medical substitute teacher
Dec. 28th, 2019 02:57 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
scrubjayspeaks[Content warning: under the cut is doctor fuckery, mentions of fat shaming/diet talk, and chronic illness. Anyone who hasn't been following along with my medical drama of the last three almost four! years can safely skip this garbage update. Otherwise, come enjoy a rant, I guess?]
So because of various scheduling-related shenanigans, I had a follow-up appointment with my rheumatologist yesterday which was actually conducted by the nurse practitioner who deals with his other office*. Which is to say, she's never met me before and can't remember what she read in my chart as compared to what's in the charts of an unknown number of other patients she was seeing that day. And hey, I get it: being the substitute teacher is hard, yo.
But goddamn, she earned my ire all on her own.
One of the first things she says is, well, you know you don't have lupus. Which is funny, because it says I have lupus on my charts at multiple doctors. But I guess that's just the Dumb Patient version--on the secret, real charts, it must say something else?
(SHOW ME THE FORBIDDEN MEDICAL CHARTS)
That's her opening gambit, though: informing me, with a certain amount of condescension, that I don't have the thing I was diagnosed with and am being successfully medicated for**. What even is the correct response to that?
O...kay? Why do you say that? Well, lupus would be affecting...your organs? Uh-huh, and will you be inquiring after the state of my internal organs at any point to determine if they've been impacted? No? Do you...have any suggestions for alternatives? Oh, no, I have no idea. Neither does the doctor. No idea what's wrong with you. Just...you're very sure it's not the thing he diagnosed me with. Right.
This is probably peak chronic illness life, and so maybe most people won't get this, but all I can say is: *insert me hunched over my diagnosis like a dragon with a particularly sickly and weird hoard*
DON'T TOUCH MY DIAGNOSIS
DO YOU KNOW HOW MANY AGES OF MEN IT TOOK TO COLLECT THIS
I AM FIRE AND DESTRUCTION AND AN ELEVEN ON THE PAIN SCALE
(Damn, now I'm sorry I never got the chance to commission that concept from iguanamouth for their Dragons With Unusual Hoards series.)
It's just...I don't think these doctors understand the sheer panic they are capable of inducing in their patients by saying this shit. Three years it took me to even get to this level of certainty, and I'm aware that three years is an absolutely trivial amount of time compared to how long some people search and fight for a diagnosis and treatment.
I will be only too happy to accept some other diagnosis if anyone figures out a more fitting one. In the meantime, though? You will pry lupus out of my cold, dead (alarmingly swollen, numb, blue) hands. Like, seriously, fuck you. You can't have this one back until you offer in exchange a disease of equal or greater value.
Now, here's the fun bit: I'm not sure she was really saying this to ME. Insofar as...she straight-up misquoted every stat from my previous bloodwork. Your ANA is normal, but you have an elevated [something else I can't remember the name of exactly]. No, actually, my ANA ratio is 1:320, compared to a normal value of less than 1:40, while that other thing is fine. WHAT ARE YOU TALKING ABOUT, MA'AM? So I'm even less inclined to release my deathgrip on lupus, if that's her level of understanding about my circumstances. Someone else on their client list, perhaps, does not have lupus, but god only knows who, because she can't remember which charts she was looking at.
Instead, she got all worked up that I might have precursors to rheumatoid arthritis. (I...don't really have any symptoms of that, which we sort of...walked through during the appointment. She seemed disappointed that I didn't fit the profile after all.) And that I'm fat, which is Secretly The Reason For Everything.
And finally, she informed me that I'll need a knee replacement eventually and my thyroid is definitely going to go bad on me. Which. Okay, again? I mean, I chewed the knee up twice, in two totally different ways, by falling off horses. My knee's been fucked since I was 19--I'm sort of resigned to it at this point. It's really the least of my problems when it comes to chronic pain. But when you say, hey, it might be forty years from now but it'll definitely have to go...it starts to seem less like helpful medical advice and more like smug catastrophizing. Like, put that crystal ball away, ma'am, you don't know how to operate one.
As for the thyroid? All I can say is, I want to put her and my GP in a room together. Because I told him the same thing--my thyroid antibodies are through the roof, so it seems likely that it's going to become a problem--and he told me, oh no, that's not a sure thing at all, we'll just test it periodically. So now I want a cage fight between these fuckers.
Actually, I would like to set up cage fights between any and all doctors. "There's nothing wrong with you that a diet won't fix" versus "your body is a timebomb" in a knock-down drag-out match. May the best diagnostician win! GO GO GO!
This post is just chaos. I hate seeing doctors. Still have bronchitis, btw. Fuck.
*She is covering for the doctor in part because he is Older Than Dirt and wants to retire. Which is why, after this, my appointments with him are going to become exponentially more inconvenient as he cuts back on his office hours.
**Autoimmune disorders are a messy, incestuous bunch, so I understand the need to take that evidence with a grain of salt. I might be responding to treatment for lupus just because whatever I really have overlaps with lupus enough to get caught in the net of that medication. That's fine. Whatever.
So because of various scheduling-related shenanigans, I had a follow-up appointment with my rheumatologist yesterday which was actually conducted by the nurse practitioner who deals with his other office*. Which is to say, she's never met me before and can't remember what she read in my chart as compared to what's in the charts of an unknown number of other patients she was seeing that day. And hey, I get it: being the substitute teacher is hard, yo.
But goddamn, she earned my ire all on her own.
One of the first things she says is, well, you know you don't have lupus. Which is funny, because it says I have lupus on my charts at multiple doctors. But I guess that's just the Dumb Patient version--on the secret, real charts, it must say something else?
(SHOW ME THE FORBIDDEN MEDICAL CHARTS)
That's her opening gambit, though: informing me, with a certain amount of condescension, that I don't have the thing I was diagnosed with and am being successfully medicated for**. What even is the correct response to that?
O...kay? Why do you say that? Well, lupus would be affecting...your organs? Uh-huh, and will you be inquiring after the state of my internal organs at any point to determine if they've been impacted? No? Do you...have any suggestions for alternatives? Oh, no, I have no idea. Neither does the doctor. No idea what's wrong with you. Just...you're very sure it's not the thing he diagnosed me with. Right.
This is probably peak chronic illness life, and so maybe most people won't get this, but all I can say is: *insert me hunched over my diagnosis like a dragon with a particularly sickly and weird hoard*
DON'T TOUCH MY DIAGNOSIS
DO YOU KNOW HOW MANY AGES OF MEN IT TOOK TO COLLECT THIS
I AM FIRE AND DESTRUCTION AND AN ELEVEN ON THE PAIN SCALE
(Damn, now I'm sorry I never got the chance to commission that concept from iguanamouth for their Dragons With Unusual Hoards series.)
It's just...I don't think these doctors understand the sheer panic they are capable of inducing in their patients by saying this shit. Three years it took me to even get to this level of certainty, and I'm aware that three years is an absolutely trivial amount of time compared to how long some people search and fight for a diagnosis and treatment.
I will be only too happy to accept some other diagnosis if anyone figures out a more fitting one. In the meantime, though? You will pry lupus out of my cold, dead (alarmingly swollen, numb, blue) hands. Like, seriously, fuck you. You can't have this one back until you offer in exchange a disease of equal or greater value.
Now, here's the fun bit: I'm not sure she was really saying this to ME. Insofar as...she straight-up misquoted every stat from my previous bloodwork. Your ANA is normal, but you have an elevated [something else I can't remember the name of exactly]. No, actually, my ANA ratio is 1:320, compared to a normal value of less than 1:40, while that other thing is fine. WHAT ARE YOU TALKING ABOUT, MA'AM? So I'm even less inclined to release my deathgrip on lupus, if that's her level of understanding about my circumstances. Someone else on their client list, perhaps, does not have lupus, but god only knows who, because she can't remember which charts she was looking at.
Instead, she got all worked up that I might have precursors to rheumatoid arthritis. (I...don't really have any symptoms of that, which we sort of...walked through during the appointment. She seemed disappointed that I didn't fit the profile after all.) And that I'm fat, which is Secretly The Reason For Everything.
And finally, she informed me that I'll need a knee replacement eventually and my thyroid is definitely going to go bad on me. Which. Okay, again? I mean, I chewed the knee up twice, in two totally different ways, by falling off horses. My knee's been fucked since I was 19--I'm sort of resigned to it at this point. It's really the least of my problems when it comes to chronic pain. But when you say, hey, it might be forty years from now but it'll definitely have to go...it starts to seem less like helpful medical advice and more like smug catastrophizing. Like, put that crystal ball away, ma'am, you don't know how to operate one.
As for the thyroid? All I can say is, I want to put her and my GP in a room together. Because I told him the same thing--my thyroid antibodies are through the roof, so it seems likely that it's going to become a problem--and he told me, oh no, that's not a sure thing at all, we'll just test it periodically. So now I want a cage fight between these fuckers.
Actually, I would like to set up cage fights between any and all doctors. "There's nothing wrong with you that a diet won't fix" versus "your body is a timebomb" in a knock-down drag-out match. May the best diagnostician win! GO GO GO!
This post is just chaos. I hate seeing doctors. Still have bronchitis, btw. Fuck.
*She is covering for the doctor in part because he is Older Than Dirt and wants to retire. Which is why, after this, my appointments with him are going to become exponentially more inconvenient as he cuts back on his office hours.
**Autoimmune disorders are a messy, incestuous bunch, so I understand the need to take that evidence with a grain of salt. I might be responding to treatment for lupus just because whatever I really have overlaps with lupus enough to get caught in the net of that medication. That's fine. Whatever.
