Tuesday, February 26, 2013

Find Yourself A GP, Listen To Your Gut & Use Your Patient Voice!

I’ve been battling a cough for two months. The cough started out nasty, but slowly it got better. And  then it would come back all loud and obnoxious again. 
Not as loud or obnoxious as the initial cough - but equally as annoying and resonating deep in my chest. 
All along, my blood sugars have been OK (for the most part,) and the phlegm ( I hate that word) was clear, except when it was white - So I just thought it was a cold. 

Still, I knew I needed to get it checked out. 

And for weeks and weeks I’ve tried my damnedest to get in with a GP,(General Practitioner) but apparently cold and flu season isn't the best time to make an appointment. And if they did have an appointment readily available ( and by readily available, I mean in the next week or two,) they didn’t take my insurance. 

Finally, yesterday I called a local GP with a good reputation who took my insurance and had a Physician’s Assistant who could see me on Thursday. 
I was ecstatic  - Until the receptionist asked me about my medical history and I told her I had type 1diabetes, and she suddenly changed her tune. “Well, I need info on the doctor’s desk and it’s up to him whether we can see you or not.”
Me: But I don’t want him to treat my diabetes - I have an Endo for that - FTR, I’d just told given her Dr’s J’s name & info. 
Receptionist: I know, but it’s up to the Doctor. 
Me: I really need to see someone about this cough. 
Receptionist: We’ll call you back and let you know either way. 

And I knew right then and there that she wouldn’t call me back and I was furious. 
I felt like I’d been unjustly profiled for having a busted pancreas. 
Here’s thing :I just wanted a GP who could DX my cough - And if I liked him I would have considered making him my primary care dr, but not my Endo. 
I need a primary and I haven’t been able to find one, so I pretty much go to my Endo for everything. 
But that's not convenient and I know for a fact that Dr. J  wants me to have a GP, too. 

All I  wanted at the moment was a GP to tell me whether or not my cough was normal or not. 

I wrote about the experience on my Diabetesalicious FaceBook page yesterday and many a wonderful DOCer pointed out that they’d rather know in advance whether or not a GP had issues working with pwds - And I get that, and normally I would have been agreeing with them 100% 
But I wasn’t going to marry him or make him my new Endo - I just wanted to know if I had bronchitis or not - THAT'S IT. 

So last night afterwork I went to Urgent Care & filled out paperwork, payed my $50 dollar copay and gave the Dr. on call the 411 on my diabetes and my diabetes management. 
And Dr. UrgentCare told me that yes, I did indeed have bronchitis. 
And he called in two prescriptions for me. One for Levofloxacian & one for Benzonatate. 
And me being me, I asked the doctor about side effects. He told me there was nothing to worry about and sent me on my way. 
I stopped at my newly reopened CVS & was picked up my prescriptions  - And again, I asked about side affects - And I was told that I’d be fine, that the antibiotic worked well with my other medications and that I should be feeling fine in a few days
Then I got home and actually took the time to read about Levofloxacin’s side effects. The nausea, diarrhea, headache and hotheadedness were pretty standard fare as far as antibiotics are concerned- And while I wasn’t going to welcome them with open arms, I could deal with them. 
But the side effects that specifically mentioned joint/ tendon problems and the potential of tendons bursting & tearing if you had joint or tendon problems jumped out at me. 
I’d just had a cortisone shot for trigger finger in my left hand a few weeks ago. 
So I called the pharmacy and told them about my fears and my tendon issues and the 20 something Pharmacist stated: Unless you’re an athlete or are elderly, it shouldn’t be an issue.
"But I’m a writer," I said. 
"You’ll be OK," she responded.
But you know what? My gut didn’t feel that way. My gut was like: THIS IS NOT GOOD, KEL - NOT GOOD AT ALL! DANGER WIL ROBINSON - DANGER!

So I called Urgent Care and told the my fears to the woman who picked up the phone, and she put me on hold and relayed my fears to the doctor.  
And according to the PhoneWoman, the doctor felt that my trigger finger and tendinitis shouldn’t be an issue - because I wasn’t over 65 and I wasn’t an athlete. 
My response: But I’m a writer, so I am an athlete -At least as far as my hands, my wrists and computer are concerned. 
And there was silence on the other end - I’m talking crickets, people. 
And finally I was told to talk with my hand doctor and get back to them in the morning. 

I hung up and I emailed some friends with various types of medical initials at the end of their names. 
And to be clear - I never ask for free diagnoses from my friends, or prescriptions for that matter - I don't roll like that.  
But that nagging feeling that I could be doing more harm then good wouldn't go away & I  wanted to know if I was: 
1. Crazy
2. My fears were actually valid when it came to Levofloxacin. 

And my friends all said the same thing - DON’T GO ON THE LEVOFLOXACIN & suggested some other antibiotics  that in their collective opinions, would work better for me. 

I didn't take the LEVOFLOXACIN & I went back to Urgent Care this morning (working from home a few days a week has its benefits) and told them my fears face to face. 

And while the Dr. on call absolutely agreed with me about the Levofloxcin 100%, I was told it was Urgent Care’s policy not to override an attending physician’s prescription. 
Me: But I called last night and spoke to the nurse who spoke to the doctor on call & he didn’t feel it was an issue, but I do - And so do you. 

Look, I’m still healing from tendonitis - I can’t risk anything happening to my already tender tendons - And you agree with me!

The best they could do was to offer to talk to the Director, who would be visiting their offices this afternoon and they’d call me back with his verdict. 
If he agreed that I needed a new RX, they’d call it in for me and if not, I needed to come in again and pay $50 bucks to be re-diagnosed and issued a new RX. 

Why am I posting this? Because I’m frustrated, I’m annoyed, and I’m  also really mad at myself about not getting in with a GP sooner so I wouldn’t have to deal with this crap.  
BTW - I made an appointment with another highly recommended GP this morning and will be seeing her in mid April. 

But I’m really posting this because diabetes or not, if you’re given a diagnoses or an RX and something about said diagnoses or RX  side effects gives you that feeling deep in the pit of your stomach that something’s wrong - Listen to that feeling. 
Listen to that feeling and use your voice as an empowered patient and person and SPEAK UP.  And speak up again if you have to - Speak up until you feel that you've been heard. 

Look, there's a really good chance that you might be wrong, but at least you'll feel that you've explored all your options and that your questions and concerns were heard..... and answered. 

And then again.... you might actually be right~

POST UPDATE: I received a call a few minutes ago from the UrgentCare nurse, letting me know that my pharmacy was called & a Zpack  Rx has been ordered. #yayforspeakinggoingwithyourgutandbeinganempoweredpatient!


Unknown said...

Thanks for posting about your experience. I think that too often we at patients don't question the authority of our doctor's even though, they are busy people and can overlook important details or may not have enough information to make a proper diagnosis. Patient engagement and empowerment is super important, as demonstrated by your experience. We need to think of ourselves as partners in our health care and in the decisions, so you're totally right, when you have a gut feeling, speak up! It's your health and your life after all.

Bob P. said...

It strikes me that one (of many) problems here is that the folks with power to change your prescription didn't see your concern as reason in itself to look at alternatives - whether the concern was valid or not. Sure, there might be situation where a given med was so clearly indicated that the MD would need to push back against a concern, but patient worries ought to be treated as a real factor.

Bruce in the mountains said...

Good post, sorry you had to go through it, but you succeeded. I've found that I react to Statins strongly, Lipitor gave me all the "you might find you experience these symptoms". Now Pravastatin insert says that it could raise my bg. I stopped that and got wonderfully level bg graphs from my Dexcom G4. Having no family history of heart disease, I'll talk to my endo in April

StephenS said...

Kelly, you are absolutely right. I have to admit to cancelling my appt with my GP this week because my gut is telling me that the relationship has run its course. She's an okay doc, but I always feel like it's a struggle to get anything other than the standard questions from her. Time for me to look for a new GP.

Scott E said...

Ugh, there are so many things wrong with this story (the way it plays out, not your telling of it) that I don't even know where to begin. Just so you know, I don't have a GP either. I tried getting one about eight years ago and effectively got the response "what do you need me for?". Less than a year ago I went to a local practice with a cough and ear infection, and the young doctor - first name Brandon and obviously born during the BH90210 craze - prescribed something. He didn't seem to have a care in the world.

So I still don't have a GP.

But you're right and always should be suspicious. When something "should be OK" and a drug is ruled safe just because of your age, do your research. I'm sorry you had to go through this.

Brenda Bell said...

The folk who answer the phones at pharmmacies are usually the Pharmacy Technicians (Technician I or Technician II), who are in the process of getting the practical experience they need (along with their degrees) to become Pharmacists. I've had my issues with the local CVS Pharma techs with respect to an adverse reaction to a pain reliever a few years ago... Sorry to hear your pharmatechs are equally inexperienced.