November 23, 2001

My mom and I made the trip into the city this afternoon to see Squirt. Over two years ago, before I realized the extent of Squirt’s limitations, I had encouraged my mother to make an appointment with him to discuss her thyroid medication. Those were the days when I in my naivety still believed Squirt when he told me that he always listened to the patient and would never give up in trying to find a diagnosis.  Today my mom and I both needed prescriptions refilled and my mom needed her yearly thyroid test.

My last appointment with Squirt had been August. I felt only apprehension and anger when the thought of seeing him again crossed my mind. During the drive into the city my mother and I discussed his involvement in my non-care. We decided that I would ask for four tests and we would base further actions on his willingness to requisition these tests.

I was called into the consultation room first. Squirt walked in the door and said, “So are you feeling better now?” I looked at him in disbelief! Here I was, face swollen, hands swollen, dark circles under my eyes from lack of sleep, bruises up and down my arms that refuse to go away, barely able to walk because of the pain in my Achilles Tendons and the man had the audacity to ask me if I was feeling better.  I guess the fool still believes that I have nothing more than a small ache or pain. Actually I believe that he thinks that I AM the pain!  I told him that I was feeling progressively worse.

We discussed my September appointment with my neurologist. Squirt had insisted that I see him. You see I have been plagued with pre-menstrual migraines since the age of 11. In the beginning these migraines would last 2-3 days but gradually by the time I reached my 30’s they would last 4-5 days. In 1988 the headaches became unbearable.  The pain would be so intense that medications no longer worked.  I still only got them before my period but now they would last for 7-8 days. Between 1988 and 1998 there were many times when I thought I would not survive these attacks. By 1992 I would pass out for hours at a time and have absolutely no memory of those lost hours. I was prescribed every migraine medication on the market but the only medication that brought the slightest relief was pain medication and Gravel shots administered by my husband. This neurologist had been a Godsend. He had consulted with me, encouraged me and recommended pain medication.   After RAI in 1998 the headaches changed dramatically. I still got the per-menstrual migraines but now only needed half the medication to actually wipe out ALL the pain.  I could now function as a human being during these episodes. This past summer Squirt decided to focus on my residual migraines instead of my debilitating symptoms. He got quite upset and animated when discussing the fact that my migraines lingered.  He felt that since I was 53, my migraines should have miraculously vanished.

My neurologist saw me in September and told me he was not worried that my migraines had not disappeared. He told me that it took several years after menopause for these migraines to  stop. The neurologist also told me that I was very fortunate that the migraines had not gotten worse during menopause. Apparently there is as good a chance of that happening as there is the chance that they will improve. Squirt had received the summary letter from my neurologist and now had no problem with my lingering monthly migraine!  Thank goodness that the migraine issue has finally been put to rest!!  I had told Squirt this summer that I had far more pressing medical issues than the migraines.  In fact, I told him that at this point the migraines were the least of my concern.

I then “took the bull by the horns” and told Squirt that I wanted to have four tests done namely PTH, calcium, IGF-1 and DHEA.  Squirt of course told me that he could not possibly order tests if he did not know what the tests were and why they needed to be ordered. I very carefully and precisely explained to him why I thought I needed these tests. I told him that I now knew that thyroid disease was rampant among members of my birth mother’s family. My birth mother’s cousin had medullar thyroid cancer, a familial form of cancer. I wanted the PTH and Calcium tests based on that information. Because of my symptoms, I told him that I felt an IGF-1 test might be in order. Of course I explained that IGF meant Insulin Growth Factor. I went on to explain that I did not have diabetes but that maybe I had a problem with my insulin receptors.

Squirt sat for a minute and then told me that he would have to think about my request for these tests.  He went on to say that he would let me know in a few days since he was taking the whole month of December off. (He just took the whole month of September off). I told Squirt that he should not take too long to think about this because I was running out of time. He looked at me with one of those condescending looks I am sure they must practice at med school and asked me why I thought that.  I told him that my body was giving out and I did not have much time left.

I mentioned to Squirt that both my Achilles Tendons and the lumps on these tendons were so painful now that at times my legs gave way and I actually crumbled into a heap on the floor. I told him that these episodes happened very quickly and without warning. Now when I think back to Thursday afternoon, I am quite sure Squirt never heard a word I said about my Achilles Tendons. He did not acknowledge that he had heard me. I am quite sure what I said went in one ear and out the other – much like a wind tunnel!!

I must have been an idiot but I tried again to tell him about another symptom that was getting worse. I told him that I had severe pain, severe enough to often make me catch my breath when I moved, on both sides of my back and just above my hips. I told Squirt that I was worried that it might be my kidneys. I also explained to him that on my last 24 hour urine test ordered by the endocrinologist, my Urine Protein levels had been higher than normal, my BUN had been higher than normal, my urine volume had been higher than normal, my creatinine clearance had been higher than normal, my potassium levels had been lower than normal and my sodium levels had been higher than normal.  These results coupled with the pain had made me quite concerned. I got the standard shrug of the shoulder and was told by Squirt that the kidneys were located much higher up and underneath my rib cage and therefore the pain I had was not kidney pain. That was the end of that discussion.

I have had kidney infections that have left me delirious, hemorrhaging and hospitalized. I tell you this to help you understand that I am not a novice when it comes to kidney problems and kidney pain! Trust me, one does not soon forget where in the body that pain manifested itself!  Trust me again when I tell you that when I would get these vicious kidney infections the pain was always exactly where the pain is now.

After this debacle I decided to go for broke and see if he would maybe listen to my last complaint. I told him that on my last series of tests ordered by the endocrinologist, my ESR and my C-reactive protein both came back higher than normal. My ESR was 19.6. The lab normal for ESR is <8. My C-reactive protein came back at 26. The lab normal for C-reactive protein for females is 0-20. I explained to Squirt that a high ESR was neither here nor there but a high ESR combined with a high C-reactive protein might suggest that further investigations be done. He blew me off. He told me that he himself had no such test results and that he would have to see these results before he could make any comment. I guess the man actually thinks that I have an incredibly fertile imagination and that I spend my free time dreaming up test results.

Squirt informed me that he would like to send me to see an internist for another opinion. I told Squirt that I would be willingly to see an internist but only if he did NOT write a letter to the internist describing my previous visits to Leprechaun and Supercilious. I told Squirt that it had been very obvious that Leprechaun and Supercilious had been told that I had been seen first by the Blonde Bimbo.   It had become very clear to me during my appointments with Leprechaun and Supercilious that they would never deviate from the diagnosis the Blonde Bimbo gave me. I told Squirt that he himself had told me prior to my appointment with Leprechaun that doctors did not always look favorably on patients who came to them for second opinions! I made it very clear to Squirt that if I could see the internist with a so-called clean slate, I would be more than happy to go. If he sent a letter detailing the diagnosis of Blonde Bimbo, Leprechaun and Supercilious, the visit to the internist would be a complete waste of time. Squirt of course tried to assure me that he never wrote letters that would influence the opinion of the doctors asked to do the second opinion. My answer was, “Of course, why didn’t I think if that? Leprechaun and Supercilious are telepathic and that is why they knew exactly what Blonde Bimbo’s diagnosis had been!”

Thank goodness I do not depend on the likes of Squirt to keep my self-confidence intact. If I listened to him I would have decided months ago that I must be the dumbest thing walking the face of the earth!

My mother’s appointment was right after mine. On the way home she told me that Squirt had ordered a thyroid panel for her and given her a prescription for Synthroid. Squirt had then told my mom she needed a complete physical exam. My wonderful mother told Squirt, “I am 80 years old and I will decide when and where I have a physical examination. I do not see why I should subject myself to a physical exam when I no longer trust the medical profession.” I can only imagine the lip quivering and series of pouts that must have crossed Squirt’s face when he heard this. He of course asked my mom why she did not trust the medical profession. She told him, “Just take a look at my daughter. Why would I trust a profession that does absolutely nothing to help her? Squirt protested and said that he had not given up on her daughter. My mother said, “You could have fooled me. If you really have not given up on my daughter then you would sit down and actually listen to what she has to tell you. I believe my daughter knows what her medical problem is but you people will not listen to her.”

I am so fortunate to have my mom. She is an incredible woman.

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