Tuesday, July 28, 2009

A Difficult Week

Temperatures are in the triple-digits here in Portland, which is not good news for people with heat-reactive MS, like me. It only compounds what was already a difficult time for me: my mother's 55th birthday was Friday, and the 11th anniversary of her death was Sunday.

Stay out of the heat, y'all....

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Monday, July 13, 2009

Tin God Syndrome: The Hit-and-Run Doctor

If you haven't read the post below...I have had two run-ins with Tin Gods in the past few months. The one below, the Doomsday Doctor, is a thankfully rare beast.

This one, the Hit-and-Run Doctor, is not.

It is possible that Hit-and-Run Doctors are the most common of all forms of Tin God Syndrome. It is very rare that a person with a chronic health issue doesn't have a run-in with at least one, and usually far more than that. Of all the Tin God stories I hear, H&R Docs are the most common.

My story begins about a month ago. Summer started early in Portland this year, and temperatures were at near-record highs. Not good news for those of us, like myself, who suffer from heat-reactive disorders. All you can do is embrace the central air and cope with the symptoms with liberal doses of medication & good-old fashioned North Carolina sweet tea (of which I am an expert).

I've had MS now for well over a decade. My most hated symptom is not pain. It's not the loss of mobility. It's nausea. I absolutely loathe being nauseated. And while I cope with mobility issues rather stoicly, and I have a high threshold for pain which goes a long way towards dealing with that unpleasant aspect of MS...I am a giant crybaby about nausea. I am the least likely person on earth to become bullimic: the idea that anyone FORCES themselves to vomit is just beyond my ability to comprehend.*

It's just my bad luck that every summer, the Nausea Fairy comes to visit me in force. I have tried damn near every medication on the market. Phenergan worked well for me for years, but it's now to the point that in order to take enough of it to be effective, it turns me into a complete zombie. I almost enjoyed watching Rock of Love on it once. It's that bad.** One of the medications I tried last year was Reglan. I used it for about three days, and it was ineffective. I was switched to Zofran, which works very well (and the pills are super-tiny, making them very easy to swallow when you're feeling sick to your tummy---I'd like to shake the hand of the scientist who realized that). I put the remainder of the Reglan away in a box, and promptly forgot about it.

Fast-forward to last month: I was suffering severe pain and terrible nausea. And wouldn't you know it: I ran out of Zofran, and the pharmacy was closed. Desperate, I checked the medicine box and found the long-forgotten Reglan. I called the doctor on call (I had begun taking one different med since the last time I was on Reglan, and I wanted to be sure it wasn't counterindicated). I got the go-ahead, and took the pill. Within 20 minutes, I was nausea-free.

Since the Zofran is rather expensive, and the Reglan was working, I continued to take it for the next week. The only side-effect were some vivid and disturbing nightmares, but I can deal with nightmares. Nausea, not so much.

Then one day, I woke up and just felt WRONG. I couldn't immediately put my finger on it: but I knew something was up. As the day progressed, so did the feeling. But now, it was accompanied by some startling symptoms: terrible anxiety; confusion; tremors in my hands; a sensation of being freezing cold (during a very hot summer afternoon); a loss of appetite; and a tightening in my chest, face & jaw that was causing my TN pain to go into overdrive. I called the doctor, and waited for a call back.

While I waited...all hell broke loose.

I began to sweat, while still feeling freezing cold. My heart was racing and pounding, the anxiety went from mild to overwhelming, and it was coupled with a debilitating sense of paranoia. I couldn't cope. I began to have a panic attack...which is not like me in the least. Most people who know me would describe me as a calm person, and at that moment, I was the least calm person in the known universe. I felt like I was going crazy. I didn't feel like me at all.

The doctor called back, and told me that this sounded like a "known and not uncommon" (WTH?) bad reaction to Reglan, and I needed to go to the ER right away. By the time my husband raced home from work to take me, I was rolled up in a ball in a corner of the bed under three blankets, shaking and crying uncontrollably, startled out of my wits by the slightest movement or noise (confusing the hell out of the cat), trying desperately not to scream because I knew, with what little sanity I had left, that if I started screaming I would not be able to stop.

When I got to the hospital, I was almost immediately taken back to triage, where another startling symptom came to light: my blood pressure was sky-high. I have never had high blood pressure in my life, having dealt with the opposite for much of my life. I was then overcome by the need to not go back into the waiting room with all the people in it. I begged the triage nurse not to send me back out there. I cried, I pleaded. I had no rational reason for it; I was far beyond being rational at that point. I just knew I did not have it in me to face that room full of people. I just couldn't do it. The startled nurse called a doctor in, a very kind woman who took me by the hand and told me, "I know you think you're going crazy, but you're not." She gave me 2 Benadryl (the first and only time I've ever been given meds in the triage room) and told me that they'd take me back to a private room right away, and I'd be ok.

If only she'd remained my treating physician!

I was left alone for about 20 minutes, to see if the Benadryl would work. It didn't. A nurse came in, got that information, and went to get the doctor.

By the time H&R arrived, my husband Jonathan was there with me and I was once again crying uncontrollably. I was also feeling very sick to my stomach. My husband helped me to explain what was going on. As soon as he heard "pain," his demeanor completely changed. I'm accustomed to this, but usually the change is skepticism, annoyance, or rarely, pity. But this time, it was more like...fear. Reticence. Maybe even cowardice. I thought perhaps it was the paranoia, but my husband noticed it as well. I didn't much care; as long as he made this nightmare stop, he could be as fraidy-cat as he wanted to be. Besides, I didn't want any pain meds at that point. I just wanted not to go insane.

Over the next few hours, I got an EEG (I have a very minor inherited heart condition) and had some blood taken (which didn't go well; I have very bad veins, and they couldn't get much blood from me before the only vein they could locate collapsed). Before the nurse left, I told her the Benadryl was not working. I was worried that if these symptoms continued for much longer, I would have a serious attack of the trigeminal neuralgia as a result of this tight-jaw business. I asked to see my doctor.

The doctor did not arrive, another nurse did...with a cup. Oh, great. Another drug test! And I wasn't even in there asking for pain meds. I just wanted to be able to stop crying and hiding under the sheets!

I took the test. And asked to see my doctor right away.

Time went by, and the tightening in my chest & jaw became markedly worse. This did not help either my TN or my panic. When next the nurse came to check on me, my husband told her I was in pain and needed help. The Benadryl had not worked. I was getting worse, and the anxiety was overwhelming. The nurse wrote on a dry erase board that my "top concerns" were anxiety, nausea and pain. I asked to see the doctor. Again.

Finally, in comes the doctor. He sees the board and looks like he's going to have a panic attack himself! He seems to be barely able to speak. We talked to him, he murmured. I couldn't understand him; it was like trying to decipher the lyrics of an early R.E.M. song. It's the end of the what as you know it? Well, I don't feel fine!

I told him I felt I needed something for this anxiety, for the nausea, and yes, I now needed something for the dreaded "p" word. He asked me if I had any of my pain medication with me. No, I had left home in a terrible state, and for the first time since I was 14, without a pocketbook. He quite visibly paled. You would have thought I was asking him to remove a thorn from the paw of that tiger who mauled Seigfried. It was then that I put two-and-two together: this was a Hit & Run Doc! Oh, joy. I'm losing my mind, and I have the bastard child of the Cowardly Lion and Speed Racer for a treating physician.

The only semi-effective way of dealing with H&R Docs is to corner them: insist they make a decision, right there and then, that they deal with your symptoms (if you let them go "look something up," or "discuss this with a colleage," you'll probably never see them again). I told him I needed this disaster to be over: NOW. I had done nothing to precipitate this. My pain was not a matter of my having eaten nachos or stood outside in the wind or put on blush. I took a medication that one doctor prescribed, and another ok'd me to take. The reaction was a KNOWN AND NOT UNCOMMON one (I'm still trying to get over that morsel of information). I passed your little drug test, so what exactly is the issue here, H&R???

The problem with backing H&R Docs into that corner is that those doctors with the more advanced form of H&R will always respond in the exact same way: they will lie. To your face. With the guile of the junkie they not-so-secretly fear you are.

This one had it bad. And so he lied, and told me he'd send a nurse in right away with some medication for me. He confirmed that my "top concerns" were anxiety, pain and nausea. He asked me what I "usually take" for a bad TN attack, and what the dosage was. He even wrote it down, the deceitful thing. And off he went!

The nurse came back with something called Cogentin: a medication to end the bad reaction. I asked her if this would address pain or nausea. No. Of course not. I sighed, took the meds, and asked to see H&R, knowing full well the likelyhood of seeing that guy again was about the same as my finding Hoffa buried under the petunias in my backyard.

Time moves on, and I wasn't feeling much better. I told this to the nurse, and asked (again) to see the doctor. Instead, she returned with another dose of the Cogentin. I was not in the least surprised. Tellingly, neither was the nurse. Twenty minutes after that...the panic was gone. I stopped crying. I felt more like myself again! But the damage was done---I was in a full-blown TN attack. When the nurse returned (no H&R! What a shock!), she told me she was "having difficulty locating" H&R. "Anxiety" was removed from the dry-erase board. "Pain and nausea" were all that remained.

By this time, Jonathan had become exasperated, and went home to retrieve my pain meds. I took two Oxycodone, and waited for H&R to reappear. I was very worried about the nausea getting worse, as I had no medications for that save the Reglan, and I sure as hell wasn't about to take THAT stuff again!

We waited. And waited. And waited. The pain subsided. The nausea, thankfully, did not get worse. I got dressed. I just wanted to go home.

And then, some unpleasant news. That tiny little amount of blood they took from me? It clotted. They would have to try again. I refused. I had been stuck now, repeatedly, in both hands. They found one vein, and that obviously was inadequete and in any event, couldn't be used again. I was already bruised, badly, from it. I was gaurenteed site reactions. I was exhausted, I was embarassed by how I had behaved in the triage while under the effects of that bad reaction and I just
wanted to go home. I had had enough.

The nurse argued with me, but it was no use. I wasn't going to budge. I wasn't always that way. Once, I let an ER stick me eleven times, quite literally from my hands to my feet, trying to find blood. They didn't get a drop. I was in agony from site reactions for so long, I went to my doctor to see if there was a cream or home remedy or something I could try to give me some relief. She chewed me out instead. "If they don't find anything in three sticks, they aren't going to find anything," she told me. "Tell them NO. You have the right to do it; exercise it." So I did.

The nurse was seriously unhappy with me. "I wonder if H&R will show up now!" I asked Jonathan.

He did. But not to admonish me over the blood work: I was being discharged. I had underestimated the level of H&R Tin God Syndrome this guy had. It was so bad in him, that even the hint of an argumentative patient was enough to terrify. I had to go.

He never asked me if my pain or my nausea were any better, or worse. Not once.

I don't know which was more stressful: the bad reaction to Reglan, or being subjected to yet another unfortunate "victim" of Tin God Syndrome while having it.

UPDATE: I was given three days of the Cogentin, but it was inadequete. My doctor upped the dosage and I took them for another week. I am, for the most part, fine now. I do have a lasting, low-level anxiety that I can't seem to shake. Two days ago, I went to the clinic and got a prescription for an SSRI to combat it...via yet another new Tin God! I am attracting them like MAGNETS these days. The feast, after the famine. I will share that story soon...

*Please don't send me hate email or comments on this. I am not making light, nor am I showing intolerance of, eating disorders. My aunt has suffered through an eating disorder for decades, and I have seen firsthand the devastation it causes not only to her but to her family as well. My heart goes out to anyone battling an eating disorder, and to their loved ones.
**I am, however, making light of Rock of Love. My heart goes out to anyone who is forced to watch it, and their loved ones. And to the poor soul who does Bret Michael's hair extensions. We're down with
your struggle, buddy.

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Thursday, July 09, 2009

Tin God Syndrome: The Doomsday Doctor

It has been a long time indeed since I have run into another physician with the dreaded Tin God Syndrome. I attribute this extraordinary good luck to 2 things: the steady and reliable care of Dr. Fetus (my PCP), and the fact that the Methadone has all but kept me out of the ER for TN pain for almost 3 years. As I have learned all too well, nothing brings on the symptoms of Tin God Syndrome in a physician quite like the chronic pain patient. It's like a person with allergies: they are just fine until they get stung by a bee, and then things go horribly wrong.

However, in the last few months I have been in the ER twice, for 2 completely different reasons & ran into 2 completely different Tin Gods: the one you'll read about here now (the Doomsday Doctor), and the one you'll read about above tomorrow (The Hit-and-Run Doc).



Several months ago, I woke up to stabbing pain in my lower right quadrant. I sighed deeply: not another kidney stone or ovarian cyst! I called the clinic, but no one was available to see me. I was told to go to the ER. I chose to go the one closest to my home. I had never been to this particular hospital before, but I figured, how bad could it be? This was a pretty easy case. Even a second-year

med student could handle it.

I had no idea I was about to run into one of the most traumatic of all Tin Gods: the Doomsday Doctor.

The motives of Doomsdays are difficult to ascertain: what makes a doctor want to take his superior knowledge of every single possible disastrous thing that can happen to the human body and use it to absolutely scare the ever-loving crap out of his patients? Were they not hugged enough as a kid? Are they unhappy that there aren't more emergency-room horror flicks? Are they just one of those people who immediately go worse-case-scenario and like to have company when they do? Or did they get into medicine simply for the chance to be the doctor who gets to tell someone they have some extremely rare and possibly untreatable disease...and they are sorely disappointed that the chance has yet to present itself?

The world may never know.

You can imagine the chaos Doomsdays ensue when they listen to your symptoms, nod wisely, lean in closer...and begin to freakin' terrify you with his honest, earnest, learned opinion that your planter's warts are actually very rare tumors and you may lose a least three fingers, if not the hand! Have a headache? He will muse aloud about aneurysms and how sad it is that your age group is statistically more likely to die while having them repaired. Got a sore throat? He will start writing down the phone number of his golf buddy, the specialist in cancers of the larynx, before you even have the chance to pop a cough drop. Doomsdays are incapable of keeping their apocalyptic thoughts to themselves: they must share them with you. Damn it, they are pretty sure they are even ethically BOUND to share them with you! And share them they will....in graphic detail. Whether you want them to or not.

I went into the ER expecting to have to take a urine test, get some blood work, have an ultrasound done, get a prescription and go home. I've been through it far more times than I'd ever care to count since I got MS. Most of the time, it's a pretty simple and straightforward matter, and rarely takes a whole lot of time. I know the drill, and know it well.

This was not going to be one of those simple, straightforward times.

I was sent back into a room fairly quickly, and the doctor came in almost right away (which in itself should have sent off warning signals). Like most Doomsdays, he seemed perfectly normal during this first interview. He nodded a lot, gave me a long and unnecessary speech about the common nature of urinary symptoms in multiple sclerosis (yeah, I noticed that about a decade or so ago, thanks) and told me he'd order some tests, then retrieved a cup from a cabinet for me to tinkle in. As I said, he seemed perfectly normal, lulling me into a false sense of security that this was, in fact, a doctor uninfected with any form of Tin God Syndrome. The only thing I noticed that was a bit off was that he not only didn't have my chart with him, he didn't have ANYTHING with him. No papers, no clipboard. I've never seen a doctor do that before, but hey, maybe he just has a really great memory?

He left, and I took the beforementioned urine test. Even my untrained eye could see the blood in the urine. The nurse also noticed it right away, and gave me a look of sympathy. She took it away, and about fifteen minutes later, came back and told me there was in fact blood, as well as signs of dehydration. It was time for the blood work, with the added bother of getting an IV put in for some fluids. Again, this is a drill I am quite familiar with. A half hour or so later, a woman came in with the ultrasound machine. So far, so good.

And then...I was completely ignored for over four hours. No nurse came to check on me. There was no sign of the doctor. Maybe my chart was lost (which would explain why the doc didn't have it), and now they've forgotten me? The bag of fluid was almost empty. I had been in a good amount of pain---not to mention a considerable amount of nausea---for a damn long time. I felt woozy, sick to my stomach and tired of feeling like I was urinating flames. And to make matters worse, I'd been put in a room with no television, and I'd left home without a book (which is a rookie mistake, and I should know better). Then to rub salt in the wound, I could just barely hear the TV in the room next to me...and they were watching a Washington pow wow! Unfair, unfair.

Another hour came and went. An orderly came in at one point, looking for someone, and I practically begged him to find my nurse. I had attempted to do so myself, but was unsuccessful. Every time I pushed the 'call nurse' button, a woman told me she'd 'find my nurse,' and apparently the search party was still out. I wasn't sure if it was a bad thing to be hooked up to a bone-dry IV, but it was pretty clear that if my nurse didn't make an appearance soon, I was gonna find out.
FINALLY, my nurse arrived, apologizing that they had been very busy and short-handed. She put yet another bag on the IV (how long did they plan to keep me here?) and also came with injectables: pain & nausea. I was shocked. I hadn't asked for anything for pain, only for the nausea. This was a first for me! I've never been given pain meds without asking for them; without begging for them 90% of the time. I wanted to be grateful...but something seemed wrong. The feeling was much stronger when I found out I was being given Morphine...and a pretty hefty amount of it to boot. I asked the nurse why; after all, I had not asked for pain meds. No one had asked me what level my pain was on either the 1-5 or 1-10 scale. So why was I being given so much Morphine? Why was I being given another bag of fluid? She told me the doctor would be in to see me soon, and rushed out.

I was, at this point, feeling very uneasy. This was all very weird. Very wrong.

I was then left alone for YET ANOTHER HOUR! I was no longer in pain, no longer felt like I was urinating fire and no longer wanted to leggo my Eggo. What I was, was scared. What was going on? Why would no one tell me?

I began to panic. I called my husband...who had begun to get pissed off. Why was a routine, MS-patient urinary problem taking almost seven hours to resolve? Why were my questions ignored? He was on his way.

While on the phone with him, the doctor came back. He had a grave look on his face. It was not unlike the look the Well-Accessoried Doctor gave me when she told me my MS had gone progressive. I felt a pit of fear in my stomach. And some curiosity, as once again...there was no chart, no papers, nada.

He asked me to sit down, and then he took a seat as well. He looked at the ground for a minute or two, sighed heavily, and then looked me in the eye. Here's how the conversation went:

DR.: "I'm afraid the tests didn't show anything."
ME: "What do you mean?"
DR.: "No kidney stones, gall stones, ovarian cysts or UTI."
ME: "I don't have a gall bladder."
(startled) "Excuse me?"
ME: "My gall bladder was removed in 1997."
DR.: "Well. That explains the lack of gall stones."

He said this with complete seriousness. I just stared at him.

ME: "Why did I have blood in my urine?"
DR.: "You didn't."
(confused) "I saw it. The nurse then TOLD me I had blood in my urine."
DR.: Well, I'm afraid the tests didn't show anything.
ME: "So what's wrong?"
DR.: "Well, I think you should go and see your doctor right away."
(startled) "Why?"
DR.: (sighing) "We don't have the ability to test for...certain things, here. Not at the moment. This is why I must STRONGLY URGE you to see your doctor right away."
ME: "How soon is right away?"
DR.: "I'm afraid you really need to be seen as soon as possible."
ME: "What do I tell Dr. Fetus? I need to tell him what to test for. I can't just go in there and tell him I needed to be seen right away for some unknown, random test."

DR.: (looks at the ground again for another minute or two) "I'm sorry, but there is some indication of the possibility of a large mass on your cervix."

I stared at him in some shock. It was one of those moments, when time seems to stop. I doubt the very large amount of Morphine in my bloodstream helped with that much.

ME: "A large mass?"
DR.: "It's important you understand, we do not have the ability to perform certain tests at this hospital, at the moment. You need to see Dr. Fetus."
ME: "Are you saying I might have cancer?"
DR.: "That's not what I'm saying at all. We would need more tests, and for that, you'll have to go to Dr. Fetus."
ME: "What tests do I have to have done?"
DR.: "That will be between you and Dr. Fetus."

Doomsday then stands up, dusts off some imaginary specks of dirt from his lab coat, looks at the ground for another few moments, and then looks back up at me.

DR.: "I wish you the best of luck, ma'am."

He said that with extraordinary gravity, the same way someone does when they let you know your dog has just been hit by a car. He then turns to walk away.

ME: "Wait a minute, wait a minute. You're scaring me. My mom died of breast cancer when she was just 44, and my grandmother died of uterine cancer at 46. Both of them fought cancer for years before they died. You need to tell me: is there a chance this mass is cancer?"
DR.: "I can't tell you that. Although I can say, with your particular family history, it is absolutely essential you see your regular doctor right away. Do you understand, Mrs. Zen? Do you understand?"
ME: "Yes, I understand. What I don't understand is this: if I don't have a UTI or kidney stone, or ovarian cyst, what is causing my symptoms? Why am I in so much pain and having so much nausea, and urinary symptoms? Could this mass cause all that?"
DR.: "Well, that's not likely but not impossible. However, with the blood in your urine, it is possible that you've got a UTI and you are in the early stages, and therefore, it isn't showing up in the tests just yet."
ME: "Wait a minute, I thought you said I didn't have blood in my urine?"
DR.: "The nurse found some blood, very small trace amounts, not enough to indicate a UTI or kidney stone. A very negligable amount."

He starts to walk to the door, thinks twice, and comes to sit down in front of me again and takes my hand.

DR.: "I need you to understand that you need to follow up with your regular doctor immediately, within the next three days at the very most. You are in need of more specialized testing and care than we are qualified to provide you in the ER. Do you understand, Mrs. Zen?"
(scared almost to the point of tears) "Yes, I understand."
DR.: "Excellent! I wish you the best of luck, Mrs. Zen. The nurse will be in in a few moments to remove the IV and give you your discharge instructions. Have a good day."

Doomsday then very abruptly leaves the room.

A few minutes later, my husband Jonathan arrives. As I tell him the story, I burst into tears and start shaking all over. Jonathan is wary. He doesn't trust this Dr. Doomsday. I don't know what to believe, and the Morphine for sure isn't helping there.

Twenty minutes go by, and my husband is now super-pissed. He tracks down my nurse and tells her that Doomsday told us to see our regular doctor right away, and we aren't going to be able to do that if we don't get out of that hospital NOW.

The fire he lit under her must have burned, burned, burned...because she showed up with a quickness. And with her: my discharge papers and yet ANOTHER shot of Morphine! She gives it to me, telling me that Doomsday ordered it, and telling me this in a tone of voice that conveys that this order was not an option, and if I'm smart...I'll take the drugs and be quiet about it. Jonathan is shocked at the amount: it is again another healthy dosage.

My IV out, and papers in hand (with the ominous-sounding diagnosis of "needs further investigation"), we leave the hospital. I have been there, at that point, for damn near eight hours.

We drive, at my husband's insistence, straight to Dr. Fetus' office. We go into the clinic, and I sit down (the Morphine has kicked in and I am feeling less than steady on my feet) and Jonathan goes to tell the receptionist what has occured. I see the look of surprise on her face, and in less than five minutes, we are shown back to a room.

Dr. Fetus is not in...I am seeing another of the clinic's doctors, Dr. Waitawhile; so named because he is quite firmly of the wait-and-see-maybe-it-will-resolve-itself school of thought.

We tell him what happened at the ER, and show him the papers. He looks at us in ever-increasing amounts of ill-concealed shock as the tale unfolds. He is especially confused as to what "tests" Doomsday thought the clinic could provide that the hospital could not, and why he wouldn't tell me what those tests were. I didn't know, because despite my repeatedly asking Doomsday, I never did get an answer.

Dr. Waitawhile went right into action. He ordered another urine test, and gave me a pelvic exam. He then went off to request the chart from Doomsday. I'm not even sure there IS one, as I never saw it the whole eight hours I was there.

We were waiting a good twenty minutes before Dr. Waitawhile returned, with a puzzled look on his face. "This is the weirdest case I think I have ever been involved in," he told me. Apparently, it was proving very difficult to get the records. Usually, it was just a matter of requesting them, then getting a fax. But he was being given the run-around, and he didn't understand why. When he finally DID get something, all he got was the results of the blood and urine tests. Nothing from the ultrasound, no doctor's notes, nothing. He then talked to both the nurse and Doomsday...and got completely different stories! The nurse said there was blood in my urine. The doctor said there wasn't. Doomsday also refused to either confirm or deny that he told me about any "mass."

I sat in utter shock. What on Earth was going on here?

On the plus side: the urine test came back with no blood. When I told Dr. Waitawhile that I had seen the blood in the original urine test with my own two eyes, he told me it was possible there had been small trace amounts of blood in the urine at that time, but that it wasn't detectable in the sample I had provided in the clinic. That suggests no UTI, but doesn't rule out stones (which could have made me have blood earlier but none now) or ovarian cysts. He then went to check on another patient, and we waited.

I was so nervous, it felt like hours before Dr. Waitawhile returned. The puzzled look was gone from his face. In its place, was irritation.

He told me that he had, after several calls and a great deal of aggrivation, received the full records. Or at least, he assumed they were the full records: there were very little nurse or doctor's notes, and it looked as if several pages were not transmitted to him. He called it "bizarre."

The verdict was in: there was no mass on my cervix. In fact, Dr. Waitawhile told me, with the sort of ultrasound that was ordered (and performed), it would be impossible to detect a mass on my cervix. For that, I would need the same exact test Dr. Waitawhile administered: a pelvic exam. Apparently, the cervix reacts in a certain way, when touched, if there is a mass. Mine didn't. He was also quite angry that I had been told that the ER could not perform "the kind of test" I needed to determine that: what ER couldn't give pelvic exams? No ER he had ever heard of. I was in agreeance on that; I've had pelvics in ERs before. I've never heard of an ER that couldn't or wouldn't perform that service. What kind of hospital was this that I had spent my day in?

And to top it all off, something other than a cervical mass DID appear on that ultrasound, despite Doomsday's insistence that the tests had shown "nothing": three ovarian cysts. These were probably the case of my pain and other symptoms. And the now-you-see-it-now-you-don't bloody urine indicated that there might be a kidney stone that wasn't showing up on the scan. I have a tilted uterus (TMI, huh?) that does often interfere with ultrasounds, a problem that was very bothersome during my pregnancies. Dr. Waitawhile gave me a prescription for nausea meds and pain relief, with the instruction (of course!) to "wait it out" and if I started having any more blood in my urine or more severe pain, to come back to see him, see Dr. Fetus...or go to any other ER in town.

In the end, it did turn out that I had a kidney stone as well as the three ovarian cysts. And those doctor's notes and other missing pages? They never did materialize.

I made a complaint with the hospital, and with the med board. This guy was the worst sort of cruel, comparable only to my experience with Caligula. No doctor should scare patients like this. I still don't understand exactly what happened, and I don't think I will ever get just why this guy chose to do what he did to me.

I do know, I won't ever forget it.

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Saturday, July 04, 2009

A Reminder This 4th of July