My relationship with doctors is problematic. I think they should at least be curious enough to find out why a pain does not resolve in a few days or less. I think they should be able to not send me on a seven week expensive goose chase. I think they should pay attention when I insist something is wrong. I think all their education should lead them to an educated guess or at least they should be able to Google my symptoms and find an answer like I can. I can’t order up tests or drugs but I can do the research.
I don’t go to the doctor if I can fix myself. Change how I eat, how much exercise I take, increasing water intake or sun exposure, applying heat or cold or pressure or a bandage, or just a little lie down, these attentions can sometimes repair physical damage. I use a doctor as a last resort. I prefer to pay my grocer rather than my doctors.
I also understand ruling things out. It’s the old computer algorithm: If, then, else. I’ve already been through that by the time I get to the doctor, except for being able to order the tests they love so much. Here’s the thing: I am not paying them to diagnose myself.
My latest frustration involved a kidney stone that did not present itself in a classical way. The pain was in the pelvic area and extreme, so bad I went to the doctor on day two of pain instead of waiting. Right out of the gate it starts getting weird. Inevitable pee test: no bacteria, just blood. Antibiotic ordered and urinary tract pain killer. Huh. No bacteria, but primary prescribes a UT pain killer and antibiotic to a patient she knows avoids pharmaceuticals like the plague and thinks antibiotics are a necessary evil only because they work sometimes. Antibiotics only work on bacterial infections. I went home and Googled pelvic pain and blood in urine, first thing up: kidney stones.
Another day of pain, three pain free days, and the pain returns. Pharmacy shorted me on the prescription. Called primary to report return of symptoms. Another round of antibiotics. What?
Pain continues randomly. End of prescription and phone call to primary again, orders pee culture and x-ray. Ka-ching. Negative x-ray. Negative culture. Referred to gynecologist. Physical internal exam. Another pee sample. Another culture. Ultrasound ordered. Ka-ching. Ka-ching. Negative culture. Negative ultrasound. New drug though, for overactive bladder.
Many days of missed work from the pain and doctor visits, going crazy from not knowing what’s happening. Peeing all the time, can’t pee. Pain keeping me awake at night. I was being a “good” girl, doing what the doctor said.
I’m at seven weeks of pain and drugs and repeated doctor visits when the crisis finally hit. By that time I was convinced it was a kidney stone because I’d read it was the worst pain ever and this was it. If it wasn’t then I had a burst appendix or an exploded ovary or intestine or something else totally strange. The pain was so bad I knew I was either going to vomit or pass out or both. Hubster and the son find me bent double in the hallway trying to get to the bathroom for the 500th time in the last 4 hours of pain. 1:00 AM visit to the ER, bent double, can’t talk, finally croaked out I thought I was going to throw up. The registrator handed me a handy blue vomit bag and we went from there. I know my signature on the admission form looks nothing like my signature because I couldn’t hold the pen. Another pee test. Consult with ER doctor, explained from my description of the pain, blood but no bacteria in my urine, my inability to talk from the pain, and my vomiting in front of them indicated a kidney stone. They loaded me up with saline, pain killers, and anti-nausea drugs. Ka-ching, but to have some relief from the pain was worth it. Transferred to the main hospital eight miles away. Lucked out there, they let me go in my own car and save the ambulance fee. Second ER, new doctor, CT scan, and proof positive, one nasty little bugger five millimeters, fairly large as kidney stones go, and at least two more on the way. Referred to a specialist in urology. Ka-ching, ka-ching.
So let’s do the math. One primary, one gynecologist, two ER doctors, two ER nurses, one urologist, and the attending assistants, an x-ray tech, an ultrasound tech, and a CT tech equals way more than 10 medical experts. Two antibiotics, two painkillers, one over-active bladder drug, massive liquid narcotics at the ER, saline, one anti-nausea drug, one UT dilator, and pain-killers to take home equals way more than eight drugs, some entirely unnecessary. Two cultures, one blood sample, one x-ray, one ultrasound, and one CT scan equals three labs and three tests. KA-CHING.
And I know it isn’t a medical industry standard, but it would be nice if just one of all those medical personnel who saw me, whom I am paying for their service, would care enough to call and see how I am after all the pain I’ve been in and all the drugs I’ve been given. Aren’t they called health care providers now?
I’m receiving the bills currently. You don’t know how frustrating it is to pay for all this unnecessary medical service, when if the primary, or the gynecologist had really been doing their job and paying attention, they would have sent me straight to the urologist and the CT scan. But, no. They were trying to “save me money”, which unfortunately, is exactly what did not happen. They did rule many things out all of which I was sure were in good working order anyway because those weren’t my symptoms.
I’m often mystified why these medical weirdnesses happen to me, and to be fair I hear of them happening to many people, so it’s not just me. I could guess it is size bias (I’m fat), appearance bias (in natural repose I have a scowly face), vocal tonality bias (I sound whiny, strident, desperate), poverty bias (I don’t make much money so they don’t want to spend much time or money on me, presuming I cannot pay or will default on the bill despite my expensive insurance), too smart bias (I often know more than the medical professional about the topic because I do my research), too curious bias (I ask too many questions), non-compliant bias (I have bad reactions to pharmaceuticals and dislike taking their prescribed drugs). That’s plenty to get me started.
My fat should have nothing to do with anything. My body is my body and after 60 years of trying I do not believe we are in control of how our bodies look. We can control what food we take and what exercise we take but we cannot control what it all does on the inside. Read one of my favorite fat activists, a dancer and marathon participant, who can direct you to the primary documents that prove long-term significant weight loss does not exist in about 95% of cases, significant weight loss being defined as 2-5 pounds. Your health is less about your body size and is more about your habits: the foods you choose, the amount of exercise you take routinely, rest, and water intake. If you are lucky enough to have a slender body, you are just lucky, not in control. If you think otherwise, you have bought the false fat paradigm our culture functions under. Be grateful to be lucky.
My face is my face. I wear every bit of sadness and sorrow, anger and resentment in the pouches under my eyes, the sagging wrinkles at the corners of my mouth marching down my chin, the overhanging eyelids that have fallen over the years, the eyes that can hardly look anybody straight in the eye for fear of seeing people as they are. Yes, I know I could use makeup; I know about makeup because I was a licensed cosmetologist in the state of Oregon for more than 20 years. I do glamour make-up and I know tricks that make your face look gorgeous with a few strokes of paint. I am allergic to all that paint. And no wonder, with all the strange chemical concoctions in cosmetics these days.
Ah, the voice. Let me just say I can cackle like the Wicked Witch of the West in the 1939 Judy Garland movie Wizard of Oz when I want to. It comes in handy on Halloween. I know the difference between an indoor and outdoor voice and I can use both. My soft and carefully modulated telephone voice has brought unwelcome compliments from men at my place of work. I know how to speak from my diaphragm as well and, like this essay, I often sound intense and dramatic. I am accustomed to not being listened to so I sound desperate when I try to convey what I think is important for medical people to know.
And yes, I’m working poor. There is never enough to go around, no matter how hard I try, or what budget I use. I’ve cut lots of corners in my budget, and I’m in the habit of reviewing my budget more than once a year to look for other places to trim. It comes to the point where there aren’t any corners to trim and you live in this tiny little circle (no vacations, no second car, no cable, no home maintenance, no reserve to replace appliances when they die, no book purchases or video rentals; thank god for lending libraries) of which bill to pay this month. I am lucky enough to have “good” medical insurance through my employer, but the out of pocket expenses left over from medical bills throw a huge wrench into the regular budget.
You have to pay your bills or life is that much worse. I might not be able to pay the whole bill the minute it arrives, but I pay every bill, no matter how long it takes me. I’m only defensive because I think the insurance rigged middle man has driven medical costs into the realms of ridiculous, and many of the people I know including myself are getting such poor health care for the few dollars we have and regardless of the “quality” of the insurance we buy.
I don’t have to have a medical degree to read and understand the same information doctors learn. But I am my body. Doctors have no clue how my body reacts to their drugs and they disbelieve you if you report a reaction different to the normal expectation. Doctors treat me as if I am lying because I cannot change my body size, as if I am lazy, or careless, or at the very least “not in control”, perpetuating the myth of body size equaling health. They are not with me as I exercise or carefully choose my food. I know how my body reacts. I don’t know how their body reacts, and I could only go by what they would tell me. Since I am paying medical personnel as consultants about my body, they should at least listen to how my body reacts to their prescriptions.
And here’s the kicker. Wait. Let me bend over again. My employer is requiring a Family Medical Leave Act packet to be filled out because of the amount of work missed. This is a federal program meant to help protect your job when you are ill. My primary is on maternity leave and treated me for an infection, sending me to a gynecologist, not a urologist. My gynecologist found nothing gynecological amiss and those weren’t the symptoms I was describing anyway. The urologist, whose specialty would be kidney stones and all things urinary, called and asked why I sent the FMLA packet to him as he’d only seen me once. Considering the CT scan shows I have two more visible kidney stones I figured the urologist would be the one to manage that with me. Bottom line: none of them want to take responsibility for my recent medical debilitation.
Once again I am on the search for a new doctor. I want a physician who will listen, really pay attention to my words and not judge me by my appearance or income or insurance or curiosity. I want a physician who is curious enough to figure out what my complaint is and help me recover. I want care from my “care provider”. Especially since I am paying premium dollars for it. I don’t think that’s too much to ask.