Saturday, August 29, 2015

When The Doc Won't Listen

I want to begin by saying that I am a retired Registered Nurse.

That being said, I have had quite a lot of experience with medical professionals as well as patients, and I have a lot of respect for those professionals who execute their jobs by actually caring and listening to their patients.

I have seen it all.  I have seen patients who were hypochondriacs and would complain just because they needed attention, or to get yet another "fix" of one type of drug or another.  This can be a real problem, especially if the doc isn't paying attention to how much or how often the patient is requesting a drug.  In one instance I took it upon myself to check with several pharmacies in town and found the patient was seeing several doctors, getting the same drug from each and filling them at different pharmacies...I informed my employer and we stopped seeing this patient.

That is the extreme, but it does happen.  I have also seen drugs carelessly prescribed to patients.  In some cases the drugs were so expensive that there was no way the patient could afford to pay for them.  Upon discovering this problem, I would go to the physician and ask if they realized the patient's insurance would not cover the extremely expensive drug, and therefore it would not be taken.  Most of the physicians I worked with were understanding and would prescribe something else.

Then, there are those physicians who think nurses are just not bright enough to know what is going on and have no business questioning anything! That is frightening to say the least.  One physician prescribed a dose for a patient that I knew would kill the lady within 15 minutes.  When I called to question the dose/medication I was told "just give it!"  I had to call another physician who was on the patient's case to confirm the order, and he called the prescribing physician and corrected the medication and dose.  Wow!  It's not easy being a nurse.

Sometimes the doc listens, sometimes he or she doesn't!

This week I am experiencing that from the point of view of the patient.  I went in a little early for my yearly physical this year because of a slow heartbeat and frequent pauses between chest pain or shortness of breath.  Upon seeing the physician on a Friday, I was given an EKG, blood work and hooked up to a Holter Monitor for 24 hours.  The doc spent no more than 5 minutes with me and the "yearly physical" was laughable.  My eyes and ears were not even looked in to, There was a cursory listening to my heartbeat before he ordered the nurse to draw my blood and set up the EKG.  After the EKG was done, I was taken back to the exam room where I figured the physician would come back in and discuss what to do from here or what the EKG showed.  I waited, and waited and waited.  I finally walked back into the hall, found the nurse and asked if the doc intended to come back in and talk with me.  "He's really running behind today, so why don't you go ahead and go and I will have him call you later," was the response from the nurse.  So, I gathered my things and went home, a little concerned over the lack of interest shown.  I hadn't seen the doctor for a year, and am not a "frequent flyer" who appears every time I have a cold.

I waited all day for a call.  None came.  Monday came and went and still no call.  Finally, on Tuesday someone called to say I had an "abnormal" EKG!  Well, that didn't do anything but make me worry.  No explanation of what was abnormal about it or if it was anything to worry about.  On Thursday, after no call on the Holter Monitor report or anything else, I called and the doctor's office was closed for the day!  So much stress worrying about the possible results of the cardiac testing caused me to develop a severe case of gout in my right foot.  Gout is hideously painful!  So, Friday I called at 8 AM (opening time) and got ahold of a "patient advocate" at the clinic and explained my situation.  About an hour later I received a call back from the nurse who said my blood work results had been mailed to me, and were essentially "stable," but the cholesterol was a bit high and the doc would like to start me on a "statin" like Prevachol.  Now, I had previously explained to the doc that I had tried statins in the past and they made me sick!  Apparently he didn't listen to me.  Additionally, my cholesterol wasn't really high enough to justify the use of a drug I find a bit risky to say the least.

I explained that my gout had gone crazy and that I was in extreme pain.  I also told the nurse that I had previously been prescribed a Medrol Dose Pak (Prednisone in just a five day dose) which backed the gout down immediately, and could the doc please provide a prescription for that.  I was told she would ask, and "Oh, by the way, the monitor showed premature Ventricular Contractions, not to worry about....nothing serious."  I was told again that I would get a call back about the scrip.
An hour later I called my pharmacy.  Nothing called in.  Called the doc and was told, "oh, I'm sorry should have called you, he is going to prescribe Indomethacin."  I haven't ever taken that particular drug, so I looked it up as soon as I hung up.  Turns out it is one of those NSAIDS that now has a HUGE red flag warning about how it can cause strokes and heart attacks and all kinds of other nasty things especially in the older generation (I'm 68).  The Prednisone in a short term dose doesn't bear any of these risks.

Okay, so I get my hubby to pick up the drug.  It has to be taken with food, for it is very hard on the stomach - can cause bleeding, etc.  Good grief.  I've been taking it for 24 hours now....still in extreme pain!  GOOD GRIEF! Why would my physician NOT LISTEN TO ME!?  I'm not a hypochondriac, visit only when I'm extremely sick (one time in the last two years for a serious sinus infection), and I am a Registered Nurse! I know what I am talking about!  I know my body!

I learned many years ago to listen to the patient's input about their symptoms, pain or whatever.  They know their body better than anyone, and not everyone responds to medications in the same way!  I have seen all kinds of unusual reactions to medications and disease.  It is CRITICAL that a medical professional LISTEN to what the patient is saying.

Obviously my doc either doesn't care, or isn't willing to listen to my complaint.  So, this Saturday morning as my foot throbs with pain and I take a medication that has considerable risk and isn't giving me any relief, I know I must find another doctor....hopefully one who is compassionate and is willing to listen to the patient.

I have always told my patients to get a second opinion if they have any doubt about what their physician is telling them or if they are uncomfortable with something prescribed....I am telling you, find a physician who LISTENS, who is compassionate and understanding and willing to take each case one on one and prescribe or advise accordingly.  When the doc won't listen, it is time to CHANGE docs!!


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