Saturday, April 09, 2005

This really ticks me off!!

What’s with the inclination these days for folks in the medical profession to want to label anyone frustrated with the (lack of) medical care they’re receiving as ‘depressed’?

Does anyone else find this fairly self serving? (and no, it wasn’t *me* this happened to)

Pretty convenient if you ask me, patient complains, set ‘em up with an anti-depressant so they won’t care how bad their care is.

A case in point, this actually happened to someone I know, let’s call her ‘Sally’.

Sally has had a number of medical problems lately, starting with her; feeling sluggish, discovering a small lump on her throat and an ‘out of sorts’ a little over a year ago. She saw her family Doctor; they discussed how she was feeling, and the lump, from that discussion she decided to see an endocrinologist (Dr. Endo#1).

  • The Dr. Endo#1 said, based on her blood work, that she had “Hashimoto’s Disease” and a ‘fine needle aspiration’ (FNA) was in order for the lump.
  • Based on the results of the FNA she was given pamphlets on Thyroid cancer and referred to a surgeon.
  • Surgeon suggested a repeat of the ‘FNA’ and explained that if you “had” to have cancer, Thyroid cancer was the one to pick.
  • At the 2nd “FNA” the surgeon brings the complete lab results from the 1st, out to the waiting room shows them to the husband and asks “Why would Dr. Endo#1 send her for surgery based on a report whose findings were clearly shown as “inconclusive’
  • The 2nd FNA was performed, the conclusion on that report was (conclusively), negative, no cancerous/pre-cancerous cells present
Y’all still with me? I swear this is 100% true… ya couldn’t make this crap up!

Ok… now things begin to get even more interesting…

  • The surgeon refers her back to Dr. Endo#1, who, upon hearing the medical opinion of the surgeon (remember, this doc sent her to this surgeon saying he was the “best”), says “Let’s find you another surgeon…” at which point Sally (and her husband) say.. Forget that! They figured if you see enough surgeons, eventually one will operate regardless.
  • They revisit the surgeon, who then recommends a 2nd Endocrinologist (Dr. Endo#2)
  • Sally goes to see Dr. Endo#2, who proceeds to tell her there’s nothing wrong with her that won’t clear up if she’d stop smoking. (Remember now, she’s had confirmation of the Hashimoto’s from three separate Docs prior to this one) and suggests she stop taking the Thyroid replacement hormone recommended by the others. Sally decides this is odd, and returns to see the surgeon.
  • The surgeon agrees to help her manage her thyroid.
About 30 days later, both Sally and her husband are laid off.

About 30 days after the layoff, she begins experiencing significant menstrual problems; Sally and her ob-gyn decide that the long recommended hysterectomy can no longer be delayed.

  • In pre-surgical testing for the hysterectomy her EKG shows some abnormal heart rythms. (Which by the way are not uncommon for folks on Thyroid replacement hormones.)
  • The Ob-Gyn refuses to do surgery until she sees a cardiologist
  • Several tests later (including a cardiac cath!) she’s proclaimed healthy enough for surgery.
  • Sally has the hysterectomy, and begins recovering nicely. The Ob-Gyn is pleased with her recovery in both speed and her overall improved health.
Near the end of this recovery, just as she’s finally beginning to feel ‘normal’ again, as she’s reaching for a piece of wood to toss in the fireplace she feels a sharp pain in her lower back. The pain is so bad she’s stuck on the couch for the rest of the day. (Sally thinks she’s strained a muscle).

  • Three days later (on the weekend of course) her husband is urging her to see a doctor that this is something far more than a simple strain. (He’s had two back surgeries)
  • She sees a physician at an urgent care center, who takes some x-rays and prescribes some anti-inflammatory and pain meds. He also feels she needs a specialist and refers her to a neurosurgeon.
  • In conference with the neurosurgeon she’s sent for an MRI which reveals two ruptured discs in her lower back.
  • Initial treatment is rest and more medications.
The surgeon, remember him? (The Thyroid surgeon)… leaves the practice he was in, so, in need of the required quarterly thyroid panel, Sally seeks out another Endocrinologist…. Dr. Endo#3…
  • In meeting with him, and discussing how she’s feeling overall, Sally breaks down and begins to cry (if from the pain she’s in, the frustration at the downturn in her health or this whole process… who knows).
The doctors response? Comfort her? Console her? Reassure her everything will get better?

Nope… he tells her that she’s severely depressed and unless she agrees to see a therapist, he can’t treat her. That (and I quote) “You don’t need and endocrinologist, you need a psychiatrist.”

Sally seeks out and begins seeing a therapist. He tells her she’s NOT depressed, that her emotional ‘outburst’ in Dr. Endo#3’s office was a perfectly normal reaction to her situation and experience of the past year or so. He does however refer her to a Psychiatrist that may be able to give her some medication for the ‘medical anxiety’ she’s feeling. Again telling her that this anxiety is normal, but some help in dealing with it might be good as well.

  • Sally goes to see the shrink, who tells her she’s, severely depressed, has lost her ‘faith’ and needs to begin to learn to trust again. He also writes her prescriptions for 3 separate medications.
  • Sally fills the scripts and begins taking them.
  • Day two on the new meds, she begins to experience tremors/spasms in her hands, arms and legs, as well as a general overall ‘intoxicated’ feeling.
  • So, Sally stops the meds and calls the shrink’s office. Leaves a message (this is a Friday, last Friday actually) about her bad reaction to the meds.
  • No one returns her call! (Remember now, she’s called and has said she fears she’s having a bad reaction to the meds)
  • She sends an email over the weekend as there is no one answering the phone despite several attempts.
  • She calls again on Monday, speaks to the office person again, and again requests to speak with the Dr.
  • She revisits the original therapist (with her husband this time. Her husband never felt she was depressed either, just tired of not feelign well!) who is appalled at what’s happened, ands reasserts his professional opinion that she is NOT depressed.
Fast forward to today…

The shrink has still not returned the calls… Her back is healing, albeit slowly, after a series of epidural injections and she’s beginning to function, as she would put it, “as normal as I ever was”…

I don’t know what the moral here is, but I do know that what she’s been through is ‘off the hook’ as far as I’m concerned. All she wanted, from any of these folks… and remember ALL of them were supposed to be tops in their fields… was help in getting better.

I don’t know how she kept from going off… I know I would not have had half of the self restraint she did… I woulda smacked (or sued, taking their money really hurts these types! ) somebody!!

“Do not give up until you have a medical ‘team’ who you trust!” That was the other piece of advice the therapist gave Sally… He told her it’s not ‘Doctor shopping’ when you’re looking for the best care provider for you and your needs. (she was accused of that too along the way).

We’re all consumers of medical services… these folks are merely ‘body mechanics’… If you didn’t trust the person working on your car, would you continue to take it there? Don’t you owe yourself that same treatment… without being labeled? I don’t think they want us to ‘shop around’… we might find out there are still medical professionals that know:
  • how vulnerable we feel when we’re sick.
  • we look to them for reassurance and comforting words
  • we just want to get better, as quickly as possible
  • we need someone that will actually care about us, that we’re more than a chart or a billable entity
Ok… now that I’ve got that off my chest… I can go enjoy the rest of my birthday
!!

2 comments:

seeingdouble said...

Oh, the joys of managed medicine! You forgot to add the "and then, she was told that they didn't have authorization from her insurance to see her, and she'd have to go speak with mystery person who doesn't exist at Invisible Clinic before they can treat her." Mustn't forget those parts! Happy Birthday!

Bill said...

Thanks! It was a great day, my wife got me a new digital camera and we've been having fun with it ever since I opened it (cats are a never-ending "Kodak-moment"!

This whole medical 'lack-of-care' thing has me ticked off (could ya tell?)

Thanks again for the comments