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10 August 2005 @ 02:16 am
hiding from the doctor  
I have a doctor's appointment this week. I've been avoiding going in for awhile now. My acupuncturist had to pressure me to go see him at all. She wants me to talk about headaches. Everytime I do talk to him about headaches we go around in a circle, it's frustrating and we don't seem to solve anything.

I can't take migraine meds because of my heart.

I can't take ibuprofen and similar anti-inflammatories because of my stomach (and there's some risk to heart patients too).

Tylenol does nothing and is hard on my liver, not good while I take statins.

Vicodin sucks. Well, the doctor doesn't say this, vicodin is what he offers me, but it has tylenol and spaces me out and slows down my digestive system in an unpleasant way (how's that for a euphemism). I take it when I'm desperate but only then.

Plus I live in mortal fear of the rebound effect (for any pain med) as I once experienced it and never want to go there again.

We have about 15 minutes to discuss this in a regular visit. That's never enough time, really. My TCM doc knows a ton more about my health, dietary habits and other physical quirks than my primary doc will ever know.

I'm trying to prioritize what I want to talk about. Now that my headaches have gone from a winter phenomenon to a daily thing, on top of the fatigue, I really need some answers (although Paula Kamen says there aren't any, according to experts she interviewed). I at least want a better system of management.

A.) Are my medications either together or separately contributing to my headaches? (TCM doc's question.)

B.) Can I take feverfew with my daily aspirin and get checked for clotting speed or should I take it instead of the daily aspirin? I'd like to try it for my headaches and it thins the blood.

C.) Topamax was suggested by neurologist but I was afraid to start it because of the side effect of raising pressure in the eyes--I'm at risk of glaucoma already. Is it safe to try and can we monitor it closely? Alternately, anti-depressants have helped some, but I understand chronic headache patients need to ramp up very, very gradually, perhaps with a liquid version.

D.) Should I have more iron infusions? I really can't tolerate iron supplements, believe me I tried.

E.) Fatigue is not just anemia or sleep apnea, we already ruled out heart disease first off in '03, is it time to consider chronic fatigue syndrome? It would also account for my memory and attention problems. That syndrome is also being associated with chronic daily headache as a co-morbidity (along with things like depression, fibromyalgia, irritable bowel syndrom, and others).

F.) Yes I gained my weight back--solve the fatigue and headaches and I can exercise again and lose it.

G.) Was I supposed to follow up with Dr. H?

That's like 2 minutes a question!

So I am dropping off a packet of info the day before and this list of questions the day before in the hopes we might have a more productive appointment. Because my memory and focus are impaired now, I'll bring a tape recorder to the appointment as well.

I hope this time we can come up with a plan of sorts. And I wish the system allowed for longer, more personal communication between doctors and patients and not this rushed thing. I always leave knowing I forgot something I should have told my doctor--or feeling like he didn't have time to truly hear me.

Sorry for this depressing, venting post, but this represents what chronic illness is like. I find that lately I'm avoiding people because I feel like I will just be a downer.

edited to add:

I ran across a good guide for preparing to see a doctor:

http://www.theacpa.org/hg_01.asp?id=73
 
 
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