Apr 11, 2010
Apr 8, 2010
The "F" Word
Fibromyalgia.
I saw an Internist yesterday about why I don't seem to ever feel 100% well. After reviewing my symptoms (constant low-grade fever, feeling flu-like ever few weeks, horrible fatigue), she mentioned that some of my concerns sounded like fibromyalgia.
I worry that if I get stuck with the "f"-word, it will undermine my efforts to find out what really is wrong with me. My main issue isn't muscle pain; it is fatigue and flu-like illness.
The thing is, I know my body. I know what it feels like to be healthy and active. I reject the chronic disease label. I don't want to give up hope and just learn to live like this.
*I do believe that Fibromyalgia exists. I just don't think that I have it.
Mar 20, 2010
Getting it Right
While it feels sometimes like all I do is critique our medical system, I have to say this: when they get it right, they really get it right.
Two weeks ago, I lost a dear member of my family. That day came too soon for us. What started out as a simple bladder infection turned to sepsis in a matter of hours.
When it was clear that her situation had become grave, the staff in the ER could not have been more wonderful. They helped us through the difficult decision to withdraw treatment and move to palliative care.
The doctors, nurses, social workers, chaplain, housekeeping staff - were all kind and attentive. It was a busy night in the ER with patients stacked in the hallways; and yet they managed to give us private space to be with her while she passed. They brought us juice and crackers. They walked us through every stage of her death.
When the Canadian system functions well, it is a thing of beauty to witness.
Two weeks ago, I lost a dear member of my family. That day came too soon for us. What started out as a simple bladder infection turned to sepsis in a matter of hours.
When it was clear that her situation had become grave, the staff in the ER could not have been more wonderful. They helped us through the difficult decision to withdraw treatment and move to palliative care.
The doctors, nurses, social workers, chaplain, housekeeping staff - were all kind and attentive. It was a busy night in the ER with patients stacked in the hallways; and yet they managed to give us private space to be with her while she passed. They brought us juice and crackers. They walked us through every stage of her death.
When the Canadian system functions well, it is a thing of beauty to witness.
Mar 15, 2010
Shame-based medical education: Is there a better way?
While working on a literature review on medicine and power, I came across this unfortunate quote. I really, really hope that this is not the general opinion of physicians, but I am curious what others think...
"I think that our working relationships [Between ICU doctors and nurses - ETA] are very forward—we are all part of the team—if the doctor isn’t there it fails, and if the nurse isn’t there, it fails. . . . I think we (doctors) lead the team by involvement and motivation.
"I think that our working relationships [Between ICU doctors and nurses - ETA] are very forward—we are all part of the team—if the doctor isn’t there it fails, and if the nurse isn’t there, it fails. . . . I think we (doctors) lead the team by involvement and motivation.
We promote, motivate, demonstrate respect, call each other by first names. I think that some of the nurses may feel that there is a hierarchy, but I think that it’s their problem. They’re shit scared of medicine, but that’s their problem.
The junior staff (junior doctors) have a rough ride if they don’t know the patient. They are trained by embarrassment [BBM -ed]. Nursing is different, it’s high on molly coddling. Nurses appreciate handholding."
-- Anonymous ICU Physician
Coombs, M. (2003) Power and conflict in intensive care clinical decision making. Intensive and Critical Care Nursing 19, 125–135
Feb 7, 2010
Fear (*a personal journal entry)
Today I am afraid that the fatigue will never go away.
I'm afraid that I will always be a heartbeat away from sleep. It comes on me and attacks and there is nothing I can do but succome to it's force.
I wonder if it's depression, but I really don't feel depressed. My mood is actually really good. I feel optimism and anticipation for the work I'm doing. But I am so tired.
Maybe the remains of my sinus infection?
Or a reaction to antibiotics?
Or perhaps my stupidly low ferritin level?
This cycle repeats itself every few months. I get a short while of energy and clarity, only to plummet back into this black hole of fatigue.
I'm afraid my husband, my school, my workplace aren't going to be as accepting this time as they were last year.
Feb 2, 2010
Patient consent and the surprise pelvic exam
I read this article in the Globe and Mail (one of Canada's two large national news papers) and was aghast. Medical students doing pelvic exams on unconscious women without consent?!
After contacting some friends who would know more than I do about this, I am feeling somewhat assured that Mr. Picard may have overstated the problem. Still, there is a problem.
This really shouldn't be happening at all. While some might argue that the consent implicit, I would certainly like to be explicitly informed if there is going to be a student prodding around in my parts. If it were explicitly stated, I would give consent - I suspect many women would.
There is one way to clear all of this up: just ask.
After contacting some friends who would know more than I do about this, I am feeling somewhat assured that Mr. Picard may have overstated the problem. Still, there is a problem.
This really shouldn't be happening at all. While some might argue that the consent implicit, I would certainly like to be explicitly informed if there is going to be a student prodding around in my parts. If it were explicitly stated, I would give consent - I suspect many women would.
There is one way to clear all of this up: just ask.
Feb 1, 2010
Open letter to the doctor I saw this morning
Dear Dr. Whatever,
I appreciate that you are filling in for my regular family physician. I understand that you probably do things a little differently than she does; but your practice leaves a few things to be desired.
Despite that you have all of my medical records electronically, I didn't make a big deal over filling out all of your paperwork, with medical history, medications and allergies. If I'm willing to go along with writing all of this down for you, the least you could do is read it. Especially the part where I wrote - "Allergies: I had a rash while taking Doxycyline." Yes, a rash. Some skin redness.
I made myself comfortable and was pleasant while your nurse took my blood pressure. Unfortunately, she refused to share it with me, saying, "the doctor doesn't allow us to share test results with patients." When I raised this with you, you told me that patients aren't sophisticated enough to understand these confusing numbers. (It's only blood pressure for Gawd's sake!) Or, worse, they might want to have a conversation about it!
You walked into the room and stated your name and stared at me. Was that an introduction? Next time you might want to try a greeting, such as "Good morning, my name is______".
I realize that you don't know my medical history, but could you please try take my word for it when I tell you that I use a saline nasal rinse every day. And yes, I do know what saline is.
And finally, when you asked me if anything seems to help my sinus pain, and I told you that a Tylenol-based decongestant seemed to improve symptoms, perhaps lecturing me about the lack of efficacy of these products ("No, that wouldn't have helped, studies have shown that these don't work) was a little uncalled for?
Thank you for your time, I hope not to see you again.
(am I being too harsh?)
I appreciate that you are filling in for my regular family physician. I understand that you probably do things a little differently than she does; but your practice leaves a few things to be desired.
Despite that you have all of my medical records electronically, I didn't make a big deal over filling out all of your paperwork, with medical history, medications and allergies. If I'm willing to go along with writing all of this down for you, the least you could do is read it. Especially the part where I wrote - "Allergies: I had a rash while taking Doxycyline." Yes, a rash. Some skin redness.
I made myself comfortable and was pleasant while your nurse took my blood pressure. Unfortunately, she refused to share it with me, saying, "the doctor doesn't allow us to share test results with patients." When I raised this with you, you told me that patients aren't sophisticated enough to understand these confusing numbers. (It's only blood pressure for Gawd's sake!) Or, worse, they might want to have a conversation about it!
You walked into the room and stated your name and stared at me. Was that an introduction? Next time you might want to try a greeting, such as "Good morning, my name is______".
I realize that you don't know my medical history, but could you please try take my word for it when I tell you that I use a saline nasal rinse every day. And yes, I do know what saline is.
And finally, when you asked me if anything seems to help my sinus pain, and I told you that a Tylenol-based decongestant seemed to improve symptoms, perhaps lecturing me about the lack of efficacy of these products ("No, that wouldn't have helped, studies have shown that these don't work) was a little uncalled for?
Thank you for your time, I hope not to see you again.
(am I being too harsh?)
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