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On How My Relationship With A Doctor Taught Me To Be A Better Patient

August 2, 2011

I have always been one of those people who has felt myself fairly invincible. I managed to make it through my childhood and most of my young adult years with infrequent bouts of illness and only a couple incidents of semi-serious injuries. I hated being sick, hated going to the doctor if I did not have to. If I went, it was because I was seriously ill, something like strep. I was all about powering through being sick and injured, pain is weakness leaving the body. So even when I was sick or injured, I would often be going on like life was normal because I hated being sick and chafed at being restricted in my activities.

Then I went to Iraq and the combination of combat boots, body armor, running with both of those on over rocks and uneven ground, thinking I was super woman and having an irresponsible gym partner who loaded me up with too heavy weights and refused to let me quit even when I literally could not do another rep safely left me with patellar femoral syndrome in my left knee and my shoulder muscles fused to my back muscles. In true military style, I was diagnosed with patellar femoral syndrom in my knee, given Motrin (then Naproxen when the Motrin did not work), told to Rest Ice Compress and Elevate it, then left to my own devices. I was frustrated and continued to push myself every time I felt good enough to do so. The pain was annoying and getting in the way of everything I felt I needed to accomplish.

By the time I got back to the States a couple months later, I was barely functional. My pain was keeping me from sleeping, my posture was atrocious, it didn’t matter if I was sitting idly or actively exercising because the pain didn’t go away. I went to the doctor and got my knee X-rayed, nothing. They told me to wear a neoprene knee brace, whatever temporary benefit I got from it went away when my pain levels shot up the second it came off. I got sent to physical therapy, where they gave me a list of stretches to do and told me to come back a few weeks later, no change. I saw a doctor who tried to imply that my knee pain was either being faked or was a symptom of the depression I was being treated for, then put me in a hip to ankle immobility brace and told me to leave. I was angry, I felt blown off, I didn’t know what to do. I was tired of being told that Vitamin M, as Motrin is often called because of the frequency it is given out, and stretching would cure my woes.
I made an appointment with a massage therapist to get my back worked on at a Massage Envy that was about an hour and a half drive from my home. I went there because of my previous good experiences with the chain and their membership benefits worked out well with my probability of being deployed. It was there that I was told about my muscles being fused and had a wonderful woman dedicate multiple hours to restoring normal functionality and flexibility to my back. The difference after the first visit was so noticeable I wanted to cry and inspired me to have her work on my leg at a later session.
The first time the masseuse I was seeing worked on my knee and leg, she did more in that two hours than a half dozen trained medical professionals had managed in several months – I walked out of the room pain free. The issue, she said, seemed to be in the IT band – the muscles that run from my knee to my hip across the front of my leg. To me, it didn’t matter so much what the issue was, I was practically floating from ecstasy. I was pain free. I was normal again. Life was prefect. I went to navy Day Ball that night and was practically glowing I was so happy.
The bliss lasted for a couple weeks before the pain came back with a vengeance. This time, it was here to stay and not even the magical fingers of my massage goddess could chase it away for long, if at all. Back I went to medical, where I was sent for an MRI. Once again, nothing. The massages kept me going for a while, but deployment time came and I found myself on a ship, facing three flights of ladderwells (stairs for you non-nautically-inclined folk) every time I wanted to go from my workspace or berthing to the galley. The pain which had been kept at a moderate level skyrocketed again. Being stubborn, I powered through it. Military medical has a reputation for a reason and I didn’t see how anyone on a ship could help me if the docs with more resources on shore couldn’t do anything for me.
Wog Day came and in the aftermath I got strep. Or laryngitis, it doesn’t really matter which. I went down to medical the first morning I realized I was getting what I thought was strep and asked to get treated. They did a rapid strep culture, which came back negative. I told the Corpsman I was seeing that I usually came back from rapid strep negative, even when I actually have strep. It didn’t matter though, I was told I probably had a virus, given Motrin, Tylenol and throat lozenges and told to try salt water gargles. Two days later I was back in medical because I had gotten progressively worse. My throat was so swollen I couldn’t eat and the pain was so bad I was sitting in my office crying. Honestly, I think it scared my coworkers because I’m not the type to show any level of emotional vulnerability in public. The Doctor I saw told me that it was a virus, refused to rapid strep test me again, upped my doses of Motrin and Tylenol and told me it would be 10-14 days before I could expect to get better.
I was distraught. I could not imagine surviving another 10-14 days when the last four had already been so miserable I couldn’t eat or sleep. The next day I went to the Admiral’s Staff Doctor and asked him if there was anything he could do. When he told me that based off the information he had from medical, he was going to have to concur with their diagnoses and treatment, I stormed out of his office crying. About 15 minutes later, he called my office. “It seemed like you were not exactly pleased with our conversation earlier…” He told me to meet him down in the main medical spaces. When I got down there, he said “So-and-so is going to make sure you get taken care of” then left.
Into the tiny office where I sat walked a gorgeous specimen of the male species with a fantastically charming smile. What? I was sick, not dead. I have to admit being not particularly friendly as he asked me what was wrong and got the full brunt of my wrath at no one believing me that I had strep and dismissing the fact that I was legitimately sick and miserable. Without even batting an eyelash he calmly said “you’ve been sick for how many days and no one has given you antibiotics yet?” I growled at him and he appeared unaffected as he documented my knee issues and asked if there was anything else wrong with me before leaving to get the doc to sign off on a treatment for me. When he came back into the room he told me that I was being given more painkillers to include lidocaine, more throat lozenges and then he paused.
In that moment where I was sure I was about to be summarily dismissed again, I gave him the scathing stare that would render him in a pile of ash on the floor if I were a deity of such talents. Then he grinned and told me that I would also be getting an antibiotic and my both relieved and exceptionally annoyed “Finally! Thank you!” seemed to amuse him even further.
I had just gotten heckled by a Corpsman while I was sick. What a jerk! I couldn’t stop smiling. His exceptionally timed poke at me caught me off guard and showed me a little bit of the human who was stuck dealing with a cranky patient who thought she knew everything and wanted to be fixed RIGHT NOW. He took care of me, put me in my place and made me smile. Well-played good sir.
The next morning was my birthday and I woke up and was practically bouncing off the walls because I had been cured of the plague. I both wrote and email and walked back down into the medical spaces to see my hero and profusely thank him for taking care of me. The message I got back heckled me a bit further, but also included a line telling me that he had arranged for me to have an appointment with the physical therapist for my knee. I was floored. A Corpsman who gave a shit about patients existed. Who knew?!
My hero is what the Navy calls an Independent Duty Corpsman or IDC for short. The job is difficult to explain, but I find the best way to sum it up is to call them the gods of the Navy medical world. They’re masters of their trade and the recognized experts in their field. I got referred to him because he’s the person who handles business and always puts the well-being of patients first, while ensuring that the fakers and troublemakers get appropriately handled. I’ve watched him drop everything he was doing from eating to working out to being in the middle of teaching to run from one end of the ship to the other to take care of a medical emergency. I’ve seen him give up sleep for days at a time to care for a patient. And yet he maintains a level of humility about his own awesomeness that is rather endearing, even when I want to smack him for being too modest.
We clicked as friends immediately and I was adopted into an eclectic circle of people who made up the medical department of the ship. My appointment with the PT (Physical Therapist) resulted in me being ordered to ice three times a day and stretch more, a prescription for a daily therapeutic dose of Mobic and follow-up appointments to get the soft tissue in my knee ground out with an implement we fondly referred to as “the evil metal death tool”. I began spending a lot of time in the medical spaces, first as a patient, then even more as my friendships with the staff developed. I ended up being around them so much that many other members of the ship thought that I was also a Corpsman, a fact that the other docs found hilarious and gleefully perpetuated.
Our friendship brought a lot of laughter and joy into my life. You know those people who connect instantly and can banter and follow each other’s though trains while everyone else stand there in awe? Yeah, we were those obnoxious people. We ended up becoming gym partners which was a mixed bag of tricks for me to deal with. On the one hand, I was getting an incredible workout with someone I enjoyed being around who was responsible and actually good at working out properly and encouraging me to do so. On the other hand, I got an earful when I went off the Mobic and wasn’t icing regularly enough and started limping when the pain flared back up.
Allow me to take a moment to clarify that I am a terrible, horrendous patient. I can whiney, irritable, bossy, demanding, a bit of a know-it-all, I have no patience for stupidity or rudeness, I’m stubborn as hell and I have a tendency to ignore the doctor’s orders if I don’t agree with them or am feeling better. When I am sick or in pain or miserable, I’m a royal pain in the ass to deal with. I do manage most of the time to be polite or seethe quietly, it depends on how I’m treated. The Mobic took enough of the pain away that I would feel better enough to be less careful. I would push myself, then pay for it when the painkilling properties wore off. As I have a high tolerance to painkillers to begin with, it would happen fairly quickly. The icing was something I ended up not maintaining very well because my work interfered with having time to ice three times a day. I know, it’s about taking care of me, doesn’t mean I’m always very good at it. If nothing else, he heckled me enough to keep me honest. I had to learn how to say I wasn’t okay and needed to take it easy. I’m stubborn and loathe admitting to weaknesses, especially to people who would play doctor every time I started having issues.
One annoying tactic he would use to try to get me to stick to my treatment recommendations was to pull the doctor card, sit with another Corpsman friend of ours who made up the third leg of our gym partner triangle and they would discuss in medical terms the causes for my limping and how it probably affected my other leg and back. This would piss me off and generally result in something being thrown in their general direction. For as much as he insists that he isn’t that smart, when he kicks into doc mode, it’s a whole different ballgame. For me, deconflicting between the friend I adore and the doctor who’s trying to care for the difficult patient often drives me insane. I want to listen because I respect him. I want to tell him to fuck off because there’s nothing he can do to help me.
The time I spent with the man gave me a profound understanding, respect and appreciation for the doctor. He’s very proud of his job and takes his duties to help those in need very seriously. His compassion and patience are without limits for those who deserve it and his justice for those who try to play the system or are unnecessarily rude and poorly behaved is swift and effective. With his guidance I learned technical things like how to draw blood. But the harder lessons took more time and bricks to sink in.
The ship had a blood drive toward the end of our trip and I spent a lot of time loudly proclaiming how I wasn’t going to do it because I couldn’t, I didn’t weigh enough. The truth of the matter is, I was petrified of giving blood. I hate needles, a fact that raises a lot of questions when people see my pierced and tattooed body. I also have had one too many bad experiences with getting my blood drawn for regular medical tests that a prolonged draw petrified me. However, I’ve always wanted to donate and admitting that I was scared was sort of pathetic, so I always hid behind my weight. Then I watched him donate and come do a crazy workout with us at the gym that same night. What an idiot move! But the stupidity put me in the mental predicament of being dared to go donate myself. If my hero over there could do it, why was I being such a ‘fraidy puss? So that last day of donations, I manned up and opened a vein for the cause. I was terrified, practically shaking as I waited for the needle to slide in. Once they hooked me up, I was fine and the process went smoothly. Afterward, I was a jackass and was up moving around, grabbing water for other donators, walking and talking to people. I was feeling great! Well, until I got woozy, almost passed out and puked. I was discreet and no one really noticed. I sat down for a while and started feeling better. He walked in with our gym parter and they started talking to me about my experience, just in time for me to get woozy again. Seconds before I passed out, they had me laying down on a cot, laughing at me. Jerks. Can’t say that I didn’t deserve it, but I was obscenely embarrassed for being the weak link. Sorry to say that it wasn’t the last time I would be a stubborn ass about following doctor’s orders.
My knee issues continued to get worse. Even with icing and physical therapy and the evil metal death tool, my pain was going up, not down. I was quietly despairing that nothing that could be done was going to help me get better. He quietly issued me another prescription for Tramadol, a drug I’d been prescribed before but had learned the hard way was not effective when taken at the same time as another medication I had been on. Tramadol is a one-step-below-narcotic painkiller and it made it possible for me to sleep when my pain spiked beyond levels I could tolerate. When I got off the ship, I went to get more massage treatments, had acupuncture done, stretched, ran, iced and even asked a civilian friend of a friend who is a physical therapist for her recommendation. Besides working on my posture, it was another statement that I needed more physical therapy. Dejected, I went back to quietly tolerating being in pain. The physical therapy department had already blown me off, when the stretches and exercises they gave me to do didn’t work, I was essentially told “oh, that sucks” and never given another appointment. When everything I’ve been given to try to rehabilitate my knee, the braces, the exercises, all of it, when nothing seems to work or makes the pain worse, how am I supposed to be motivated to continue on? I gave up and resigned myself to being in pain while often laying in bed at night unable to sleep, crying because I just wanted not to hurt anymore.
What finally drove home the point that I need to make a better consistent effort for my own sake actually happened after I left the ship. Iraq had given me another parting gift besides the physical injuries, I have been chronically ill since I left there. Burn pit exposure has caused me to have recurring sinus infections, laryngitis, etc. My immune system took a beating I can’t seem to recover from. This meant that several months after I left the ship, I got the flu for the first time in years. Before you ask, yes I got my flu shot. I was bedridden and miserable. While many people offered their condolences, it was what he said that meant the most to me. For some reason, being told the ways that he would care for me, hold me, comfort me, take care of me, was music to my ears. It was more than feeling bad that I felt bad, it was action to do something about it. He’s done it every time I’ve been sick or hurt and the novelty hasn’t faded yet, most likely because I know it’s a genuine statement. The demonstration of his character has proven it to be true.
How then can I continue to dismiss the treatments that have been recommended to me, when this person cares enough to keep encouraging me to get better?
There’s a request for another MRI for my knee waiting for me to act on it. His doing. Magical prescription refills. His doing. Flowers and phone calls when I need them the most. Absolutely his doing. I’ve had more than one person who has stepped up to encourage me to try rehabilitation again, sharing their stories of how it does hurt, but it does get better. Facing more pain scares me, I don’t know how much more of it I can tolerate. I don’t know if living like this for the rest of my life scares me more or not, it is a miserable existence, but when you get used to being in pain, change is scarier than the familiar. At least with the familiar, I know it won’t get worse. A few days ago, I went to have a massage done for the first time in several months and the resulting flare up in my leg left me unable to walk without excruciating pain. It was then I had to face how bad “normal” had gotten. My pain levels had been elevated, the pain had been spreading to my hip, ankle and foot, there had been other symptoms of concern like numbness in my toes. This was not okay to live with anymore. I went to the urgent care and was gifted to a refill of my long-empty Tramadol prescription and made an appointment to get evaluated for physical therapy again. Since then, I’ve been wearing my knee brace during work, because the boots aggravate my knee immensely. I’m taking the Tramadol when I need it and I’m making an effort to stretch and ice more, as well as avoiding doing activities that I want to do but shouldn’t because I know it’s going to make my knee worse. I’m still stubborn and could be doing more, but I’m trying.
If you hadn’t figured out in my long rambling story that I’m rather enamored with this man, let me say now that I definitely am. His genuinely is one of the kindest, most caring, most compassionate people I know. He goes out of his way to bring laughter to everyone around him. He’s a healer in the truest form, working not just on the physical body, but the mind and soul as well. I’m blessed to have a doc in my pocket who is so exceptionally pleased to be there and look forward to the day I get to have him in my life for longer than the moments we can steal.
We live in an era where the internet can provide knowledge to anyone about anything and while this makes us better informed, it also leaves untrained people self-diagnosing. While I’m not advocating that a patient be ignorant, give your doctor a chance to his/her job. This person is a trained professional, sometimes that means knowing what s/he is talking about. If you don’t like what you hear, you have a right to a second opinion. Doctors are humans, just like the rest of us. They are not infallible, but they do the best they can with what they are given. If we make an effort to be better patients and work with them, maybe, just maybe, we can actually get the results we are working for. Find a doctor you love and let that person know that you love him/her. They definitely don’t hear the words “thank you” anywhere near enough.
I love you Doc, you’re my fucking hero and a god among men. I’m still not the best patient in the world and I doubt that I ever will be, because hey, between me and WebMD we know everything. *winks* But with my goal to get myself pain free in the next year, I guess I better get to working on that.
Until next time,
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