modern medicine thoughts

Posted: March 20, 2017 in Uncategorized

There are good and bad things about growing up in a small town/rural area; one of the big blessings from it for me was having a small-town doctor.  While I had a few different docs from age zero to 40-ish (one retired during my childhood, when I got married the first time I changed from “my” family doctor to “his” much nicer one, and later I changed to a local clinic doctor who would see me at 7:30 AM so I didn’t have to miss work), the consistency of my medical care over most of my life was a wondrous thing, which I didn’t understand or really appreciate until my choice to move away from that rural setting eventually demanded a change.

For awhile I drove back from my home in the Quad Cities to my small-town clinic when I needed medical care.  It seemed silly to drive 45 minutes each way to do this (and ironic, as I knew so many people from that town drove 45 minutes each way to get to the Quad Cities to see non-small-town doctors!) but the business of finding a new doctor was daunting.  Too much “adulting” for me.  I just kept putting it off.  I asked my favorite nurse practitioner at that clinic how I was supposed to find a doctor, now that I had moved.  He advised me to visit the emergency room of my nearest hospital during off-peak hours and ask the nurses, who would tell me “which ones were not assholes.”  It sounded like a smart plan, but you know, I’m an introvert.  I didn’t do it.

Then I moved to Chicago, and finding a doctor was a non issue.  No income, no insurance, and I’m a tiny dot in the sea of humanity in one of the world’s biggest cities?  Yeah, I can’t navigate that.  When I ended up too sick avoid seeking medical treatment, I had my own Cook County Hospital adventure, which gave me a new perspective on healthcare and poverty – but that’s a blog – or a book! – for another day.

When I moved back  to the Quad Cities and immediately had severe fatigue issues that were sending me home to go to bed for the night as early as 3 PM some days, my boss sent me to HIS doctor, who got me through that passage, but I didn’t end up making that doctor mine, so I was still just kind of out there floating.  I had discovered Express Care, which would see me without an appointment during regular business hours.  Maybe I didn’t NEED a “regular” doctor.  Maybe this was enough to meet my healthcare needs for now.

The docs at the Express Care did not like my stance on this.  They probed me each time I was in their office on this subject.  “You need to have your own physician.”  I ignored this, since they had no power to enforce it.

Getting married changed my attitude.  Now it wasn’t MY OWN health about which I was thinking/refusing to think.  Now my concern was G.  I work with seniors.  I know that almost without exception, the men die first.  I got this amazing man so late in life, and I want to maximize the window of our time together.  I need him healthy.  I knew he’d basically never had decent health care to speak of in his 46 years of life, and I worried about what might be going on, undetected, in his body.  Very soon after we married, with the help of the docs at the Express Care I found a medical practice in the area that was accepting patients and signed us both up – a female doc for me and a male doc for G, both in the same office.  I can’t describe to you how responsible and very adult I felt, that day when we walked in together for our first annual physicals with our new docs.

All of the above is just background info to my point for today, which is the strange arrangement of my healthcare “package” as it exists.  I’ve been thinking about it almost round-the-clock this last week or so of being sick.  I have 3 separate medical/health solutions in my life right now.

Once upon a time, my “regular” doctor’s office would have been at the center of that, at least.  But I can’t see my “regular” doctor on less than 2 months’ notice.  So she’s not really “my doctor” in the way I want.  She is the lady who sees me once a year for the annual physical.  She orders expensive testing like mammograms and colonoscopies and full blood panels.  No matter what I tell her about how I’m feeling/problems I am having – arthritis that won’t let me up out of my chair, fatigue that won’t let me function normally in life, whatever – she tells me basically that I’ll have to live with it.  She’s a very pretty young doctor and is super smiley, warm and nice while she sends me back out into the world, unhelped, but at least thoroughly tested for cancer.  I have come to see her as my “cancer detection” doctor, since I can’t see that she has concern about anything else for me, and I assume if cancer ever turns up, she will promptly send me somewhere else to manage that.  She is not going to enjoy my next annual physical, in which I am going to tell her about how I tried to leave her this past year but couldn’t find an MD functional medicine practitioner who is on my insurance plan, but how a wonderful chiropractor is solving all the problems she has so smilingly dismissed these last couple of years.  I’m going to have that hard conversation because she owed me better than I’ve gotten, and she needs to be a better doctor going forward, and how can she get better if no one points these things out?

The second part of my health solution strategy is that Express Care.  I really appreciate those folks.  Being seen without an appointment has helped me to not miss work on many occasions.  They are friendly and nice and the place is clean.  They are part of the same mammoth hospital system as my “regular” doc, so my health information is passed easily between those two offices.  The only bummer for me is that I’ve come to see Express Care as sort of a prescription-writing vending machine.  No health solution is almost ever discussed there except what scrips are being written – I am told basically here are your symptoms, so here are your scrips and sent on my way (though there was one exception around this time last year, when the doc there gave me some pretty severe resting instructions while drawing a Sharpie circle around my infection and ordering me to get myself directly to the ER if the infection got outside the circle).

And then there is the wonderful new third part of my health solution strategy – my chiropractor/functional health practitioner.  We’ve only been at it for less than six months, but she is actually helping me.  Actually addressing my issues.  Bringing my arthritis pain down so I can exercise again.  Reducing my fatigue so I can function like a normal human being on 8 hours of sleep, not 10.  Changing my monthly menstrual cycle from a tornado I could barely get through to a minor inconvenience – the thing it was B.K. (Before Kids).  Taking my PMS that left me feeling massive sensory overload/ready to murder the world 1-3 days a month and just lifting it away – gone – POOF – no more PMS!  Blowing away my mental fog, returning me to clarity.  You understand, I didn’t even ASK her about any of these things except the fatigue.  I had no expectation any of the other stuff would/could ever change.  It just keeps happening.

I can’t help but note the difference in how I am seen.  At the first two places, it’s an in-and-out as quickly as possible deal, and I know why.  I work in health care.  I read industry stuff almost every day of my life, thanks to my boss.  I know the pressures that are driving those docs to see me quickly and to get me well on as little funding as possible.

Then there’s my chiro.  I had to fill out a nearly 30-page background on my health before we could even start.  She performed a 1.5 hour interview with me on our first meeting, going over that document and asking question after question to pull more information out.  Before I see her for our regular appointments, I have to fill out and turn in a health update with her – it’s like 4 pages or something – describing in detail how I’ve been, which symptoms are better/worse and by what degree, and including exactly everything I have eaten for the past two days as well.  The document also pushes me to ask her questions.  We spend my appointments going over my answers, with her asking question after question and making copious notes as I talk.

She doesn’t only look at my symptoms.  We talk about stress management, exercise, diet.  She skillfully coaches me on my attitudes and assumptions.  As she makes her supplement recommendations for me, she talks through each one – what is in it, why that is appropriate for me, what I can expect from it.  She directs me to documentation to back up everything she says.  Invariably as she looks at what I have eaten in the past two days, she sees changes I need to make and she communicates those clearly.

In between appointments, I can email her as often as needed and she always answers quickly.  She supplies web links for further study as she answers my questions.  When I got home from the Express Care this past Friday morning with my pile of scrips, I emailed her immediately and she was quick to adjust some of my supplements accordingly, and to send me more tips for getting through.

The bummer about my chiro is she’s not on my insurance – she doesn’t DO insurance, preferring to invest her time in clients rather than fighting about funds.  She spells out up front in the first, free appointment what her time costs and the ways that she will work to reduce cost on supplements.  I know what it costs to see her, and what it costs to have a phone appointment with her by 15-minute increments, and that the emails are free, no matter how many.  I know what it costs to have her read labs, even.  She’s not cheap.  We are middle income (at the “middle” of the middle) people, and it takes some intention for us to manage the cost.  My supplements that are changing my life are $6 a day – while I’ve never been a smoker, for years I’ve wondered how people who smoke a pack a day come up with the money to do that, and now I’m figuring it out daily for a way better reason.  $6 a day for supplements, plus the cost of our appointments.  It’s not thousands of dollars, but it’s somewhere between most and all of our margin much of the time.  G and I both consider my return to health to be worth the cost, and we live inside the luxury and privilege of being able to make such a choice – a point for which I never fail to be grateful.

The supplements she’s giving me are all natural stuff from a highly reputable company.  Plants.  I read the documentation on them and I feel sorry for all the ladies across history who knew about which flowers and plants helped cure with things and got called “witches” doing “magic” because of it.  These plants are giving my life back to me.  My chiro would I think for sure have been called a witch in dark days past.

At this point I’m not ready to just kick traditional medicine to the curb.  It helps me.  It bailed me out of not breathing on Friday morning, and that was a big deal.  I just think if we did a whole lot more of what my chiro is doing, we’d overall be so much healthier that it would change the way the rest of medicine would work.  I think it would bring costs down and rescue people from the cycle of taking a medicine for their illness, and then a medicine to deal with the side effects of their medicine, and then another medicine to deal with the side effects from that one, ad nauseam.  I think while $6 a day is a lot of money for some of us, it’s not much money compared to some of the scrips people are figuring out how to pay for so that they can live.

So for me, I’ll keep cobbling these three pieces together, because I am DONE being a passive consumer, where it comes to my health care.  I will be seen, I will be heard, I will NOT be dismissed and sent on my way, told that I “just have to live with” something.  I THOUGHT it wasn’t true, and I was right.

Something to chew on, if you’re being told you have to “just live with” whatever is dragging you down.

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