Wednesday, July 6, 2016

On The Record, Part Two

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Given that I wasn't getting anywhere gaining insight as to why I couldn't get taken seriously for my weight loss issues and bathroom bouts by medical doctors, and the student psychologist wasn't helping me with it, I decided to go to the community health clinic and request a copy of my records. I hoped that by going through the notes, I would find clues as to what made my health issues something to ignore. Making the request in person I was told it would take a bit and I spent about an hour roaming the large clinic building and even walking the grounds. Finally the copy was done and I picked it up and went home on the bus. Once there, I looked over the notes and found nothing unusual or informative except for my body temperature. With each appointment at the clinic they would take my temperature and blood pressure and note it in my records, I had never thought to ask what the readings were. Now I was looking at them in the notes to discover that my body was usually ninety-four degrees Fahrenheit with one time being recorded as ninety-two degrees. That seemed surprisingly low but the doctor had never mentioned it to me.
I would later learn that with emaciation one of the last things that happens when a body doesn't have enough calories to burn is to lose temperature once the body had finished burning much of what's left, such as muscle mass. If anything, this objective measurement in my records reflecting my emaciation only redoubled my concern that my health issues were being ignored by medical doctors! But what could I do except seek the advice of the student psychologist I had started to see? I would soon get frustrated with him and find someone else to see.
During that time I had developed a line of pain going down the back of my left leg. At first I thought I must be sitting funny at my computer chair and tried different positions without improvement. The pain just persisted and continued to grow worse to the point that over the counter pain killers didn't mask it enough to let me fall asleep easily. I made a new appointment to see my assigned doctor at the community health clinic. When I arrived, Betsey listened to my complaint with concern and did some mobility checks with me and then made an appointment for me with their 'pain specialist'; she had been very impressed with him and was sure he could help me.
When I arrived a few weeks later I checked in and was directed to next check in at the doctor waiting area. When I was called, I was ushered into a new exam room, or so I had at first thought until I got there to discover a small room with just a chair and a love seat and nothing else, it was like a smaller waiting room. I thought the nurse had brought me to the wrong room but she confirmed the name of the doctor I was supposed to see and it was the same name I had been told and so I took a seat and waited. A moment later this new doctor came in to see me and asked why I was here to see him. I told him about the line of intense pain going down the back of my left leg and he still didn't know why I was there. I told him that I was told he was their 'pain specialist' and he would be able to help me with it. He told me he was actually the clinic's on-site psychologist and didn't understand why I had been sent to see him. Did I know why? I didn't. And as he didn't know either, we mutually concluded the appointment had been setup by mistake and I was immediately back at the doctor waiting area desk to make a follow-up with Betsey to find who the right doctor was I should have seen.
The following week I saw her and asked about their 'pain specialist' I was supposed to have seen as I had been sent to the wrong doctor. It turned out I had been sent to the right doctor she thought I should see about it. I told her that when I told him about the line of pain down my left leg he said it wasn't the type of issue he helped with. So how was that the right doctor for me to have seen? She just said with that and my multiple other symptoms, she had felt he was the right doctor to see about 'my pain'. Did the clinic have an actual, medical, pain specialist who could help me with the line of burning pain down the back of my left leg? No. Was she going to help me with it? No, she answered with a polite smile, she 'didn't think it was something in her field'. So who should I see about it, then? I asked in frustration. She didn't know and that was the end of the appointment.
After my bizarre time with the female counselor came to an end as noted in the previous segment, I was once again back to the doctor referral helpline and they had nothing left to suggest to me, so with little other clue I pulled out the phone book and looked through the yellow pages for counselors and began to pull names out at random. For most of them, they had answering machines and I would leave a message asking if they were taking new patients and if they could help me with issues working with medical doctors, a few were at offices with a receptionist who told me they weren't taking new clients. Of those I left messages with, most didn't call me back, some that did recommended I just see another medical doctor and get a second opinion. When I explained I'd been doing that for years and not been able to find one to take my health issues seriously, they didn't know what to make of that and either way didn't think they could help me.
The aide for one of the doctors called back and told me he was accepting new patients and we set an appointment. When I arrived at his office, I was ushered into a large area with plants and a windowed wall letting the afternoon sunlight in. And then he arrived and I realized he was the same psychologist as I had met at the community health clinic. This resulted in our mutual surprise as I hadn't recognized his name in the phone book and he opened up his copy to review the listings to find they had misprinted his name in the book, using his first name rather than his last. Still, since I was here why didn't I talk to him about what the problem was?
I told him that I wasn't comfortable about it as I thought it would be a conflict of interest given that he worked with the very community health clinic staff I wanted to talk about. He noted that, since I was already there and he didn't have anything else scheduled we might as well talk a little bit about it. So I decided to give him the gist that I was seeking a counselor who could help me understand why so many people in the medical profession wouldn't seriously address my health issues and used the burning line of pain down my left leg as an example. Rather than having a complete medical work up to figure out the source of the pain and address it, I had instead be sent to see him without either of us being told why.
He reflected that we had concluded it had been a mix-up, hadn't it? I answered that I was told at my follow-up appointment with Betsey that she had sent me to the right doctor in her opinion and otherwise wasn't going to address it herself. That didn't make sense to him and he didn't know why she would have told me that. And that was exactly why I had been looking for a counselor, I told him, to help me understand this and work out a strategy to get by the problem so I could have my health issues successfully addressed. Did I want to work with him about it? I again said I felt it was a conflict of interest given that he would likely want to support his colleagues rather than me. He agreed that might be the case and we decided to stop there. He asked if he could write a note about this meeting to add to the community health clinic's records. I asked him not to and he agreed.
When it was time for my next three month supply of fat enzymes, I was to get the script from my assigned doctor, Betsey, then take it as before to Premier Medical Center to have their doctor copy it under his name and then I could get my next three month supply from their pharmacy. After this proforma appointment with Betsey where we didn't talk about anything else but the renewal of the prescription, I went back to the records department to ask for a copy of my file since I had last seen it. My hope was to again get insight as to why I had been sent to the on-site psychologist rather than a doctor who could help with leg pain. Again, the records shed no light on that decision, but the copy did include a report by the on-site psychologist about our meeting outside of the clinic in direct contravention to our agreement at his office!
In Colorado, it seemed patient confidentiality meant absolutely nothing.




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