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Friday, October 9, 2015

The shit my doctors say

I love me a good doctor – a doctor who is knowledgeable, respectful, and listens (but emphasis is on the knowledgeable part for me). Unfortunately, *some doctors are just total ass-hats, who either 1. Don’t care; 2. Are too terrified of getting sued to REALLY try to help the patient; 3. Are really not knowledgeable at all (read: they get any if at all CE from rx reps).

In no particular order, here’s some shit my doctors have said:

1.       “Oh, you have diabetes. Just don’t eat any white foods. Cheese, butter – those are all bad for diabetics…” (UMMMM…. I didn’t have a reply for this one. I was simply stunned.)

2.       “Oh well, I don’t want to write you a prescription for lorazepam because that can be addictive. Let me give you an SSRI instead – it works in the same way for anxiety.” (Cue my rant about SSRI mechanisms of action vs. benzodiazepines, concluding with the fact that SSRI “discontinuation” typically has pretty significant withdrawal symptoms. As I proceed with my rant about not wanting to take a pill every day [with a number of side-effects], when I may use the lorazepam on a prn basis once or twice a month maybe [if even that frequently], she concurs that the two drugs are in fact very different and that there are withdrawal symptoms from anti-depressants, although she prefers to call them “discontinuation”. In the end, I went a floor down at the University health clinic to get the rx I needed from a much more knowledgeable NP). I haven’t had a lorazepam in about two years – the three remaining pills sit in my cabinet still.

3.       (from staff at dentist’s office in a sarcastic/derogatory tone) “Oh wow – a risk of “zero” – you must never eat anything or drink anything at all, which may be good for your teeth but not so good for the rest of your body.” (Did this woman just skinny-shame me? She definitely did! I roll my eyes…)

4.       “Oh, well if you continue on this way, you will be on dialysis by the time you are 30!” (He was probably right. These words were spoken when I was in DKA and refusing to treat my T1D due to severe denial that I in fact had diabetes. BUT – trust me when I say saying that kind of thing to a patient is not motivational – just devastating.)

5.       (eye doctor after hearing my A1C) “Oh- so you are an UNCONTROLLED diabetic!!! *Scoffs and turns to me and says in an accusatory tone – “Did you know that Diabetes is the #1 leading cause of blindness? Here is a pamphlet of what you vision will look like soon if you remain UNCONTROLLED.” (This eye doctor did get confronted, and ended up apologizing. No need to treat patients like shit – no really. This especially ticked me off because my A1C was in the 7s at the time, and honestly – I know that’s not ideal, but also I can only imagine how she would treat someone with an even higher A1C.)

6.       Her: Do you have any eye disease? Me: Not yet J Her: Oh, don’t be so pessimistic - glass half-full right? (After a while I realize that she has not a clue that I have diabetes…) Me: You know I have type 1 diabetes, right? It’s right there in my chart – along with my most recent A1C – I was assuming you’d want it… Her; Oh, WOW! I had NO IDEA……

Well, doc, since I went on this rant about medical professionals, let me let you in also on a few heart-warming moments with them:

1.       Nurse Erin at MGH. OMG. I love her still – to this day. She took care of me when I started treating and she was so upbeat and helpful! She brought me literature about diabetes management, magazines, and told me all about her T1D auntie who lives a great awesome life, and diabetes is just part of it. THAT. THAT IS what I needed to hear (she also stood by my side as I performed/ butchered my first injection, together with my mom, and was reassuring and when I did it she said – great job, see – nothing to it!)

2.       My old endo. I loved him so and was slightly devastated when he moved his practice back to Cali last year. He was THE MOST knowledgeable endo I could imagine. He did research. He actually read studies. He actually took the time and listened to patients. He was reassuring. He was helpful. He was in no way ever an ass-hat.

Unfortunately, it seems that I can think of more ass-hat than heart-warming moments. SO – if you are a medical professional, please (pretty please):

1.       Do your own research (at least read the studies yourself before giving advice about meds)
2.       Don’t expect your patient to not know more than you about some things – you never know who you are getting (and I’m pretty sure some of these doctors thought I was a difficult ass-hat – but hey – it’s MY health, MY life, and I deserve the best care I can get – and so do you!)
3.       Don’t be rude. Don’t be fear-mongering. It’s one thing to make sure your patient understands the possible consequences of their condition, but shaming or accusing in NOT ACCEPTABLE.

Cheers J