Not the Doctor

I didn’t go to the doctor for a really long time before I moved here. A large part of it was that I worked too damn much, and really, who has time to take care of their health when there are press releases to be written! Investors to call! MEDIA TO RELATE TO! And so, I neglected my health, like so many overworked, Type-A fools.

And really, after having the kind of doctor experiences I’ve had lately, I’m starting to think that approach was a *little* bit better. I felt a hell of a lot better when I wasn’t going to weekly doctor appointments, and being diagnosed on a near-constant basis with something new, ranging from benign maladies like allergies and eczema, to more severe, chronic conditions like anxiety, asthma and Hashimoto’s thyroiditis.

Kris, has already written an astonishingly wonderful account of exactly what I’m feeling, but yet, I feel compelled to add more fuel to the fire because, well, I’m fucking pissed off. Thyroid disease is an oft-misdiagnosed, deceptively hard-to-treat chronic illness, and it doesn’t seem like that big of a deal to many doctors, because you just stick ‘em on Synthroid, and off they go! FIXED!

And it’s pointless to explain the mechanics except for this basic background: Hashimoto’s is an auto-immune disorder that basically means that my thyroid is being destroyed by my own body, and as part of this destruction, stops working in increments, as parts of it are eaten, my dose of synthetic hormones need constant adjustment. And it also gets rather large and swell-y and cyst-y. And sometimes, those cysts get really big. And sometimes, there are other masses, that aren’t benign and friendly and fluid-y like cysts, but are mean, ugly and cancerous! And angry! But those are very, very rare and highly uncommon – like less than 2 percent of all thyroid masses are cancerous. Really.

Thyroid hormones control basically everything – from our menstrual cycles to our metabolism to our thought processes. Hashimoto’s can cause hair loss, depression, anxiety, high cholesterol, weight gain, menstrual problems and heart palpitations, and that’s just scratching the surface. (I’ve had them all, for the record, or so it seems, except for high cholesterol, and it sucks). And sometimes, despite treatment, you’re not fixed, because it’s so squishy, and it changes all the time based on bodily circumstances – anything from weight to the speed with which your disease progresses can mean you need an adjustment in synthetic hormone. And worse, doctors don’t agree with the best approach or what is ‘normal.’ And if you’re trying to get pregnant, or are pregnant? Forget it. A whole new set of rules. God, and it’s all so NEBULOUS. And hard to fix. End background.

I went to the doctor a few weeks ago after having an ultrasound to look at my ever-growing thyroid and was referred to (yet another) endocrinologist. Apparently I have two abnormally giant cysts that may or may not be angry, but are likely friendly, as 99% of them are! Happy! Full of molasses! After I arrived, it became clear that my new endocrinologist had never looked at my chart before, and didn’t realize that the radiologist who did my ultrasound wrote an ambiguous interpretation that could either mean happy! shiny! cysts! or could mean angry! bitter! solid! masses! and GOSH, we should call that radiologist, right, maybe before we treat the patient and see if she needs a biopsy? Except, see, that radiologist? Was unavailable, but promised to call back in five minutes, which in doctor speak means, “the twelfth day of never.” Meanwhile, Endo was telling me that GOD, with the size of these cysts they are probably malignant (not necessarily true), and when I suggested that thyroid cancer is usually well-contained for a very long time, so might I be okay, even if it’s malignant, he replied:

“Um, not necessarily. I mean, let’s face it, you could have had this since you were 15, and it could have metastasized everywhere by now. What do you want me to say? Yes, you could be in very bad shape. That’s just the way it is.”

I need to remind you that no one even knows if I have a mass or a cyst, and even if it’s a mass, PS, it’s STILL more likely than not to be benign and thyroid cancer IS VERY TREATABLE. But it’s okay. It’s metastasized and I’m near death, so why not give up now? I should just slit my wrists and move on.

He followed this little gem with, “You have acne. BAD. My guess is that you might have polycystic ovarian syndrome. Which isn’t good either, and might mean you’re infertile.”

Based on acne. ACNE. But who cares if I am infertile, because I am dying! DYING! RIGHT NOW AS WE SPEAK. I may not be alive in the morning, you know. Just saying.

Despite four phone calls to determine the status of the rogue radiologist, Endo still hasn’t called me back. Which is unacceptable, given that your patient is apparently dying of metastasized thyroid cancer she’s had since she was 15, based on an inconclusive ultrasound.

Fucker.

I waited an HOUR to see this asshole. And this is what healthcare has become. This isn’t unusual, and while it’s unacceptable, it’s not as uncommon as we’d all like to think. While healthcare in the US is better than other countries, we’re still stuck with HMOs and managed healthcare, and squeezed patient time, and doctors who just don’t give a shit. It’s common. I’d like to think this is abnormal, but it’s common. I have friends with countless stories just like this, from all over the country. One of my friends was told she likely had herpes, but GOD, the doctor just didn’t have time to deal with her right now, so could she come back later? This caused quite a stir with my friend and her boyfriend of five years, as you can imagine. Turns out? She had a laundry allergy in an unfortunate location. But the doctor was throwing herpes around like Wonka bars with no follow through. It happens.

And it’s unacceptable. And for the record, I don’t think I’m dying, and I don’t think I have cancer – I think he was just trying to scare me for the fucking fun of it, because he is an insensitive cocksucker, and even though I hate that word, sometimes IT MUST BE USED. Because, thank God, I am an informed patient who knows my odds, knows my treatment and knows what to look for, shitty doctors be fucking damned. But what if I wasn’t? I’m sure someone out there isn’t, who’s been near suicide because of someone like him.

I’m going to be fine. I am fine. I cannot say the same for this doctor. I just can’t. Because there may be an ass beating heading directly for him.

I will kill that doctor! Kill him! Don’t think I can’t do it! AM STRONG PUG!

*Alanis Morissette. Because that’s just how angry I am. And really, I’m not making this up. After the Dr. Polando thing and the Topamax, you’d think I was some kind of magnet for bad healthcare, or completely neurotic, but I assure you, I am not. This is what is actually happening to me. And, to keep this positive, I hasten to add that my primary care physician is *amazing*. An old-time family doctor who remembers me, knows my husband, takes as much time as I need, and actually cares. In this respect I am more fortunate than most.

21 comments May 9th, 2006