Tuesday, June 8, 2010

Arguing with Doctors

After work yesterday, I decided to go to the doctor to refill my prescription for an inhaler.

Doctor walks in, looks at my chart, "But you don't have asthma."

"I know, but I have allergies, and they affect me in a way which mimics an asthma attack, and the inhaler I had 5 years ago worked for me, and I'd like a new one."

"Let me listen to you breathe." ... "Have you been tested for asthma?"

"Yes, and I don't have it."

"But you want an inhaler? Do your allergies give you rashes? Do you get hives?"

"No rashes, unless the allergens come in contact with my skin. No hives, ever. But when I'm allergic to grass and trees and pollen, and I'm outside in the spring, and I am also exerting myself physically, thus increasing my breathing rate and the number of allergens in my system, I do have allergy induced asthma attacks, and I stop breathing. I had to rush myself to the nearest grocery store, buy some liquid Benadryl, and chug about 1/4 of the bottle, and wait half an hour before I could breathe normally again. So yes, I would like an inhaler."

After the breathing, and my lungs being fine, and no signs of anything else wrong, she looks down and says "Oh, you're a smoker... I should have guessed."

We then argued over the relative health benefits* of smoking 7 cigarettes per day vs. taking a very large amount of over the counter, and prescription drugs to get rid of the migraines I'd had for 7 years prior to when I started smoking. She finally let it drop. I had a doctor tell me, years ago, that I was going to suffer from liver disease by the time I was 25 if I continued taking as many medications for migraines as I had been before I started smoking. I am no longer at risk of imminent liver failure, so I'm happy.

I also had to explain to the doctor, and her shadow, that even though I'm "only 22" and not a doctor that I DO know what I'm talking about, and here is a list of all of the other things wrong with me, and the steps being taken to correct/manage them, and I am currently trying to get into better shape by exercising, which I am more prone to do outdoors, as there are more incentives to continue and push myself. So PLEASE GIVE ME AN INHALER SO I CAN START GETTING HEALTHY.

They were very brisk on their way out the door after handing me my prescription with several refills.

I really need a doctor. A REAL one. One I can make appointments with. One who won't argue with me when I'm right. One I can trust not to give me medications which will send me to the hospital. I think I need to move to Denmark. That would be nice.

*I do not condone, nor do I promote smoking.


Sherlock said...

I had such a doc and he was WONDERFUL!! Sadly, he's leaving the practice and I'm seeing his replacement in two days. I fully expect to spend a lot of time doing just what you described. I'm taking my list of meds and explaining that I need these and they've worked for the past two years (see my chart please since it's all right there).

I dread doing the "new doc" visits. If I don't like her, I'm moving on.

BTW one of my sons has allergy-induced asthma and he keeps an inhaler with him always. Doesn't often need it but it's there if he does.

Good for you standing up to the docs! Unfortunately that's the way it is all too often.

BubbleGirl said...

Thanks for the comment! I'd return the favor, but you seem to have a private profile...

It's the most horrible thing when doctors don't understand... "I know you've gone to medical school for a minimum of 7 years and specialized in your field... But I've LIVED IN MY BODY MY WHOLE LIFE and I think that makes me a bit more qualified when I tell you something's going to work, and that I NEED it."

Achelois said...

I so so get this post. My encounter with an ENT consultant last week was another example of what it is like having ehlers danlos and talking to someone who thinks they are of superior intellect to me on all counts but knows nothing of EDS! If I could afford it I would pay to see a gp whom I could talk to about three times a week just to get it out of my system.

As a smoker and completely addicted I would say that I hate myself for not having the will to give up. I wouldn't have the guts to argue that out with a doctor. i just hold my head in shame on that front. Regardless of the migraine factor I am afraid.

Just because I don't know what it is in nicotine that helps with migraine would you mind explaining please.

Thank you for your kind words on my blog the other day.

Sherlock said...

Not sure how the profile got marked unavailable. I think it's fixed now :-) Thanks for responding!!

I like docs who consider patients full partners in the healthcare process. I won't have one who does not. I've been used to an open doc/patient relationship for so long now that there's no going back. I've walked out of rheumys' offices before simply because they weren't like my former doc.

*sigh* I'm dreading the doc-interviewing process again. But hopefully this gal tomorrow will be open and willing to listen. We'll see and I'll definitely update on my blog tomorrow afternoon.

BubbleGirl said...

Thanks for the comment!
I really don't know what it is about smoking that stops my migraines, but for about 7 years before I started smoking, it felt like I had A SINGLE MIGRAINE which only let up every once in a while, and then I had a cigarette, and after the initial head rush/dizziness wore off, I realized I didn't have a migraine any more. For the first year or so I only needed about 1-2 smokes a day, but now I'm up to about 7, and obviously more if I'm under stress.

Good luck with your doctor interview! I'm going to head over to your site now and you'll probably find some randomly placed comments later on in the day!

elise said...

Give your doc a copy of this article. I did and was referred to pulmonology. It is now in my chart that I have both increased lung volumes and impaired gas exchange. They dosed me up with 4 puffs of albuterol and it did nothing other than make me horribly jittery. Now I have a rescue inhaler plus an every day one to manage the long-term inflammation during the nasty summers here. If you want the PDF, let me know. :)

Morgan AW, Pearson SB, Davies S, Gooi HC, Bird HA. Asthma and airways collapse in two heritable disorders of connective tissue. Ann Rheum Dis 2007; 66: 1369-1373.

"Pulmonary physiological studies revealed increased lung volumes, impaired gas exchange and an increased tendency of both the lower and upper airways to collapse. CONCLUSIONS: We have demonstrated, for the first time, that individuals with HMS/BJHS and EDS have respiratory symptoms in association with various pulmonary physiological abnormalities. The increased prevalence of asthma may be due to linkage disequilibrium between the genes causing these conditions or a function of the connective tissue defect itself. In the non-asthmatic population, changes in the mechanical properties of the bronchial airways and lung parenchyma may underlie the observed increased tendency of the airways to collapse."

BubbleGirl said...

Thanks for the info! The PDF for that would be great!