26 June 2010

This is what REALLY bothers me!!!:

So I left the doctor's office yesterday feeling horrible. I now realize it wasn't JUST the fact that I was reprimanded for not getting my cholesterol checked in two years (though it was only 162 or so when I did get it checked and has always been around that number) - it wasn't that I was curtly told that my weight loss was not sufficient and that I was still overweight (not even a pat on the back for my new gym, personal trainer and low fat and low sugar diet - not even a nod to the fact that I was flawlessly on target, even above and beyond, with weight and fitness for years - the consecutive pregnancies broke my stride a bit - and, really - is 5'4" with an extra 20 pounds or so as horrible as you made it seem? I'm a size 8 currently.) - it wasn't that I was reminded again and again that, as an adopted person, I have no family history and so need to remain vigilant about breast health, etc. (I check my breasts daily and I ask many questions as I am a hypochodriac with OCD tendencies - I also brush my teeth 6X a day - tell me to do something and I do it - plus, I have always been adopted - you don't think I've had this conversation before with a doctor or nurse?) - it's not that I was freaked out by the stories my health care provider decided to share with me about her friends being diagnosed with cervical cancer after years of normal tests (I was about 4 months late with my check-up, having had to cancel a couple of times, but.... was made to feel that I had not seen a doctor in 10 years).... So, believe it or not, it wasn't what they did, really; it was what they DIDN'T do.

They did not inquire about my fitness routine as they normally do (and I had been told to implement one to lose the post-baby weight and get my spirits up after some post-partum crap - so I thought they would be, if not thrilled, at least wanting to follow up with me). They did not ask about my post-pregnancy anemia that I couldn't shake and that they were quite concerned with for a while (could not get my numbers up - speculation was that I may need to go back on Iron - though, now, it appears no one cares - am I supposed to put myself on a supplement?). They did not ask me if my post-nursing cycle had returned to normal (yes - it has - thanks for asking ;-). They did not follow up on some the leg pain I had been having, despite my pregnancies, birth control, etc. (probably an old athletic injury, but... when I mentioned it a year ago, they were all sorts of interested - now - who cares, right?). They did not ask me how it was going with the three little ones five and under, which they usually do (especially since I had some hormonal ups and downs after my last few babies and they had been watching me, again, just a year ago, to see if depression had set in - asked me to report back next check-up - only... this time, no one asked or cared). Over the past few years, I've had a series of UTIs (again, became a trend after the consecutive pregnancies), and... I mentioned this time feeling like I may have had one recently, though... no one checked me for that - no lab work in that area - did they forget? OR - again, just not care?

OK - so I don't want to be babied or handled with kid gloves. But... I am concerned that my specific needs as a patient are not being met. Yeah - I'm a forty-ish woman with small kids, which is maybe not the norm - maybe they are usually thirty-ish with small kids, but.... I am fit, healthy, a good patient in terms of staying up to date with my healthcare, etc. I do have specific needs - past history with anemia and other minor ailments - stopped nursing a year ago so my body is still returning to normal (my c-section incision just stopped being sensitive - AND, because of the FOUR c-sections I've had, I was asked last visit to report any changes, issues that did NOT return to normal - again, it appears no one cares so I didn't ask some questions I wanted to). I mean - sure - I have forty-ish needs and concerns now, but... I am also a busy mother of small children, still trying to lose her baby weight, still trying to deal with other lingering issues related to a post-pregnancy body (why do I still get the UTIs? do I need another iron supplement? are you still concerned about my sore leg? are you still wondering if my toddler has been keeping me up at night? how 'bout those nutritional concerns you had last time regarding mothers with small kids keeping themselves healthy?).

Anyway - all I got this time was - why don't you have another PCP? And... a bunch of snarky comments on how I should do this - should do that. When I asked about the patchy dark spots on my skin that have not cleared up since I was pregnant with Lil - instead of the - this is common - can take a few years to clear up - usually hormonal and common with olive-skinned people, I got - "I dunno. Maybe check with a dermatologist." When I attempted a follow up on something that had changed when I stopped nursing last year (again, something I had been told to watch), I was told it was probably more age-related as opposed to nursing-related (exactly the opposite input from last year). IN FACT, when I did begin to go over my list of things to follow up on (remember, I am fastidious and wanted to be sure to give them the input they asked for last year - things to watch over the course of this year), I was cut short - told things like, "Well I wouldn't worry so much about your anemia; at your age, you need to get your blood pressure and your cholesterol checked" WTF? And, I apologize here - I don't like to swear given the fact that my daughter and her friends read me - some of my gentle readers do not like it (and those of you who do, call me - we can rip it up ;-) - in fact, I kinda feel like a little kid trying out swear words right now (poopy, butt, booger) - plus, I'm not REALLY swearing (but I digress)... Anyway - so WTF? WTF? WTF? In 12 months, I go from busy young mother to forty-something woman who should be looking for an old age home for myself instead of preschools for my kids? Cholesterol? Mine is consistently UNDER 160 (to the same point, my hemoglobin was hovering around 9 last time you checked - so glad YOU are not concerned). Blood pressure? Mine is usually around 100 / 60 or even lower (though, with all the cervical cancer as the silent killer talk, it did creep up to normal during the course of the visit - and I could feel my mouth getting dry - my heart beating faster - in fact, I needed to pace and cry a bit when I left the office - I felt like I needed to go make out my will - make sure my kids were Ok when I was gone, which would be soon). WTF?!!!

I ended up leaving with a mammogram script and a reprimand for not having another PCP (at my age). I was also about 90% sure that, given the fact that I was 4 mo. late for my annual check-up that I had advanced cervical cancer (I was told a number of times during the exam that it has no symptoms and is very common). When I asked if I could get a script for blood work (if they were THAT concerned about cholesterol - and I was worried about the hemoglobin), they ignored me. I did not ask ANY of the questions I had. I did not recognize anyone in the office. I did not get the opportunity to follow up on any of the issues I was told to last time, making me feel a little panicky. I went from harried mom of four who needed input on weight, nutrition and offsetting depression born of hormonal fluctuations that I was told were due to my body readjusting from pregnancy and nursing and lack of sleep due to life with little ones, and I left thinking I needed to call another PCP to get some geriatric testing done. This visit did nothing to help me with my current health concerns. I need to find a new place..... bummer. Advice?

9 comments:

Facie said...

I do not like my practice (Womancare), but b/c I go there only once a year and so far have had no major health problems, I suck it up. But if I had had the experiences you described, I would be out of there. That said, maybe you are talking about a PCP? I was not sure, since you mentioned your doc telling you you needed another PCP, so why two? And why wouldn't they give you a script for bloodwork if they are pushing you to get it done.

I have been getting my cholesterol checked every four to five years and just assumed five years was the norm forever. Interesting.

Healthcare in general has so many issues, including the "you can talk about only one thing while you are here." Maybe that was part of the problem? Good luck and let me know if you find someone better (better yet, tell me who you go to now so I can be sure to avoid!).

Sherri said...

THAT is where I go. Hmm..... seems many of us are unhappy.

You know - I don't think they were pushing anything.... that's what was weird - they didn't seem to care.... they just wanted to reprimand me for some reason. NOTHING I said went without a scolding. And - I did see a PCP for a while, but... Womancare started doing my bloodwork scripts for me and told me to just go there. Sick of it. When I was pregnant, they switched me from the office I REALLY liked because they were overbooked - couldn't see me to confirm the pregnancy for a number of weeks (with Milo), then.... literally yelled at me for coming in so late when I was finally able to get there - on a hot day - downtown where parking was taken up by a conference.... They redeemed themselves after that (I do like the doctors who delivered my kids AND the one I saw last time, but...) so I stayed. I think I am outta there, though....

Sherri said...

And yeah - why DON'T they have a record of the PCP I have been using off and on. Did they not get my bloodwork? They were supposed to. Come to think of it... they didn't seem to reference my past history at all.... just the last pregnancy, which then went ignored in terms of follow up to some lingering issues (albeit minor).

Sue said...

Ask around about a good family practitioner. She will do a complete physical and order a full panel blood work up. They are trained to fully treat you, including girl stuff. I love mine, and she always seems to have time for my questions.
Good luck...finding healthcare can be so tricky.

Emily said...

I am convinced my OB-GYN doesn't give a darn about me as a childless 40-something who asks about perimenopause at every visit now. I have also always thought he didn't approve of me taking an antidepressant. Haven't cared until now, when perimenopause is on my mind all the time. So I am leaving him done by my PCP. I adore her. I asked her about my weight once; it was at its highest and she hadn't brought it up. She said, "How about this. Don't gain any more." She also said why stress about weight when I was at peak stress over my mom? I love her. Good luck.

Emily said...

A line got cut out - I am leaving him so I can have my GYN services taken care of by my PCP.

Sherri said...

Quick fyi, too. Perimenopause can occur as early as late 30's but actual menopause may still take YEARS to present. I know someone diagonosed with peri in her 30's (which means you may need a hormone supplement - too early), but... got pregnant and had a healthy pregnancy in her early 40's. Now... her "cycle" is back to "normal" - as in the way it was in her early 30's. Hormones. What the hell? THANKS, everyone, for all your input! Helps A LOT!

Sherri said...

You know... quick last bit of info..... Years ago, before I got pregnant with Enzo and Olivia was little... I was having some issues that appeared to be hormonal and may or may not interfere with fertility (and I was thinking about additional children),but... my OB, who was pregnant herself at the time and very detached and clinical (would quote statistics as opposed to actually examining the problem), basically just put me on a prenatal vitamin and told me to shut up, go home, not to worry. Because I was being treated pretty regularly by my PCP, who was super cool, she began to take interest - treated me, the person - took all my health issues, etc. into concern and alleviated this stress-related issue. My OB didn't even notice or follow-up. As soon as I got pregnant, I told her to take a hike.....

Sue said...

I just have to echo what Emily is saying...my PCP is far more concerned about my total healthcare, including these tricky GYN times.