20 February 2013

Doctors: Aiming to Scare

(Some may feel that I am just whining in this post. If you do, well... that's too bad. I rarely get in a complaining mood about my multitudinous medical problems, so when I'm in one, just deal. Or don't read this post. Your choice.)

I went to the rheumatologist yesterday at the advice of my PCP to get a "life plan" for my joints. She was concerned with the amount of daily pain and inconvenience that I experience, so she referred me to the rheumatologist to see if there was a solution.

I wasn't terribly thrilled at the prospect. I've been to many doctors and they all tell me more or less the same thing: I have Ehlers-Danlos, type three (or benign hyper-mobility). It isn't dangerous, even if it is painful and inconvenient. They can't really do anything except prescribe physical therapy to strengthen the muscles around my inadequate tendons and ligaments. Oh, and I'll have an early onset of severe arthritis. Yay.

As I sat on the table, slightly chilly in my straight-from-Paris, one-size-fits-all gown, I listened to the same diagnosis and (more or less) the same solution that I have heard countless times. I wasn't terribly upset by any of this. I was, however, pleasantly surprised by this doctor's suggestion of a quick, easy, more comprehensive physical therapy program that I could easily do every day. As it is, I have had about three years of physical therapy. All of my therapists have been kind, professional, competent individuals, but they have all treated a different joint. Consequently, if I were to do all of their programs back-to-back on a daily basis, I would spent almost two hours on PT. And that's not going to happen.

So far, so good.

Then it got exciting (read: not so pleasant).

We started talking pain maintenance and the use of non-steroidal anti-inflammatory drugs. I told him that I used them consistently for about ten years... and that I stopped when my stomach basically erupted into a bleeding ulcer. Well, I had kinda stopped. I have been taking them as part of my hormone regulating regimen (more on that later) and when I got the flu a few weeks back, the only fever-reducer we had on hand was ibuprofen (a NSAID), which I took for the duration of my flu (about 10 days). Ever since then, my stomach has been bothering me.

Needless to say, the doctor freaked out. Don't get me wrong, he was very professional. His face registered "panic" for a moment, and then he calmly started to try to put some fear into me. I kid you not. He was trying to scare me. I think this may be because I don't usually take my medical problems very *ahem* seriously. He told me that I need to see a gastroenterologist and will probably need an upper GI endoscopy. Yay. A tube down my throat so they can look around the inside of my stomach.

I sorta had figured that this was the next step, which is why I have been avoiding the issue. The doctor assured me that if he had my history and knew what he knew, he would be in a big hurry to get one done. Because... and this is where he really got into the scaring me bit... I could bleed to death. Oh, joy.

To make matters worse, I have been (inadvertently) taking things that I should not have been taking together given my history of bleeding ulcers. The anti-inflammatory medication that my previous PCP gave me to help reduce some PMS symptoms irritates the stomach. The fluoxetine he gave me for the hormone imbalances prevents blood from clotting as effectively as it normally does. Given my history of bleeding ulcers, my stomach is sorta a time bomb. Double yay.

The rheumatologist ended the appointment with, "I hope I've scared you." It takes a lot to do that, but I think he managed. 

So with the promise of future PT and a GI appointment, my outlook on life took a turn for the less-optimistic in the past 24 hours. I'm sure I shall regain my bubbly, exuberant spirit again soon, but at the moment, I'm wallowing. Hehe.

(note: I really, really liked this doctor. This post is not intended to give the impression that I was unhappy with the treatment I received. He was kind, well-dressed, and listened very attentively, even to the benign things. I will have no qualms going to him again if... probably when... necessary.)

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