Tag Archives: doctor’s visit

Misunderstanding

The other day, at the office, a receptionist told me a story about her recent emergency room visit. She was having a migraine, and when she came into her room, they asked for a urine sample. She had just used the restroom, and told them that she would be unable to give a sample. They told her they would not be able to give her any medication without the urine sample. She was so angry that she left and went to a different ER.

At the different ER, she was eventually treated and given a prescription for her regular migraine medication. She complained that every time she sees her neurologist, he only gives her seven pills. She understood that insurance would only pay for that amount, but she felt if he wrote for more, then she would just pay out of pocket for the extra. She gets more than seven migraines a month.

I explained to her that in the ER they took her urine to test for pregnancy. A lot of medications cannot be used in pregnancy, and tests such as CT scans can cause radiation and affect a growing fetus. She argued that she told them she was menstruating, to which I replied that sometimes women can have  bleeding that resemble their periods even while being pregnant.

I also explained that when pain is involved, sometimes they need to do drug screening to make sure the patient is not using recreational drugs, or abusing prescription medications. I told her that doctors have become suspicious when patients aren’t willing to give a urine sample because many drug-seekers use this tactic to avoid getting caught and obtain pain medications for recreational habit or to sell.

I then explained that the reason she only gets seven migraine pills is because it is an as needed medication to be taken only when she has a migraine. It is a quick onset medication to be used when the migraine symptoms begin so it will not worsen. If she is having such frequent migraines, it may mean that she needs to be on a daily medication to prevent migraines.

She agreed to see her neurologist, and that’s when I realized so much of the discord between doctors and patients is due to simple misunderstanding. By simply educating patients, we can empower them. So in an attempt to keep the air clear, I’d like to answer any general questions you may have. Send me your questions, and I will post them with my answer. Here’s your chance to “Ask the Doc”

Please keep in mind that I cannot offer medical treatment advice.

The Waiting Room

I read a post on Facebook, where someone was complaining that they were in their doctor’s office and the doctor was seven minutes late for her appointment. Hearing these type of things really frustrate me. I’ve been on my fair end of long wait times, and believe me I know it sucks, but I promise you it’s just as bad on the other side. Chances are if the doctor is late for your appointment, then she is running behind in general, which ultimately means she’s going to be staying way late to finish everything up.

I understand as a patient what the waiting room feels like, and I encourage other doctors to understand too. Sitting in a waiting room can be a very anxiety-provoking experience. You’re concerned about what the doctor is going to say about your test results, or that she’s going to be upset at you for not taking your meds for the past couple days because you ran out. You’re scared that you won’t be able to express yourself or have enough time for all your questions. You may also be worried that you have to go pick up the kids, or make it to the bank, or that time is running out on your meter.

And then on top of all that stress you are sick. Your exhausted and your body hurts. The only thing you want to be doing is laying in bed, and truthfully it’s what your body should be doing. And maybe you’re hungry. God knows what happens to me when I’m “hangry”. I get dizzy, and my head hurts, and I turn into Oscar the Grouch. You need to be home, but instead you are in the office waiting for what feels like hours.

Doctors don’t like keeping patients waiting, but it happens. Maybe the patient before you came in late, or perhaps someone walked in because they were sick. Or maybe someone had a fifteen minute appointment, but it ran a little long because they had a lot of issues. Sometimes it’s a scheduling issue. Someone from another department accidentally double booked, or even worse, the administration requires time slots to be double-booked. Other times we have a serious emergency where we have a patient who needs to be transferred to the ER. We’ll have to fill out transfer paperwork, update the medication and medical history lists, provide emergent treatment, and keep an eye on the patient til EMS arrives. Sometimes it’s a phone call from another doctor or family member about a patient in the hospital. I remember being locked up in my office on a twenty minute phone call like this, and when I came in to see my next patient, she accused me of sitting around on my computer in my office doing nothing.

For my patient readers, I ask you to be understanding with your doctors. It’s not an easy job, and the truth is when you are the patient who has the emergency or special situation we will give you all the time you need. And for my physician readers, we have to respect our patient’s time as well, keep them in the loop so they don’t feel forgotten,and be considerate of what they are feeling as they wait.

My Story: Part 2- Bad News

I was in the Family Health Center when the call came in. I wasn’t with a patient at the moment, so I snuck outside into the warm summer air in the front of the building. My facial swelling had improved on the steroids and I was feeling better, so I didn’t think I had anything to worry about.

I heard it in his voice. Something was wrong. He told me that my bloodwork came back and it looked like I may have lupus or some other rheumatologic disease. He said I’d need further evaluation and gave me the number of a good rheumatologist he knew.  He was apologetic for the bad news but wished me good luck.

I ran back inside speechless, guarding the center’s fax machine as I waited for the papers that would deliver my fate.  I snatched up the warm papers as they flew out of the machine. Looking at the words and numbers on the page, nothing made sense to me. What are speckled antibodies? What I did understand  was the protein in my urine, and that made me nervous. I went to consult with my supervising physician, hoping for an explanation and reassurance, but none came. She told me solemnly ” I’m not sure what this means, but it doesn’t look good”.

I met with my rheumatologist the next week. I liked her instantly. She had a genuine and caring demeanor, and seemed very knowledgeable and thorough.  She asked me every question in the book, and examined me completely, looking inside my mouth, searching my skin for rashes, testing every joint and reflex, and combing her fingers through my hair.She said the labwork pointed to lupus, but she needed to do some confirmatory tests. She also said she needed to check a few other labs to rule out any other medical conditions. People with autoimmune diseases tend to get other autoimmune diseases.

The follow-up appointment came and I was beyond anxious. I had lupus and anti-phospholipid antibodies. She said my kidneys looked okay, but we would have to monitor them, and we may need to do a  kidney biopsy. We discussed my ability to conceive and carry a baby due to my anti-phospholipid antibodies which can cause blood clots. She informed me of the worrisome symptoms to look out for, and answered every single one of anxiety-laden questions. She was patient and devised a medical treatment plan for me, explaining that we may need to make changes until I am stable. But most importantly, she told me she was there for me and that we would get through this together. I may have had bad news, but I also had hope.