Thursday, May 26, 2011

You only get one chance to make a first impression...

..and the new pain specialist I saw today didn't make a very good one.

I'd been told to consult the doctor with the idea that maybe, just maybe, a morphine pump would be a good thing for me. Chronic pain in my hips, knees, and feet just might be exactly the right things to require such a pump. And when Becky and I were brought back to an exam room, it seemed as though this wouldn't be a bad visit. I mean, the nurse got along well with me, and handled my banter rather nicely. And when the doctor came to the room for a few brief questions, he seemed like he was a nice guy with a sense of humor.

But then he said he would be back in a few minutes, left the room, and things seemed to go awry from there.

The nurse instructed me to undress enough so that the doc could see me clearly from the knees on down. When he returned, he took one look at my right foot and said, "Oh wow." This was not the "wow" the podiatrist gave me, the latter being significantly impressed that my foot looked kind of ugly. No, the pain specialist reacted as though he'd never seen anything so horrible in all his life...and this was not a young guy.

From there, he turned into Captain Doom and Gloom. He went off on a monologue about how Medicare and Medicaid would want us to exhaust every single avenue to treatment before they'd even consider allowing me to receive a morphine pump. That's because the installation of the pump apparently costs $85,000, and the government would rather not spend that kind of money. He also said something about a psych test being required for the pump, and this had me rather concerned. With my mental health hospitalizations of the past, I was immediately concerned that I'd be disqualified based on that.

But he also had more to say, like the cocktail of pain meds I'm currently on. He said it was not only too much for me to get proper relief, but also dangerous. Gee, thanks doc. Like I didn't know that already. It's not like I wanted to be on narcotics to begin with. He said I needed to be detoxed...but that insurance wouldn't cover the rapid version thereof, but I could get it done in Connecticut for $1,000. The way he said this last part made it seem like I should head down to the docks and talk to some guy named Moe. Moe would ensure I saw the local mob doctor in the back of the fish market and get detoxed, just as long as I had the cash on hand.

As an added bonus, when I told him about the multiple nerve decompression surgery I'd had on BOTH legs, he commented that it had not only been a waste of time, but may have made my diabetic neuropathy worse. I started feeling like an idiot for agreeing to allow any of my past doctors to treat me at all. Perhaps I should have ignored all of my aches and pains until one of them killed me.

The doctor was also called away from the room several times, and this irked me. From all my experience with many, many doctors, when they walk into my room, I am the only patient receiving care in that moment. They examine; they answer questions; they care about me, and only me. This doctor acted as though he had better things to do than bother with my concerns.

After one of his returns, he went on about the risks for the pump. More doom and gloom, as I apparently risked outright death if I went for it. He offered no kindness, and DEFINITELY offered no hope whatsoever.

Oh, but we should wait and see. I mean, when I see the orthopedic surgeon on 22 June, maybe afterward we could pursue the pump. By that point, I'd had all the hope for relief washed out of me. So in response, I said, "For all I know, I won't even have a foot to bother me this much." THAT'S when he became something of an optimist. "Oh, don't think like that."

Why not? This is what's been dominating my mind since my foot went completely sour on me. I didn't need an extra dose of doom and gloom; I'd been carrying around more than enough. And I have a superstitious theory about diabetics and amputation that has me dreading the day a doctor says something has to come off. I absolutely dread the idea of amputation, and not just because I'd lose a foot I've become rather dependent on.

So there I am, lying on a stretch in the doctor's little corner of the hospital, and the tears start to come. Now that I'm good and upset, he wants to know if I'm upset and what he can do to fix it. I wanted to say, "Leave the room and don't come back this time," but instead, I told him that I'd just been hoping I'd be able to walk again. That's when he added even more joy to my life. "Oh, the pump wouldn't have guaranteed you'd be able to walk again." Thanks, doc. Do me a favor and get the hell out of the room before I beat you over the head with my CAM walker.

Once again, I'm ultimately thankful Becky was with me. She was there for me when the tears started to roll. She has an understanding of my frustrations because she sees it every day. Facing said frustrations with a doctor who acted as though I was an inconvenience for being given an idea by two different doctors was helpful in no way whatsoever. This guy put the fear of treatment in me, instead of offering me hope. This leaves me to think he should have applied to become the Grim Reaper instead of going into medicine. Becky and I came away thinking that his first impression will hopefully be his last with us.

No comments: