Ever have one of those times when you think you know someone at least well enough to generally predict the avenue of their behavior, only to suddenly find out you don’t? It was one of those days for me. It all occurred while I was shoe shopping, which requires doctors, money, time, and patience.
I’d seen Dr. R twice before; he is my podiatrist (foot doctor). The first time I met him was in early January I believe, when I was seeking out a second opinion from the first podiatrist I’d seen regarding my leg pains and fracture-but-not-just-a-fracture symptoms. He was about 20 minutes late to the first appointment, and waiting for doctors isn’t something new for me so I figured 20 minutes was excusable.
(Am I the only one who finds it ironic, however, that if a patient is 10 minutes late for an appointment, that appointment is cancelled and the patient is “fined” $30-$50 because they were “tardy” like getting detention in grade school…yet if the doctor is late, THE PATIENT STILL HAS TO PAY the same amount of money for his/her appointment! Let me get off that one before I go on and on….)
During that first appointment, perhaps he found my case interesting enough not to keep darting in and out of the room. He did leave twice but I thought it was to get x-rays ready for the glamour shots of my legs. He didn’t catch the diagnosis of CRPS, but honestly, nobody had for the last 10 years, so I don’t bash him for it. Besides, my left leg wasn’t all shades of ungodly that day, just showing localized swelling, sensory issues, difficulty moving my foot, and burning pains. I complained of all these things, naturally, and told him I felt this was more than just the average fracture. He agreed, noting the demineralization of the bones in both of my legs. All in all, I was pleased with this appointment and my next, grateful at least that someone recognized something beyond “just a stress fracture” was present.
I was there to get a script for special shoes. It’s fairly obvious that I need them, but such things require papers with doctors’ scribble. For the last few months I’ve been wearing post-op booties – what I call Darco Boots. A friend ripped the seams out of my left Darco Boot so it wouldn’t touch my toes, but the material they’re made from is so thin the wind blows right through them and that hurts badly, so I put duct tape on it. After only 2 months of wear, my boots are falling apart again and I keep plunking down $50’s to keep something on my feet. These post-op boots just aren’t designed for everyday wear, and they are dreadfully painful in the winter.
I waited about an hour and a half to see the doctor. I was in a patient room and he kept walking into the room, asking me a question, then interrupting my answer and saying “Oh, sorry Ma’am, I’m not here yet. I’ll be right back.”
First, “Ma’am?” Tip for Doctors: Don’t call your lady patients “Ma’am,” supposedly a title of respect, while you’re busy disrespecting. Just saying. It’s bad manners of almost the worst sort IMO. Wow, I know I just turned 29 this week but…”Ma’am”?
Second, Why the heck aren’t you dealing with your patients one at a time? Just do what you gotta do, attend to your first patient, and when you’re ready, come deal with me! I’ve been waiting over an hour so you know I’m not going anywhere unless I first make a scene (which you *really* don’t want anyways).
He didn’t hear my eye-beamed thoughts, evidently, as he darted back out.
I was bored, staring at the blue and white wall clock which had been so courteously provided by a drug rep who wanted you to know you needed a specific type of antifungal tincture. The clock was so ignorantly designed that all the numbers were at the bottom and it ticked in an unnecessarily loud fashion. I wondered if Dr. R had put this clock in all his patient rooms, and if it was there purposely so that you simply COULD NOT, not matter how hard you strained, actually tell what time it was (and therefore tell how long you’d been waiting). I decided I’d never buy that brand of antifungal cream because they couldn’t even make a useful clock.
Dr. R popped his head in about 15 minutes later and asked hurriedly again, “So, what did you say you’re here for today?” I sighed briefly, sucking my sigh back in to hide it, and repeated what I said the last time as fast as I could spit the words out, not sure if he was here to stay. He wasn’t here to say.
I overheard the conversation he was having with another patient – they spent 7 minutes talking sports and guy talk. I ground my teeth slightly. I hoped he was doing something productive during those 7 minutes.
On the third “visit” however, he asked yet another question as he unplugged a procedure lamp to relocate it to another room for his first patient he was with, and said he’d be back, again cutting me off mid-sentence. I was really feeling annoyed. “Seriously?” I muttered under my breath as I rolled my eyes to the ceiling.
I decided that since he was taking so much of my time, I’d review my medical records which were in a file folder on a table in my room. It’s always interesting to read your own notes, especially if you, like me, know how to read medical-ese. I grit my teeth. The notes said on my first appointment that I presented with no swelling, no burning pains, no muscle pain, no joint pain, etc. If I didn’t have these symptoms, I wouldn’t have come the first time! At least he did mention that I had severe hypersensitivity to touch and that this made it very difficult to examine my legs. I guess because he had “stress fracture” on his brain as the primary diagnosis, he missed what I HAD clearly told him were my symptoms. Always good to look over your records when you can. At this point, he had taken enough of my time that I felt unashamed about nosing through his notes. Besides, I was bored and rather than getting into a conversation or text-fest on my cell phone in the office (which I find disrespectful to the doctor and staff), I figured I’d snatch a peek at my file. That’s less disrespectful, right? Why do patients often feel that we cannot review our own records? Why do doctors seem to hold them with such an iron fist?
I began wondering if he was going to charge Medicare and Medicaid for each of these “visits” separately!! He brought his laptop into the room, as he’d done on previous visits, sat on a rolling stool, asked another question, and I casually handed him the chart without mentioning the omissions from my first visit. He stood up, slipped the chart under his laptop on the table, and then he left me again. Another 10 minutes. If I had hair to pull out, I just might have done it! Finally, he comes in and mostly shuts the door. Good, he’s trapped! I thought. Ah, but he’s a slippery little bugger, he is!
MOTS (more of the same) ensues – questions. They are the same ones he’s already asked so I repeated my answers, adding “as I already told you…” (HINT, HINT!). He moved closer and I reminded him not to touch my legs because doing so might result in the need for false teeth, but the unspoken part of me dared him to touch my legs so I could really let him have it. I felt that warm rush of blood to my face as I tried to put the angry thoughts away.
Lord have mercy on me please! I really just need him to write a stupid script for special shoes and it shouldn’t be this hard!!!! I’m not asking for him to perform a miracle and I don’t even have a list of questions for him today!
He asked about symptoms and slowly hunt-and-pecked his laptop keyboard; I couldn’t see what he was writing. We talked for a few minutes about shoes. He told me that he would be glad to work with my orthotist/prosthetist to get the kind of shoes the orthotist thought I needed. I was grateful for that. It’s nice when doctors can work together.
He then asked me WHY I NEED SHOES (uhm….duh?) and how much am I actually weight bearing? He told me he needed to “justify” the shoes for insurance. (It comes as no surprise to me that Medicare may believe I need no shoes, as they won’t pay for them anyways though they set the price for them anyhow and I have to pay that myself.) I told him that I’m trying to weight bear as much as possible during the day to prevent this condition from spreading, that I’m standing 5-15 min at a time, and that I have to wear shoes because if my legs get too cold they burn and the wind blowing on my legs really hurts too. His face was still buried in the computer. After a few seconds, I added “I can’t even gently rest the weight of my left foot on my wheelchair footrest without shoes on due to the pain and hypersensitivity.” He gives an absent-minded “uh huh” like he has the last 10 times, but now he looks distracted by whatever he sees in the hallway through the crack in the door. He leaves, but this time he comes back rather shortly, leaving the door open. Guess that door doesn’t do much to restrain him anyways. When he returns, I ask him directly if he heard what I said last about my wheelchair? “About your wheelchair? No.” “AS I SAID” I emphasized with hopefully a hint of annoyance, “I can’t even put my left foot on my wheelchair rest without wearing shoes because it hurts too much. “Oh, okay,” he says.
He began to pay a little more attention. Maybe he finally realized that I recognized he wasn’t “all there” – perhaps not even there at all besides being a warm body sharing the same room for 1.5 minutes at a time.
In the last few weeks since my diagnosis of CRPS/RSD, I’ve been trying to piece together what long term prognosis for someone in my situation really looks like. I’d prefer to get info from doctors rather than the almighty Google, but this is a tall order. “How many other patients with RSD have you seen?” I asked. “A few,” he said, nice and specific. “Okay, so can you tell me straight how do they fair? How do they turn out?” “RSD really varies person to person, by degrees. Some get it and it goes into remission or it stabilizes. But for others like you, who have it more severely, it flares and usually doesn’t go into remission. It does get worse with time. What are your doctors doing for you for treatment?” It kinda struck me that he had not asked this question right after asking about my symptoms, but I told him what we’d tried and what had not worked. “Ok, I wish you the best” he said, telling me I could pick up my script with the receptionist.
I was happy to fly out the door of Dr. R’s office, thinking to myself, “That may be the last time I see you!,” or rather, praying, “MAY that be the last time I see you! I need no further exercises in patience today, Lord!”
My orthotist/prosthetist “lives” next door, so I swung by, script in hand. Except I couldn’t get through the font door – that door is impossibly heavy, especially when you’re using a wheelchair and you’ve got a box of ill-fitting shoes riding in your lap. My orthotist/prosthetist is awesome, however, and Brian, the “front desk guy,” always comes to relieve me of the door if he hears me struggling to get in. I made an appointment that day for 3pm. It was about 12:30pm now, and I couldn’t justify driving all the way home just to return to the same location – gas money is to be used wisely.
I had been out of my house since 9:30am and I had not brought lunch nor any snacks because I wasn’t expecting to be gone so long, much less all day. Due to my diet, I can’t eat anywhere either, unless I go to a grocery store and get a banana, which is what I decided to do. I also picked up a few other groceries. I worked on making some phone calls and balancing my check book, emails, and other things I could get done using my smart phone. So grateful for that phone – it is my brain. I knew I also had to get home before starting my real part-time job at 4:30pm. This was turning into a long day! I prayed for strength because I knew I wouldn’t get a nap.
3pm came and I saw my orthotist/prosthetist exactly on time. I’ve waited 15 minutes tops in his office for all the times I’ve been there (probably 7 times or more now). He really scraped his brain to figure out a shoe situation that would work for me. He paid close attention to what I said I needed and asked questions directly related to what I’d told him. He was definitely “in the moment” AND “in the room” with me, rather than burying his face in a laptop, his mind out-in-space. It became clear that I needed something that almost doesn’t exist – Extra depth, surgical opening, rocker bottom, wide, non-flexing shoes. Fashion? A thing of the past, my dear, a thing of the past. He left the room to go look on a computer for what we needed. If he couldn’t find it already made, I might have to have special shoes made, and those would cost about $450 per pair, which simply isn’t an option. He came back and brought an iPad to show me what he’d found. It was called the “Lucie-X” by Dr. Comfort, and it’s a shoe made for people who wear leg braces, but it’s the only one like it. Seems to be our only hope at this time. We talked about price and he was going to order it at-cost for me as well as try to help me on the cost of getting the rocker bottoms fitted if I felt I needed them after trying on the shoes. I was really pleased that he was willing to help me.
The shoes will cost about $215 for just the one pair, with rocker bottoms added (the picture doesn’t show rocker bottoms on the shoes; my orthotist/prosthetist would have to add those himself). And that’s the best we can do. I decided to go ahead and order them with my tax refund money. So much for buying medications!
The shoes should come in next week. They only come in black, so that’s the color I’m getting. I’ll be glad to have a real pair of shoes to wear. Let’s pray they work!
I never want to hear another woman complain about shoe shopping EVER AGAIN! 😛