Doctors/Venting

[Jan]

Kudos, Sparrow, we’ll send good thoughts your way.

[dingter]

A good way to get quality care is to pay cash. Not every doctor will take it but it creates a different relationship when you find one who does. It feels like the way of the future and, in my experience, it has been cheaper than using my insurance every time.

[Jan]

A good way to get quality care is to pay cash. Not every doctor will take it but it creates a different relationship when you find one who does. It feels like the way of the future and, in my experience, it has been cheaper than using my insurance every time.

dingter, could you possibly elaborate a little on this idea? How you first make the proposal to the physician, differing reactions from physicians, any pitfalls you've encountered. ... IF you would like to share.

[Sparrow]

Foxfors5,
I do believe what I experience is laryngospasms. I have trouble breathing and experience stridor (a strained breathing sound similar to a wheeze that comes from my throat). The pulmonologist saw when she was scoping me that I was having closure of my vocal cords both when breathing in and when breathing out. I notice it most when breathing in, though. I wonder if I might be tired because I'm not getting CO2 out! I have a hard time keeping up with emails, Facebook, posts... It's regrettable because these are also connections for me, and sources of support and information. I'm sorry I didn't reply sooner.

Heather

[Sparrow]

Two weeks before Easter, I finally got in with a doctor who may be a real blessing to me under the circumstances. He exceeded my expectations. I was just hoping for someone who would be willing to re-evaluate me/re-test me.

He said he didn't feel a retest of the methacholine challenge was necessary or even a recommended course of action. Here's where he's such a gift to me: He explained that he used to do research, and that while the methacholine tests were considered very useful in research, he's not committed to the results that they give in clinical/doctor office settings. He said that one of the things that can happen in a clinical setting is that the methacholine medication/chemical may not be prepared exactly as necessary. He doesn't see the test as a useful tool for giving a diagnosis.

I was floored. I had been nervous about a re-test but it seemed that my PCP, an allergist and the ENT were all going to wait for this re-test. Yet, I was reading that if there isn't an allergic exacerbation, the test could give a false negative result and something about how certain (deep?) breathing that's done as part of the test can actually reduce airway constriction... I had printed out the guidelines from the American Thoracic Society and other legitimate sources - prepared to argue that the test is NOT necessarily flawless.

... I never had to take those papers out. Thank goodness! I didn't want to be "that patient" who is "difficult" -- whatever. Advocating for myself like that takes an extensive amount of energy and my ability to express myself verbally is impacted by this effort and fatigue!

So, I didn't have to make any arguments -- the doctor made them for me. We're on the same page!

He's going to treat symptoms. He did listen to my medical history. What I say *IS* important to him. He said to call him if I have difficulty. He has a plan that will make sure I get enough medication but that I'm not over-medicated (since my symptoms are seemingly connected to allergic exacerbations). My chart says ?Asthma. He sent me for a chest x-ray since it had been awhile. He asked me if I had a CT scan before (no) but will only do it after he evaluates the x-ray. Everything is step-by-step and very well-reasoned.

My depression has lifted. I am getting things done around the house again. I was so preoccupied before, wondering if eventually, I wouldn't have medication to manage symptoms at all, and if any doctor was going to "believe me" when I said I couldn't breathe and needed help. That call that I made to the on-call doctor at the other office still kind of haunts me - she said none of the medications (that I used to use for asthma) would help me. That office never called me back or answered my online message that I sent -- I had always thought that if I needed help for breathing, that I could count on a response. It was downright traumatic to have been left in the state that I was in.

Doctors can cause depression. They can cause harm. Fighting doctors is exhausting and demoralizing. Since I've had complex health issues, I've realized the importance of the doctor-patient relationship.