“When I read that article, it was as if you were writing about me!”
I glanced at Barbara’s intake form. “Referred by: ‘Internet’. Chief Complaint: ‘Fatigue and pain – everywhere’. Symptoms began: ‘Forever’. Treatments tried: ‘Everything’.”
It appears that one of my articles was copied onto someone’s Blog. With difficult-to-treat conditions such as Fibromyalgia, after having their own doctors fail them, patients will do their own research on-line, in a desperate search for relief.
“On the weekends, I crash and need to sleep all day. My muscles hurt to the point that I don’t want to move them, even though I know I should.” Barbara cried, “I’m not even 50 yet!”
I handed over a tissue, “It’s okay. I know what you’re going through. I have fibromyalgia myself. Many a weekend I’ve spent watching Turner Classic Movies.” “You have fibromyalgia? You don’t act sick.”
“That’s because I don’t have many symptoms; at least not anymore. When I was an undergrad at Cornell, my back would scream at me whenever I had to go up and down those hills. Now that I’ve learned how to help myself, I no longer ache, I’m no longer tired.”
“So how did you do it? How did you get better?”
“First, I realized that there were limits of the in-network doctors I was going to. With 5-minute appointments, they weren’t really listening to me, much less examining me. Many of them didn’t even believe that fibromyalgia was a real disease.
“I did all the testing they said to do: blood tests, stress tests, CAT scans, MRI’s, EMG’s … even a spinal tap.”
“EMG? Is that where they stick needles into your arm?”
“Yes. Hurts like a dickens! And even though I had health insurance at the time, I still had to pay thousands of dollars for these tests that didn’t show anything. I now realize that some doctors ordered tests to get information; others ordered them to get the markup.”
“I have that same ‘pseudo-insurance’.” Barbara frowned, “It seems no doctor worth their salt takes it anymore.”
“It’s tough. When insurance companies pay less than Medicare….” I stopped my rambling. “Anyhow, I found a doctor that truly understood what I was going through. He spent over an hour with me. Of the tests I had done before, he taught me that there is a difference between normal (common), and normal (optimal) (www.thyroid-info.com/articles/woliner.htm). I did need to do some tests, most, I never have had done before. Even though this workup was more intricate and detailed than the university clinic, it still was far less expensive than dealing with the bill collectors the
hospital sicked on me when my insurance paid only part of what the ‘supposedly in-network’ doctors charged.”
“And then what did you do? Or better question: What should I now do to get better?”
“We’re going to finish our 80-plus minute history and physical exam, going through the old records you brought with you. I need to make sure the tests I order are drawn correctly to give valid information (instead of confusing us), but because I’ve aggressively negotiated with several labs, my lab fees are only 1/3rd of what hospitals charge.
“As data comes back, we’ll be able to make some simple and specific changes to your behavior, diet, exercise, and vitamins you take. I can see already that we’ll need to increase your thyroid dose…”
“I don’t know if I can do all this.”
“Don’t worry Barbara. Even though we are treating everything simultaneously, we will be starting low and going slow. You won’t have to become a vegan or swallow hundreds of pills a day. It’s just that “The Tack Rule” (coined by Sidney Baker, MD) says that if you sit on a tack, removing it, you feel better. But sitting on two tacks, removing one…
“…doesn’t result in a 50% improvement. Got it.”
And she did.