I have a policy with myself for when to call my back pain doctor. When I get to the point of needing 2-3 breakthrough pain pills to get through the day, its time to make the call for an appointment. I have been at that point for a while and got in to see him yesterday afternoon.
My points of discussion with him were two: My right SI joint is in serious need of having its nerves killed off and my varying total back pain needs to be discussed. We don't always change my pain meds at a single appointment, we often discuss them over a few appointments before making changes.
My right SI joint (which is the long seam joint down the side of your tailbone if you are wondering) has been giving me problems for months. We have had the treatment discussion before but previously we have focused on other pain areas.
Yesterday afternoon, he had me lie on the exam table and he moved my legs around and pressed on my hip. That hurt. Then he had me lie on my side and he pressed right on the SI joint. That was like a live wire running through me. I had to catch my breath after.
I think he realized how much it hurt and said he would send the nurse in to schedule my treatment. It took a while for me to recover from the amount of pain. I know he had to make sure he knew where the pain was coming from before heated needles to kill the nerves - because you really don't want to kill the wrong nerves.... But, yowza!
October 25 is the date for the treatment... It will be three years from the last one, which was the second one on the same place. These treatments (radiofrequency) can be repeated over and over again and each time the nerves come back, it takes longer and longer and they are weaker and weaker so the pain levels are less and less.
On a side note, my pain management doctor says I can actually take up to 8 break through pain pills a day and he considers 2-3 a day a very low dose. But my rheumatologist tells me that from her point of view, 3 should be the maximum because of convulsions. Its the different perspective from the two doctors that gets damn confusing.
Showing posts with label doctor appointments. Show all posts
Showing posts with label doctor appointments. Show all posts
Sunday, August 16, 2015
Wednesday, August 5, 2015
Appointments can mess up everything!
We are going on vacation in a few weeks and looking forward to it. This is an annual trip that has been planned. (And no I am not giving special insight to burglars as we will have a house/cat sitter while we are gone.) As part of our getting organized for this trip, I have longstanding plans to have tea with the house/cat sitter to discuss details of what is the latest food the cat will eat as well as other general information.
We are supposed to have tea (or possibly champagne and paté) at 3pm.
Yesterday I gave up on my back issues and decided living on Tramadol is not the lifestyle I enjoy, and called my back pain doctor for an appointment. The only available appointment in the next month is at 245 on the same day. Wah!!!
So now I need to reschedule our tea/champagne and paté to later in the afternoon. Obviously I can't drink champagne and then go see the doctor.... I know I could have said no but it would mean more time living on tramadol.
This always happens. We are at the mercy of our doctor's and their schedules. I also know that we are also stuck with scheduling around our other appointments. But damn! I hate it when doctor appointments conflict with the fun parts of my life.
We are supposed to have tea (or possibly champagne and paté) at 3pm.
Yesterday I gave up on my back issues and decided living on Tramadol is not the lifestyle I enjoy, and called my back pain doctor for an appointment. The only available appointment in the next month is at 245 on the same day. Wah!!!
So now I need to reschedule our tea/champagne and paté to later in the afternoon. Obviously I can't drink champagne and then go see the doctor.... I know I could have said no but it would mean more time living on tramadol.
This always happens. We are at the mercy of our doctor's and their schedules. I also know that we are also stuck with scheduling around our other appointments. But damn! I hate it when doctor appointments conflict with the fun parts of my life.
Tuesday, July 28, 2015
Getting even or driving your doctor crazy
We all try to be a good patient. We try to eat better foods, less red meat more chicken and fish, get 8 hours of sleep, drink less, brush our teeth, floss, yadayadayada...
Huffington Post conveniently posted a list of 9 things that drive your doctor crazy:
But I have 1:58 left to come up with my list of questions for her.
Huffington Post conveniently posted a list of 9 things that drive your doctor crazy:
- Dr Google - we all know Dr Google is an idiot.
- Refusal to vaccinate - which has caused more problems later on
- Demanding antibiotics - they don't fix everything
- Claiming you are eating less and working out more but still not losing weight - obviously you aren't
- Asking for a quick fix - there is no magic pill (I know this because I ask regularly)
- I only eat low fat - low fat is good but some fat isn't bad
- I don't have time to come in - really? You have time to go to the gym, work, out to dinner, etc.
- I can keep smoking as long as I exercise - They don't get it
- I don't eat carbs - don't demonize a whole group of food. Whole grains are carbs but are good ones.
But I have 1:58 left to come up with my list of questions for her.
Friday, July 17, 2015
The Best Hospitals
US News and World Report just released its annual list of the best hospitals in the US. The hospital I go to is not in the top ten.
And I am not concerned. I mean what is the benefit of going to one of the top 10 hospitals inthe US? My bet is it comes down to two issues:
I have been told by someone who worked at one of the big name Boston hospitals that unless you are related to a senator, you can expect a long wait to get in to see a doctor. And a recent study of Boston hospitals showed that the big name hospitals offered the highest fees.
With all my medical crap, I am very comfortable with the medical care I receive at Lahey Medical Center which is ten minutes from home.And that recent study of fees in metro Boston put it near the bottom of that list.
My only complaint with the hospital is that I am there too damn often.
And I am not concerned. I mean what is the benefit of going to one of the top 10 hospitals inthe US? My bet is it comes down to two issues:
- More expensive bills
- Longer waits for appointments.
I have been told by someone who worked at one of the big name Boston hospitals that unless you are related to a senator, you can expect a long wait to get in to see a doctor. And a recent study of Boston hospitals showed that the big name hospitals offered the highest fees.
With all my medical crap, I am very comfortable with the medical care I receive at Lahey Medical Center which is ten minutes from home.And that recent study of fees in metro Boston put it near the bottom of that list.
My only complaint with the hospital is that I am there too damn often.
Tuesday, July 14, 2015
Good or bad, I'm not sure
"Smart Scheduling mines patient scheduling histories to determine who is more likely to cancel or miss an appointment. It then sends alerts to the scheduling programs that doctor offices use to book appointments."
So it digs into your history and looks at your background to see if you are likely to show up for an appointment or not.
"If a patient is in a high-risk category, for instance, it prompts office schedulers to call with a reminder. If the patient cannot be reached, there is a good chance he will not show up at all. So, the doctors could then book another patient for that time slot, keeping the patient flow consistent throughout the day."
Younger patients, new patients, and those without phones are least likely to show up. Established patients, older patients, married patients, and for some reason 10am appointments are most likely to show up.
I'm not sure what happens if an expected no show, shows up. But I'm not sure if I like this kind of intrusion into my file. I mean it makes me want to be a no show a few times just to break the mold.
My thought is people should stick to appointments - it doesn't matter if its a doctor appointment, a business meeting, or meeting a friend for coffee - just show up.
But I really don't want a computer looking into my background to decide if I am going to be a no-show.
Monday, July 13, 2015
I'm running out of doctor's appointments
I got my latest appointment list from the hospital. I was shocked to realize that I only have eight scheduled appointments. Total. That's amazing. I haven't had less than ten scheduled appointments (which is the most shown on the appointment list) in years.
On one level this makes me very happy. I am sick of being sick and going to the doctor. I spend way too much time there. I have been making a concerted effort to cut back on unnecessary doctor appointments. I have opted out of some doctors simply because I don't think they do me much good. I cancelled my appointment with my radiation oncologist because I have no idea why I am still seeing her.
On the other hand, with the constant doctor appointments comes a sense of a safety net - nothing that bad can be found at a doctor appointment if someone else has seen you just a couple of months before. This can be seen with cancer patients facing the end of active treatment when their oncologist says 'all done, see you in six months' and all the continual follow up ends. This is when the most cancer patients fall apart - their safety net has ended.
When I hit the end of active treatment, I got a therapist who I still see monthly and my health continued its downward spiral so I saw doctors constantly. Finally seven years after my diagnosis, six years after active treatment, my health is stabilizing (or so it seems today) and I stop seeing doctors as often.
Now I am down to a PCP annually, rheumatologist every three months, pain doctor every four months or so, endocrinologist annually, oncologist annually - maybe not any more after the next appointment, dermatologist annually, therapist monthly, and meds therapist twice a year I hope. That works out to 11 appointments a year plus 14 for my mental health. I can live with 25 total appointments. Plus dentist twice a year and periodontist twice a year. So 29 appointments. Plus a mammogram is 30 appointments. Which is really 12 medical, 14 mental and 4 dental. If I split it up, it sounds better. Or I need back injections. Damn I guess I don't have only a few appointments.
Unless of course something happens.
I will push that looming thought out of my brain because I need to 'grow up' (is that a good term?) and get past the 'being sick' stage of my life for now. I need a being healthy stage of my life for now so I can do the things I enjoy and not go to thedamn doctor. That would make me much happier.
On one level this makes me very happy. I am sick of being sick and going to the doctor. I spend way too much time there. I have been making a concerted effort to cut back on unnecessary doctor appointments. I have opted out of some doctors simply because I don't think they do me much good. I cancelled my appointment with my radiation oncologist because I have no idea why I am still seeing her.
On the other hand, with the constant doctor appointments comes a sense of a safety net - nothing that bad can be found at a doctor appointment if someone else has seen you just a couple of months before. This can be seen with cancer patients facing the end of active treatment when their oncologist says 'all done, see you in six months' and all the continual follow up ends. This is when the most cancer patients fall apart - their safety net has ended.
When I hit the end of active treatment, I got a therapist who I still see monthly and my health continued its downward spiral so I saw doctors constantly. Finally seven years after my diagnosis, six years after active treatment, my health is stabilizing (or so it seems today) and I stop seeing doctors as often.
Now I am down to a PCP annually, rheumatologist every three months, pain doctor every four months or so, endocrinologist annually, oncologist annually - maybe not any more after the next appointment, dermatologist annually, therapist monthly, and meds therapist twice a year I hope. That works out to 11 appointments a year plus 14 for my mental health. I can live with 25 total appointments. Plus dentist twice a year and periodontist twice a year. So 29 appointments. Plus a mammogram is 30 appointments. Which is really 12 medical, 14 mental and 4 dental. If I split it up, it sounds better. Or I need back injections. Damn I guess I don't have only a few appointments.
Unless of course something happens.
I will push that looming thought out of my brain because I need to 'grow up' (is that a good term?) and get past the 'being sick' stage of my life for now. I need a being healthy stage of my life for now so I can do the things I enjoy and not go to the
Saturday, June 6, 2015
Social visiting and doctor appointments
I have spent a few hours twice this week at the hospital taking other people to doctor appointments which means I was not by myself while I was there. I was there as the designated driver/note taker. These days I go to my doctor appointments by myself again. I went alone for years and then with the second cancer diagnosis with lots of bad news my husband went with me. He also went with me for chemo infusions and for any medical (mis)adventures where I was not able to drive home.Otherwise, I fly solo.
Yesterday afternoon I started noticing groups of people who seem to accompany patients to their appointments. I can understand bring one family member or friend in case of icky news or because of sedation or something. But I can't understand bringing multiple friends, family members, or children.
I was sitting in the x-ray waiting area sitting next to a woman who was watching a tv show on her tablet (without headphones) who was sitting next to a man (husband?) while they waited for another person. There were also several people drinking the prep for one of those 'fun' tests which takes a good hour or two. I think there were at least three patients in that group who had more than one person with them.
The chemo infusion areas are clearly marked that only one person can accompany each patient in the infusion rooms. The patient exam rooms are just big enough for a patient, a medical professional and one other person. There isn't room for another chair.
When is it a social visit to hang out in the hospital waiting room? The hospital is never a 'fun' visiting place. Even the in patient rooms are not fun places to visit. I just don't understand the urge to travel in groups to the hospital. I prefer to avoid the place myself as much as possible.
Yesterday afternoon I started noticing groups of people who seem to accompany patients to their appointments. I can understand bring one family member or friend in case of icky news or because of sedation or something. But I can't understand bringing multiple friends, family members, or children.
I was sitting in the x-ray waiting area sitting next to a woman who was watching a tv show on her tablet (without headphones) who was sitting next to a man (husband?) while they waited for another person. There were also several people drinking the prep for one of those 'fun' tests which takes a good hour or two. I think there were at least three patients in that group who had more than one person with them.
The chemo infusion areas are clearly marked that only one person can accompany each patient in the infusion rooms. The patient exam rooms are just big enough for a patient, a medical professional and one other person. There isn't room for another chair.
When is it a social visit to hang out in the hospital waiting room? The hospital is never a 'fun' visiting place. Even the in patient rooms are not fun places to visit. I just don't understand the urge to travel in groups to the hospital. I prefer to avoid the place myself as much as possible.
Sunday, May 10, 2015
How to be a bad patient
Doctors (and dentists) have their own pet peeves about patients. Of course, we can't all be the perfect patient but here are the best ways to piss off your local medical office:
I try to not do these things. I admit to be guilty of most of these at times. I am human. But I try not to be a bad patient. I have enough ailments so I usually am not a quick visit for them.
- Show up late. Its often a medical emergency or patient issue which makes your doctor run late. But you are not helping if you wander in 45 minutes late and your doctor now has to fit you in because your time slot has passed.
- You ask unrelated questions to your doctor or their staff. If its not a medical problem, its not their problem.
- You lie about taking your medications. If you didn't take your medication for some reason, at least be honest about it. And if you didn't take your medication as directed and didn't get better, its not their fault.
- You self diagnose yourself and tell the doctor what you have. Some things are easy - you have a rash for example. You can see it. But don't tell your doctor you have a specific ailment unless it has been diagnosed. That is there job, not yours.
- You start asking questions at the end of the appointment after your conversation with them has ended. To help remember, bring a list of questions with you and highlight the most important ones so you cover them.
I try to not do these things. I admit to be guilty of most of these at times. I am human. But I try not to be a bad patient. I have enough ailments so I usually am not a quick visit for them.
Saturday, April 25, 2015
Preparation
I have to get prepared. For what you might ask? Doctor appointments. On Monday I meet with my pain management doctor. I need notes to ask him questions. If I show up with a list, he wants me to read him my questions and then he answers each one. If I do not remember my list, I sometimes feel rushed with him. He has a very efficient manner so, in his efficiency I sometimes do not get all my questions answered because I forget to ask them.
My questions for him will cover my (annoying) back pain. My lower back pain is caused by my degenerating disks. It only happens if I bend over or attempt gardening (which I love) or sweeping, shoveling or vacuuming (which are optional activities in my life). The decision will be do we do more needle treatments or not. Probably not.
My upper back pain is caused by fibromyalgia and myofascial pain. We can do more needles and things but they can be very helpful. The problem is they make me uncomfortable for a few days and we are going away for our anniversary (and will have a house/cat sitter so burglars don't get any ideas).
On Wednesday I see my rheumatologist and I have a big list for her. What to do about numerous body parts and their aches and pains. Do we stay on the same medications or do we switch or add others? I don't like the idea of more medications but I also want less pain in my life. And sometimes the side effects (mouth sores) of my current medications make things like eating difficult. Not that I wouldn't mind eating less and losing weight but its the pain part that I dislike.
I need my list for both or my chemo brain/fibro fog/whatever will not allow me to recall a damn thing when I get there. My life is full of some many adventures isn't it?
My questions for him will cover my (annoying) back pain. My lower back pain is caused by my degenerating disks. It only happens if I bend over or attempt gardening (which I love) or sweeping, shoveling or vacuuming (which are optional activities in my life). The decision will be do we do more needle treatments or not. Probably not.
My upper back pain is caused by fibromyalgia and myofascial pain. We can do more needles and things but they can be very helpful. The problem is they make me uncomfortable for a few days and we are going away for our anniversary (and will have a house/cat sitter so burglars don't get any ideas).
On Wednesday I see my rheumatologist and I have a big list for her. What to do about numerous body parts and their aches and pains. Do we stay on the same medications or do we switch or add others? I don't like the idea of more medications but I also want less pain in my life. And sometimes the side effects (mouth sores) of my current medications make things like eating difficult. Not that I wouldn't mind eating less and losing weight but its the pain part that I dislike.
I need my list for both or my chemo brain/fibro fog/whatever will not allow me to recall a damn thing when I get there. My life is full of some many adventures isn't it?
Saturday, March 28, 2015
Doctors and coping with multiple ailments
Do you consider your doctor to be the be-all and end-all of all your medical questions? "I need to ask my doctor about that...." Or "let me see what my doctor thinks..." Then you accept their words as guidelines for your life - food, exercise, modifications, etc.
Me, I have so many ailments, I take what my doctors say for the most part with a grain of salt (which is sometimes accompanied by a large margarita). The problem is I have so many ailments that sometimes they can't tell. Why do I have a rash/headache/pain? No idea. Maybe its just a side effect of one of your medications... Or from your blah-blah-blah, we don't really know.
If you are like me and have multiple ailments which cause pain and fatigue, it can be impossible to figure out what causes pain and fatigue. I mean I know the bone deep pain in my arm or leg is from fibromyalgia. And that the pain in my lower back is from degenerating disks. And that the pain in my right SI joint means I need to go back to get those pesky nerves killed off again.
But then I get many other pains that meander through my body of unknown origin. My doctors shrug their shoulders and say keep track of it and monitor frequency, etc. Then when one pain is resolved often I find other pains hidden behind them.
Then when I develop new symptoms, we need to figure out the cause. I can get a preliminary diagnosis of something new and then if I learn about it, I find that some of my other symptoms could be directly related. But unless I test positive for the new ailment, it maybe a pile of hooey and I give up on that. My favorite is 'you don't test positive for it but you probably have a similar unknown ailment'. And the best part is then 'there's nothing we can do about it'.
So I take what I learn at one doctor appointment, do a pile of research, and then I go back to my doctors and ask more questions...
The eternal life of the patient and questions with all my ailments.
Me, I have so many ailments, I take what my doctors say for the most part with a grain of salt (which is sometimes accompanied by a large margarita). The problem is I have so many ailments that sometimes they can't tell. Why do I have a rash/headache/pain? No idea. Maybe its just a side effect of one of your medications... Or from your blah-blah-blah, we don't really know.
If you are like me and have multiple ailments which cause pain and fatigue, it can be impossible to figure out what causes pain and fatigue. I mean I know the bone deep pain in my arm or leg is from fibromyalgia. And that the pain in my lower back is from degenerating disks. And that the pain in my right SI joint means I need to go back to get those pesky nerves killed off again.
But then I get many other pains that meander through my body of unknown origin. My doctors shrug their shoulders and say keep track of it and monitor frequency, etc. Then when one pain is resolved often I find other pains hidden behind them.
Then when I develop new symptoms, we need to figure out the cause. I can get a preliminary diagnosis of something new and then if I learn about it, I find that some of my other symptoms could be directly related. But unless I test positive for the new ailment, it maybe a pile of hooey and I give up on that. My favorite is 'you don't test positive for it but you probably have a similar unknown ailment'. And the best part is then 'there's nothing we can do about it'.
So I take what I learn at one doctor appointment, do a pile of research, and then I go back to my doctors and ask more questions...
The eternal life of the patient and questions with all my ailments.
Thursday, January 22, 2015
Breaking in new doctors
Its an ongoing effort that can take months or years! Today I am off for my third appointment with my rheumatologist. We are still getting to know each other.
My first rheumatologist, who I met a whopping two times, left the hospital and moved to another one which was closer to her home where she was a mother to two small children. I completely understand her reasoning. She was a nice woman and seemed like a good doctor but I just never got to know her well in two visits.
Then I met with a nurse practitioner for a three month follow up who was also nice. She got me started on injected methotrexate - and I HATE needles but that's another story.
Finally I met my new rheumatologist, who was recommended to me, in July. I saw her next in October and we made some progress. She got to know me a little more but we have a long way to go.
Today I meet with her for the third time. I hope for lots of progress. I have a big list of questions for her. I hope she has lots of answers for me.
My problem with doctors is I come with lots of baggage - meaning I have a really FAT medical file. Its full of cancer, endocrine stuff, autoimmune stuff, and a few decades of over use which has left me with assorted ailments. I have multiple doctors updating it constantly and regular blood work to keep track of things.
However I expect by a third visit a doctor will be up to speed and understand me a bit better. I'll keep my high expectations to myself and see how things go.
My first rheumatologist, who I met a whopping two times, left the hospital and moved to another one which was closer to her home where she was a mother to two small children. I completely understand her reasoning. She was a nice woman and seemed like a good doctor but I just never got to know her well in two visits.
Then I met with a nurse practitioner for a three month follow up who was also nice. She got me started on injected methotrexate - and I HATE needles but that's another story.
Finally I met my new rheumatologist, who was recommended to me, in July. I saw her next in October and we made some progress. She got to know me a little more but we have a long way to go.
Today I meet with her for the third time. I hope for lots of progress. I have a big list of questions for her. I hope she has lots of answers for me.
My problem with doctors is I come with lots of baggage - meaning I have a really FAT medical file. Its full of cancer, endocrine stuff, autoimmune stuff, and a few decades of over use which has left me with assorted ailments. I have multiple doctors updating it constantly and regular blood work to keep track of things.
However I expect by a third visit a doctor will be up to speed and understand me a bit better. I'll keep my high expectations to myself and see how things go.
Tuesday, January 20, 2015
Preparation
I have to get prepared. For what you might ask? Doctor appointments. On Monday I meet with my pain management doctor. I need notes to ask him questions. If I show up with a list, he wants me to read him my questions and then he answers each one. If I do not remember my list, I sometimes feel rushed with him. He has a very efficient manner so, in his efficiency I sometimes do not get all my questions answered because I forget to ask them.
My questions for him will cover my (annoying) back pain. My lower back pain is caused by my degenerating disks. It only happens if I bend over or attempt gardening (which I love) or sweeping, shoveling or vacuuming (which are optional activities in my life). The decision will be do we do more needle treatments or not. Probably not.
My upper back pain is caused by fibromyalgia and myofascial pain. We can do more needles and things but they can be very helpful. The problem is they make me uncomfortable for a few days and we are going away for our anniversary (and will have a house/cat sitter so burglars don't get any ideas).
On Wednesday I see my rheumatologist and I have a big list for her. What to do about numerous body parts and their aches and pains. Do we stay on the same medications or do we switch or add others? I don't like the idea of more medications but I also want less pain in my life. And sometimes the side effects (mouth sores) of my current medications make things like eating difficult. Not that I wouldn't mind eating less and losing weight but its the pain part that I dislike.
I need my list for both or my chemo brain/fibro fog/whatever will not allow me to recall a damn thing when I get there. My life is full of some many adventures isn't it?
My questions for him will cover my (annoying) back pain. My lower back pain is caused by my degenerating disks. It only happens if I bend over or attempt gardening (which I love) or sweeping, shoveling or vacuuming (which are optional activities in my life). The decision will be do we do more needle treatments or not. Probably not.
My upper back pain is caused by fibromyalgia and myofascial pain. We can do more needles and things but they can be very helpful. The problem is they make me uncomfortable for a few days and we are going away for our anniversary (and will have a house/cat sitter so burglars don't get any ideas).
On Wednesday I see my rheumatologist and I have a big list for her. What to do about numerous body parts and their aches and pains. Do we stay on the same medications or do we switch or add others? I don't like the idea of more medications but I also want less pain in my life. And sometimes the side effects (mouth sores) of my current medications make things like eating difficult. Not that I wouldn't mind eating less and losing weight but its the pain part that I dislike.
I need my list for both or my chemo brain/fibro fog/whatever will not allow me to recall a damn thing when I get there. My life is full of some many adventures isn't it?
Sunday, January 18, 2015
How I spent my evening or a day in the life of the eternal patient
This is truly the life of a long term medical patient. I spent last evening watching TV with my husband and making lists of questions to ask my doctors in upcoming appointments. I have had the luxury of the past few months with out a lot of doctor appointments. Now I have a big clump of them coming up over the next six weeks or so.
I know I have my rheumatologist and then my endocrinologist and then my back pain doctor. These visits require planning and lists on my part. I need to think about what I want to ask them and decide if I want to do any more research before they see them. Finally I want to think back to the last time I saw them and decide if I have follow up questions from those.
This isn't as easy as you may think. I have a first draft of my questions so far. My next step is to look at my calendar and see when the actual appointments are. Those are the only three appointments I can remember and I am sure there are more.
My most important goal is to put the lists some place where I will not lose them.... Sounds pretty easy doesn't it? I believe at my last round of doctor appointments, I lost the damn list. I frequently lose the grocery list as well.
So in my future may be another evening making my medical lists. Damn.
I know I have my rheumatologist and then my endocrinologist and then my back pain doctor. These visits require planning and lists on my part. I need to think about what I want to ask them and decide if I want to do any more research before they see them. Finally I want to think back to the last time I saw them and decide if I have follow up questions from those.
This isn't as easy as you may think. I have a first draft of my questions so far. My next step is to look at my calendar and see when the actual appointments are. Those are the only three appointments I can remember and I am sure there are more.
My most important goal is to put the lists some place where I will not lose them.... Sounds pretty easy doesn't it? I believe at my last round of doctor appointments, I lost the damn list. I frequently lose the grocery list as well.
So in my future may be another evening making my medical lists. Damn.
Saturday, January 17, 2015
The Best Hospitals
US News and World Report just released its annual list of the best hospitals in the US. The hospital I go to is not in the top ten.
And I am not concerned. I mean what is the benefit of going to one of the top 10 hospitals inthe US? My bet is it comes down to two issues:
I have been told by someone who worked at one of the big name Boston hospitals that unless you are related to a senator, you can expect a long wait to get in to see a doctor. And a recent study of Boston hospitals showed that the big name hospitals offered the highest fees.
With all my medical crap, I am very comfortable with the medical care I receive at Lahey Medical Center which is ten minutes from home.And that recent study of fees in metro Boston put it near the bottom of that list.
My only complaint with the hospital is that I am there too damn often.
And I am not concerned. I mean what is the benefit of going to one of the top 10 hospitals inthe US? My bet is it comes down to two issues:
- More expensive bills
- Longer waits for appointments.
I have been told by someone who worked at one of the big name Boston hospitals that unless you are related to a senator, you can expect a long wait to get in to see a doctor. And a recent study of Boston hospitals showed that the big name hospitals offered the highest fees.
With all my medical crap, I am very comfortable with the medical care I receive at Lahey Medical Center which is ten minutes from home.And that recent study of fees in metro Boston put it near the bottom of that list.
My only complaint with the hospital is that I am there too damn often.
Friday, January 16, 2015
Damn, more meds!
And an expensive one at that. My pain doctor put me back on Lyrica. We tried it about four years ago for the nerve pain issues I was having with my back. We decided it didn't really work for me after about 9 months so I went off it. But now that I have been diagnosed with fibromyalgia, my doctor is suggesting I try Lyrica again.
I don't have a problem with it. My fibro pain has been pretty bad. Just sitting still, knitting, watching TV, driving, or whatever, all of a sudden I will get a bone deep pain in my arm that shoots up to about a 9 or so. Then it goes away. So its no like you can treat it specifically. Sometimes I ice it afterwards if there is any residual achiness. I get other pains as well.
These are all signs that my fibro is active. The decision at my diagnosis was to treat my RA first and see if we can get it under control and then focus on my fibro. So now we are at that point.
I went and picked up my prescription yesterday and took my first dose - twice a day. That's where the problems started. First I have to talk to my insurance and see if I can get it cheaper - $70/month right now!!!
Next I have to figure out when I can take it in the morning. The Lyrica bottle says I can take it with any other medications as it doesn't interact. The other pill I take in the morning, Levothyroxine or synthroid, clearly states take one hour before or four hours after eating. Do not take other medications or vitamins for four hours. So now I have to call the pharmacist and get a real answer.
Finally I have to talk to my meds therapist about interactions with my other medications. This is what I have to do after most new prescriptions
Adding one more medication is not easy. I am on a lot of different things that cause different interactions. Some pain medications and some anti depressants work the same way or in different ways that can cause problems.
This is complicated..... Crap.
I don't have a problem with it. My fibro pain has been pretty bad. Just sitting still, knitting, watching TV, driving, or whatever, all of a sudden I will get a bone deep pain in my arm that shoots up to about a 9 or so. Then it goes away. So its no like you can treat it specifically. Sometimes I ice it afterwards if there is any residual achiness. I get other pains as well.
These are all signs that my fibro is active. The decision at my diagnosis was to treat my RA first and see if we can get it under control and then focus on my fibro. So now we are at that point.
I went and picked up my prescription yesterday and took my first dose - twice a day. That's where the problems started. First I have to talk to my insurance and see if I can get it cheaper - $70/month right now!!!
Next I have to figure out when I can take it in the morning. The Lyrica bottle says I can take it with any other medications as it doesn't interact. The other pill I take in the morning, Levothyroxine or synthroid, clearly states take one hour before or four hours after eating. Do not take other medications or vitamins for four hours. So now I have to call the pharmacist and get a real answer.
Finally I have to talk to my meds therapist about interactions with my other medications. This is what I have to do after most new prescriptions
Adding one more medication is not easy. I am on a lot of different things that cause different interactions. Some pain medications and some anti depressants work the same way or in different ways that can cause problems.
This is complicated..... Crap.
Starting my big break
I am about to leave for my last doctor appointment for, drum roll please.... SIX WEEKS! I have not had a break like this in years. You may think I am kidding but I am not. I have to go back to like February/March of 2007 since a break like this.
I resolve to stay healthy and not need any medical care until October.
And I only have five more appointments scheduled for the balance of 2013. Plus at least two more set of blood work. I wonder what miracle caused that? Maybe I am getting healthier.
I will also add that my back is significantly better than it was after the trigger point injections.
No time for a big blog post today because I am late!
I resolve to stay healthy and not need any medical care until October.
And I only have five more appointments scheduled for the balance of 2013. Plus at least two more set of blood work. I wonder what miracle caused that? Maybe I am getting healthier.
I will also add that my back is significantly better than it was after the trigger point injections.
No time for a big blog post today because I am late!
Why do they do that?
I have a policy with myself for when to call my back pain doctor. When I get to the point of needing 2-3 breakthrough pain pills to get through the day, its time to make the call for an appointment. I have been at that point for a while and got in to see him yesterday afternoon.
My points of discussion with him were two: My right SI joint is in serious need of having its nerves killed off and my varying total back pain needs to be discussed. We don't always change my pain meds at a single appointment, we often discuss them over a few appointments before making changes.
My right SI joint (which is the long seam joint down the side of your tailbone if you are wondering) has been giving me problems for months. We have had the treatment discussion before but previously we have focused on other pain areas.
Yesterday afternoon, he had me lie on the exam table and he moved my legs around and pressed on my hip. That hurt. Then he had me lie on my side and he pressed right on the SI joint. That was like a live wire running through me. I had to catch my breath after.
I think he realized how much it hurt and said he would send the nurse in to schedule my treatment. It took a while for me to recover from the amount of pain. I know he had to make sure he knew where the pain was coming from before heated needles to kill the nerves - because you really don't want to kill the wrong nerves.... But, yowza!
October 25 is the date for the treatment... It will be three years from the last one, which was the second one on the same place. These treatments (radiofrequency) can be repeated over and over again and each time the nerves come back, it takes longer and longer and they are weaker and weaker so the pain levels are less and less.
On a side note, my pain management doctor says I can actually take up to 8 break through pain pills a day and he considers 2-3 a day a very low dose. But my rheumatologist tells me that from her point of view, 3 should be the maximum because of convulsions. Its the different perspective from the two doctors that gets damn confusing.
My points of discussion with him were two: My right SI joint is in serious need of having its nerves killed off and my varying total back pain needs to be discussed. We don't always change my pain meds at a single appointment, we often discuss them over a few appointments before making changes.
My right SI joint (which is the long seam joint down the side of your tailbone if you are wondering) has been giving me problems for months. We have had the treatment discussion before but previously we have focused on other pain areas.
Yesterday afternoon, he had me lie on the exam table and he moved my legs around and pressed on my hip. That hurt. Then he had me lie on my side and he pressed right on the SI joint. That was like a live wire running through me. I had to catch my breath after.
I think he realized how much it hurt and said he would send the nurse in to schedule my treatment. It took a while for me to recover from the amount of pain. I know he had to make sure he knew where the pain was coming from before heated needles to kill the nerves - because you really don't want to kill the wrong nerves.... But, yowza!
October 25 is the date for the treatment... It will be three years from the last one, which was the second one on the same place. These treatments (radiofrequency) can be repeated over and over again and each time the nerves come back, it takes longer and longer and they are weaker and weaker so the pain levels are less and less.
On a side note, my pain management doctor says I can actually take up to 8 break through pain pills a day and he considers 2-3 a day a very low dose. But my rheumatologist tells me that from her point of view, 3 should be the maximum because of convulsions. Its the different perspective from the two doctors that gets damn confusing.
Thursday, January 15, 2015
Doctors and coping with multiple ailments
Do you consider your doctor to be the be-all and end-all of all your medical questions? "I need to ask my doctor about that...." Or "let me see what my doctor thinks..." Then you accept their words as guidelines for your life - food, exercise, modifications, etc.
Me, I have so many ailments, I take what my doctors say for the most part with a grain of salt (which is sometimes accompanied by a large margarita). The problem is I have so many ailments that sometimes they can't tell. Why do I have a rash/headache/pain? No idea. Maybe its just a side effect of one of your medications... Or from your blah-blah-blah, we don't really know.
If you are like me and have multiple ailments which cause pain and fatigue, it can be impossible to figure out what causes pain and fatigue. I mean I know the bone deep pain in my arm or leg is from fibromyalgia. And that the pain in my lower back is from degenerating disks. And that the pain in my right SI joint means I need to go back to get those pesky nerves killed off again.
But then I get many other pains that meander through my body of unknown origin. My doctors shrug their shoulders and say keep track of it and monitor frequency, etc. Then when one pain is resolved often I find other pains hidden behind them.
Then when I develop new symptoms, we need to figure out the cause. I can get a preliminary diagnosis of something new and then if I learn about it, I find that some of my other symptoms could be directly related. But unless I test positive for the new ailment, it maybe a pile of hooey and I give up on that. My favorite is 'you don't test positive for it but you probably have a similar unknown ailment'. And the best part is then 'there's nothing we can do about it'.
So I take what I learn at one doctor appointment, do a pile of research, and then I go back to my doctors and ask more questions...
The eternal life of the patient and questions with all my ailments.
Me, I have so many ailments, I take what my doctors say for the most part with a grain of salt (which is sometimes accompanied by a large margarita). The problem is I have so many ailments that sometimes they can't tell. Why do I have a rash/headache/pain? No idea. Maybe its just a side effect of one of your medications... Or from your blah-blah-blah, we don't really know.
If you are like me and have multiple ailments which cause pain and fatigue, it can be impossible to figure out what causes pain and fatigue. I mean I know the bone deep pain in my arm or leg is from fibromyalgia. And that the pain in my lower back is from degenerating disks. And that the pain in my right SI joint means I need to go back to get those pesky nerves killed off again.
But then I get many other pains that meander through my body of unknown origin. My doctors shrug their shoulders and say keep track of it and monitor frequency, etc. Then when one pain is resolved often I find other pains hidden behind them.
Then when I develop new symptoms, we need to figure out the cause. I can get a preliminary diagnosis of something new and then if I learn about it, I find that some of my other symptoms could be directly related. But unless I test positive for the new ailment, it maybe a pile of hooey and I give up on that. My favorite is 'you don't test positive for it but you probably have a similar unknown ailment'. And the best part is then 'there's nothing we can do about it'.
So I take what I learn at one doctor appointment, do a pile of research, and then I go back to my doctors and ask more questions...
The eternal life of the patient and questions with all my ailments.
Getting even or driving your doctor crazy
We all try to be a good patient. We try to eat better foods, less red meat more chicken and fish, get 8 hours of sleep, drink less, brush our teeth, floss, yadayadayada...
Huffington Post conveniently posted a list of 9 things that drive your doctor crazy:
But I have 1:58 left to come up with my list of questions for her.
Huffington Post conveniently posted a list of 9 things that drive your doctor crazy:
- Dr Google - we all know Dr Google is an idiot.
- Refusal to vaccinate - which has caused more problems later on
- Demanding antibiotics - they don't fix everything
- Claiming you are eating less and working out more but still not losing weight - obviously you aren't
- Asking for a quick fix - there is no magic pill (I know this because I ask regularly)
- I only eat low fat - low fat is good but some fat isn't bad
- I don't have time to come in - really? You have time to go to the gym, work, out to dinner, etc.
- I can keep smoking as long as I exercise - They don't get it
- I don't eat carbs - don't demonize a whole group of food. Whole grains are carbs but are good ones.
But I have 1:58 left to come up with my list of questions for her.
Wednesday, January 14, 2015
A Human Pincushion
My upper back h as been bothering me for a while. I haven't been sure if something new is going on, if it is referred pain from elsewhere in my body, or the pain was hidden by the horrible pain I had in my lower back until the successful procedure where nerves were killed off in my lower back in June.
Last week I broke down due to back pain and called my pain doctor. I thought I wouldn't be able to get an appointment before October because it usually takes that long. They said 'how about next Tuesday'. I said 'sure'. So I went.
We have never treated my upper back before because it has not been a problem. Its not rheumatoid. Its not cancer metastasis (the first thing that jumps into any cancer patients head). It could be fibromyalgia. It could be myofascial pain. Or it could be something else.
The doctor, after pushing on my back to make it hurt, suggested trigger point injections where he makes a series of intra muscular injections on my back in the painful areas. He has done this before on my lower back and they relieved a fair amount of pain.
There were five measly injections which he said would cause a pinch... and they were followed by deep pressure pain causing me to breath slowly out of my mouth instead of crying. The nurse came in to check my vitals after (they do that so patients don't pass out as they leave). When I got to my appt, my blood pressure was 123/78. After the injections it was 103/66.
I nixed the trip to Kohls and the trip to the gym after that adventure and came home to sit with my giant ice pack. I gave my husband two choices for dinner - he cooks or takeout. The delivery guy showed up on time with dinner.
So today I feel like a human pincushion. The doctor did say to take it easy for a day or two. I will see how it goes today at work. I am supposed to meet a friend for a walk this afternoon but it may be one of those days where I can't walk. But I hope that when the shots stop hurting, they will make my back stop hurting.
Last week I broke down due to back pain and called my pain doctor. I thought I wouldn't be able to get an appointment before October because it usually takes that long. They said 'how about next Tuesday'. I said 'sure'. So I went.
We have never treated my upper back before because it has not been a problem. Its not rheumatoid. Its not cancer metastasis (the first thing that jumps into any cancer patients head). It could be fibromyalgia. It could be myofascial pain. Or it could be something else.
The doctor, after pushing on my back to make it hurt, suggested trigger point injections where he makes a series of intra muscular injections on my back in the painful areas. He has done this before on my lower back and they relieved a fair amount of pain.
There were five measly injections which he said would cause a pinch... and they were followed by deep pressure pain causing me to breath slowly out of my mouth instead of crying. The nurse came in to check my vitals after (they do that so patients don't pass out as they leave). When I got to my appt, my blood pressure was 123/78. After the injections it was 103/66.
I nixed the trip to Kohls and the trip to the gym after that adventure and came home to sit with my giant ice pack. I gave my husband two choices for dinner - he cooks or takeout. The delivery guy showed up on time with dinner.
So today I feel like a human pincushion. The doctor did say to take it easy for a day or two. I will see how it goes today at work. I am supposed to meet a friend for a walk this afternoon but it may be one of those days where I can't walk. But I hope that when the shots stop hurting, they will make my back stop hurting.
Subscribe to:
Posts (Atom)