Tuesday, December 05, 2006

You Call This Health Care?

I am sick. I don't know if it's the strep making a comeback or something else. I know strep can make your throat sore. Can it also make your sinuses leak, your teeth sore, and your joints ache? What about the chills, the weepiness, and the part where I can't breathe deeply? Because that's the scary part - I can't breathe. I don't feel like I'm getting enough air and my ribs hurt. There is a stabby feeling at the bottom of my right shoulder blade. I am allergic to actifed, codeine, and naproxen and am leery of taking any of their medicinal cousins. It's not safe for me to experiment with medicine (even the over the counter stuff) to try treating my own symptoms. In short, I feel crummy and need to see the doctor AGAIN! I can't stand it, but I have to go A-FREAKING-GAIN!

Here's a little back story:
I may have mentioned that I am NOT good at going to the doctor. I'm good at going to the chiropractor. My chiro rocks! She takes my migraines away, away, away! (Insert rejoicing here - if you are a migraine person, you KNOW what I'm talking about!) I'm great at going to the pediatrician. If I have to get sick once every couple of years, then I always hope that I'll get the same thing the kids get so our fabulous pediatrician can peer at my throat and give me amoxicillin (or whatever) too. And that worked last month. I got an actual illness (so the chiro was out) but lucky me, I got what the kids had. One trip to the pediatrician was all it took (well - actually three. I took Chaos and then the next day I took Mayhem and then two days later I took Havoc and the pediatrician took one look at the two of us and whipped out that Rx pad!) That should have been it. Strep should count as my once-every-couple/three years illness. I should have been home free for the next 24 months at a minimum.

Much to my dismay the VERY NEXT WEEK I had to go to the doctor. My doctor. I couldn't breathe, my ribs hurt, and my chiro wanted me to have it checked out. As luck would have it, my doctor - the one I like even if going to her makes me panicky - is on maternity leave. They
gave me an appointment with another guy in the practice whom we'll call Mr. Big Jerk. (<--You can see that appointment went well, can't you?) I told him about the breathing and (since if I'm going to go to the stupid doctor's office then I'm going to mention everything) I told him about this place on my skin (on the very same ribs that were sore) and also about my hurt toe. He looked at me with the strangest (almost astonished) look and said we couldn't cover all of that in one visit. Um-kay. But in my head I'm thinking, "Why the hell not?" He made me come back for the skin thing. He reluctantly dealt with the other two issues in one appointment. Hmm - and by "dealt with" I am really saying he told me to take ibuprofen for the ribs and said he couldn't do anything for my toe. Helpful guy.

I was a mess when I came back for the skin thing. (I hate the word biopsy. It's so much easier for me to think of them scraping off my skin with a scalpel and sending it to a lab than it is to think the word "biopsy". This is one small example of how completely illogical I am about medical experiences.) I was seriously anxious that morning - mostly just about being there - and not quite so much about the procedure itself. Then they weighed me. Now I ask you - is it that important to weigh me twice in one week?
One time I can understand. I haven't been there in a long time; they may have to prescribe meds; yeah, yeah yeah. But twice in one week is just pointless and mean. Adding insult to injury - it was the week after Thanksgiving.

They put me in a COLD, little room and the nurse handed me a robe with the instructions that I could leave my jeans and my bra on but I needed to make sure the robe opened in the front so the doctor could get to the place on my ribs. Okay. I put the robe on. It was too small. You know
how some hospital robes overlap? Well this one was designed to meet in a line down the center - only on me it didn't. Not even close. There was a good four or five inch gap. It seems like such a whiny thing to mention but wow! I'm standing there fighting the anxiety that's been building since I had to make the appointment, freezing, shaking from both the cold and the adrenaline, feeling crappy about those five Thanksgiving pounds, and now feeling ridiculous and exposed in a gown that might, just might fit a size 4 gal but certainly won't come close to wrapping around my size 14 hips or to covering my 36DD boobs. Arrgh. I covered my chest with my arms and paced the room. And paced. And paced. It's a small room. It's a quiet room. Or at least it was a quiet room until a nurse and Mr. Big Jerk stood outside of my room and chatted about some personal drama or other. Don't they know I can hear them? Guess not because then the nurse went away and a new voice asked Mr. Big Jerk what procedures he did while she was away. He said, "None. I turfed them all to you." "Really. I didn't see that. Like what?" Then he proceeded to describe in this incredibly snarky voice how this one woman had come in and wanted him to look at her toe AND check out her breathing AND have this place removed. What are the odds that two people matching that description had come in that week? And he got the order of importance wrong anyway. Creep. I was worried about my breathing the most, not my toe.

Anyway, now I felt like I was going to throw up. And I was even more nervous, which I hadn't thought possible. I don't know the woman who's going to do this procedure. Sweet Hubby liked her when he saw her a few weeks ago, but he's not easily spooked by medical stuff. I thought that she'd be in any minute but ten minutes after I heard them talk about me I was still there pacing to keep myself from tossing my cookies.

Twice I took off that stupid robe and put my sweater on to leave. The thing that stopped me was that I hadn't paid my co-pay yet. At this office you pay when you leave. (At the pediatrician's you pay first.) When your appointment is done, the doctor hands you your chart and a coded instruction sheet and you walk down the hall and get funneled through to the two nurses on duty whose sole function is to take your payment and schedule follow-ups based on doctor's codes. There is no other way out; there's no way to slip past them; and I was such a mess that I knew I'd burst into tears and make a dramatic fool of myself if I tried to explain why I was shoving a twenty at them and wanting to go home but didn't have a chart or a code sheet. In other situations you can say you're sick and people will let you go - but that doesn't work
so well at the doctor's office!

I tried to make myself stop pacing. I read the informative charts on the wall. If I ever need to diagnose the difference between a one-time sinus infection and a chronically infected sinus cavity by looking at the cross section of someone's skull - hey, I could do it! It was the least
gross poster available. I don't want to see pictures of coronary artery diseased hearts. I don't want to see photos of smokers' lungs. And I CERTAINLY don't want to see pictures of eyes. Have I mentioned that, in addition to all my other neuroses about medical stuff, I have an eyeball thing? My kids tell me that they are the only ones they know who are not allowed to talk about eyeballs at the dinner table. There are movies (e.g. Minority Report) that I have wanted to see but have not because someone I know and love told me there is an eyeball thing in it. (Attention people who love me, where the heck were you when I was in college and somehow accidentally managed to see that Salvador Dali film not once but TWICE?!! No link is provided because I PROMISE you that you do NOT want to see this film.) Back to the doctor's visit - everywhere I looked in this room there were pictures of eyeballs. And weird ones. Real eyeballs are awful enough but look at this:
What is this?? An eyeball with glasses? Sitting on a folding chair? With its optical nerve curled up like a hat? And is that a mouth? A mouth? On an eyeball?? WHO thought this was a good idea? I do NOT want to meet that person. Ever.

I was in the twilight zone. Or hell.

I found myself staring at the only non-medical thing on the walls. It was a calendar. It had a lovely picture of the lake. I stared at it for a while before reading the text printed on the different days. Here is a sampling of the important information I gleaned from that calendar:
Nov 13 - white-tailed deer rut in full swing
Nov 15 - groundhog begin to hibernate
Nov 21 - blackbirds begin roosting in large flocks
Nov 22 - brook and brown trout begin spawning
Nov 30 - bear season opens
Dec 17 - Chanukah begins this evening
Dec 19 - river otter begin breeding

Do not ask me why there was a state wild life calendar in the patient treatment room. By the time the nurse practitioner came in I was beyond freaked out by the whole morning. She took one look at me and asked if I was ok. I said, "No. I'm panicked. Can we just get this over with so I can go home? Please." She was very nice. She explained what she was going to do but in my head I was going "La la la, I can't hear you!" She was trying to chat with me but I couldn't speak. I just turned my head away and tried to hide the tears that were streaming out of the corner of my eyes. It was a relief when she finally gave me a shot and started cutting on me. It gave me something normal to focus on. Yay pain! THAT'S how messed up I had become in the course of this office visit. It was a little disturbing when she kept emptying out little cups of my blood into the biohazard tub. There was less scraping and more digging than I had expected out of this whole business. She said she'd been extra careful but thought "everything looked good." Ok. Great. Please, for the love of God, let me go home.

She said, "Come back next week and I'll take out those stitches." Come back? Stitches? I burst into great, big, sobbing tears, totally startling the nurse. She tried to explain to me that we were done, that it was ok. How can it be ok if I have to come back? I will gladly rip the little fuckers out myself at home if you will please, please, please tell me I don't have to come back to this eyeball infested, wildlife sex tutorial hell hole of a doctor's office!!! I didn't say that. I couldn't say anything. I snatched my chart and code sheet, ran down the funnel, forked over my twenty, nodded yes to the first appointment time the gal offered (with NO INTENTION of keeping it) and scooted out to my car to go home and cry some more. I cried about how horrible and strange the whole process was. I cried in relief that it was over. I cried because I had stitches I hadn't expected. I wish I could blame all those tears on my cycle, but no. My period didn't start until today. Today. The day I had scheduled the follow-up, follow-up appointment. The one I had every intention of skipping. The universe had other ideas.

On Saturday, I started sneezing. "It's just allergies," I thought. Sunday my throat hurt and I felt terrible all over. "Post nasal drip," I explained to myself. "Use the neti pot." I did. It didn't help a whole lot. Yesterday I felt like someone had beaten me up in my sleep - except I hadn't been able to sleep. "It's just PMS?" I hoped unconvincingly even to myself. The kicker was that I couldn't breathe. It is scary to have a stuffy nose and to have to breathe out of your mouth only. It is even scarier when you breathe through your mouth and you're still not getting enough air. (For the record, motrin helps sore ribs but does NOTHING to make it easier to breathe. Mr. Big Jerk is a a quack as well as a creep.) I started moving slowly and sitting up very straight. I took two long, hot showers because it was the only time I felt better. My good friend, Nurse Nice, kindly offered to take my stitches out (she thinks it's fun!) but also pushed me to go to the doctor. Sweet Hubby and VBGF agreed. Fine! I even called yesterday morning to see if I could get an appointment a day earlier. The only one who had any openings was Mr. Big Jerk. Imagine. I said thanks but I'll keep the other appointment. I told the receptionist that I'd made the appointment to have stitches removed and I still needed that done, but now in addition to that, I was sick and wanted to have the doctor look at me and possibly do a throat culture. I asked if the appointment time I'd scheduled would be long enough for that or if I should reschedule for a longer office visit. She said, "Oh. That's a good question. Let me check how long they have you booked for and if we need to change it." Tappity, tap. "No problem. They have you scheduled for a good ten minutes. That should be plenty of time to cover everything. I'll go ahead and confirm your appointment." Ten minutes? A good ten minutes? Maybe I'm naive about the business aspect of managed health care, but do they schedule appointments for less than ten minutes??

I started this post before I went this morning but now I'm home. It went ok. Sweet Hubby went with me. (To support me? To make sure I actually went? To protect me? All three?) There was very little wait time; the stitches are gone; she gave me antibiotics for the sinus infection/strep/whatever the heck it is AND she gave me an albuterol inhaler to help me breathe. She was pleasant and kind and yet, professional. It couldn't have been better. Except for one thing. She said she wants me to come back in two weeks. Arrrrrrrrrrrrrrggggghhhhh!



Caitlin said...

Ooooh sweetie!
*sends virtual chicken soup*, plumps up your pillows, and sends you back to bed with a vaporiser with eucalyptus going in the bedroom. BACK TO BED with you!

Carolie said...

WHY do we allow doctors to treat us like that? We wouldn't put up with that shit from ANY other service provider!

Imagine the tip you'd leave for a waiter who treated you that way...heck, I would refuse to pay for the meal, AND ask to speak to the manager! You wouldn't put up with that kind of abusive (YES, abusive!) treatment from a sales clerk at a store, or from a customer service rep at your bank. But with a doctor, we're totally cowed.

It's been hard as hell, but I've been working on it. If my health care provider introduces him/herself as "Dr. So-and-so" then I introduce myself as "Mrs. My-last-name." If the doctor wants to call me by my first name, I return the favor (or lack of respect). I actually said, a month ago, to a doctor who introduced himself as Dr. HisName but called me by a diminutive of my first name, "I would prefer that you called me Mrs. LastName, until and unless we're on a mutual first-name basis."

I've learned to take a notebook or a friend (or both!) to an appointment, and insist that the doctor repeat/explain things until 1. I understand, 2. Friend understands or 3. I've written everything down word for word.

We go to the doctor as supplicants...but it should not be that way. A doctor is a service provider--an extremely educated, expensive service provider, but a provider all the same. YOU are the customer. Once you've gotten past the emotional freak-out, write a good long letter detailing your anger and the poor treatment -- or if you can keep it together and not chicken out, make an appointment for a consultation (I can't do it in person yet, but I'm working up to it!) Take husband, friend or lawyer with you!

YOU are worth better treatment!!!