"Cookbook Medicine": Really?

I'm afraid I've fallen into that phase where I have so much to tell that, because I have no idea where to start, I've become paralyzed.  What a silly way to be!  I'm sorry it's taken so long to write a post in order to let you know about the colonoscopy, but I came home pretty sick from the ordeal of the recovery room and quite upset by what went on there.  In fact, I wrote an immediate account but realized I needed a few days to settle down and get over the unprofessional conduct of the recovery room, the out-and-and lies, the fights. Someone had to take the higher ground and I was determined it would be me. (Deep breathes: I'm still stunned!)  So, this post is not so much about my colonoscopy but the lessons I learned - or which were reinforced as a result of my experience - in the recovery room with doctors who seemed more like robotic technicians than patient advocates.  More on this in a moment.

First, the news which you, my friends, are waiting for: I'm clean!  I don't know what the fuss is about when it comes to getting cleaned out for the procedure, nor the fuss about the procedure at all.  It's really a piece of cake.

I do have two recommendations, however, for anyone who needs a colonoscopy: 

• Watch Dr. Oz get his colonoscopy (part 1 and part 2) at the very least - though there are other segments as well where one can hear his explanations.  Definitely see the the first part of his experience, however.  And then realize Dr. Oz is a man not used to being sick.  He complains of bloating, etc?  Please.  Easy peasy!  Though make no mistake: I have to give the man kudos for having done this service for the rest of us who need to go through the procedure.
• Prior to the procedure, read Colonoscopy for Dummies, available on line for free. There, important information can be found, such as, "can I wear makeup to the procedure?"  (And the answer is "yes," for those who wonder!)

The few days before I went in, I was in pretty bad shape, ME/CFS and fibromyalgia-wise, continuing with sweats (drenched bedding and nightwear), shakes, shivers, pain, ulcers on my tongue, swollen lymph nodes and the like.  In fact, my rheumy worried if I should postpone the colonoscopy, fearing what the "trauma" would do to my system once I got out of the procedure.  I wouldn't listen to such "nonsense," so he made me swear that once I got home I'd be on strict bed rest for a week, at the very least.  Since I was beside myself being so ill, I had no problems promising to rest.  I really needed to eliminate at least this part of my body as a cause of any sort of new health problem.

Let me make it clear: I had a terrific experience when it came to my own private doctor. It was the hospital system that I had problems with, much of which I'm not even going to go into at any point.  Why?  Because it is like beating a dead horse.  Period.

However, other parts I WILL address, if not here and now, then in future posts.  Why?  Because they are really important and we all need to be aware of the fact that these are problems that are too dangerous to our health.

The "fun part" I wish to address today came in the recovery room.  I woke up in no pain until ten minutes had gone by and slowly my BP started rising as the overall body pain started back in.  My abdomen, I should add, was in no pain, however.   Pretty soon my BP was dangerously high and I wasn't going to end up being discharged within the expected thirty minutes but only once my BP reached a safer number.  Unfortunately, the BP kept rising and rising.

And then the lying and arguing began.  I'd told the intake people, as well as the recovery room staff, that my BP was an indication of where my pain level is.  For many reasons, I have no anxiety from being in a hospital nor with any operations nor procedures.  Best, I was quite comfortable and trusted my own attending physician.  

However, as soon as the pain issue came up in the recovery room, the bull started.  First I was told (as in "threatened"?) that were I to receive any pain medication whatsoever, it would prolong my recovery room stay, delaying my discharge from the hospital.  I looked at the clock and realized that I'd now been there for at least fifteen minutes and that meant fifteen minutes to go.  I thought I could hold out as far as the pain went.

However, the pain and my body didn't agree.  The blood pressure and pulse rate were rising steadily.  When I pointed this out to my nurse, she, in a clearly disgusted voice, said that I was holding my arm the wrong way and shoved it.  The reading instantly came back even higher.

When I said that I needed some pain medication - the BP was now in the range that NO one would be sending me home any time soon - I was told the hospital no longer carried Demerol, a pain medication that had worked for me in the past.  I knew it to be a lie and told them so.  Important point.

To put things out in the open, I also pointed out that I was not a drug seeker, that they should read the chart (in the computers they'd spend a fortune on installing but no one seems to like - or read) and see what my BP has told them in the past, indeed why I was there in the first place (that the impaction had scared the beejeebees out of my attendings) and what medications I'd been on before.  By now,  nausea was striking hard. Thanks to the music playing over the loudspeaker and the light (glare) coming in through a window without curtains, I was now also getting a head migraine and the body migraine was quickly getting out of control.

Might I add, it seemed that the recovery room was designed with the staff in mind and most certainly not the patient?  Did I really need to hear pop music as I lay there, and then a DJ?  Worse, I couldn't even make out what the DJ was saying: it was all just much-unneeded noise.  But let's forget the patient.  

The same old bull, though on a higher level, began.  Another pain reliever was offered, a strong narcotic (fentanyl), which, unfortunately, had not worked on me in the past.   And so it went.  Another doctor was called in,  Dr. "Whiteman-not-foreign-physician" who - they must have thought, for what else could it be? - would have more influence than Dr. "Woman-and-worse!-foreign-trained-physician."  How bigoted can you get?  It reminded me of the incident in the ER when the charge nurse was afraid we'd object to a doctor with a ponytail and actually asked us if we objected to said ponytail.  

This doctor (Dr. "Whiteman") also said there was no Demerol in the hospital - they simply did not carry it any longer.  I told him I knew that to be a lie.  He, with a bit of shame on his face, admitted that the hospital DID have it but that he couldn't prescribe it.  I said, "No, you CAN prescribe it.  You simply choose not to.  You simply don't want to fight with the pharmacist in order for me to have it."  I also added, "since when have doctors allowed themselves to be dictated to by pharmacists?"  This is a HUGE bugaboo of mine.  I absolutely loathe that physicians have allowed the pharmacists to undermine the care of their patients.  In fact, I especially hate it because of the old joke, "What is a pharmacist? Someone who couldn't make it into medical school."  And it's been payback ever since! 

At this point, though I hated to, I asked for them to allow hubs to come back: I needed him to come in and fight my battle.  My BP was now in the stroke range and I was in way too much pain.

My husband and I were both appalled when we realized that the doctor had allowed a pharmacist whom we'd never met, nor knew his name, to dictate medical care from the shadows.  This pharmacist, indeed any hospital pharmacist in ANY hospital in the US, has no accountability for the care of patients.  That is the doctor's role.

My husband and I were dumbfounded, indeed our jaws dropped, when the doctor told us that he had to practice "cookbook medicine."  That was stunning.  The term "cookbook medicine" is a "somewhat" derogatory term, one I've actually used a few times in this blog.  I asked him, "have you no pride in your work?  What has happened to you that you feel no qualms about that term, indeed own up to it?"

I asked the doctor: 

• Since when have you allowed the insurance companies to dictate your medical treatment?
• Since when have you allowed the federal government to dictate the practice of medicine?
• Since when did you allow the corporation that owns the hospital to overrule your medical judgement?
• Since when did you allow the fear of having to justify your medical decisions prevent you from following your oath, afraid to explain to a board why you made such-and-such a decision?

How sad!  How defeated!  One can say, "is this the future of medicine"?  No, we were told in no uncertain terms that this IS medicine today.  Right out of the robot's mouth. 

I did get the Demerol I needed - in fact it had been ordered before the doctor used the term "cookbook medicine" in his defense, but "they" (the pharmacist?) took their sweet time about it - as my BP continued to soar, breaking records yet again.  Again I wondered, "What is my BP Trying to Tell Me?" as I looked at numbers I've never seen before.  But that last part about the BP is for a future post.

In the meantime, I hope everyone is feeling their very best, only better! Thanks to my very good friends out there who prayed for me and sent me such supportive emails, tweets, messages. I so appreciate y'all!  Ciao and paka!


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