Doctors Not So Smart

Some of my experiences with the doctors I've seen, whether GPs or specialists ... they aren't that smart after all but they're a real disppointment having gone through years in medical school, seen countless patients and yet give me stupid answers.  Due to the mysterious nature of Fibro, I have learned but am still searching for answers.  Researchers have proven that Fibro is medically recognised although many doctors are still living in the dinosaur times.  As far as FMS and HepC is concerned, I have done my homework.  So don't ever test or challenge me.  Whenever I see a doctor, I would mention about my symptoms with the hope of an answer I want to hear something like ... "Ms, you have Fibro or FMS".   The very first Rheumatologist I consulted was a disappointment because after examined me, she said I have no auto-immune diseases, so the verdict is:

 

• "I have normal muscle aches too, so have the nurse here" (But are yours never-ending like mine and doesn't improve with rest?)
• "Everyone of us here feel hot and cold too" \Not fluctuating regularly like me)
• "We have a high temperature in the morning too" (Isn't our body temperature is lowest in the mornings??? doctor???)
• "We have night sweats too when the weather gets too warm" Do you drench EVERY night in your sleep, upon waking up EVERY morning???)
• "We feel tired all the time too"(Do you feel tired EVERY morning feels like you've been ran over by a truck the night before?)
 

The next Rheumatologist I saw from the same hospital I paid as a private patient did made my money worth.  At least he mentioned "Lady, you're having fibromyalgic pain, try Gabapentin for a start with physiotherapy".

 

I was referred to the Orthopaedic by the A & E doctor for Tendinitis.  I received no treatment nor advice.  All I got was a shock ... "this is Vasculitis, your hands are ischemic and you may need to medicate for life, you are referred to the Vascular surgeon".  The Vascular surgeon said to me:  "This is definitely NOT Vasculitis or Raynaud's, you need to see a Rheumatologist".  He scare the shit out of me because if ischemic is present, I can't start Hepatitis C treatment because the Interferon is heavy and may cause vasodilation/vasoconstriction issues.  I was so worried about this whole plan would have to be postponed until a much later date.

 

My Hep doctor also had me referred to a Rheumy in the same hospital.  Thought I was supposed to make sure that the coast is clear before starting the devilish treatment.  The appointment was dated in November 2012.  But he started my treatment in June.  So I had the Rheumy appointment brought forward to September.  It was a long wait and almost impossible to get an alternative date.  I thought this doctor must be popular and wonderful but it was another disappointment that I feel so hopeless about our local medical field.

 

She did some basic examination for Rheumatoid Arthritis (RA) asked the same questions for AI and said my symptoms are treatment-induced.  I guess she was not attentive enough when I did mentioned all my symptoms started long before starting treatment and I am so used to the discomfort and pain that I have forgotten what it is to feel normal.  Doctors usually are not attentive enough when patients start to talk.  They tend to miss out on the important points to note.  She was not at all satisfied to have such a patient like me asking too many questions and having her repeat the same answer which was:  "Its due to HepC that causes fatigue and HepC treatment causes aches and pains".  So EVERYTHING is due to HepC.  Nothing was mentioned why I have persistent aches and other symptoms because she just doesn't know the answer! 

 

The only thing I felt quite satisfied was she is sure mine is Raynaud's.  So 4 doctors said its not but this one said it is.  At last my condition is recognised by someone!

 

My Hep doctor is no exception.  I have wanted to have him changed all along but too troublesome on the administrative procedures.  He started my Interferon Alpha 2a at 180 mcg and Ribavirin 800 mg/day as the standard-of-care therapy.  From the 2nd to 4th week, my WBC was dropping and Neutrophils were averagely low.  He reduced my dose to 135 mcg with the reason given that my WBC have been declining.  I requested him to give Neupogen instead but he said its not time yet.  So he reduced according to his personal experience on patients' well-being only.  He have forgotten the guidelines to achieve the goals of treatment, the reason for wanting to treat and that he should have given Neupogen if my Neuts were low enough.  So, it was not even at the level to be even excited about!  He even advised me to be careful not to get bleeding from cuts, wear masks in crowded places and stay away from sick people.

 

I went back to look up my literature and discussed with the support group members.  This doc was definitely over-excited about it and there was no medical necessity for a dose reduction.  I saw him the following week, showed him my print out that he did not adhere to the guidelines of the US. I nag and nag at him and demanded to be rx'd for the original dosage of Interferon Alpha 2a of 180 mcg.  I was prepared to give him a piece of mind and maybe complain to his boss if I was detected at 4th week.  So this is another medical stupid expert.
 

 

Almost due to have my 4th week PCR to find out if the virus is undetected.  Being Genotype 3, the first 4 weeks were the most crucial in this battle to eradicate the virus if not it means that I'm a slow responder and may need to extend my treatment.  I was a nervous wreck waiting for the results.  I was afraid that due to the dose reduction, I did not fight well enough to stop the virus replication or have 2 logs drop in viral load.  But because my baseline was low, I could possibly be even undetected at 2nd week!

 

I was so happy when my results were out the following week that I achieved RVR (Rapid Virological Response - undetectable at 4th week)!  I will stick to my 24-weeks regime with no extended treatment or side effects!