my unwanted guest

I woke up three days ago with the most awful, stabbing pain in my upper right arm - lil' miss shoulder pain had arrived for another visit. She literally took my breath away. The back of my arm down to my elbow was numb.

I will never forget the first time she inflicted me with her presence - it was about 8:00 am, the morning of September 11, 2001. Shortly before I turned on my television and found the world changing before my eyes, she stabbed into me and twisted herself into my fibres. Since then, she comes to visit every few years, bringing days of relentless pain.

Despite setting her up on dates with Tylenol and Advil, shoulder pain is playing hard to get. She laughs at the humble analgesic's efforts to sooth and comfort her. She is a real bitch - an unwanted guest.

I want to show her the door, but she seems to have unpacked her bags and plans to stay a while.

mistaking a miscarriage for a drug seeker?

Three years ago I miscarried at 12 wks - an awful event that I documented in this blog post, in which I explored the psychological turmoil that surrounded my pregnancy loss. What I didn't write about at that time was the physical experience of the miscarriage. It was long and painful.

Yesterday, a post at one of my favourite medblogs "ER Stories", (where 'ERP' writes about life in the emergency room from a physician's perspective) touched me. The post lamented that medical staff discussed withholding pain medication from a known drug-seeker...who was dying of cancer. After yesterday's tone of compassion, I was disappointed to read today's post about drug seekers and how doctors are keeping score. I appreciate that ER physicians must make difficult calls for each patient, but the 'keeping score' attitude results in a culture of suspicion that undermines patient care.

Case in point: my miscarriage. After waiting nearly a week for the pregnancy to abort (they advised against a D&C), I was a physical and emotional wreck. The miscarriage lasted three days - over the May long-weekend. The only option for pain relief was the emergency room.

In the ER, I waited hours to be seen so that I could ask for pain relief and to find out how much blood loss was to be expected. The doctor who saw me asked me if I had tried Advil. Seriously? Who in their right mind would wait hours at night in a busy ER next to angry drunken people and police if they weren't in a LOT of pain and had tried everything else? He went on to ask me if I wanted to be examined. I don't know, you're the flippin' emergency room doctor. I've never miscarried before. You tell me - Is this normal?

The doctor treated me with a skepticism I would hope would have been reserved for repeat customers with a history of drug abuse. It was humiliating and made an awful experience even worse. Did he doubt I was really having a miscarriage? I would happily give consent for an internal exam to clear up any concerns about 'faking it'. Perhaps he thought that I was exaggerating the pain? Perhaps; even I was surprised at how painful it was - it was nothing like any period pain I had ever experienced. It was clear that he certainly didn't care.

Did he feel like he had scored after he failed to treat my pain?

Doctor 1 - Patient 0

another piece of the puzzle?

A few weeks ago, I was driving to class when I started noticing a pain in my right rib just under my breast. Over the next few days the pain got more and more miserable. It hurt to breath, it hurt to sniffle, it hurt to sit, it hurt to lie down.

I started popping extra strength Ibuprofen, and decided to visit my massage therapist to see if it was being caused by muscle pain. He evaluated my pain and pressed lightly on my sternum. HOLY FRIG it hurt!

For the life of me, I could not remember hurting myself. I mean, if you hurt so badly you can hardly sit or stand, wouldn't you have some idea what you did? Sleepwalking? Too much arm waving with the Wii?

His best guess is that I was suffering from a condition called "costochronditis."

It's been about a month now and I am starting to feel better, but interestingly, I was just "googling" it, and it looks like it has some relationship to autoimmune diseases. Perhaps the whole autoimmune theory isn't as crazy as I thought.