That was the subject line of the email I received today from Dr. SWWNBN (you remember her, don't you?...the neurologist, Dr. She Who Will Not Be Named??) while I waited in young Sports Medicine Ortho Doc's waiting room to be seen this morning. Apparently Healthcare has entered the larger "social media" scene and they now have their own networking capabilities amongst themselves, much like Twitter (only it's called MyChart...how *original*.). My ER visit somehow triggered an external "twitter" to my neurologist who immediately "tweeted" me via email, like a squawking peacock (have you ever HEARD a peacock squawk?...if not, here you go) Nothing is apparently sacred or private anymore. It's not like I CARED if Dr. SWWNBN knew I was in the ER...I was more concerned there would be a notation in my chart of me telling the ER Physician's Assistant that I was "on the lam" with my neurologist!!! And yes, I DO say that to other healthcare providers...hehe.
But this brings me to another point about healthcare, MS, and other strange notions (just trying to bring the Multiple Sclerosis tie-in here since this IS an MS blog...still...I think). I have now very recently had 3 or 4 contacts with *other* healthcare providers who are new to me and, each time I've had to "disclose" the MS issue. I say *disclose* because lately, this feels like a big, dirty secret! For some reason, telling providers (who do not already know my history) that I have MS has become akin to disclosing I wear men's underwear, like to be spanked, or eat my boogers...none of which I DO by the way!!! Well, except for the spanking part, but I digress...LOL
One might think this feeling is the old "but you look so good" (so how could you have MS?) topic that is discussed in MS circles, but it isn't. I have no worries they won't BELIEVE I have the diagnosis (pull up an old MRI and it's pretty clear)...quite the opposite. It is when I tell them I am diagnosed with Multiple Sclerosis and they immediately inquire what Disease Modifying Drug I am taking that I cringe. The look on some of their faces is interesting if not down right dismissing!
I find myself quickly doing the verbal scramble to explain I already have been ON most every DMD out there (except Fingolimod I think?!?) and made an executive decision (much to the chagrin of the neurological world) to stop all treatment...that currently I am doing WELL without the DMD's and taking things one day at a time with improved diet, exercise, and the roulette wheel. They still look at me like I'm a liar...or worse...they look at me like, "well what are you doing HERE then if you don't tend to follow your healthcare provider's advice?!?" Maybe it's just my bizarre opinion, but I don't think doctors LIKE being told "no". :-) And they REALLY don't like being told something besides drugs or what they were taught in medical school works...for me...right now.
I suppose really my recent (and old) healthcare providers share the same sentiment as I do...just not the same opinion. They firmly believe in THEIR medicine/treatment and I stubbornly believe in MINE. Two peas in a pod I guess...of like minds at opposite ends of the spectrum.
I DO try to qualify my position with the idea I am open to changing my opinion should the internal *science* of my body or belief system shift...and I usually explain the true value of "medicine" psychologically for both the physician AND the patient is belief whatever is prescribed will work (see placebo study outcomes over the years, or a more recent one here: http://abcnews.go.com/Health/Depression/story?id=117057&page=1 ). It's hard to have two RIGHT people in the same exam room as exam rooms tend to be quite small for two big and bull headed people to fit into...sigh.
On a *happier* note, I did get "the shot" today for my shoulder and there is no surgical intervention necessary at this point. Apparently, I suffered a bad contusion in my socket, which resulted in fluid accumulation in the joint, subsequent inflammation and swelling, and ultimately F^<@ing bad pain! I am on the cautious mend...I was told to stay off unstable high places, refrain from any boxing matches, no stunts on the trapeze (especially when being SPANKED...just can't let that visual go, can I?!?), and head to my nearest Physical Therapy office for some PT.
I can do that...all of it. :-) Anything to avoid seeing yet another new healthcare provider who MS-guilts me or be asked the question, "What did you DO?!?" again. Who knows, my next story may include SPANKING in my explanation of pain or injury to providers just to throw them off the MS trail scent...
Yeah, yeah...I've got nothing better to do while I sit around at home *recuperating*, so you get the second blog post in a year here. It IS a better day today in the world of Cheese, I must say. As the haze of narcotic-filled drama lifts from my junkie eyes, I am beginning to see a faint light at the end of this ordeal. So don't anybody MOVE because I don't want a breeze to blow this candle out!!
I managed to slink in to see young Sports Medicine Ortho Doc yesterday and left with nothing more than when I went in...except a mother load of Oxycodone, that is! WTF?!? Most people who are TRYING to get doctors to prescribe narcotics can't...I tell them I don't WANT anymore painkillers, but a remedy instead, and I walk out with drugs that have a street value high enough to pay this month's mortgage. I just don't get it...
OK, I suppose it was the tears. I probably would have prescribed something too, to get me out the door quickly after I started bawling like a farm yard baby calf (insert sound effect here). Strangely, I am learning the stoic approach to pain doesn't really lend any empathy, but sobbing like a two-year-old sure causes anxiety on the part of the professional! I am considering sobbing hysterically on the phone next time I just need to make an appointment and see if I can get in sooner than a month from the time I call...hehe.
So, my appointment began by young Sports Medicine Ortho Doc sending in his kindly female Physician's Assistant to give me the once over and hear my tale of woes regarding my injury, pain, and recent ER visit. She was very kind...she offered me the Oxy script immediately and I explained I already HAD narcotics at home (compliments of a neurologist who also likes to prescribe big drugs in hopes her patients will STFU, too) and I didn't want to continue taking them, but rather find a more permanent solution to the acute pain. I also disclosed the high amount of NSAID (Ibuprofen) I had been taking just to get 2-3 hours of relief, but I was having to take it way beyond the recommended 24 hour dose. She checked me over (physical exam), then said she would consult with young Sports Medicine Ortho Doc, and there would probably be some repeat x-rays in my future.
I didn't wait but a few minutes before young Sports Medicine Ortho Doc entered the room with his laptop computer and what appeared to be the skeletal version of my left shoulder plastered across the screen...the x-rays the ER took 2 days prior. I must digress here and say I rather LIKE the x-ray version of my arm as it cuts off considerable fat and, other than a faint shadow around the humerus, I DO look svelte! But anyway...
Young Sports Medicine Ortho Doc puts me through the same physical exam as his kindly Physician's Assistant did, then takes a stern look with me to inquire WHY I had been taking such high dose NSAID? I explained again...adding that I didn't like the effects narcotics had on me as far as nausea, drowsiness, and feeling out of it. He maintained his stern look (which is pretty funny if you think of a 15 year old boy trying to look *cross* with you!) and announced it was "far better to feel out of it than to be on dialysis because you've blown your kidney's out".
**My head snapped up with the "stern" look of a 47 year old beauch about to attack and eat her prey**
"Yes," I calmly said, albeit my lips were already quivering with a mix of anger and angst. "I realize the dose I've been taking is far above the recommended dose. But you see, I WENT TO THE ER and they offered me nothing, no advice, no words of encouragement, and no pain management...they just said to come see YOU. All I got was this expensive sling", I said pointing to the $750 dollar contraption that cost $10.00 dollars to make. I could tell we were NOT understanding each other at this juncture.
Young Sports Medicine Ortho Doc changed his pose with me and began showing me my x-rays on his high tech laptop...he pointed out what he thought were abnormalities (and never ONCE commented on my svelte skeletal structure...boo!) and told me he needed to see an MRI (MSer's...we KNOW the MRI routine). He said he couldn't be certain, but was concerned I had a lesser density area of the head of my humerus bone and (again wasn't certain) that I may have a bone fragment "torn" away in the shoulder. He continued talking while I stopped listening.
Seriously?!? Bones do NOT tear. WTF?!? Somewhere in his talking he said the word "surgery" and I went on auto-pilot cruising at an altitude that lacked oxygen and was making me lightheaded. Things blurred. His medical assistant/handler came into the room to schedule my MRI and announced they only "do" MRI's Wednesday through Friday and there were no appointments this week, so "how does next Wednesday sound?"
**Commence bawling like a farm yard calf with full sound effect here**
Somehow I managed to choke out the words, "that does not work for me" and told the handler maybe I had misunderstood her? Did she seriously intend to have me wait ANOTHER 7 days before obtaining the test that might possibly diagnose the acute pain?? I started to leave without scheduling...
PATHetic. The handler then announced she had procured an appointment at a different location for the next day for my MRI...she said it as though she may have just discovered the Theory of Relativity or the appointment had just suddenly fallen out of the sky into her lap. Surprise...
Somewhere in my PATHetic-ness, I DID inquire about the cortisone shot I had really come in for in the first place...the handler and the kindly Physician's Assistant stepped back ready to fend off a cobra strike. The kindly Physician's Assistant explained (again...I guess I missed that part of young Sports Medicine Ortho Doc's speech due to my high altitude cruising earlier) they could not give me the shot today because not only would it interfere with the MRI results, it "could" do me more harm than good in the long run.
I left the office eventually in my expensive sling but at least with an appointment for the MRI in hand (my still good hand) and today had the MRI done. I filled the mega-script narcotics and did try the crap yesterday, but again decided I would rather suffer pain than be unresponsive and still HAVE the pain. And oddly, today is a much improved day...the pain has lessened significantly on it's own (no thanks to the Medical Establishment) and I can lift my arm about 6 full inches from my side and I'm tolerating some range of motion exercises better! WOOHOO!! That's a mighty improvement.
Who knows? Given some time, I may be back to BEAUCH SLAPPING people again in no time...doubt anyone will want to prescribe me narcotics for THAT...
Yes, it HAS been over a year since I posted anything here...thank you for noticing. Ehem. I've been busy living life, working, and paying my mortgage. Yes, apparently I DO still have MS somewhere in my pea-brain, but for the most part, it continues to keep itself on simmer on the back burner...WooHoo. I am still off all the DMD's, have not needed any ROIDS for well over 2 years, and continue to be employed full-time. Now don't be a "hater" bout this, Mkay? It is what it is...for ME, but prolly not for YOU.
But just because I am not frequenting my neurologist's office every five minutes anymore with an MS complaint DOESN'T mean I am exempt from the dysfunction of the Medical Establishment (ME) these days. O' quite contrare', dear-ies. I still have *issues* with living and I still have delightful encounters with the Medical Establishment...which is why I am coming back to this blog today...
I probably should have titled this blog post, "The System IS Broken"...but it's hard to sheepishly return to something I haven't paid any attention to for over a year, then blast out an opinion, still narcissistically thinking anyone out there still CARES what my opinion may be (if they ever did)! Perhaps it is only the painkillers talking now anyway...
Saturday evening I was assisting with the hanging and OCD straightening of some pictures while standing on a not-so-secure-chair and, as would be typical for a blundering idiot, I managed to fall off said not-so-secure-chair to the floor. After the laughter ceased from my graceful performance piece (because I MEANT to do that...hehe) and much later in the evening, I began to get twinges of pain in my left shoulder and neck, which became pounding aches while trying to sleep at 3:00AM. By Sunday evening (24 hours later, but seemed like a week), the pain in my shoulder was so great, I began contemplating my Last Will and Testament (because I realized if I died from this mystery pain issue, there were a couple of people I wanted to add and delete from my Will!). I had out the ice bags, the Ibuprofen, the narcotics, and dusted off the Bible (just in case).
Now, for those of you who used to read this blather, you may recall I have *issues* with the Medical Establishment anyway and will generally avoid the Beast at all costs...and, because the last time I was in an ER it was because I had removed a Scopolamine patch, then promptly stuck my finger in my eye, causing my pupil to "blow", and a subsequent emergent $7,000 work up for a stroke that I didn't have...well, I am a little embarrassed to go through those doors again unless I am squirting blood from my aorta and really can't apply pressure myself to stop the hemorrhage!
So, I gritted my teeth, chewed the leather strap, and waited it out until Monday morning.
Because I have been assigned to so many specialists in the past for so many reasons (some necessary, some unnecessary), I already have my name on the roster of an Orthopedic Doctor. At the stroke of 9:00:01 Monday morning, I hit the speed dial for young Sports Medicine Ortho Doc and pushed the magical buttons several times to reach a live person...with my good arm/hand. I was told by the young Sports Medicine Ortho Doc's gate keeper that the soonest I could get an appointment was Wednesday and to try calling my Primary Care Physician...*click*.
The pain was too great...I dialed my PCN (Primary Care Nurse...because I believe in ARNP's far more than MD's) and pushed the magical buttons several times again to reach a live person...only to be told my ARNP was on vacation (how DARE she be during my time of need?!?). I was advised by the 12 year old receptionist at my PCN's office to try calling the Urgent Care Clinic instead.
Sigh...the pain continued. So I looked up the number for the Consulting Nurse for the Urgent Care Clinic I have gone to in the past and dialed AGAIN. This time I got a live person who took my information and told me someone would call me back. I waited...in pain...less patiently than I had waited at 9:00:01AM.
Eventually a Consulting Nurse called my number and I answered it before the *ing* could sound on the *burring* noise the phone makes. The Consulting Nurse asked me a bunch of questions, wrote down some information (like what meds I take daily), then advised me to GO TO AN ER because she felt my symptoms warranted an ER visit per her checklist sheet she was using to tentatively diagnose my condition because free thinking is NOT a part of the consulting component of healthcare.
**THUD**
I girded my loins, took an hour to dress myself with the use of only one arm and the other in bad pain, and headed to my local ER...only to wait another 2 1/2 hours before getting into a room (which frankly is a pretty short wait these days at an ER, given EVERYONE now uses the ER for primary care issues due to lack of insurance...but I digress). I had my blood pressure taken and 3 x-rays of my shoulder before a Physician's Assistant knocked on my curtain and introduced herself...she told me she had to wait until the radiologist (at some remote site in Liberia) could read my x-rays before she could talk to me and left.
GOOGLE is a wonderful search engine...and, in my obvious spare time, I began GOOGLING (verb) my condition. I AM a healthcare professional myself, after all...I know how to GOOGLE as well as THEY do!
Rotator Cuff Injury...Ta Da! Classic symptoms, moderate to severe pain, inability to lift the arm laterally, deep/aching pain in the shoulder joint, clicking noise with attempted movement, pain much worse at night. GOOGLE even told me the treatment: rest, ice, passive range of motion exercises, cortisone shot in the tendon.
By the time my x-rays were transmitted electronically to Liberia, read by the radiologist, called back to the PA in the ER, and her return to throw back my curtain and announce her diagnosis given to her by the radiologist, I already HAD the diagnosis in hand...the look on her face was one of let down when I told her first I was pretty certain there was nothing broken and I had sustained a Rotator Cuff Injury. She "concurred" (I love using that term). I also had Calcific Tendonitis in the shoulder (she got to add that one to trump me) as seen on x-ray. She told me I would probably need an MRI as well as there was a high probability I had torn the cuff, but that wasn't a test they would typically do in an ER because there was no "urgency" (like the urgency of someone having a freaking stroke or THOUGHT to be having a freaking stroke because they stuck their finger in their eye with medicine on it!!).
I explained I had already been doing the rest, ice, ROM to the extent I could, and taking way too many narcotics/anti-inflammatories to try to cut the pain (causing me stomach upset and probable ulcer) and inquired about the cortisone shot to give me some relief. And THIS is where I became painfully aware of how broken the system is:
The PA told me, "Oh, we don't give cortisone shots in the ER because it's a specialized shot and you'll have to see an Orthopedic Doctor to do that because we don't want to rupture your tendon in the ER." She gave me a sling, told me to do what I had been doing, and go home and see my young Sports Medicine Ortho Doc.
********************
Day two off work and I wait...in pain...for my Wednesday appointment that I made on Monday because apparently only a SPECIALIST can do "special" treatments. I called this morning at 9:00:01AM to the young Sports Medicine Ortho Doc's office to inquire if I could be on a wait list for anyone who may cancel today because I am only 10 minutes away from his clinic and remain in moderate to severe pain. I was told by the young Sports Medicine Ortho Doc's handler that the doctor was in surgery all day and not in the clinic...apparently there are also SURGICAL repairs for my condition. I GOOGLED it...
