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Re: perhaps another approach (sorry, long)

Posted by Robin B. on 1/25/00 at 00:00 (015090)

Alan, I will probably get my butt chewed out on this board (not the first time) for this post, so let me say up front that I'm not posting this to seem unsympathetic, unkind or uninterested. I went through 3 docs myself, none of them helpful, all of them with their own agendas, so I DO understand. When your feet hurt, everything hurts. And the more they hurt, the less the world seems to understand. Believe me, I personally know EXACTLY how that is, and it's hell.

But I think you may need to adopt a different approach where doctors are involved. Medicine is a business nowadays, as Elise posted somewhere in this thread. It's not about individual attention or individual treatment. It's about giving a treatment to a patient, supposedly repairing that patient, sending the patient on his way and collecting the insurance money. Everything else is superfluous. If the first treatment doesn't work, a second treatment is tried. Sometimes a third, but not much beyond for most doctors. I'm not saying that's good or right. We all know it isn't. But that's the real playing field that you're walking on -- and I think maybe you're walking on it with sneakers instead of army boots.

I think you may need to shore up your strength and when you visit any doctor, filter out all the information that is superfluous to your case and approach this with the utmost serious business-like demeanor you can. It seems to me that you are looking: 1) for a concrete, definable diagnosis; 2) a single or a stream of treatment methods that will alleviate the pain and hopefully cure or repair the cause of your pain. Everything else -- your theories about vitamin B-12, your wife's condition, carpal tunnel syndrome, etc. -- is superfluous to the vast majority of the docs you will visit (and I'll bet the neurologist falls into this category). When they start to hear that stuff, they start in their minds to put labels on patients that the patients don't deserve -- but labels which nevertheless influence the course of their treatment. In short, I think you may need to treat the medical practitioners with the abrupt detached business-like attitude they apply to you -- except you may need to filter into yours the premise that you expect something will be done.

Sometimes when we are pain, we want to be listened to and heard, because it seems (logically so) that if a medical person understands our symptoms, he or she will be able to approach treatment planning more effectively. That's not been my personal experience. I fact, my experience is the opposite. The issue for docs is not about developing a treatment plan for you, Alan K., so that you will feel better. It's about treating you, sending you on your way and collecting insurance money.

You say that no one takes an interest in your case. The reason is -- no one genuinely IS interested. They are by necessity in a treatment/send you on your way/collect payment mindset. You present a set of symptoms; the doc tries Treatment Plan A. If that doesn't work, he tries Plan B, maybe Plans C and D, and beyond that, you do not represent a concern to him.

Again, I'm not saying this is right. I'm saying -- this is what is. The only way to counter it is with equally staunch businesslike attitude. I can tell you that the greatest degree of success I have had with any doctor (other than a GP for a general flu kind of stupid office visit) I had with an orthopedic surgeon. Because of my wretched HMO plan and a not-too-interested PCP, it took me 2.5 months following an MCL tear in my knee to get authorization to visit the visit the orthopod. When I finally got there, I handed him a one-page, succinct-as-all-get-out description, date by date, of exactly what had occurred to my knee from the time of injury up to that date (including 4 PCP visits and other nonsense). I indicated that I wanted a diagnosis and I expected treatment -- and then a shut up. Within two weeks, I had an MRI, a complete diagnosis, a follow up appointment, 18 visits of physical therapy auithorized and a $900 custom made knee brace.

So -- I think you may need to change your strategy. What you're doing isn't getting you the reaction and the results you want. So do something else. It's all a game, Alan, and unfortunately they control the game board. They make the rules. The only way to win is to figure out how to use their rules to get what you want.

I earnestly hope you get some satisfaction, but more than that -- I hope you get a reasonable diagnosis of what your problem is and then you can begin down a conventional (or even unconventional) path of treatment. I know this post was not quite what everyone else is saying -- but the truth is, it doesn't matter who says what to you on this board. Nothing that any of us do or say can get you a correct diagnosis and treatment plan for your feet and that's what you need. I honestly do sympathize with you and I share your frustration. But I also know that sympathy and sharing frustration gets you squat. You need results from the health care system, and so my very best heartfelt suggestion is to change your approach until you find an approach that yields what you want Good luck, Alan.