Paradox

I have been seeing the same family practitioner for the last 10 years or so.  In the beginning, she was smart and fresh out of residency.  I'm not sure what happened, increasing patient loads, HMO demands for cheaper service, greater overhead, or just plain burn out.  Whatever got this bright woman there, she was most definitely burned out.

There have been a dozen incidents over the last couple years - trying to strong arm me to take lexapro because I mentioned in passing that I get a little down during the winter months (No shit.  She really did this), being treated like a runofthemill redneck dumbass, being scolded, being talked down to and the worst insult of all, being reduced to a body only worthy of five minutes of her time.  If that.  Probably not even that.  I know the only thought she gave to me as a patient was the 30 seconds that elapsed between pulling my chart off the door and walking in.  About a year ago, I remember having a conversation with her about the necessity for taking all the drugs I am on and whether any of them might be stopped.  I got a response equivalent to a pat on the head and an I know best.  Real discussion around this topic never happened just the sit down, shut up and trust me because I know better doctor 'tude.

I get that I am not your average patient.  I don't want the magic bullet to make me feel all better.  I want to understand.  Understand how I got to this point, what are the available treatments - Western, homeopathic, behavioural, what the effects of those treatments is and when or if I will see improvement in whatever brought me in.  I want them to use the big doctor words.  Trust that if I don't understand, I will ask.  I want them to engage in a real dialogue with me about my health care in which I am intimately involved.  It would be stupid NOT to be.  I mean no doctor really gives a shit about your health - unless you are about to DIE on their watch.  That just looks bad.

It's been sad really to watch this bright and compassionate woman be reduced to this.  

So, I have been thinking about switching docs for a while, maybe going to a naturopath.  But, my insurance doesn't cover any part of that and treatment from the naturopath is often as expensive as from a Western doc.   My budget couldn't take that.  So I have been waffling.  Unhappy with the current doc but not really sure how to proceed.

About three weeks ago I needed a prescription refill.  When I went to the online pharmacy, I saw that I was out of refills.  SHIT!  I guess in the madness of making sure my mom is getting to her doctor appointments and is being compliant in HER meds, I forgot about my own.  Of all the scrips I have, this is the one I asked for - the aldactone.  This one is an anti-androgenic compound that is supposed to help me keep the hair I have.  One thing I know is - you do not fuck with my hair.  At least not in ways that make it fall out faster.  I have been on this drug for 10 years and am kind afraid to stop taking it for fear I will end up bald.

I made an appt to ASAP, but couldn't see my regular doc.  I saw a young newbie female doc instead.  I grok her muchly.  I know that part of this is her shiny new doc status and that there is a possibility that she may become old and jaded just like my last shiny new doc.  But she was engaging, asked lots of questions, when she could tell that I knew what I was talking about, a conversation ensued about PCOS and the meds that I have been taking because of it.

One of these, metformin, is a drug they give diabetic and pre-diabetic patients to control their blood sugar.  It is also given to PCOS patients to alleviate some of the symptoms associated with blood sugar imbalances.  I have no doubt that I needed this drug when it was prescribed.  I was a 350lb angry hot mess of a woman.  This medication helped me drop 50 pounds - mostly by retraining my eating habits.  Metformin has serious GI side effects when you eat a lot of carbs.  Any kind of carb - good or bad.  So you become fearful of pounding down a bag of skittles for fear you will crap your pants.  OK.  Not quite that bad, but you get the point.  You begin to associate high carb consumption with cramps and crapping.  It's a very effective behavior modification tool.

She looked at my blood tests - not just the last one, but the last dozen.  Then she did the UNHEARD of and spun the computer monitor around so she could show me the downward trend in my Hemoglobin A1c (this is a measure of steady state blood sugar over the last few months).   Seems my blood sugar was now too low all the time.  She then did unheard of thing #2 and actually suggested I STOP TAKING THIS DRUG.  I made her repeat it which I'm sure made me look like a dumb fucktard.  But in all my adult life, I have NEVER had a doc ask me to stop taking a med.  WTF kinda weirdness is this?  I readily, giddily agreed and walked out of the office elated.  That was certainly a strange feeling.

Two weeks later, today to be exact, I went back for a follow-up.  I feel much more energetic than I have in the past couple years and I feel less desire to open a bag of refined white sugar and inhale it down to the last grain.  AND my fasting blood sugar is in the low normal range without the drug.  WTF kinda magick is this?

As I sit quietly to write this, my brain is sending out a thousand I told you so's.  And I sheepishly admit, my body has been trying to tell me this for the last year.  I stopped taking the full dose over a year ago.  I just couldn't make myself swallow both doses any more.  And the days when I 'forgot' to take it, I did feel good.  But then I felt guilty about not taking it, worried that I was doing harm to my body and would start again -at least to half dose.  I kinda blame my tarnished old doc for instilling that guilt and fear and myself for buying into the idea that someone who thinks about my health for 30 seconds knows more about how my body works than I do.  She might know the general way of things, but there are exceptions to every rule.  I am in every way exceptional.

The shiny new doc has suggested when I come back in three months to check the blood sugar again, that we discuss stopping the aldactone.  Maybe I will be ready for that then.  Maybe I don't need that drug to keep my hair in place.  Maybe I did once.  But no longer.

Cheeky grin.  

PS - Yes, the title is a pun.