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Monday, September 24, 2012

Name, Date of Birth, Diagnosis...

I recently had to go the ER for back spasms.  It's not a fun thing to experience and even less fun when the focus lands on all my other "problems" instead of the pain I am currently in.  I was experiencing what is known as breakthrough pain.  Though I have had several courses of epidurals for my back problems, sometimes the pain breaks through and is worse than you can imagine.  Sometimes it can be managed by prescriptions at home and sometimes it's so vast that an ER trip is needed.

As a plethora of people attempt to sign me in, take an EKG, and ask way too many questions for me to handle at once, I hear the most dread question of all, "what medications are you currently taking?"  Although I know this is needed to consider medication interaction and to see if my pain could be cause by any other ailment I have, I loathe this question.  Instead of asking "what are you on XYZ for?" doctors and nurses like to pretend they know everything and insist on guess.  "Oh, so you have heart problems and are bipolar?"  Nothing makes me angrier.  As a client I should have the right to not be judged by every professional who thinks they know what every medication is for.  My only victory is when I get to tell them that, no, I have no heart problems, I have Sphincter of Oddi  Dysfunction and I get blank stares because it's not a very common ailment.

I am not saying that every doctor or nurse I have ever had does this; I am just pointing out  how irritating it is when they do do it.  Assumptions and judgments based on medical history have the power to make a patient feel defeated.  They then become afraid to disclose anything else.  For example: I know that morphine does not work for me (nor for my sister or mother; it's called "morphine tolerance"), but I fear telling doctors this because they often assume I am drug seeking.  My pain management doctor has me on percocets as needed (I take less than one a month) for bad back pain, extra strength tylenol for mild or every-day pain, and dilaudid for breakthrough pain.  However, dilaudid, being more potent than morphine, sends red flags to doctors and nurses alike who assume a young woman in her late twenties should not be on such a potent drug.  Immediately I am flagged as a drug addict, often because they have already decided my every-day medications are for a disorder often associated with drug use.

Thankfully, this last ER trip turned out well, with the Doctor listening to me and my wife and the nurses becoming very understanding.  The interaction between patient and medical staff is vital to correct diagnosis and treatment.  Unfortunately, a some professionals do not understand this.  They still have a "I'm the Professional" attitude, which leads to mistrust and fear in patients.

As with any profession, the only way for professionals and clients to each get what they want is to work together and listen to each other.  I know that the professionals working with me were great once they realized their mistake in assuming they new what my medications were for.  I hope that all clients learn to use their voices and let professionals know that making assumptions is never okay.  And I hope that all professionals learn to put down their guard a little and listen to what their clients have to say.

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