Monday, April 9, 2007

Slow Burn

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I went back Friday to have another back adjustment. That one, overall, went better than my earlier visit. However, there were a few things that bothered me...."bothered" isn't right...properly pissed me off might be more accurate. I actually had a pretty nuclear rant worked up by Friday evening, but decided not to post it. Partly because sitting and typing has been unpleasant. Partly because I didn't want to come across as some sort of frothing psycho.

Let me backtrack juuuuust a little. Thursday, I ran errands. Nothing major, just took my mom to her tax preparers' place, did some light shopping. About a half hour in, my left arm started hurting and soon after that, so did my shoulder. It was bad. I couldn't lift and load a 20 pound bag of cat food. By the time I was home, the knots in my shoulder were back and I was ready to cry. All in all, the entire trip took about two hours. Once I got home, I took some otc painkillers and tried to relax on the couch.

Friday, I get to the clinic office and sign in. Based on my wait time for my previous visit, I tried to be there about 10 minutes before my scheduled time. I sat down and started flipping through an issue of Consumer Reports which ironically, had a section on people's experience with doctors. It discussed aspects of what a consumer can do to make the most of their visits, what bothered patients about their interactions with doctors and what bothered doctors most about interactions with patients. There was also a sub-section about how to discuss 10 embarrassing medical conditions with your doctor (everything from jock itch, to yeast infections, to other sorts of itching.) It was about seven or eight pages of material, all told. I'd finished the article and was skimming back through it when I was finally called back. By now, it was after 3:00 (my scheduled appointment time.)

The nurse ran me through the preliminaries: bp, temp, heart rate, weight. She took me to an exam room and we did the "why are you here today" routine. She made some notes and left, leaving my file in a little holder on the outside of the door. And I waited. And waited. And waited. At some point there was a knock at the door--sooner than I expected--and I was pleasantly surprised, expecting it to be the doctor.

But nooooo, it was a nurse making sure they had the right patient file for that exam room. That struck me as a little odd, because I've been going to this clinic since I was 11 or 12 and nothing like that had ever happened before. But it was a little interaction that kept me from pacing around the room, reading the BMI charts ( I seriously need to lose about 15 pounds), the big allergy poster, the listing of codes for common symptoms and treatments (it amused me to see that they'd handwritten codes for gonorrhea and chlamydia in the margin.) Seriously--I don't know how long I waited. I don't wear a watch anymore and I've stopped taking my cell phone in with me because if I can see the time and know how long I'm waiting it just makes me angry.

Finally, the doctor comes. He asks how my shoulder/back feel and I tell him. I tell him about the previous day's problem while running errands. He says "Well maybe you should've walked." Ha ha. Funny, funny doctor. My visit earlier in the week, I'd told him about the problem and not being sure what range of motion set off the pain. I mentioned it acting up when I drove and then being set off by washing my hair the previous day. "Well stop washing your hair." Hardee har har. Now, tell me to try the veal. If he does this or something like this again I'm remarkably tempted to ask him if he intends to be dismissive. If you want to engage with your patients in some way, fine. You sure as hell need to do something if they're going to be waiting for more than a half-an-hour to see you. But this is not the way to do it.

I asked him about what I could do for pain management (knowing that the answer would be pretty conservative; the clinic has a policy of not prescribing more than necessary, which I whole-heartedly agree with.) He said (as I knew he would) "Ibuprofen." I explained that I'd taken ibuprofen the day before and it hadn't really done anything. He said something about a muscle relaxer and had me get on the table to put the heating pad on. Now--let me be clear. I am not/was not angling for heavy duty painkillers or muscle relaxers. A muscle relaxer would've been nice, more than I would have hoped for, but I was actually seeing if I could get a small scrip of prescription strength ibuprofen for the pain.

We got through the adjustment with much less popping and cracking than my earlier visit. He provided me a sheet with a series of stretches on it for my spine, neck and shoulders. All of which I've been doing. But no scrip. Fine, that's his prerogative. It's all sort of dulled down to a throb that I can live with.

There is one more thing that he's done that I want to comment on. It's about the smoking thing. Yes, I should stop smoking. I know this. Smoking is bad bad, dirty dirty. I get it. But, as I told him during my first visit--I have tried to stop smoking. Hypnosis, nicotine replacement (a few times), cold turkey (more than a few times.) Done it. Read my file. It's in there. I've gone through your frigging clinic to do it. There's a paper trail. I've asked about (and been shot down on) Welbutrin. What exactly would you like me to do? Give me an option that I've not tried. I'll do it. But don't scold me two or three times in the minutes you spend with me like some bad parent with a kid who's wet his pants.

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