if you have anything beyond the flu, a need for birth control pills, or a general pap, and you have any other insurance or a family doctor, run, don't walk to a private practice rather than going through a University health service. I say this because, in retrospect, the thirteen years where I relied solely on Student Health are starting to be a series of missed opportunities.
Case in point:
1) When I was 19, I was having trouble getting very shaky in the afternoons, especially if I ate a snack like fruit and fell asleep. I asked them to check my blood sugar. They didn't want to, said I didn't need to worry about it, that I didn't have diabetes in my family. I pointed out that one great-grandmother died of complications of the disease and another's (on the other side of the family) entire family (parents and brothers) had had diabetes. They said it wasn't close enough. At the time, my mom was 38, my grandmother 62. When I said that my family tended to run hypoglycaemic for many years then go into diabetes as they got older, I was told that this was impossible. I finally stuck with my request until they finally did the test just to get rid of me. It came out just a little off and they felt quite smug, I'm sure.
At the same time, I was checked for thyroid issues because of a sudden weight gain and hair growth. Then they checked my cortisol levels. Eventually they sent me to an androgen clinic at the University where a doctor felt my abdomen, took a blood test, then left the country for a couple of weeks. When I finally did get through to the clinic, I was told that it was what he suspected and that he had a prescription for me. I went over and it turned out to be birth control pills. The nurse(?), when I tried to get information on the problem, just said that girls like me might have trouble getting pregnant when we wanted, and we might have to take fertility pills. That's a pretty big bombshell to drop on a 19-year-old. At no point was I told anything beyond the fact that my androgens and testosterone were high. Mind you, this doctor put me on birth control pills knowing that I'd never had a pelvic exam and that I was a DES daughter. At no point did he do a pelvic. Theoretically, I should have had a special kind of pap that checks the walls of the vagina as well the cervix because of the DES and a specific type of cancer that strikes, often in the teens and early 20s. But I got nothing. This doctor later spent years as the medical school dean.
The problem? Now, eighteen years later, my grandmother, mother, aunt, and I are all diabetic. I was lucky. At the time I first went, no one realised that the blood sugar issues and the hormones were related, part of insulin resistance syndrome. Nor was I told I had polycystic ovarian syndrome or given any useful information. When I went back to get my pills refilled 6 months later, a nurse practitioner hit the roof when she found out I'd never had an exam. It was the first time I ever felt my trust in the medical field was misplaced.
But eventually--when I got health insurance from my first job--I was referred to an endocrinologist (by all things, a psychiatrist evaluating me for problems concentrating, especially in the afternoon). I went on medication before I 'technically' became diabetic. My aunt was sent home from an annual pap with insulin because her blood sugar was over 300. My family members are dealing with neuropathy and other issues, indicating their diabetes has been around for much longer than diagnosed. I used to think diabetes was a silent killer because people didn't know the warning signs or go to their doctors in time. Now I'm realising that a lot of time, the health care providers haven't an idea what to look for, if it's a gradual onset.
2) At some point--I think I was a grad student, maybe 21 or 22, but still under the Air Force's health insurance, I was having pain and numbness in my wrist. I thought perhaps, due to all the typing I was doing for school, I had carpal tunnel. Oh, no. It was probably tendonitis, they said. But it didn't go away. Then they checked me for rheumatoid arthritis. I asked if I needed to go to a specialist, but they had one who came in a couple of times a week, and he diagnosed me with fibromyalgia and gave me a brace to wear at night, thinking that I was clenching my fist in my sleep and causing the issue with my wrist.
Fast forward to today, after years of not being able to feel much in my hands and not thinking much about it. My hand would go numb and my handwriting illegible after about a page. Typing helped, and I tried to use wristpads and other ergonomic aids, but I'd drop things, especially holding a can of pop. It would get a little better if I stretched my shoulders, but the reprieve would last maybe 15 minutes at best. Lately, the numbness was turning over to pain, shooting up to my elbows and even shoulders. During the move, a friend had to massage my hands just so I could drive. So, it was time to go back and see what was really going on. Dr N immediately set up a neurology consult, and that was yesterday.
They did a nerve conduction test (shock you with a current, which feels like being snapped with rubber bands) and an EMG (sticking needles into the muscle and gauging the response), both of which sound worse than they were. The verdict? Severe carpal tunnel in my right wrist with moderate to severe carpal tunnel in my left. Bracing may help, but more likely I'm looking at surgery. The doctor actually indicated the nerve in the right was basically crushed (I don't know if that means squished by the tendon, so it would be okay once released, or if there's permanent damage.)
They didn't specifically dismiss the fibromyalgia diagnosis, but made it clear that the earlier consult missed the boat in terms of my wrists. Meanwhile, because of several bouts of dizziness and several falls in the last few months coupled with the fact that fibromyalgia symptoms can be the same as neurological ones, I'm going to have an MRI next Monday. On the one hand, that's interesting and I'd like to see what my brain is like. On the other, I'm a little scared.
In the meantime, the shocks yesterday caused a flare-up of the pain in my wrists (I guess it mimics overworking them), and so I checked with work to see if they would be willing to get me some ergonomic wrist gloves to better brace them. Virtually everything I do at work uses the movements that are bad for carpal tunnel--typing, shelving, adding copying paper, etc. Things are so tight I can't afford even $30 for the gloves. So, I was happy when they went ahead and approved the order. A friend congratulated me, saying that years ago I wouldn't have even asked them to cover it because I wouldn't want to be a bother, whereas now it just seems natural to do so--it's a cheap accomodation, I need it to do my work (I realise I've been putting off some of the arranging tasks because of the pain), and since they cut my hours (and therefore my pay) I can't afford them myself. It seemed logical. But here's to not being afraid to speak up.
Which brings me to this--doctors know a lot, and often they're right on track. But ultimately you are responsible for getting them to listen. I've long had a reputation as a hypochondriac, although everything I ever thought I had turned out to be true. Yes, I do sometimes dwell on my issues (and I used to get into the, 'poor me, aren't I special?' madness you see some people do), but they are real, and it's good to have some verification, even though it's frustrating to. Why don't medical people realise that you are the one person on the planet who is an expert on your body and how you feel?
Okay, I've typed enough for now, must check my laundry.
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