Sunday, June 6, 2010

referrals only from now on!

I had a really unpleasant experience Friday morning with an orthopedist. He asked for my history so I told him i had lupus and his immediate reaction was "who told you you had lupus?" "about 20 different doctors over about 18 years." Then he goes on to tell me he doesn't believe that diagnosis until he runs his own test or talks to my rheumatoloist. Then he wants to know if I had an internist, a cardiologist, etc. I say "no, I get tired of going to appointments and they're running redundant tests, so I just go to one doctor. I used to have all those specialists but I don't feel I need that many doctors." I guess in his mind, if i don't have about 10 doctors, I must not have lupus. Now look, I don't *want* to have lupus. I wish I didn't have lupus. I hope one day I don't have lupus. And now I'm sitting here having to defend this diagnosis to this jerk, when I didn't even go in there about lupus in the first place. I just want to know what this thing is on my friggin' arm. Is it a tumor? A mass? a Cyst? Why are we having this conversation???

But I can't let this go, so I convince him I have lupus by telling him the details of my most recent labs: postive ANA, double stranded DNA, high sed rate, nephritis. I tell him I've been on prednisone for over a year at 3 different occasions.OK, now he believes me. But now he has to scare the crap out of me by telling me how common it is for people who've taken prednisone to end up having hip necrosis (bone death in the hips). Gee thanks, that's really helpful. (How'd you like some face necrosis?) And so relevant to the conversation about whether or not i have cancer in my arm. Oh and if I ever have hip necrosis, I should come back and see him. Not no but hell no.

Now that we've sat through 2 excruciating opening acts, can we get on with the main attraction, the whole point of my being here? The test results, please. Well, it's a tumor, he says, delivered with the same dispassionate tone of voice you'd use to tell someone that the telephone bill just arrived.

Now he wants me to get this isotope test to determine whether it's benign (or not). I express concern- aren't they going to shoot radioactive dye into me. His response (and I quote) "so what?" So my grandmother died from an iodine test, that's so what. I have a history of kidney failure, and shooting poisonous crap into my veins is risky, that's so what.

Well the good news is, he is not qualified to work on tumors, so I never have to see or talk to him again. I have to go to an orthopedic oncologist. He referred me to one, but it occurred to me that anyone who's a friend of his might share his bedside manner, so I decided instead to save myself further insult to my existing injury, and possibly further injury as well. I suspect if they killed me or accidentally lopped off my arm they'd still send me a bill and say "so what?"

Lucky for us we have a friend in the area who is a really good doctor and a decent person, so we called him and got a referral to a different ortho oncologist. I'm not going to any more doctors without a referral from someone who knows them. And if they don't like it, "so what?"

In the future, I'd love to be able to take the "Who told you you have lupus" as a compliment to my appearance rather than an insult to my intelligence. I am glad don't look sick right now. But I don't like defending my diagnosis. Do doctors do this with other diseases? "Who told you you have cancer? Who says you have MS?" I don't know, maybe they do. But there's got to be a better way to present such a question.

12 comments:

Unknown said...

The doctor team is an incredibly important key to lupus recovery. Without security in your docs, you're just adding more stress in an already high-stress situation. I hope the next doc (referral) is really good and really listens and really really gives you confidence in his/her ability.

Loretta said...

I am sorry that you have a tumor!

I had a night nurse in the ER once ask me "You sure you have lupus?"

I wish I had said, "You sure you're a nurse?"

Urgh!

I will say a prayer that things turn out well for you.


Loretta

lifebeyondlupus

Violet said...

First off, I am sorry to hear of your current situation. I hope everything works out well.

Secondly, I just went through the same thing with my boss actually. She asked me if I *still* had Lupus because I have been looking *well* She see's me maybe once a week if that (I am offsite)so her perception of my well being is well, pretty distorted.

I should have asked her if she still had her arthritis but I just replied that I believed I was in remission....I must have spoken too soon, I've been in pain since last week.

My best to you.

lupine.butterfly said...

I had my oncology surgeon tell me that it was impossible to have Lupus, RA, Raynaud's, and Sjogren's Syndrome because you can only have ONE thing and not a whole group of things. I looked at him and said...they are called SECONDARY for a reason.

I am praying for you. Please keep us posted. God Bless!

Carla Ulbrich, The Singing Patient said...

lupine butterfly, i wish it was impossible to have 4 autoimmune conditions at once.
I wish it were impossible to have one autoimmune condition!
An I wish it were impossible to be uninformed and insensitive and keep your job as a doctor :)

Carla Ulbrich, The Singing Patient said...

thanks for the prayers and well wishes, y'all. The rumor mill is that because of where the tumor is, it's probably benign. But I can't get to the orthopedic oncologist until July 11.

lupine.butterfly said...

I actually looked at the man and said..."Guess that's why it's called 'practicing' medicine." He wasn't too happy. Then again, neither was I!

It's great news that it is taking so long to get into see someone. The faster they get you in to an oncologist usually means that they are pretty certain it is cancer or that it is affecting something that can cause you permanent damage.

Miriam said...

Carla, I'm so sorry you're going through this awful stuff and then to have a real jerk of a doctor make it worse. I want to scream on your behalf! Instead I send you healing thoughts and good karma your way.

Best wishes always,
Miriam

Carla Ulbrich, The Singing Patient said...

hi miriam,
well at least i never need to see that guy again! luckily he is not qualified to do tumors. (or to do bedside manner).

lupine butterfly, i tried to tell myself that if it were serious they'd have seen my quickly, but the fact is when my kidney were failing in 1992, the rheumatologists' office said "well we can fit you in in 3 months."

I thin if i want to be seen fast, i need connections. however, and this is weird, people think because of where the tumor is on the bone (near a joint) it's probably benign. So I'm not pulling strings to get in quicker. Luckily, for once, i have some strings to pull (my husband has a doctor friend), but we're not using them just yet (except for getting the referral).

my arm is feeling a bit weak, though.

Kirsten Schultz said...

I hope that everything goes well for you! I hate when doctors don't listen to their patients, trust that the patients know things about their body, or trust the opinions of other doctors.

It doesn't make it any easier having one of the more easily hid diseases I'm sure.

I just nominated your blog for the One Lovely Blog award: http://notstandingstillsdisease.blogspot.com/2010/07/one-lovely-blog.html

raina.nijinsky said...

hey carla, keeping my (arthritic) fingers crossed for you! me too, i have Lupus SLE, Raynaud's, and Sjogren's no :):)RA tho' keep smiling! :)

Carla Ulbrich, The Singing Patient said...

it's not a tumor! yay! it's an enchondroma.
whee- another new word :)
anyway the new doctor, who is awesome, wants to avoid surgery (yes!).
So worth getting the referral and waiting to see him.