Thursday’s post part II…
Health-wise, I am doing better. Physical therapy is finally starting to help (it always takes a while for you to get over the soreness) and I am feeling stronger. Last Thursday I went to the pain specialist. That is a story in itself….I’m trying to decide if I want to tell it…ok, you pulled my leg.
So, at my pain clinic, a “Comprehensive Pain Clinic” (meaning that everyone works together to make sure that you receive the best health care possible…) the doctors see you on the initial visit, set up a ‘plan of action’ and if procedures such as nerve blocks are involved, they perform those. During the monthly ‘check-up’ visits, you are usually seen by a nurse practitioner or a physician’s assistant. Well, I have formed a very good relationship with one of the nurse practitioners. She listens to what I say, takes into account the medicine’s effectiveness against the side effects, and (a very rare quality for someone in the medical profession to have) she realizes that I KNOW MY BODY. I know when something just isn’t right or when things start to get better. Well, last time I went to my appointment, I was seen by a physician’s assistant that I didn’t know instead of my nurse practitioner (haha notice how I say ‘my nurse practitioner’…I would almost rather see her than the doctor…she’s great!). Anyway, I was seen by someone else who put me on the max dose of Lyrica (which is almost enough to put an elephant to sleep) and when I got my discharge summary for that visit, I noticed LOTS of errors.
This month’s visit (Last Thursday) I was seen by yet another PA (physician’s assistant). She didn’t seem to want to worry with the discharge summary that I brought back from my last visit full of highlighted areas where I had found errors. I had to repeat 3 times the types of surgeries that I had just had and the dates. She asked about trigger point injections (which my ob/gyn-specialist in pelvic pain – gives me…and always has). I gave her the dates of my trigger point injections. Then I start to tell her how the Lyrica is just not working out for me. I have to continue to take it per the neurologist, but not at the dose they had me on. I wanted to go back to the dose the neurologist had me on. Then I asked her what type of procedure/nerve block/etc. they had in mind for me since I was done with my surgeries and the last one didn’t work. (Let me stop a minute and explain that the ‘plan of action’ was to get me to a point where I no longer had to take narcotic pain medication. That is why we have been trying different nerve blocks and other procedures.) So, the PA is completely confused as to why I would want another procedure done if I had just gotten trigger point injections done. Well, she asked. So I tried to explain to her that my adhesions are so bad that there is actually muscle involvement which is why we do regular trigger point injections for the stiff and sore muscles, but that it has nothing to do with my normal “adhesion pain”. Well, I guess she decided that she wasn’t going to receive lessons from a patient, so she stands up, yells “I know what adhesions are thank you very much” walks out of the room and slams the door….(crickets chirping…) I was speechless. I could not believe that a medical professional could be so childish and rude to a patient. I sat there for a few long moments trying to convince myself that what happened was real. I considered writing a letter to the medical board. I considered not doing anything (and if you believe that one, you still don’t know me very well, do you?). I opened the door, walked out of the room and right up to the ‘check out’ lady (she just happened to be the closest employee to me). I informed her that I was going to continue to sit right there in that room until one of the five or six doctors who work there or my nurse practitioner were able to come in and perform a cordial visit. I informed her that the lady who had just left my room was incompetent as far as my medical needs were concerned and instead of leaving and asking for help, she yelled at me, left, and slammed the door behind her (I think the ‘check out’ lady actually heard/saw her slam the door, because she was right in front of the door, so I guess that corroborated my story). I did not wait for an answer, I turned around, went back in my room, and sat waiting for someone to come in.
It took about 10 minutes for the clinic manager (who, by the way, is not a doctor, but a business man in charge of making sure that professionalism is maintained). The clinic manager asked me to explain what had happened. After telling him, he apologized like five times wanting to make sure that I understood that this was not the norm there and (after I mentioned looking for another doctor) he said that the last thing that they wanted was for me to find a new clinic. He left me his card so that if anything further happens I am able to get in touch with him directly. That was nice of him and I must say, completely unexpected.
Next, my nurse practitioner came in. I told them both (the manager was still there) that I have a complex history. If the PA or NP is only given 5 or 10 minutes per patient, that time needs to be spent discussing treatment options and compliance. If I have to see a new person each time, then that time is spent on a medical history that absolutely can not be told in 10 minutes, leaving no time to discuss the treatment plan, side effects, or possible changes in medication. I told them that if they wanted me to continue to go there, then they were just going to have to schedule me for when I can be seen by the doctor or the nurse practitioner. Both agreed. The manager left, and the NP and I were able to discuss my goals and priorities and which ones were and were not being met. We discussed side effects and possible new treatments that would reduce the side effects of the other medication and get me to where I need to be to reach some of those goals.
After having a “normal” visit, they sent in a girl to go through my chart and correct all of the discrepancies that had been found. We went slowly and made sure that medicine dosages were correct, that diagnosis codes were correct and that diagnosis that should be listed were and ones that shouldn’t were taken off. Right before she left (by this point I had been there over 4 hours and the clinic was about to close) my doctor (the one I saw on intake and right before they put me nighty-night during procedures) actually came in the room to also apologize for the rudeness I had experienced and for the discrepancies in my chart. He assured me that all diagnosis would be checked and corrected and that I will be provided with the copy of my medical record since my first visit there at no charge to me. Well yeah, that’s the least they could do…
Although the visit started off horrendously, it ended on a good note. They made sure to correct all mistakes and to make sure that I got the medical attention that I deserved. Since that visit, I have felt much better. They lowered the dose of Lyrica, which allows me to stay awake during the day and to sleep better at night. I also started a long-acting medication to see how I would tolerate it. So far, it’s doing great. I will go back in two weeks (well, one week now) to discuss the results of the medication change and to see what I think about completely changing to it. Also, they will be doing a second caudal (nerve block on my tail bone…I broke my tail bone at the beginning of the year and they did one then that helped so much it was like night and day). But recently I have been having trouble sitting down and my hips have been giving me a lot of trouble. By doing the caudal block again, we will be able to see how much of the pain is from my tailbone and how much is from my hips. That way if I still have trouble, they can send me to a rheumatologist to find out what is going on with my hips.
See, this is exactly what I was talking about in my post Be Your Own Advocate. You have to stand up for yourself and demand that you get the service you deserve. My clinic was fast to make amends and correct the problems. Why? Because they know that I can go somewhere else. If I go somewhere else, my money goes with me…and they want to keep that money there. Also, there is the small matter of the medical board. If you are treated disrespectfully, and the doctor is unwilling to make amends, you should report him (or the clinic, whichever the case may be) to the medical board in your state. If we don’t speak up about mistreatment, then no one knows that it’s happening. You have to be strong and speak up for yourself. Everyone (but especially a person with a chronic illness) deserves to be respected and treated to the best of the doctor’s ability. If the doctor is unable to treat the patient, then they should be referred elsewhere, but the patient should NEVER be disrespected. NEVER EVER! Be strong my friends. I know that when you are dealing with a chronic issue, you lose faith in the medical profession and sometimes even in yourself…but don’t. Because YOU ARE WORTH IT! You deserve to be treated with the utmost respect and you should demand it. BE STRONG!
- Advanced Practice Nurses Fill the Void (health-host.co.uk)
- The most important part of the patient history …. (drsam1980.wordpress.com)
- Nurse practitioners, physician assistants will have increased role under new law (yumasun.com)