut with the drugs and am really, really tired of it. We talked only a little about treatments I am interested in, extensively about what I've tried and she assured me that we would "finish up" at our next appointment, since we barely touched on anything other than my head. My head is my biggest issue, obviously, but I have some concerns about arthritis and birth control, which she wrote down and promised we would come back to. She is ready to dive in, summon all of my records from everywhere and order new tests. And she sent me home with prescriptions for valium and soma, despite her misgivings about the possibility of addiction.

This is the part where my head explodes from the bafflement. In the past, when a doctor has said that they don't like prescribing something, they just don't give it to me. Why would she write me a prescription for something she doesn't like? I stared at the slip of paper in wonder. Don't doctors make the decisions? (It started to dawn on me slowly, right about here, but I continued with my inner dialogue, afraid to believe it could be true.) She doesn't like prescribing soma and valium, because she worries about their addicting qualities, which is valid, so I didn't argue with her and just waited to see what she would suggest for pain management but she didn't offer an alternative and instead gave me what I asked for.


I think this doctor trusted me, essentially.

Color my mind blown. I was so confused. I have never had a doctor openly disagree with me, but do it my way anyway. I expect that we will evaluate my usage in a month or two, and if she thinks I am showing any signs of addiction, she will no longer prescribe it. Which makes sense, doesn't it? A doctor should assume that the patient knows what is best for themselves until it's proven otherwise. OF COURSE. That this basic show of respect has eluded me thus far in my search for treatment is very sad. Is it because I am a chronic pain patient? Or a woman? Young and disabled? Probably all of the above. It took just one appointment with one doctor to release the weight that's been on my shoulders. I've been bearing the guilt of an addict, feeling like the lowliest, most desperate drug-seeking junkie when I beg for a few pills for when it gets bad. And it is never asking, it's always begging because once you ask and they give you the stinkeye-raised eyebrow and then you start to cry a little because your helplessness just smacked you in the face and you see the doctor making the crazy-face and I have never felt so naked as I do fully clothed sitting on that stupid crinkly paper that always rips the second you sit on the exam table, and can we please call it a bench or a bed, not a table, because a table is for objects to be examined, not people. And dignity is fragile, like that paper.

Which essentially the point of this post. I was treated like a real person. Hooray for dignity.


Migrainista said...

THE hardest thing to do is to find a good doctor. I'm so happy for you for finding this great PCP!!! A rare wonderful gem :)

Sue said...

I'm so happy for you. A good pcp is so very hard to find. I can SO identify with that frightening, helpless feeling when the topic of rescue pain relief comes up. It doesn't matter whether it's my pcp or an ER doc, the minute I mention pain-relief - with REAL pain relievers - that "Oh crap, another drug-seeker" look washes over their smug faces and i want to scream.

This one that you've found sounds like a winner for sure!!! Keep us posted....

WinnyNinny PooPoo said...

The anger I have is why is it only 1 in 100 that actually thinks of the patient as a PERSON instead of an inconvenient way to earn money??

So glad you found a winner, hoping the soma helps the pain, and the valium helps the sensory overload!!!