A Wheelie Cool Therapist

, , , , , , | Healthy | March 16, 2020

(I’m a physical therapist. My next patient is reportedly frail; she’s wheelchair-bound and doesn’t leave her bed.)

Patient: “Can you teach me to do a wheelie?”

(I couldn’t help but laugh. She ended up being a fairly healthy girl, albeit with less muscle tone due to her condition. The reason she hadn’t left her bed? The nurses had put a bed alarm on her — standard procedure for someone like her — and she hated moving with an IV.

I wasn’t allowed to teach her how to do a wheelie, but I was able to teach the basic concept. Get a friend to pull you back, practice balancing for a while, and then try it on your own. Shove the wheels, hard, and have someone catch you when you fly backward. I think she’ll be just fine.)

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Enough Of This Song And Dance!

, , , , , | Healthy | March 14, 2020

I am a musical theatre major, meaning that I spend the better part of my day in a ballet studio dancing or working out, and during what’s left of that day I’m either singing, acting, or both. After having an inherent heart condition fixed as a young teenager, I am proud to say that I am mostly healthy, a couple of minor-ish issues — as well as notorious unresponsiveness to most kinds of medication — aside. 

About fifteen months ago, though, I get sick with something that is labelled “minor, superficial pneumonia” at first, and after sitting in my body for about two weeks turns into “asthmatic-spastic bronchitis.” Later, it becomes full-blown asthma bronchiale which, thanks to hyperreactive bronchia, I am very used to catching around twice a year. Usually, after a couple of weeks, it’s gone again, and my asthma falls asleep into insignificance once more.

Not this time. 

The weeks come and go, and nothing happens. I’m fully incapable of doing anything at the conservatoire — but thankfully most of my professors are amazing and give me all the support they can possibly give me — and I’m getting more and more frustrated. My pulmonologist, after failing to succeed with several more antibiotics and cortisone therapies, is unwilling to give up on me and refers me to all possible colleagues. I get tested for pertussis, even for tuberculosis — and pretty much everything else — but they can’t find anything. 

After just barely passing my semester with the worst possible acceptable grades, I go home for my semester break. By that time, this has gone on nearly two and a half months already. My pulmonologist tells me to continue my treatment, or rather, the search for a concrete diagnosis, as she is at her wit’s end. 

I do, and they actually get the idea to do a bronchoscopy where, at last, they find not only a virus, but also bacteria that seem to cause all the trouble, sending me into a spiral of a constant asthma attack, which expresses itself with the symptoms of a chronic, constant bronchitis. They send me home with more antibiotics, telling me I can’t do much more but “sit it out and hope it’ll be gone in four to six months,” and put me on sick leave for my upcoming semester, since I can neither sing, dance, nor do anything on the acting front. I move back in at home with my most amazing, most supportive parents, and I begin my journey of doing not much of anything at all. 

All throughout the time, I’m feeling flu-ish sick, with often insufferable headaches and horrible sore throats, short- as well as flat-breathed, and I obviously also cannot get rid of that cough. I have better days and worse, but the worse days definitely outweigh the good ones. Basically, I’m knocked out of my life entirely, and I often even have to think twice if I want to take a brief trip to town. 

The months pass and nothing happens. There’s no improvement that lasts longer than two weeks and doesn’t follow a massive breach again. I lose another semester, as well as a fair share of friends. And, due to lack of movement, unsuccessful medication treatment, and, as I only just recently found out, my hypothyroidism acting up again, as well, I gain quite some weight; I’m not obese and still fit into most of my clothes, but you wouldn’t believe me the dance student, either. 

I haven’t been idle over that time; I’ve been looking into common and alternative medicine and am in the middle of a doctor marathon, to not much avail except for the revelation of several more issues to work on, and about a month ago — as this has been going on for longer than a year already, and I’m beyond frustrated and only very desperately trying to scratch the final pieces of my patience together — I am referred to the pulmonologist department of my local hospital to finally treat my set-in-stone asthma diagnosis, as many doctors seem to purposefully ignore the bacterial aspect of my issues. 

I have so many hopes for this appointment. But when I walk in, I see that, instead of [Doctor #2], who I am supposed to have the appointment with, I am met by a super young, and super overwhelmed-looking [Doctor #1]. 

I present him with all kinds of older to recent-ish but not super recent bloodwork and diagnoses and some very real proof that there are indeed physical issues to be resolved.

I explain, “…and this is why your colleague from the immunology department referred me over to you. It’s a rather pressing issue because my new semester is about to start, and I’d hate to miss the third one in a row. I really can’t do any dancing, singing, or much of anything at all, so I’m quite desperate about making progress. But unfortunately, I have issues with medication showing proper effect; it’s been like that since my heart issues way back as a child and starts with super simple things like common painkillers needing super high doses to start working.” 

The doctor doesn’t even seem to listen properly. “Well, we couldn’t find anything physical in your test results…”

All they did was a basic lung function test, the results of which often fluctuate depending on my day. 

I respond with confusion, “Um… But… I am officially diagnosed with asthma bronchiale already. Also, my lung function results fluctuate really badly, from unacceptable to–” 

The doctor cuts me off. “There are no physical issues, and your lung function seems to be low but not concerningly so.” 

“Well, as I explained before, it really fluctuates and–” 

He interrupts again. “Well, this is definitely not a physical issue, and your lung function is–” 

I cut him off this time. “But I really just said…”

[Doctor #1] ignores me and gets up to get [Doctor #2], who doesn’t even bother to sit down, and very clearly looks like she has no interest whatsoever in being here or helping me. 

“Well, as my colleague already informed you, we cannot find any physical issues to work with, and clearly, you are not asthmatic.” 

I sigh inwardly. “I really just explained to your colleague before that I have my official asthma diagnosis; I just need treatment for it, which is difficult because most kinds of medications have a really hard time to show any kind of effect besides the side effects, if they even work at all–“

[Doctor #2] says, interrupting me harshly, “If you were asthmatic, we would be able to treat you with cortisone inhalers, and those never showed any effect, so all you really have is a hyperresponsive larynx.” 

I’m absolutely stunned at how they both have so successfully ignored anything I’ve said in the past couple of minutes. “But… as I said… and my lung function… I know it looks better now but it really, really depends on the day and… It’s really not only the cough; there are so many other issues that–” 

Cut off again! “And your lung function isn’t that bad. I’ll just give you [super intense nervous system medication that is usually prescribed to epilepsy and severe anxiety patients, neither of which I even remotely suffer from] for your hyperreactive larynx. As for the fatigue, here’s a referral to outpatient rehab.”

[Doctor #2] gets up and leaves again without giving me the chance to say anything at all. 

“It’s really not just the cough; it’s–“

[Doctor #1] proceeds to explain the effects of the just-prescribed medication without listening. 

My mum, who had accompanied me, hasn’t had much of a word, either, so we just decide to give up on that lost cause and leave, both of us boiling inside. Not for one second do I consider having that prescription filled and taking this stuff, no matter how desperate I may be. Looking on the piece of paper, I was handed, I also find out that [Doctor #2] put “fatigue,” “chronic cough,” and “obesity” on my rehab prescription, which I am still livid about. 

Later that day, I have a routine follow-up appointment with a new cardiologist, who not only is as appalled by this behaviour as we are, but also draws blood and reveals several very physical indeed issues, among them high inflammation signs, my hypothyroidism being at a not-dangerous-but-alarmingly-low level again, and the bacteria still being very, very present within my body. I’m referred to another pulmonologist immediately.  

While I am, indeed, missing my third semester in a row, quite unsurprisingly, that new pulmonologist has not only found out that my lung function is currently at a new low point, but confirmed a “clearly asthmatic reaction and movement,” put that into the diagnosis, and promised to investigate if there is anything else behind it that I need to be treated for. 

Fascinatingly enough, he has also listened to my medication issues and prescribed me two new inhalers that he’s hoping will help me as one of the 5% who actually do not react to common cortisone treatments.

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Anti-Antibiotics

, , , | Healthy | March 13, 2020

(I am twelve weeks pregnant. I have already seen one doctor who left the medical practice and I am seeing a new doctor. He goes through my test results, which the previous doctor had already spoken to me about.)

Doctor: “It says here that these numbers are fine, but the other doctor had you on an iron supplement. You don’t need that.”

Me: “Are you sure? The other doctor was quite worried about my numbers.”

Doctor: “I’m sure. And you are taking antibiotics for a UTI, but you don’t have one.”

Me: “The other doctor said I had proteins in my urine which indicated a UTI.” 

Doctor: “No, definitely not.”

Me: “Okay, I need a referral for a twelve-week scan.”

Doctor: “You don’t need that.”

Me: “My daughter had a congenital heart defect; I’d prefer to get all scans.”

Doctor: “The only reason they want to diagnose in the womb is to do surgery in the womb.”

My Husband: “They needed us at a bigger hospital when she was born, in order to give her surgery.”

Me: “Can you just write the referral, please?”

Doctor: “You don’t need it, but if you insist.”

(We left the office and quickly realised he had written a referral for a twenty-week scan which the ultrasound place can’t take. I organised an appointment with another doctor who also checked my blood. She immediately pointed out that I had a UTI and should be taking antibiotics, and that I had low iron and should take a supplement.)

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Being A Pill About The Pills

, , , , | Healthy | March 12, 2020

(I work in a community pharmacy. I cannot tell you how many times I have heard this story in some variation, as have my staff and coworkers in this field.)

Patient: *comes up to the counter* “Hi, I need to fill my medication.”

Clerk: “Oh, of course. Which medication did you need today?”

Patient: “I don’t know; it’s on my profile.”

(The clerk reviews the patient’s profile, which has more than 25 prescriptions dating back years.)

Clerk: “Do you know which one? There’s a bit of a list on your profile.”

(At this point, they will usually say one of two things:)

Patient: “I don’t know. Just fill all of them.”

(Or…)

Patient: “It’s the white pill.”

(This is where the clerk will grab one of the pharmacists.)

Pharmacist: “I’m sorry, sir, but we can’t just fill everything on your profile, as we don’t know which of these medications you take or have stopped taking.”

(Also, the staff hate having to fill a dozen or more prescriptions, only for the patient to say they need one or two of them; the rest we have to put back, wasting all the time and effort we needed to fill.)

Pharmacist: “Do you know what you take it for? Diabetes? Blood pressure?”

Patient: “I don’t know. It’s the white pill.”

Pharmacist: “Most of the pills on your profile are white. Do you know how many times you take it? Was it big or small? The first letter of the name or the doctor who wrote it?”

Patient: “How am I supposed to know?! You’re the pharmacist! You should know this! IT’S A WHITE PILL! I KNOW IT’S ON THE COMPUTER!”

Pharmacist: “Sir, I need a little more information to go on than just the color. Here’s our card; you can go home, find it, and then call it in. Or bring the bottle with you next time and we can help you more.”

(The patient stomped off. Seriously, if you come to the pharmacy, please know something about what you want to pick up. The vast majority of all the pills on the shelf are white. Bring the bottle, take a picture of the bottle, write down the name. Something!)

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This Doctor’s Stubbornness Runs Deep

, , , , , | Healthy | March 11, 2020

(Whenever I start coming down with any sort of respiratory infection, my voice gets deeper. The deeper the voice, the worse the illness is. I am stationed overseas in the nineties when a couple of coworkers notice that my voice is getting deeper. I go to Sick Call the next morning, and the corpsman, familiar with my history of pneumonia, sends me to the nearest US military hospital about 100 kilometers south to get seen by actual doctors.)

Doctor: “What brings you in today?”

Me: “I’m coming down with some sort of chest bug. Every time my voice gets deep, I get sick a few days later.”

Doctor: “What sort of symptoms are you having?”

Me: “At the moment, just the deep voice.”

Doctor: “That could mean anything. It’s probably acid reflux.”

(So far, the doctor has not examined me in any way.)

Me: “Whiskey Tango Foxtrot? Sir?”

Doctor: “I’ll prescribe you an antacid for a week or so. You should also prop up the head of your bed just a bit, to help control the reflux.”

Me: “First, I’m not here for acid reflux. I’m coming down with some sort of twitching awfuls, because my voice is getting deep. When I start sounding like James Earl Jones, I always get pneumonia or bronchitis or some other chest ailment within a couple of days. Every time. Since the deep voice just started being noticeable, I’m trying to get ahead of the disease. Second, I have a waterbed. Propping up the head of the bed will have no effect.”

Doctor: *frowning* “Sure, it will work. Just put a boot under the corners of your headboard. This will raise your upper body slightly and help prevent acid reflux from irritating your larynx.”

Me: *sighing internally* “With all due respect, sir, you cannot tilt water. It always stays level.”

Doctor: “Just raise your headboard a couple of inches. You’ll see.”

Me: *sighing out loud this time* “Sir, it’s a waterbed. Here’s a demonstration: run a little bit of water into that portable basin next to the sink.” *pointing at the small metal basin*

Doctor: “Okay.” *runs water into the basin*

Me: “Now, tilt the basin up on one end.”

Doctor: *lifts one end of the basin slightly*

Me: “Notice that the water stays level, no matter how high you raise either end of the basin? That’s why raising the head of my waterbed will be less than useless.”

Doctor: “Oh. I guess you’re right. I suppose we’ll have to get you an appointment with the gastroenterology clinic to cure your reflux.”

Me: *facepalm* “Sir, I don’t have reflux. Could you please listen to my chest?”

(I was given a prescription for antacid and told to go back to work, all without the doctor conducting an examination. Three days later, I was back in the hospital as an inpatient… with pneumonia.)

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