Sunday, September 30, 2012

concerning the ineffectual techniques and person of my GI doctor

Last week -- strangely, just a few days before the big episode -- I had an appointment with my GI doc.  This was not a regular check-up, nor did he care to see how I was doing.  I made this appointment because for the last 6 months, he has not been able to find my medical records.  Yes, truly.

He says "they're here in the office somewhere, I know I didn't throw them out," Yes, I know I didn't throw them out.  This is an actual thing that he said to me.  For the moment, I withheld the threat of a HIPAA lawsuit.

The medically related subjects we touched on were these:
1) "So when was the last time you got a CBC/liver panel done?"
"Well, that was something I wanted to request since during the first 2 years that I was on Remicade, I had panels done once every 3 months and I haven't had one for over a year now [since I have been your patient]"
"Oh sure, yes let's have those done then." 
2) "My 3-part-sagas have been infrequent and I finally found an antispasmotic that works, after 10 years of trying things that did nothing"
"Oh that's great, what is it?"
"Marijuana."
"Oh..." He huffs a little and looks at the floor, disappointed. "Well have you tried everything else?   Bentyl?"
"Yes, you prescribed me Bentyl last year, it didn't do anything"
"Clidinium?"
"Yes."
"Hm."  With that, he was out of ideas and proceeded to ask me about pot.  A series of idiotic questions that made it abundantly clear that he had no idea how it is used medicinally.  "So how did you get it?  It had to be prescribed, right?  So you go to a doctor who examines you and gives you a card?  Do you smoke it?"
"Yes, it was prescribed.  I use a vaporizer, which only releases the medicinals of the leaves.  There is no burning, and no smoke."
"Can you... I mean, are you able to do things afterward?"
"If you mean, do I get stoned, no I do not.  I take one hit and that is sufficient to relieve my abdominal pain within 10 minutes."
"Huh.  Because you know I have a patient who uses marijuana and smokes every day, and does nothing with his life and lives in his mom's basement.  So..."  
"That is unfortunate, if only your patient had access to a psychotherapist who could help him work through Crohn's related depression and dependence.  But not to worry, I do not have an addictive personality and I have the motivation to avoid drug dependence.  I use it once or twice a week."
"Well, I guess whatever works." Let me emphasize, at this point, that this is an OD, not an MD.  An osteopathic physician whose schooling is specific to harmonizing the body, not just about which prescription drugs do what.  This is a man who should at least know what marijuana is and how it is used medicinally.  This is a man who should be open to non-pharmaceutical therapy, not excessively closed minded toward and ignorant about it.

3)  "So I'm trying this new anti-inflammatory diet and it seems to be going pretty smoothly.  I've been weening into it for a month now.  But still, I eat a banana and I'm constipated for 2 days."
At this, he laughs.  "Yeah, I have another Crohn's patient that that happens to."  That was the end of his response.  No commentary about how often I should be eating bananas, or other ways by which I might acquire potassium -- not that I need direction.  "So you're not eating any grains then?  No wheat, no rice -- well, except brown rice -- no oatmeal?"
"Well, oatmeal actually has anti-inflammatory properties," I corrected as nonchalantly as I possibly could.  How does this guy have a gastroenterology practice and not know anything about marijuana or diets?  How, I ask you.
"Well alright, let me order those tests and I'll give you a call when the results come in."  Really?  You have nothing to say about my dietary choices?  No recommendations based on my medication?
"What should I do about not feeling that great lately?  Lots of constipation, nausea and the big D?" I asked desperately trying to get any kind of medical advice out of him before he shuffled me out the door.
"Well, it's up to you.  Do you feel like you want to increase the dose?"
"Is that something you recommend based on my symptoms, or do you think they are just IBS and not related to inflammation?"
"Well, it's really your call on the Remicade.  You can increase or decrease it at your discretion."  Again, not remotely answering my question or giving any kind of medical advice.

This is the kind of medical treatment that student insurance covers.  God help me survive the next 4 years, or until H.K. gets rich enough that he can help me acquire real health coverage once Obamacare finally kicks in and I can no longer be denied for pre-existing.

2 comments:

  1. NO! dude. that's so god awful. i'm so sorry. i recommend my doctors, but none of them take insurance.

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  2. This is bullshit. Full stop. Such bullshit! (Okay, I guess I wasn't ready for the full stop.)

    ReplyDelete