Connie's Concerns (aka Tarheel's Trepidations)

[Guest guest]

Connie:

OK, this is gonna be a long one, so get comfy......:-)

Your ultrasound is suggestive of....(but NOT absolute confirmation of)

several possibilities..... MRI should be able to nail down whether it's truly

adenomyosis. With respect to the right ovary, the fact that the area has been

so

slow growing, is certainly reassuring.

Your report says: " This is not a simple cyst because it has internal echoes. "

Again, not necessarily worrisome, because it may be the hemorrhagic ovarian

cyst, or endometrioma mentioned in the report.

Furthermore, sometimes what we read--or what the radiologist sees-- ain't

necessarily what it turns out to be. As I have recounted on various occasions on

this list, I, too had an ovarian mass years ago, which was very strongly felt

to be malignant. TWO ultrasound reports said " THIS IS NOT A SIMPLE CYST "

because of the internal echoes. My gyno was prepared to remove the ovary, until

I

read Dr. 's book and insisted that he (my gyno) not remove the ovary on a

" just in case " basis.

I had the laparoscopic surgery to remove the mass. Lo, and behold, and

contrary to everyone's expectation. it WAS nothing more than a simple cyst.

Nothing

more dramatic. So much for the " THIS IS NOT A SIMPLE CYST. " But, no--Simply

stated, it WAS a simple cyst.

DOCTOR'S FEES

Next--I've really just gotta address that $167 charge... for a routine (??)

family doc office visit?!?!?!?

Um......What exactly did he do??--What services did he provide???????--Did he

throw in a perm and manicure, while you were in there? Maybe...??? ....some

live entertainment in his waiting room? (ly, at those rates, I'd kinda

expect that.)

Such apparently inflated charges may jut inspire me to issue a brand new NUFF

" Purple Patient Patient Protest Pillow " --this new pillow, especially designed

for your doctor shall be called the " Purple Patient *PAYMENT Protest* Pillow. "

YOUR INADEQUATE GP

Reading your account about your physician really sounds like he doesn't

provide the proper support for his patients.

Too often docs focus on the technical aspects of medicine, at the expense of

the seeing the patient as a complete PERSON. Patients are people, NOT their

charts or the sum total of their diagnoses!!!

Don't sell yourself short, Connie. He isn't the only GP in town who can help

with disability forms, guide you through panic attacks and depression.

" Nice " is nice, but if this guy won't talk with you, unless you " pitch a

crying fit. " --he's not good enough to be your family doctor. (However, he may

potentially be a magnificent pathologist.)

And I think it's absolutely UNACCEPTABLE for doctors to delegate to the

receptionist the task of " interpreting " ultrasound results to the patient.

" Benign

thing??? " (BT?) Sheeeeeez! With that kind of brilliance, sounds like she

might be a potential candidate for the Nobel Prize in Medicine!!!

That would NEVER, NEVER happen with my GP.

Of course, I had to go through a few " adequate " GP's until I found him--but

he is worth his weight in gold. Soooooo glad I didn't " settle " for the

inferior version.

It really sounds like YOUR GP dismisses you and your complaints.

You mention your history of anxiety, depression, and social phobias.

Sadly, if a doctor doesn't know a lot about psychiatry, or is uncomfortable

about , OR has his own unexamined psychiatric issues, he may be an incompetent

doctor for a patient with depression and anxiety. Actually, let me rephrase

that: Since illness can make ANY of us depressed and anxious, a physician had

better be aquainted with anxiety/depression/phobias, or he's not gonna be a

very good doctor. (Unless, of course, he prefers to specialize in pathology,

and

look at slides, specimens or cadavers all day!)

A good doctor knows that EMOTIONAL AND EDUCATIONAL SUPPORT IS THERAPEUTIC IN

ITSELF!!! Your doctor can't or won't provide that! Time to find out one who

WILL!!!!

Quality care means more than just ordering the right tests. It's also about

making the patient a partner in his/her health care, and teaching and

communicating, and being reassuring and leaving room for hope--ALWAYS!! Not

doing all

of the above can undermine the care you receive!

Here's a great quote--an exerpt from the classic _Love, Medicine and

Miracles_ by Bernie Siegel, M.D.

Siegel writes:

" Exceptional patients want to know every detail of their x-ray reports. They

want to know what every number in their lab test printouts means. A doctor who

harnesses that intense self-concern, INSTEAD OF REJECTING IT, AND BEING " TOO

BUSY, "

dramatically improves the patient's chances. "

Siegel is referring to cancer patients, but, of course, his advice pertains

to all of us.

As a patient with a myriad of health problems myself (some rare and serious)

in the past fifteen years, I could write volumes about the difference between

a so-so doctor and one who is good or even, exceptional.

Trust me: once you've been in the care of a really good doctor, you really

won't want to settle for the " adequate " version.

Connie, your concerns need to be taken seriously. A good doctor won't leave

you hangin' in the breeze--especially with a patient who has a history of

panic/anxiety disorder.

A good doc will encourage you to be proactive and to do everything he can to

help you stay informed.

In your earlier post, you mentioned " coccyx pain. In this post, you refer to

having had " post-prandial " (after meals) diarrhea. And yet your doctor did

not respond or even provide a tentative diagnosis for the loose stools????

Possible food intolerance? Infectious process? Irritable Bowel?

IS THIS GUY REALLY LISTENING TO YOU?

I doesn't take a medical genius to figure out your complaint warrants further

investigation.

Did you know the rectum lies on the front of the sacrum and COCCYX?

Therefore, some or even all of this might be a gastrointestinal problem, like

Irritable Bowel AS well as your seriously retroverted uterus contributing to

your

coxyx pain.

Perhaps the next step should be a consult with a competent gastroenterologist

to evaluate your symptoms.

MRI TIP

Learn from Roma's experience with one of my early-morning MRIs

My advice? No matter how early you get up, whatever you do, DON'T do as I

did--DON'T drink any caffeinated beverages prior to your 7:10 AM. test.

I once foolishly had a couple cups at breakfast prior to my MRI, and during

the MRI, had the hardest time lying still--especially since I brought a rousing

toe-tapping jazz CD along to hear. And with the caffeine coursing through my

veins, and the music in my ears, I was ready to get up and boogie. Not lie

still for the MRI!

Ideally, at that hour you'll be able to snooze through the jackhammer, the

galloping horses and all that MRI cacophony. It would be much better to bring

some Brahm's Lullaby-type CD to promote a good " dream state " while you're

horizontal. And NO CAFFEINE!!!

Keep the faith and... keep us posted!

-Roma