Wellness Wednesday: Medical Practitioners

Today is Wellness Wednesday, I'm going to gripe. About my colonoscopy.

I am already at odds with my primary care provider about my decision to use bio-identical hormones. She doesn't believe in them. She may or may not give me a referral related to them (I think I need to have my hormone levels checked) and if she doesn't (meaning I'll have to go on my own and pay cash instead of having the insurance pay), I'll be in the market for a new pcp.

Why oh why can medical professionals not simply respect people with views different from theirs? The field of medicine is so vast and can never be mastered by any one individual; so much is controversial, and physicians should be supportive of patients who they cannot help who then choose to seek treatment elsewhere, imho.

Then there was my colonoscopy, so poorly scheduled on Inauguration Day. I did the colon prep on LoveHubbie's birthday and Martin Luther King Day. Great timing.

I had previously worked out a way with my gastroenterologist's partner to avoid the week long diet requirement of a low fiber all-white diet---white sugar, white flour, nothing fresh or frozen, only highly processed and refined white foods with all fiber removed. For one week. A whole week! I'd be climbing the walls after just a day. Lose my mind by day three. LoveHubbie would have left me on day five. If they could corral me and bring me in on day seven, I'd then have my colonoscopy. I am extremely food-sensitive.

So my gastroenterologist's partner said, no problem, all the recent studies show that the week long all-white diet does not produce significantly different results from just a standard diet. However, I'm thinking that she didn't understand that I don't eat a standard diet. I eat clean, whole, local, organic, mostly unprocessed fresh foods and cooked foods. This ended up being troublesome.

But at the time I went in for the procedure, I didn't know it. For the previous 36 hours I'd been drinking mostly fruit juices and chicken broth and was getting a migraine. I couldn't drink any water or take any medicines. I was weak and hypoglycemic and very anxious.

I was immediately put into a queue of at least a dozen patients in beds. Lots of nurses rushing around. Little tiny "rooms" cordoned off by cotton curtains with only enough room for the bed itself. Only visual privacy. I felt like an animal on a factory farm. I had a nurse, a harried RN named Lisa. She was in a great hurry and a bad mood. She wouldn't let me ask any questions, cutting me off and insisting that I would have to wait and ask the doctor anything medical. She seemed to be having a really bad day. I was having a bad day too, so I felt sorry for her, but still wanted to find out about my migraine. Once the migraine "blossoms"---without any medication at all---it takes Demoral and an ER visit to contain it. It has been about 8 years since that's happened last because I practice good self-care and have good migraine drugs.

It was a terrifying feeling to have no control, to be getting a migraine, and to be alone and silenced. In that queue of patients and involuntary sounds. In a bed, ready to get drugs that would "take the edge off" but make me even more disoriented. I had tried to ask various questions, to no avail. I knew that I would be going in to the OR soon. Lisa told me they would give me something to "take the edge" off and "if I remembered my questions I could ask the doctor then". That scared me too. She wouldn't take any questions and acted as though I was impertinent to even have questions.

Finally...yes, finally...I insisted that my husband be paged and told Lisa. My voice was different and I wasn't nice. Now, thinking back, I wish I would have gotten up and left. Stuck them with the lost surgical billing. It's a free country and I was not a prisoner. However, I really wanted my colonoscopy. I'd worked so hard, done that awful prep, and I wanted to know that my colon was okay! Still, knowing what I know now, I would have left. I would have felt better about myself. Proud of myself.

Lisa heard the change in my voice and decided to ask the doctor my question. Seemingly perturbed, he came out and talked to me. He told me that he didn't want me to take the medication and that the anesthetic would take care of it. I thanked him. Just a simple question, and a simple answer.

So I went in, suffering from the migraine until I lost consciousness, and had the colonoscopy.

However, the results were inconclusive. They couldn't see the inside of the colon, despite the days of clear liquid and the Colyte prep and me spending several hours on the toilet. I had not followed the diet, and there were seeds and evidence that I had had fresh fruit and other things that were not white in the previous week. There was even proof I'd had vegetables! The gastroenterologist---we'll call him Dr. GE---was very unhappy that I had listened to his partner. He said there were plenty of healthy things that I could have eaten---especially white rice. For a week. I told him that I eat brown rice. He seemed really, really annoyed then, and said that he would not negotiate, that I could either eat the white diet and do it right or it would be a waste of time. I told Dr. GE that there must be a healthy way of doing the diet, and he looked at me like I was from Mars. I left with LoveHubbie.

All last night and today I felt weak and bad about myself. That colonoscopy was all I could think about. I eventually realized that I felt so badly because Dr. GE did not seem to respect my dietary needs, or to even feel they were worth considering. To me this would be like saying to a vegetarian or a vegan, "Well, just eat meat for a week, it won't hurt you." I would never, ever do that! I am extremely food-sensitive, and I respect others' ways of eating. I'd just wanted Dr. GE to respect my way of eating and to be willing to work with me to come up with genuinely healthy things that would satisfy his requirements.

Once I realized why I felt so terrible, I got angry, and that made me feel better. I found out the name of a gastroenterologist on the other side of town who competes with Dr. GE (who has my side of town sewn up) and who is well-respected as well. I don't think I will ever take being treated like I've been treated this week by my pcp, by Lisa the RN, or by Dr. GE again. I'll be alert ahead of time and observing how I'm treated instead of focusing on being compliant.

Now, on the other side of these few experiences, I don't blame Lisa and Dr. GE. I did this to myself. It was all me. Plenty of patients want to be told what to do. And to just follow. It's simple and easy. Plenty of physicians don't want their patients to think---just to be compliant. They are a good match and have much to benefit from each other. I am a poor match for this way of practicing medicine. I want to be a responsible patient and to seek out the progressive and informed and well-educated physicians who are looking for patients who think and who are committed to their own health. Patients who will consequently be ultimately more compliant than the others, because they truly care about their own health and know that it is their responsibility, not the physician's.

So I learned a lot from this. I know I'm venting here. I'm worn out from the medical establishment.

On the plus side, tonight I attended a function where I met an integrative physician and a naturopath. The integrative physician (an MD who practices complementary medicine) has a one year waiting list. But still, they are out there. And whether or not I get the referral from my pcp, in February I have an appointment with an MD who will check my hormone levels and adjust my bio-identical hormones. Even if I have to pay cash.

We are fortunate to have alternatives. We just have to stand up and demand them. I wish I had learned these lessons earlier (like when I was in my twenties. or thirties. or forties.) But in truth I do consider myself blessed to learn them at all.