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Chronic Snarkopolist: The Snarkopolist Way – Strategies For Positive Doctor Patient Relationships
Hello my libertines!
I am pleased to report that my gall bladder and small intestine peeping surgery went well and I’m recovering quite nicely. Friday I have my final pooper surgery from Doc McHotterson and hope this is the last and final of them. Thank you ever so much for your loving words and your show of support!
Meanwhile- I got some requests to give you something in this weeks’ column and I’m so thrilled by this!! I want this to be OUR column. If you ask, you shall receive – and I’m a generous snarkopolist – so I will cover you in chocolate sauce too – with whipped cream and a cherry to boot! I love requests! Ask away!! This week I was asked about my views on maintaining good doctor patient relationships based on a discussion with another member.
I have a multi-sided view of medical and hospital and sickness life because my mother worked in a hospital all her life and I grew up in a “hospital household.” (Insert strong accent) “Leenda – if Melissa doesn’t stop playing in the pathology lab we will have ruined specimens – please ask her to go to the morgue where she cannot hurt anything. She may roll around on the free gurneys down there and I will give her my orange for behaving.” So I know exactly what and how most hospital workers feel about patients. I have also gotten to know many doctors professionally in my line of work when I was counseling people in their loss and grieving processes – and I know how some doctors feel about their sick and dying patients. And I am a chronically ill patient who is sick as fuck right now – and I know how I personally act and feel as a patient. I’m often a patient advocate.
From these multiple perspectives I can tell you that the PATIENT – especially the chronically ill patient who is road weary, often fearful, tearful, tired, worn out and broke – is NOT the center of the universe… and yet often wants and DEMANDS to be seen that way.
THINGS I HAVE LEARNED
POINT 1: Remember – YOU are the CEO of your own body. You make wise decisions in PARTNERSHIP with your doctor. Doctors won’t save you or rescue you without YOU to participate in your healthcare plans. Be your own hero and SHOW UP for yourself.
Point 2: Your doctors MUST work well with other doctors. If your doctors don’t play well with others – you can get sicker and dead. Nip that EGO COMPLEX shit in the bud.
POINT 3: Be good to the office staff and nurses and they will move the sun, moon, and stars for you.
POINT 4: DO NOT BE A WHINEY LITTLE WHORE
You know how you want to pimp slap kids who whine and tune out that grating voice? I KNOW we’re in pain and we hurt… I know we’re tired. Tell your doctors one too many times and they will medically pimp slap you by shutting down faster than my original iPhone battery.
Point 5: THE HUG FACTOR – I won’t go to any doctor who won’t hug me within six months. I can tell if they are open hearted and compassionate. If they are burnt out and compassion weary – I do not bother. I NEED LOVING KINDNESS.
POINT 6: THE CRY FACTOR – I won’t go to any doctor who won’t let me cry in front of them. They don’t need to fawn all over me – but they don’t go running for the nurse either. My rheumatologist says, “This is the place for tears – and a safe place for the crap you’re dealing with.” And then we move on. I never feel judged nor do I feel that the doctor is vomiting lunch in their throat because I cry. Tears are as big a part of healing as laughter.
POINT 7: THE LAUGH FACTOR – I won’t go to any doctor who won’t laugh with me. I prefer one who finds me fiendishly hilarious and loves me but I will settle for some laughs. I want them to see me as a human and part of my humanity is that I have a sense of humor.
POINT 8: THE HOMEWORK FACTOR – (I’m flexible about this) I prefer my doctors to answer their cell phones and tell their kids to do their homework in the middle of my visit. This happens perhaps 1/8 of the time. Many of my doctors are so comfortable with me will they do this. I’m a long-term patient. I’m there for life. I NEED this flexibility. We let our hair down together. I CRAVE THIS. I CRAVE not being medicalized. I WANT them to lecture their kids in front of me. It humanizes the doctors and it makes me feel safer and humanized. If this would freak you out – then I’m sure it would never happen but it leads to my next point.
POINT 9: DOCTORS ARE HUMAN – They have feelings, relationship problems, their spouses cheat. Their kids get sick and fight. They sometimes can’t FIND a partner because they spent all that time in med school. Some of them ARE BROKE if they can’t get good jobs. The highest number of involuntary virgins are female med school grads (not men, OF COURSE- grrrr – thanks double standard). So – doctors are HUMAN.
And after YOU are done and gone home – DOCTORS OFTEN – FREQUENTLY are either ON CALL or they go to the local HOSPITAL and do ROUNDS – meaning they have to deal with people like US – the chronically ill who are lying in our beds waiting for them to come with their capes and make us feel better – SAVE OUR LIVES EVEN.
My neurologist came to see me at 10pm one night AND SAVED MY LIFE- boom JUST LIKE THAT. Another surgeon performed a last minute surgery one night at 9 pm. They both had a home and families to go to. They put ME FIRST. (Go back to NOT BEING A WHINEY LITTLE WHORE. They are tired too. Neither one of them told me how tired they were. They just did their jobs and performed minor miracles. No whining.)
Doctors often have their critically ill patients being admitted to the hospital in between each patient they see every day. They are often HEART SICK because each day or each week they are watching us DIE and they cannot save us. This is especially true with oncologists and rheumatolotists and cardiologists. WE WILL NOT BE SAVED AS OFTEN AS THEY WANT. No no. We insist on our kidney failure and our intestinal infections going septic and our six weeks of full system shutdown and DEATH. And they watch it on their ROUNDS. And they are HEARTSICK. And they go to the office and see each of US and know full well how sick we are and are not.
So when you go in with your JOINT PAIN and INFLAMATION and complain that they DO NOT UNDERSTAND – they do. THEY DO UNDERSTAND AND THEY SEE IT EVERY DAY – MULTIPLE TIMES PER DAY. But they know that you are not CRITICALLY ILL. They just looked at death in the face and YOU are NOT it. They forget how to have compassion because you’re being a stompy little brat. And it is EASY to forget that PAIN is real. So here’s the deal.
POINT 10: MAKE EMERGENCY PLANS & PAIN MANAGEMENT STRATEGIES WITH YOUR DOCTOR.
They will love you like a whore loves a balmy Saturday night. Really. If YOU take control and say, “I need a code yellow for when I start to get too intense to avoid the ER – what about 20 darvocets and 20 klonopin and if I use them up I will check back with you to reassess this pain management but it will keep me out of the ER.” They will probably kiss you full mouth – WITH TONGUE.
Do this with pain management. You can either request a pain management doctor who will give you smack OR my rheumatologist and I just sign for the junk right in her office and I do my best not to become a street pro for the stuff. Get it. That is what they are afraid of. People OD. People die. People become addicted. This shit is real. I know you have pain. Pain is part of life. The point here is that THERE CAN BE PAIN WITHOUT SUFFERING.
Don’t think you can hoover increasing doses of dilaudid and oxy for the rest of your life. You’ll kill your liver, grow dependent, and you’ll become resistant to the pain meds and when you REALLY NEED THEM post surgically and have REAL LIFE PAIN you’ll be sad like a whore. Your doctor knows this.
LEARN ALTERNATIVE METHODS TO DEALING WITH YOUR PAIN. Be willing. And tell your doctor what you are doing to deal. And build trust. And they will give you more smack for your pain. See. Happy dance and happy pills! *confetti*
POINT 11: HANDLING A SOUR RELATIONSHIP WITH A DOCTOR – Be the bigger person. If it is too far gone, you need to leave. Especially if the doctor is abusive or YOU have fucked up so badly and your apology isn’t being heard – walk. Have you apologized?
I once forgave a doctor for missing an important (life altering) test and the next time we met we were like timba style best friends for life- BFF’s. She whipped out a pen knife and made me her blood sister. Only because I said, “Hey- we all fuck up- please don’t kill me next time ok.” And she was happy to not get sued and happy that I TRUSTED HER enough to try again. And she was a good doc. It was merely an oversight and she was busy and overworked. Before that – we were just people who stared at each other and mumbled about test results.
Remember – doctors are human. They can be shitty humans or fabulous or in between. Try to find the awesome sauce ones and stick with them for life. BE THE BIGGER PERSON. Your doctor is too tired to do it. Help them get it up. It isn’t fair – do it anyway. If they still suck – WALK. Get a referral from them or another doctor to a GOOD SPECIALIST IN THAT AREA. And then go BE ON YOUR BEST BEHAVIOR and use the Snarkopolist Methods to building a good relationship. You can do it!
[If something REALLY AGGREGIOUS HAPPENED you can contact their chief of staff or the AMA but this is probably stupid and not going to help you. You can also sue them, but again, usually stupid unless it is REALLY HORRIFIC. (If they killed you by shanking you maliciously or neglectfully in the jugular– please by all means –some doctors suck so hard they NEED to be kicked in the junk- most of them will never be taken to task- it is easier to avoid them by GOOD REFERRALS. If you TRULY have found yourself in this situation I’m sorry. Deal accordingly but I’m TOTALLY gonna have to snark you to my good friends in the law field –your’re out of my league).]
POINT 12: IF ALL YOUR DOCTORS SUCK – IT IS YOU. NOT THEM. GET HELP.
POINT 13: DO NOT FLIRT WITH YOUR DOCTOR –don’t dig through their trash, don’t flash them your junk, they’re not into you. Honest. You are a slab of meat to them. Sorry. They have to shut it off – they just do. Nothing personal. It is their job. Move on. If you want to say THANK YOU – do it with a note and keep it short and simple. (If you’re wealthy – send food – they love food and the whole office will blow you next time you come in).
POINT 14: YOU DON’T NEED A DIAGNOSIS TO GET GOOD TREATMENT
Most chronic illnesses especially of the autoimmune variety begin with the words, “unknown etiology” for several years. This does not mean your doctor does not believe you. It just means that the illness has not come all the way to it horrific beady eyed fruition. Your doctor SHOULD be giving you the very best treatment possible even without a diagnosis. Diagnoses make people FEEL BETTER but they do not stop you from being sick. Lately I blow off new diagnoses from doctors – I am over diagnosed and over sick. I DON’T NEED YOUR DIAGNOSIS – they are just more words – just give me some treatments yo. Diagnoses make insurance companies happier than they make me. I just want to FEEL BETTER. Learn to be zen about the diagnosis.
POINT 15: BE YOUR WALKING MEDICAL DICTIONARY OF YOU – Carry all of your doctors names and numbers, your allergies and medications and pressing medical information with you.
POINT 16: THE DOUBLE DATE – Always try to take a friend or spouse along on a first date with a new doctor. A good doctor LISTENS before anything else but it goes better when there is someone else in the room. On a new patient meet and greet there should be time for this. Your backup partner is there so you don’t forget anything and to give you some support and to legitimize you as someone who actually HAS FRIENDS. Once you have established yourself you can go alone. While this is not always possible- it is always preferable.
POINT 17: YOU ARE NOT YOUR ILLNESSES – You can have sickness without your sickness having you. Keep your personality from becoming corrupted by illness. I’ve seen too many “new” chronically ill patients almost fall in love and marry their illness they are so enchanted by the newness of it and ATTACHED to the having of it. And they want to BLAME their entire loss and life on it. If you get sucked into it – you can almost blame everything about you on your “condition” and then you forget who YOU ARE. It is almost easier of you have MULTIPLE illnesses because your illnesses are so complex you have NO ONE and EVERTHING to blame. Sicknesses are everywhere but they are NOT ME. Do NOT BECOME SICK – be a person who has sickness as part of your life. There is nothing more sad or lonely than someone who has nothing more than a list of symptoms as friends.
POINT 18: OUR DOCTORS LOVE AND HATE US THE SAME WAY WE LOVE AND HATE THEM – They laugh at some of us and love some of us just as we adore them and despise some of them.
POINT 19: BECAUSE WE ARE CHRONICALLY ILL WE WILL HAVE MORE GOOD AND BAD MEDICAL EXPERIENCES- This is not your fault.
POINT 20: SNARKOPOLIZE YOUR WAY TO BETTER MEDICAL TREATMENT – when in doubt always trust your guts and always use honesty, integrity and love. Do not be guided by fear, bitterness, or anger no matter how easy it is as a chronically ill patient. If you have been mistreated it becomes too easy to think it will always happen. BECOME YOUR OWN ADVOCATE but do not become a bully. SMILE. LOVE. BE GENEROUS WITH YOUR KINDNESS.
I see doctors as human and I view some of them as monsters. I feel a strong sense of responsibility to talk about this today even though it is not as pro-patient as I normally feel I am – I see far too many whiney patients who make it bad for the rest of us and too many people who abuse the doctors and their staff members- once again – making it difficult for the rest of us to get the loving TLC that we want. And trust me – you WANT a good nurse on your side. My rheumatology nurse is my gem and I love her and I know she adores me. We have a connection. And I NEED THAT FROM HER. She has moved mountains and stopped the sun with her bare hands for me. I have been kept alive more often than I have been harshly treated by the medical profession. And I have been monsterously treated more than I care to tell you.
So—Any new questions? Is this old news? I’ve never been sucker punched by a doctor before but I’ve had the best and worst experiences as a patient.
Dish my loves! What do you want to talk about? Regale me with your stories or questions. I’ll snarkopolize you more. Dish me on what you want to talk about! Tell me what you think! Is this YOUR experience? Am I full of shit? What’s the haps in those hot little heads of yours? Tell! I gotta know. I adore you like whipped cream loves my face!
Reach me at melissa@dearthyroid.org or make your lovely voices heard on the comments below. I’ll be seeing you next week! Same time same place! Kisses!
Tags: building doctor patient relationships, Chronic Autoimmune Conditions, Chronic Snarkopolist, chronic surgeries, communicating with doctors, managing chronic conditions, medical issues, medical treatments, multiple autoimmune disorders management
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27 Responses to “Chronic Snarkopolist: The Snarkopolist Way – Strategies For Positive Doctor Patient Relationships”
Leave a Reply to Amanda
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I Love This.
Melissa–
First things first–I’m SO glad your gall bladder and small intestine surgery went well. I hope your pooper surgery goes just as well and I hope this is the end of the pooper issues.
Now, onto your article. 🙂 LOVE it so much. You truly have a good perspective on the doctor-patient relationship and I thank you for sharing it with us.
It’s too easy to slip into the thought process that doctors know all and can heal all. It’s just not true. Like you say, they are human. I feel fortunate to have found a wonderful endocrinologist on the first try. That said, I still had to figure out how to best interact with him. It’s like any other relationship–it takes effort on both sides of the table.
I could go on and on, but you’ve already said it better than I could ever hope to, so thank you for these wonderful nuggets of wisdom.
xoxo,
Joanna
Melissa,
You crack me up! If you were not still recovering, I would invite you out for half priced margaritas! : )
My husband and I always talk about how we each go into our appointments (I with thyroid cancer and he with melanoma) wanting the staff to like us. Have them leave the room giggling or at least with a smile on their faces. They will remember that good feeling and in turn remember you in a good way. It’s a big world out there with a lot of sick people. It feels good to be the individual they look forward to seeing in the office rather than that crazy chick the nurses are cringing about while pulling straws out to see who “has” to take back to the room.
Humor has been our only way to keep us going through the rough patches we have had to deal with. I know it will get him through my surgery next week, and me through the recovery. We also just discussed making sure that my endo is on board with what exactly I need out of her office after the surgery. So we have our plan and will see if we need to “walk” after next week…Let’s hope we can get her on our side, I think it is a good place for anyone to be. I have only met her twice and she has told me nothing of what to expect…but thankfully I have done research, and have found this gem of a site to help us both through.
Thanks for your post, thanks for your rawness, and happy healthy thoughts are being sent your way.
Cheers!
: ) Molly
Melly Mel,
So pleased to hear that your op was successful and trust that you are recovering well.
Some of the things you say i can relate to like having a good relationship with the receptionist crack a joke even when you feel like shit I know all the Nurses in my practice after all they were taking my blood 3-4 times a week.
It’s a shame I cant say the same for some of the Dr’s in my practise even my own. Don’t get me wrong he’s good at what he does, but when it comes to thyroid he’s full of shit. I have to disagree with some of your points,WHY is it our faults if they fail to diagnose you when you present them with your symptoms surely the first port of call would be to do a full blood analysis checking thyroid function not just dismissing things as either Hormonal or a virus.
I don’t mean to sound harsh but i am going to speak my mind anyway because I know you just wouldn’t have it any other way. But when you have chronic illnesses,in most cases you tend to get more one on one care build up a good rapour/relationship with a compassionate doctor surgeon gyn who ever is treating you they have to work together for your whole being but put thyroid into the equation and i don’t mean thyroid cancer but Autoimmune and your fucked. They don’t understand it, hey your Symptoms are not thyroid related because your fucking TSH is good. FT3 isn’t important, just keep taking the pills. Now I’m going to be a whiny fucking whore I’ve tried the other way tried to be nice,but my patience is running thin. Especially when nearly everyone you see dismisses your symptoms what you got to do to get heard walk a round with a dick on your head and say you got a fucking hard growth,
Autoimmune thyroid diseases, can effect your whole being mind body and I ain’t got a soul but my heart. Not to mention the physical sign of eye disease. We may not be as important as someone who has cancer and I understand that but doesn’t mean to say we are fucked up too.
You gave some great pointers which I have done for some years and that is take someone with me for my first maybe second appointment sonmeone to job my already failing memory if i forget to say somethibng never mind a long list you forget to take with you anyway, I try keeping it simple because they just don’t have time to go through every aspect of your symptoms.
Getting off now beofr I say too much, I do recent it when though when we are told we are to blame for the Docotr relationship problems. I had a bruilliant docotr when I first move here I loved him then he left to emigrate and I was left with a next to useless one chasnged and well I still havnlt found that right one for me.It just seems to be getting harder and harder.
Thanks for your great column and I hope you don’t mind me voicing my opinion cus I’m going to anyway.Good luck with your next surgery seems lime a weekly thing I do hope that you can get some rspite from it so your body has time to recover the the aneastia and surgery.
BTW I soent 20 year working along side doctors some good some bad I know they are human and I know I shouldn’t be so anal but sometimes I just wanna fucking Scream at them for Fucks sake just take the time to listen for once in your life.
sending healing vibes your way
Lolly
Hear, hear!
I love this post, Melissa. I am as patient-centric as the next chronically ill patient here, but sometimes we fall into the trap of passing the buck, playing the blame game. Most doctors are decent (good, even) people, most of them do not want to f*ck up at our expense. Keeping perspective, while educating and advocating for ourselves is imperative.
As for support staff, you don’t even have to woo them with food or money bribes. Sadly, they are so often scowled and growled at that a simple sincere smile and greeting, eye contact, “please” and “thank you” and “How are YOU?” goes a really long way. If you have a history of at least appearing like you give-a-shit to the support staff, they will be in your corner.
Hi Melissa,
First, so happy that your surgery went well and good luck with the next. I will be thinking positive thoughts for you!
You are too funny and I agree with almost everything you said. All very valid points but like anything there is always an exception to the rule.
The exception for me is Point 3 relating to office staff. There are definately lovely people out there that have been nothing but wonderful to me. I am an extremely nice person who always empathizes with people in any job and generally can get most anyone to laugh or at least smile. Nevertheless, I still had an ongoing awful experience with the gatekeeper from hell. I could go on and on about incident after incident with her and her awful self but I still have anxiety ridden visions of her in my head so I’m not going there, lol. I will say that I let her bully me for years and I’m no pushover, I can’t even figure out why I let her treat me the way she did.
If you have no empathy you don’t belong in the medical field, especially as a receptionist. If you become hardened and don’t give a fuck about anyone, you need to move on. Personally I think she knows where all the dead bodies are buried and that is why she is still there. I’m not a violent person but if I was I would not think twice about kicking her ass. Seems I was not the only one who thought so, a friend is a visiting nurse and she heard numerous horror stories about her from her patients.
After all is said and done she is one of the reasons I finally left them and I am in better hands now so maybe I should be thankful.
Yikes, that felt good.
Thanks again and good luck with your next surgery sweetie 🙂
Hey Melly,
As I have mentioned in many of my past columns, I am priviledged to have found good doctors. That said, I have also been faced with inhumane and rather cruel abd rude doctors and receptionists. Sadly, I can’t say that in my experience most doctors are good, decent people, but I know that some of them are. I strongly believe in treating people as you expect to be treated, so I meet a new doctor with courtesy, consideration and respect, but sometimes that just doesn’t work if the doctor is not the right one for me.
I have felt it important in past columns to highlight the negative experiences that some thyroid patients go through with their doctors because we shouldn’t sweep these under the carpet and we need to speak out in order to raise awareness and improve things. However, I am very happy that you have turned it around and looked at things from the doctor’s perspective. I always remember with both my doctors that they can have their off days (and indeed they do) because they are only human and I try not to take this personally despite the fact that I can be quite sensitive to things like this. In a recent appointment we had with our PCP, he was a bit short with both of us, but we discussed it afterwards and came to the conclusion that he was just having a long day. He works very hard and even on Saturdays!
Because of my perseverance with my gyno, who behaved like an insulting prick at first, I now have a great relationship with a doctor who cares about me. I try and look beyond the person and see whether or not the doctor has good intentions and a good heart. I have come across doctors who are sheerly in it for the money (a past dentist of mine who tried to pressure me to have some treatment I did not need despite the fact that I have near perfect teeth that every other dentist waxes lyrical about), I have come across doctors who are tactless and demeaning (gynos who have made hurtful comments about my weight, but didn’t seem interested in figuring out why I wasn’t as skinny as they expected me to be) and I have come across doctors who are patronising and can’t deal with the fact that I know my shit as I make it my business to do all my research.
My current PCP was VERY grateful that I brought in a list of symptoms and medical history for both Corey and I. I bring him in research and recently figured out how to get hold of NDT here in Germany so that he could prescribe it. Let me tell you, he was very happy as this means he can hopefully prescribe it to more of his patients. He likes the fact that I am well versed in thyroid disease and what is going on with my body and I feel as if both my gyno and PCP have grown to respect me more because of this. My PCP is very happy that I am involved in DT and actually asked me to attend a thyroid conference where he will be giving a talk, so I can perhaps help other patients who need support.
You are so right – like all people, doctors are only human! If they consistently behave tactlessly, patronisingly and disrespectfully, however, I prefer to terminate the relationship and change doctors because I do expect to be treated like a partner instead of being talked down to.
One last thing I wanted to mention is the issues I have recently been having with one of my gyno’s receptionists. When I met her, she was friendly and supportive, but recently I have witnessed how she has been very rude not just to me, but to other patients for no apparent reason. I have come to the conclusion that she may be having some kind of issues (possibly hormonal, as I already know she suffers from hypothyroidism) and I am being as polite and kind to her as possible because I know deep down that she has a good heart. That is more than I can say for other receptionists I have met who were consistently rude and hurtful and it’s difficult to give those people the benefit of the doubt.
It’s funny you should mention crying and hugging. With my first thyroid doc, I burst into tears as I was so frustrated and despairing with her failing to listen to me and telling me that a TSH of 1.6 was fine and that I was cured when I was still sleeping for hours at a time. She didn’t even have any damn tissues in her office, which in my opinion is the least a doctor should have. I didn’t expect any comfort, but a tissue would have been nicer than having to try and dry my eyes with my fingers.
On one of our first appointments, my weight-obsessed gyno made me cry as he made a very cruel comment about my weight. If you know my history, you will know that I have been subjected to years of cruel comments due to my thyroid-induced weight gain as I was no longer the Size 6 that people knew and had instead turned into a curvier 12/14. This means I am VERY sensitive on this topic – after all, my own freaking family were the worst when it came to making cruel comments and if you can’t get acceptance from them, who can you feel accepted by? Anyhow, my gyno has a history of having hissy fits and is well known with his office staff and patients for being snappy and moody. He misunderstood me defending myself. I won’t tolerate being told the way I eat is the cause of my weight gain as that is incredibly presumptious. Anyway, he laid into me, shouted at me at the top of his voice and made me cry. He felt so bad afterwards that he apologised with soft words and gave me a hug. I forgave him because I understand how he ticks and I also understand how much he cares and you know what? Since that time, he hasn’t ever snapped again. It’s as if with that experience I pressed a magic button and caused him to treat me more kindly. He knows also what hell I have been through with past gynecologists – he said it himself – and I appreciate him for understanding that and for being kind to me. We need kindness from our doctors and they need kindness back from us!
Besides, anyone who is big enough to apologise for being mean, insulting or rude earns extra points in my book anyway as I am used to people here trampling on my feelings and it often seems like an apology is a rare thing to the point where I am shocked when I actually get one. I don’t wish to generalise, but I have lived here for over 10 years and can tell you that Germany is not the most polite culture ever, particularly when it comes to customer service, so when I say I have been through shit, that is exactly what I mean. Being home in the UK or in the US can sometimes be a breath of fresh air because customer service is more evolved and people are often politer, but things are getting better and since we moved to Düsseldorf, things have been more tolerable as this is a more cosmopolitan city which caters more to the expectations of its expats. Despite living here so long, knowing the culture back to front and speaking the language fluently, this country still seems a culture shock to me at times. I think that the cultural aspect is probably something that affects the way doctors treat us in different countries and, as Christina and I discussed, patients here seem to kowtow more to authority and consequently to doctors. You need to get the balance right to get good treatment and that doesn’t involve kowtowing; it involves creating a partnership. As for Robyn’s comment on courtesy, eye contact and smiling: I couldn’t agree more. This is something I try to practice daily (not just with doctors and their assistants) and I have found that it is well received and that sometimes people are pleasantly surprised.
Love,
Sarah
Mellarella –
Excellent column. I love so many of the points you made. I am very glad that your surgery was a smashing rectal-success. This is great news.
We have to be our own advocates, period. So many points you made, I relate to, and a few I am guilty of. I appreciate that you took the time to highlight them.
I do think some doctors – the egregious sick fucks that have no business practicing medicine need to be sued or reported, because they shouldn’t be allowed to mis-practice medicine.
I need highly analytical, no bullshit, straight up, transparent doctors. I would much rather a doctor say “I don’t have the answer, Katie”, than lie to me. I need them to laugh at my jokes, and yes, most of them are inappropriate, so knowing that they’re a bit uncomfortable makes me feel better. IE: I know they want to laugh, but they’re not sure if they should.
My current shmendo I just started endo dating and we shall see. I love my integrative internist. She has the biggest stones I have ever seen in a medical professional. I love my Shrinktail because he’s the first doctor to ever advocate on my behalf. The fact that he’s easy on the eyes doesn’t suck. I LOVE our professional relationship and boundaries. This is important to me. I am a freak about crying in front of doctors. So much so, if I cry, I make them look away. Or I excuse myself.
My lady ball doctors are absolute pricks. HOWEVER, I don’t care. They’re so brilliant in GO, I’d be a schmucktard not to utilize their expertise.
Love the column, baby.
xo
I love point #2, about finding people who will play nice with others. I once had a surgeon and physical therapist who wouldn’t speak to each other, return each others phone calls, all that shit. I ended up in much more trouble than I should have because these two couldn’t have a simple conversation. I’m so grateful it was only pain and joint dysfunction and not liver failure or something- at least they didn’t have the power to kill me.
Haha – Amanda – thank you.
Dish up on more of your views. You’re a patient too!
x
Melissa
Dearest Joanna –
You rock my socks off! Thank you for the compliments! I am in NO WAY saying that we shouldn’t walk the fuck out if a doctor is mediocre or sucks. I just think patients too often go in thinking the doc must do ALL THE WORK. I like to think of my doc/patient relationships as similar to any relationship in life…
Meanwhile – YOU ARE A ROCKSTAR and I adore you and your column!
xo
Melissa
Hi Molly!
I am SO GLAD you are here too!
Thyca and melanoma are both big deals. I’m so glad you and hubs have each other. You sound terriffic. Good luck on your surgery and keep us apprised to your healing!! And come and tell me all about your views too!! I ADORE FEEDBACK. I want this column to be ours – not mine. 🙂
I’m rooting for you big big like honeycombs sister! I’m glad you use humor and the tag team double-date system as well.
Come back and tell me any troubles you have and any positives you experience and we’ll learn from you as well.
BIG STRONG HUGS.
xo
Melissa
Dear Lolly-Lol –
OH HOW I LOVE AND ADORE YOU. So hard. Big.
And I LOVE that you’re challenging me my sweets! I’m so NOT SAYING it is our faults EVER if an incompetent schmoe fails to diagnose us. Ever. EVER.
I’m going to give you an example of WHEN a doctor SHOULD diagnose us properly and when a doctor CANNOT.
Here: you go in with weight gain and lethergy. Your T3 and T4 are “high” but in “normal range” (as if normal means anything). They don’t arse themselves to take any anti-biodies to SEE if perhaps you have hashimotos. (Or if you are losing weight and have opposite land and cannot sleep etc etc to see if you have graves). You’re getting horrific constipation alternating with diarrhea, can’t get out of bed, cold all the time – can’t eat but are gaining weight faster than you can blink – they don’t BOTHER to do anything but tell you to stop hoovering food at the buffet – THAT IS THEIR FUCKING LAZY ASS PROBLEM.)
IF THEY did their job and did the peroxidase test and found out you were carrying antibodies they’d realize you had hashimotos. Then they’d be all – woah – yah – YOU CANNOT HELP THIS… then they’d check your thyroid and make sure you don’t also have thyca. And on and on … they can do MANY THINGS if they arse themselves. Make sure your androgen levels are ok, make sure your blood sugars are ok, and if you are dealing with OTHER auto-immune disorders – the medications you are on aren’t flipping on and off crazy triggers in your body. AND TALKING TO YOUR DOCS.
If your endo is being a lazy fucker AND YOU KNOW YOU HAVE THYROID ISSUES b/c it runs in your family – JUST WALK THE HELL OUT and get a new endo. SEE. Not. Your. Fault.
Different scenario:
I started having seizures for YEARS before I was diagnosed with lupus. YEARS. My doctor didn’t know WHY I was having it. It was “unknown etiology”… we didn’t know if it was MS or lupus or what. He put that it was PROBABLY an auto-immune disorder b/c of my SED rate and my positive ANA but I was not being seen by a good rheumatologist at the time.
The rheumy that did see me was a lazy ass fucktard who specialized in BLAMING HIS PATIENTS. He poked at my finger joints (seriously?) and said, “If you would take better care of yourself- you wouldn’t feel so bad) – and *I* walked out of the room. FUCK HIM.
See – so BEFORE I got a good diagnosis – I was STILL on anti-seizure medication because an EEG showed that I was having seizures.
By the time they diagnosed the lupus – I had seizures for several years. When the lupus hit my kidneys- it was an easier diagnosis. Make sense. But there ya go. The neurologist MADE A TREATMENT PLAN FOR ME – for choreia and seizures WITHOUT KNOWING why. No diagnosis.
Many many people with autoimmunity deal with unknowns for YEARS AND YEARS. And we del with shitty horrible pain and symptoms and equally shitty horrible doctors. I GET IT.
I’m in your corner sister. I’m NOT SAYING YOU’RE WRONG. I get you. I’m down.
I’m just saying – once you’re in the room – don’t start acting all huffy with a new doctor because of PAST EXPERIENCES. Because that dooms you to more of the same. That is all.
You are the apple of my eye.
Always and forever. I adore your outspokenness, your spirit, and your generous spirit. You’re a beautiful soul. Truly you are!!!
And NEVER LEAVE before you have “said too much” -holy crap loveliest thing — get back on here with your pokey fingers and SAY MORE MORE MORE. I CRAVE YOU. I love your words.
You are perfect.
xoxoxo
Melissa
Dearest Robyn,
Thank you for the compliments!! You are a treat!
Now – what I’d love to hear are some of your brave and courageous experiences!!
Dish out sister!
You are so right about not even having to bribe people. Jobs are soul-sucking day after day… and even being “pleasant” and not a surly sour pus can usually make sure we get decent treatment. (USUALLY).
xo
Melissa
Oh DAT –
that is horrific. Stories like dealing with mean caustic BULLIES make me what to SHANK PEOPLE in their HEADS.
You’re right — staying with a doctor who has a mean cunt in the front is too much. I would have probably talked to the doc or… left – just as you did!! I hate HATE dealing with shitty people. And YES YOU ARE RIGHT!!! There are exceptions to the rule!!!
In every incidence there are EXCEPTIONS. And yes you are right!! When I am making my points – I always want people to use their heads! If you know you did nothing wrong- get the fuck out. You do not have to stay in abusive situations where people are shitty to you. NEVER. EVER.
I’m so sorry you dealt with it too long. But – like rainbows and unicorns you ARE in a better situation. And – like 20-20 vision, you know better to NEVER EVER take that shit from anyone EVER AGAIN.
I’m glad you brought it up. Perhaps in another snarko piece I will use your advice and Lolly’s advice etc and put together the “exceptions to the rule” and remind people WHEN TO WALK. 🙂
biggest hugs and thank you for the good wishes on the surgery. I’m getting nervous!
xo
Melissa
Wow Sarah-
You definitely stand for WAY MORE SHIT than I would in a doctor or a receptionist!! I guess I’m far more intolerant. I suppose I MUST make another column called WHEN TO WALK OUT and it will called, “pretty much always”. lol
I’ve left 2/3 of every doctor I’ve gone to after an initial visit or 2 by getting the first impression of them and finding them TERRIBLE and their manner BAD. I like warm huggy comfortable laid back doctors. It takes a while to do that. But once I DO FIND THAT I keep getting referrals to the same kind of doctors OVER AND OVER AND OVER by my Internist WHO KNOWS ME AND LOVES ME and my neurologist – the same. The two of them have a good pulse on me. My rheumatologist is also a good bet. Between the 3 of them I feel SAFE finding a good match.
I have 11 specialists and so far I’ve been good at finding quality doctors. And they spend TIME WITH ME. I’m talking an hour per visit. They lavish me with attention and time.
If I get a specialist who whisks me in and out – I feel like they aren’t spending enough time – because I have a complex history.
And YES – FUCK THOSE ASSHATS who make you feel bad about your weight and don’t get to know the back story.
I’m appalled too at the horrific doctors. REALLY I AM.
I am GLAD you point out bad and terrible doctoring. I guess I should have been more honest about how long and hard I search for GOOD DOCTORS and how MUCH I fight to KEEP THEM my doctors once I find them. I do. Truly.
You are so so right about the lack of consideration and how many of them grow weary or were never good in the first place. WALK OUT. GET THE FUCK OUT.
I have literally gotten up in the middle of an initial visit and walked out BECAUSE I didn’t want to bother with the rest. If a doctor says to me, “I have only enough time to listen to one problem you have” I know they are not the doctor for me. If I bring in a list of issues (because I have a complex history) and they get antsy and worried – then I know they are not for me.
Honestly- You are so so insightful. So – perhaps I do need to make a shiny example of WHEN TO PULL THE PLUG AND HOW FAST YOU NEED TO PULL IT.
And omg – you make me want to come over there and put on shit kicking shoes and beat the fuck out of some of your past doctors!!! I’m so sorry you’ve been treated so badly. That’s like PTSD style terror!!
Imagine a doctor who doesn’t have TISSUE in their office. They KNOW they will be giving their patients bad news MANY times per day. How preposterous!
I hold many awful experiences as well. I do – truly I do. I just try not to let them corrupt NEW experiences with NEW doctors.
I can see that I must make a new column. 🙂
you are a fabulous and amazing and insightful chick. I adore you – tips to toes!!
xoxo
Melissa
Aloha Katie/Dear Thyroid –
Why thank you for the kind compliments and pooper greetings. I’m preparing for the last of it tomorrow! The time is nigh!
Yes – I agree – there are some ignorant fucktards out there. And NO ONE to really police them. And really awful doctors practice and GET AWAY WITH MURDER and good doctors often get sued for nothing. I hate it. There is no good balance out there.
And I adore your analytical straight up style docs – I like the “here’s your chicken soup come cuddle up Melissa” style doctors as well. I have found a variety of doctors work for me. What I DO NOT LIKE at all – are the doctors who tell me 200 things that CAN BE DONE but don’t ever really give me good sound advice. That makes me have to waste my time going to my other doctors and getting THEM to help me make sound medical decisions. It angers me. If you are my specialist – BE MY DOCTOR. Help me. I’m feeling weak and scared and confused. Stop scaring me more – you fucker.
Meanwhile – I have a few doctors who seem to enjoy scaring me. I’m learning how to eat fear for support lately and nibble fear’s heart for dessert. I have good doctors but they don’t all act like I want them to.
*whip crack* BEHAVE DOCTORS – CODDLE ME!
I love that you make your docs look away or you leave the room. And I will make them watch me cry… hahahaaaaaa. I LOVE THE DIVERSITY OF LIFE!!! spin world! spin! I have said the words, “Just sit there and let me cry- be the compassionate person you were before med school ruined you.” to a doctor before. I’M A CUNT LIKE THAT. (These are short term docs who are NOT comfortable with my jokes or my tears etc – but I need them for my quick fixing).
You are fabulous!!! FAB-U-LOUS!!! I adore you.
And love the site!
xo
Melissa
Hello Graves Situation!
yes indeedly – that is exactly what I’m talking about! Once when my kidneys were staring to blow – it could have been sepsis OR kidney failure OR a mere infection and several doctors (at least 3 and 2 surgeons) needed to privy to the situation.
They all had to PLAY NICE. They all had to talk to each other and do their best to keep me alive and not kill me dead. And they did it. Ultimately I was VERY involved too – and moved the ball along and was active in ensuring that I wasn’t dying of Dread Pirates Disease!
But importantly – If you have a doctor who doesn’t arse themselves to return calls or is “too busy” or KINGLIKE to kiss the rings of other doctors – FUCK THEM. Especially if you are chronically ill with multiple illnesses.
You need doctors who are respectful of your health and that means TAKING CARE OF YOU FIRST – not their egos!!
Rocking my socks off!!!
xo
Melissa
Hey Melissa,
Don’t get me wrong – I am not a walkover. However, I am good at reading people and differentiating between when someone is having a bad day and when someone is just a complete and utter twat and not worth my time and effort of getting to know them or persevering. This has really paid off in the past. For instance, I have a current customer who is now one of my best customers and now treats me with respect. At the start she didn’t, but she learned to respect me and it was worth the perseverance in my opinion.
I would also like to point out that as soon as doctors made nasty comments about my weight, I was out of there – I will not tolerate that. However, the one exception I made was with my current gyno. He made a mean comment, but apologised right afterwards and I could tell he really meant it. Furthermore, he is the best gyno I have ever had and the first gyno who has truly bothered to get to the bottom of my PCOS without making fun of me. His initial temper tantrum I forgive him because I am tough and used to people’s bad attitudes, quite simply because I have had to become very tough to live in Germany. People have been and are insanely rude and hurtful here, which is one of the reasons I cannot live here forever. I can tell you that many other expats feel the same way. You don’t know how great you have it in the US sometimes!
My main priority in a doctor is finding the best possible one to treat my condition. My gyno was and is and that is why I persevered. As I said, it paid off and now he respects me because he has reason to respect me as I do my research and know my body very well. We get on very well at present. However, as soon as I cotton on to the fact that a doctor is not going to help me, I am out of there as fast as you, but sometimes it really is worth investing the perseverance, the understanding and the patience and being able to read people is a really useful skill when it comes to this.
PS: Love and luck for your upcoming op!
Melissa, I “am” a patient, but one who currently can’t put a coherent sentence together. I do love the information you shared, and I have added it to my “stuff to take to the doctor” notebook. Point #3 is correct in theory, but having recently had a run in with an rude receptionist via telephone, I think that my usual “killing with kindness” just pissed her off more. Maybe she was having a bad day, I will find out when I meet her face to face. Honestly I don’t have much to share, never have really been sick until the past few months… I guess I just don’t know what to do and am hoping you all will come to the “endo” with me.
Wow – welcome to DT Amanda – hopefully the receptionist is nicer in person. *big hugs*
And – while you’re there – we’ve all got your back. Being sick sucks and being a NEWB to the sickness scene is scary.
I’m holding you big. E-mail me or twitter me for more TLC. I know what it is like to be a brand new sickness baby. It is easy for me, a wizened veteran to the chronic illness lifestyle to remember what it was like when I FIRST got sick.
Really- I have time for you on a more personal level if you e-mail me. melissa@dearthyroid.org Everyone here is sweet and calm and kind. We’ve alllll been down this path. There are many ins and outs to this. And you will have many questions. You never know what to expect AND being sick – you’re also not on top of your game.
This is the SHITTIEST part of being sick – YOU’RE NOT ON TOP OF YOUR GAME.
take care. I’m not kidding about the twitter or the e-mail. I’m always honestly happy to scoop people up and give them extra tlc. It makes me feel more necessary — especially because you’re new at the game.
big hugs.
x
Melissa
Sarah – yah – it IS more helpful if you’re good at reading people. For me I think it depends on the time of day and my moods if I’m good. I can get pretty snarky and demanding.
It is EASIER for me once I’m in an established relationship… for the NEW doctor visits those are THE SCARY ones for me. ugh.
Once I know and love and trust my docs – I am hunkering down with them. BFF’S FOREVAHHHH.
I’m probably far more of a “walkover” once I trust you than in the beginning. If you mess up AFTER we have an established relationship or have a bad day AFTER that – ugh. But in the beginning – if I’m on MY best behavior – I want YOU to be as well.
That’s how it works.
I think you and I are on the same page. And after reading YOUR stories I think I AM grateful to be in the U.S.
Thanks for giving me more things to be grateful for.
Sending you so much love that you “persevere” whilst in the Deuchland!!
♡
xo
Melissa
So, I have some time, and I wanted to share some “tips” based on my experience as a doctor (veterinarian) that is sort of on point to this post and commentary….
1. Regarding the receptionists/support staff: I know that frequently they are surly, particularly at the end of the day. And, at least at my office, they are “counseled” about it when we see it/hear about it. BUT, they take a lot of shit, too. All the complaints, all the issues, all the schedule conflicts, all the lost labs, etc. is put on them first. They get yelled at daily by unhappy clients, even if it was not their fault. This will put some of them on the defensive, and for many, this is a high-turnover job because they can’t deal with it.
So I reiterate my initial comment. Be genuinely nice to them. Smile, make small talk, remark about their pin or shoes or earrings without being too much of a chatty Kathy. Will this work 100% of the time? No. But I can’t tell you how many times a receptionist has said to me, “Mrs. Smith is so nice, we just love her.” That makes a difference to me before I even see them.
2.Nurses: Don’t be dismissive. Same general rules as for #1 apply. Most of them are quite highly trained–some of them know as much or more than the doctors. Get them to be your advocate by first acknowledging them (ie, don’t just sit there with your arm out for your BP and bark one-word answers to them), being kind and considerate, etc. Then ask about deeper stuff while they’re working–“How long have you been at this office?” “Is Dr. X in a good mood today?” “What’s your favorite part about this job?” Ask if they have a voice mail box for questions that they may be able to answer for you, or that they can approach the doctor with, etc.
If I get one of my nurses/techs coming to me to bring me into an appointment, and they tell me that the client would not really talk to them because they “weren’t the doctor”, or were rude or dismissive, or overly complaining off the bat about the wait time, or the need to spend money on a recheck or whatever, this makes a difference to me before I even see them. (I have no problem with complaints–in fact I have been lambasted the moment I walk in the room by some needing to get some perceived injustice off their chest–I find it best to let them speak their piece, acknowledge any fault/mistake/problem if present or explain why their “treatment failure” or wait time occurred, and then ask if we can come up with a resolution together so that it doesn’t happen again. Usually then we can both wipe the slate clean and get on with our current business). Leverage the nursing staff to work with you, don’t get them on your bad side.
3. Doctors: Well, can only speak for myself and a few colleagues that I know well. We talk. If you are rude, if you don’t let us finish talking, if you tell us the moment you walk in that we are the 5th doctor you’ve seen with Muffy because the rest of them were all stupid shits, if you want us to FIX this issue that has been going on for 3 weeks, but was an emergency right.this.minute, if you argue with our assessments (“Muffy is not fat!”), or if you tell us what we “should do” (“I just want antibiotics, I don’t want to spend money on any testing.”), we will most likely downshift into doing the bare bones, minimum, emotionally disengaged treatment from there on. It’s true–if you are gonna be surly, if you’re not going to listen to my opinion, etc., then I am going to basically become a robot–“OK then, here’s what I would do: X, Y, Z. Good luck.” You’ve lost me. I would never harm your pet, I would never intentionally deprive you of service, but you aren’t going to get my best, and you certainly aren’t going to get my above-and-beyond.
If you are engaging, if you are polite, if you are well informed without being preachy and accusatory (“Hey doc, I saw an article about this–do you know anything about it? Should be be considering this?”), if you are patient with a longer term treatment plan in difficult cases, if you are respectful that I was 30 minutes late to see you because a hit-by-car case came in just before your appointment, then you are going to get my best. I will work with you on alternatives when things don’t work according to plan or begin to get expensive, I will give you my cell # to call me day or night, I will consult with specialists on your behalf at no charge for my time, I will send you home with a free toy or product when you had to wait, and I will tell everyone in the office what a joy you are to work with!
I work part time presently, and for every 3-4 hours of appointments I see, I have roughly 1-2 hours of paperwork, phone calls, and follow up (for which we don’t get paid, since we’re not hourly). I have bad days when I’m not as “perky” and “on my game”. I try not to let that spill into my appointments–if you have a bad attitude too, it’s definitely harder. If you have a good attitude it can sometimes totally change my mood!
I’ve talked a lot about partnerships in the past and I really think we have to remember that the doctor/office is only half the equation. If we bring our best to our 50%, we run the better chance of getting the best from the doc’s 50%. If we don’t, we have no chance. If we do, and we still get “shafted”, then you can rest easy that it’s not you, it’s them, and you can move on with clear conscience!
Oh, and I’ve meant to say twice now–good luck on your surgery! Full steam ahead!
Melissa, I think we are on the same page, but I wanted to point out above that I am dealing with a different culture of people who are simply not always very easy to deal with. Many Germans I have known in the service industry (and that includes medical) don’t have time for empathy or politeness. Sad but true. I think it is more of a given that people are going to be polite in the US or the UK and an exception when they are not. That said, there are of course nice people, but I never expect it, which is why I am now usually on my guard when I have to deal with people here – also sad, but true. I give people the benefit of the doubt, but to some extent I know now that people may be nasty or rude to me because that is just the way they are sometimes. I am tired of dealing with nurses/receptionists who can’t even answer simple questions about the blood they are taking. There are obviously different standards in the US when it comes to that too because I have yet to come across any highly trained nurses/receptionists. On the plus side, I have health insurance that pays for much more than it would in the US and is also tons cheaper and I have two doctors who work together to proactively get me well. I even have their cell phone numbers for my efforts, but frankly I don’t like to use them because I think it is important to respect their personal time, so I’d only use their cells if it was absolutely necessary – it’s nice to have them though, isn’t it? When I came here, I was much more sensitive, but had to change my attitude somewhat in order to survive. It’s good training living in a foreign country, that’s for sure. One thing that I find works well with people in general is to ask them their name (if you are on that kind of informal level here) and use it with them to make them feel like a person. I don’t think many people bother to think of stuff like that. By all means, ask them how they are. As Robyn says, above many people seem to forget that medical office workers are people too. Well, they are and I think they appreciate you giving a shit. It makes you stand out from those who treat them like machines. I don’t hate Deutschland, but it is a challenge and culture shock for many expats I know as people here are much more direct and don’t always have time for niceties. However, I’m not one of those expats who doesn’t even try to fit in. I speak the language and I know the culture very well as I have dated many Germans, but I will never ever feel at home here, partly because some of the stuff I mentioned above.
Melly Mel,
Sorry I never got back to you yesterday computer was in for repair.Just got it back.
I hear you on what you are saying, I alwyas go in with a smile on my face and a warm greeting, I may sound like a hard bitch who is ready to punch someones lights out but in reality I am all bark is bigger than my bite.
I get on with al the receptionist I ageree with that one but your always going to get one who got out the bed the wrong end and fell on there fucking head or stubbed there toe, I alwys find the nurses pleasant pays to make friends and some of them are good friends having nursed myself for over 20 years my patienst loved me i had time inbetween jobs to talk to them cheer them up, everyione seems to be in a hurry these days no time to stop and chat or reassure a patient.
I know there are soem good docotrs probably endos’t out there few and far between I have had some rerally good ones in my time. and I know the one i have jsut been referred too is rweally lovely and i know I will feel at ease with uim because i went with my friend to see the same one. and he included me in the conversation had time to expelain everything about her test results prognosis and what they want to do next. Now just to get the appointment mioved forward as Urgent referral wantl urgent enough it will be nearly 12 weeks to see the specialist from intial referral and that wasn;t good enough so I went back to GP who wasn;t happy with it either so he has faxed them a more urgent appointment.
Oh meissa baby it seems every week you are having surgery how is your body coping you must have made soem friends among the medical profession because you#’re probably an old hand at this now and no doubt you have them pissing there pants with your great humour. I tend to crack a hjoke or tow to break the ice you can tell the oens who have a sense of humour to ones that don’t but if you can crack one smile bingo your in there kid and your able to converse. I do think however some docs have had a personality bypass and they no longer know how to smile or even show any fucking emotion they just go through the procedures they donlt like it when you no so much question there decison or even ask if they will try or do thios those are the docotors I find fucking annoying.
You got so much going on girl I iwnder how you cope sometimes, you’re a great addition to DT and you kmow your always going to get straight talking from me I donlt mince my words I may not have a way with word but I know what I want to say sometomes it don’t always come out like I want but i do get there in the end.
I hope this is your last surgery for awhile and you can start recovering from it all. sendign you the biggest softest gentlest hug donlt want to hurt you now and some healing ?vibes that your surgery will all run smoothly and your recovery well. do let us know how it goes wonlt you.
I agree with all you said to me and i know you what you mean now I know sometimes it can be donw to the patientbut then it cuits both ways if doctors knew how to get the best out there patients they wouldn;t just dismiss things and look further.
I love you too
Lollyxoxoxo