Wednesday, April 7, 2010

Hysterical White Female

Thank you for the lovely comment on my last post. Things are slowly improving here but I need to vent. This may not make much sense because I am really really upset.

I signed up for a weight management clinic because I decided I didn't want to lose weight alone. Fine. Well, unfortunately, while the doctor is nice enough, I have pushed his 'hysterical white female' button. I am an intense person, a creative thinker, a fast talker, am well read and I know that sometimes I 'hit' people wrong. It's a consistent issue. I also have 'bully pheremones'. People like to think they can dominate me through various power games, but fail because I am often smarter than their games (power games tend to have inherent logical flaws I have found), act with integrity, and stand up for myself.

So I had a follow up appointment yesterday. I wasn't sure if I was going to make it because my breathing has been dodgy still since I left the hospital. I am still using the nebulizer. Still wheezing. I'm better in that I don't need to go to the ER, but I'm not stable either.

I decided to go to the appointment because being on prednisone for a month is not going to help weight loss, I need all the help I can get. Got there and couldn't feel my knees. Just was really weak. Then I couldn't breathe well. Then I realized, I hadn't been breathing so hot all day, but had been ignoring it. Living in 'I'll be fine land'.

So I sit in the waiting room and enter 'the zone' where I'm just working on finding where I'm going to get my next breath. It's a delicate process. Breathe too deep and I make it worse. Breathe too shallow and I make it worse. I have to find the sweet spot between the constraints so that I don't completely lose control of my breathing.

I finally take my rescue inhaler which brings some minor relief, but by now it's too late. I'm getting tighter. Suddenly my chest and shoulder muscles feel so heavy and I can't lift my shoulders to breathe. At this point, I'm in the exam room waiting for the doctor and I realize I am in trouble. So I start to panic.

Panicking is never good. Don't ever panic. It makes things so much worse. I am usually so good about not panicking, but I had hit my limit.

So I had a bronchospasm and lost control of my breathing rate.

Apparently, however, I looked like a big faker????

Because next thing I know the weight loss doctor is trying to play mind games with me. "Do you want to have asthma? What if you could have something else?"

First, who the fuck asks someone to answer that kind of question without disclosing the something else? Because how do I know the something else isn't cancer, you know? Are we playing 'Make a Medical Diagnosis Deal' and I have to decide which door to open? Really?

So I say, "Well in my medical records is a pulmonary function test where my FEV1 is 70% of predicted."

He says "But you also have normal pulmonary function tests."

I just looked at him as I couldn't figure out what to say. What I should've said was "I have had pulmonary function tests when I'm healthy so yes there are normal ones. I was not symptomatic when those were performed so they would not have shown much." Because I suspect he's thinking I had those tests because I complained of being sick when, in fact, they were administered at every pulmonary visit for years regardless of how I felt. (And I hated them.)

I also should've pointed out he had access to my medical records and could have viewed my hospitalization records himself. I had documented drops in oxygen. I have scarring and now a growth in my lung. The xrays also showed airway constriction.

Basically, this jerk thinks I have a vocal cord problem which can mimic asthma and tends to have a psychological component. So you know, I'm making it up and his asking me if I wanted to have asthma or not was a psychological test to see if I was emotionally invested in being sick.

There is a power gradient in medicine that favors the doctor and it is easy for them to abuse. I am at the mercy of their education, intelligence and character--which all too often I have found lacking. To me, what happened yesterday was an abuse of this power. I felt manipulated and discounted. I hate feeling like I have no credibility or power and I feel threatened because this kind of stuff is when they start taking away medications or refusing to listen to me.

Now I don't know if I want to go back. I mean, I do want to go back and confront him on this, but do I want to continually subject myself to someone who thinks I'm a hysterical white female who just needs therapy????

No. Not really.

My husband is going to be coming with me to some upcoming appointments and I've appointed him my 'medical bouncer'. Because I am treated so much better by male physicians when there is another man in the room.


T Rex Mom said...

What a horrible experience.

Have you ever had a nitric oxide test? That can tell if an asthma attack is coming on and sometimes be a little more sensitive than a spirometry test.

(I'm a nurse and I work in allergy/asthma and am currently going back for my NP.)

Often someone can have normal pulmonary tests when they are in remission from their asthma and then it can flare up as quickly as it went away.

Have you identified any triggers to your asthma. If they are allergy related it could do a lot to help you if you could do immunotherapy or allergy shots. They really are not that bad and can significantly help someone with asthma whose asthma is triggered by allergies.

Also, did they do a pulse oximeter test while you were there? There's no way to "fake" that so if indeed you were having an asthma attack and not getting enough oxygen, then the pulse ox would tell them that.

Vocal cord dysfunction can mimic asthma but usually there is a wheezing sound on inspiration not expiration (which is characteristic of asthma).

Not sure if any of this helps or if it's just rambling non-solicited advise. Feel free to email me at jralderete at yahoo dot come if you want to discuss more.

Take care and hope you can get onto the wellness track of your choice soon. (Look into getting a nurse practitioner to take care of you as they tend to be a little more down to earth than many physicians but then again, I might be biased!)

Mrs.Flabby and Unfabulous said...

Hi, me again lol. T Rex has great advice. I have no knowledge on what you might be able to do to PROVE to a doctor that you are in fact ill. See I always thought it was the Dr.s job to fgure that out. To be really honest here, if that had been me and he had pulled that crap I would have said you know what. I'm gonna let you keep that thought to yourself and I am going to find a new doctor who will listen to me instead of deciding before he spends any time with me that I need therapy or that I am faking.

It's not like you were in there trying to score narcotics. What is the point in coming at a patient from that angle? Hmm it seems you are having trouble breathing. You must be one of those crazy hypochondriac females that I see so often. If that is his first notion , honey you do NOT want him as your doctor.

I know things like this often are a process of discovery in regards to what is the problem and then finding what works for you. If his first notion was you are faking and have a "psychological" component. He was not really present in that office. He was being lazy. How easy it is to label someone as faking, then he doesnt have to take the time to really see you.
Blah what a douche. The best way to combat judgement is with documentation. You have plenty of it. If it were me I would go in with all of my tests, records and whatever I could find and say. This pile of papers represents me medically. You dismissed it all with a wave of your hand and now I dismiss you. I want a doctor who is in tune with me and actually WORKS to help me instead of discounting me and all I have been through. I cannot have a doctor who thinks I am crazy. I would have an asthma attack in your office and you would let me die because you are far to invested in believing you know me and what my "problem" is , instead of being invested in simply listening.

Oh and I'd also tell him to get bent. Stick to your guns and be the manager of your healthcare. Demand to be treated with respect and compassion. You have that right. So many Doctors now feel that they are doing their patients a favor instead of a service.
You pay for that service and in regards to your health that is a HUGE responsibility. Find a Doctor that respects his responsibilities.
hang in there!