Note: This post may take you farther than you want to go...and keep you longer than you planned to stay. If you have the time and the patience, bear with me=)
Hey Joan...I am feeling rather "pooch-mouthed" (pouty) this afternoon. I think I must be the "misery" who needs "company". I saw your topic and read through the posts. Boy, can I relate? I have to admit I chuckled out loud to the "old and ugly" comment...not laughing at you, but with you.
Once upon a time I had a PCP who treated me for almost 50 years, if you count that he delivered me from the womb. He was the kind of doctor that is a dying breed. He was the pillar of our community. He was capable of everything from administrative duties at our local hospital, to general surgery, OB/GYN, to setting broken bones. He NEVER FAILED me. He would refer me to specialists when necessary, then ultimately diagnose/treat what they couldn't. He put "Humpty-Dumpty" back together again and again and a-a-a-again. He was my life support. I always believed he would be there for me unless he slumped over his desk, with transcriber in hand and peanut M&Ms melting in his mouth=) Instead, he was forced into retirement in 2009-10. Insert tears of sobbing ugly cry even now, as I visit him in the nursing home where he and his wife now reside. He is wheel chair bound, and spiraled into dementia...yet he is dressed daily with shirt and tie, slacks, shoes shined to reflection w/white lab coat. In his mind, he's still Dr. M and he's in charge. He keeps a lap full of files and records, constantly doodling his "orders". He doesn't recognize me or my husband, but enjoys pleasant conversations with us (and peanut M&Ms). Okay, regroup myself after total digression.
I had to find another doctor in 2009 to manage my complicated medical issues. The strongest med he'd ever prescribed for me was Darvocet, yet it too was "retired" (ugly cry again). He had worked through so much with me over the many years, and had me in a place of "maintenance". He prescribed my GI meds, arthritis meds, anti-anxiety/anti-depressant meds and Darvocet. We both knew I needed stronger pain meds, but I had/have such intense gastric responses, they weren't feasible. He gave me weekly B12 injections and frequently hospitalized me when I was collapsed in dehydration. IT WAS going to be hard (impossible) to replace my Dr. M=(
I live in a very small town that is 2 hours from anywhere. My first 2 attempts made me run...um...limp quickly away in horror and panic. Both doctors wanted to "change my cocktail of maintenance meds because there are newer, better meds available". One even asked "Why do you need Ativan? You don't seem anxious". hmmm---could it be because the Ativan is working, and has been for 20+ years with NO increase in dosage? YES, I am definitely physically dependent on it, but I don't see that as a bad thing if it's kept me from an asylum, you bee-otch! Then we debate the benefits vs. risks of Donnatal, which also has been my Holy Grail, easing spasms of a crimped colon that will eventually lead to a resection w/possible colostomy bag. She wants to "change" that too. Nope, Humpty's learned over the years that the proverbial "if it ain't broke..." sincerely applies to maintenance medications.
I finally found a doctor who basically read the synopsis of my volumes of medical records/history and AGREED to treat me status quo...same scripts less Darvocet (replaced w/Tramadol). He told in 2009 that my pain is due to arthritis from aging, my belly and pelvic/vaginal/rectal pain is caused by adhesions from multiple surgeries for stage 4 endometriosis. He laughs and scoffs saying "You can't possibly have residual endometriosis. You're too old to have estrogen and you don't have a uterus"...that'll be $150 for office visit, which I require every 3 months. Even more bizarre is that I've stayed with this jerk for 5 years. I was afraid to wonder into the abyss again. He has allowed me to suffer through a UTI for 11 months with only Bactrim, which I've told him doesn't work for me. I ended up in the ER with severe flank/kidney pain (oh, God...another volume of idiocy and arrogant jerk doctors) twice in May. The result was pre-septic UTI requiring 30 days of Levaquin, which the ER doctor suggested I chew...YUK...without fail to avoid IV. I wanted them to do IV push of Rocephin, but they refused. When I saw my regular jerk PCP in June, I was in full outbreak of shingles in my right eye. (his office couldn't get me in to see him, so I was treated for shingles in a quik-clinic) He didn't acknowledge or examine my face as he tapped his IPad. In fact, he answered his phone and booked a tee time in my presence.
OKAY...THAT'S IT...I'm DONE. I may be "old @ 53...every line in my face has a story...I may be ugly...because unlike his young hot nurse protégé, I'm not spray tanned orange with tattoos on my French manicured toes, wreaking of Coach Summer fragrance...though as we say in the south, I "clean up" real well. But I'm not stupid. I deserve to be treated with respect, and some semblance of concern. I'd ask him repeatedly over the years to help me to get relief from just some of my pain. He told me he wasn't about to get bogged down in PM and that opiates would "kill my liver". What use will I have for a healthy liver if I'm 6 feet under?
Long story longer...I just consulted in August with a wonderful new lady doctor in a nearby town who has agreed to take me as her patient. She has moved back to her home town to take over the practice of yet another aged life-long "country doctor". She is also the administrator of their rural hospital. She is a SWEETHEART...answered prayers, indeed. She is 47, married w/2 sons, involved in the community and church where she has DEEP roots. She hugged me repeatedly throughout our discussions. She brought NO phone or IPad into the room. She sat and TALKED with me. She maintained constant eye contact, though my face is now not only "old and ugly" but deeply scarred from shingles in my eye this summer. I felt like Quasimoto (sic) and she was going to help me ring the proverbial bell. I was in disbelief as she wrote (I said wrote) out my prescriptions for maintenance meds w/5 refills. She said that when my PM doctor reaches an established regimen for my pain control, she will happily write my scripts for the pain meds...Hallelujah! My current PM is a maniac at best (not my choice) so I look forward to my new PCP...Yes, Virginia, there is a saint country doctor who actually cares about her patients...taking the reigns of PM for me.
Joan, I apologize for being so long-winded. My crap can't be summed up in text form. I just wanted to say I AGREE with your assessment of healthcare these days. If I go into the "rabbit hole" of economic crash that "restructured" our entire lives, including loss of Fortune 500 jobs along with excellent health, prescription, dental and optical insurance...let's just not and say I did. I KNOW that I am treated differently now that I don't have that "big gun" insurance card to offer at the front desk.
I'm sending HUGS of support for your appointment with PM tomorrow. "It will all be okay in the end. If it's not okay, then it's not the end." I love that quote from the movie The Best Exotic Merrigold Hotel =) I also loved their culture's philosophy toward their elders. I highly recommend that movie...especially if you're feeling old and ugly;)
HUGS~~Dixie