Sunday, October 18, 2009

Time for a change

Editorial note: Wrote this 2 weeks ago. Forgot to hit "publish"

So, it's October. It's time for me to go get meds for my allergies.

Last time I went, my doctor did something that really bothered me. It started after she'd given me a sample of Nasonex to try along with prescriptions for the drug I needed for my bronchitis and the Allegra and the inhaler I normally get. Nasonex is a topical medication that you apply to your nose, it's supposed to suppress allergies. Worked wonderfully. My breathing was great.

Sleep, however, was another story. I was getting maybe 2 hours' sleep a night, if any. It took me a while to figure it out, and only then because I forgot to take the Nasonex one Friday morning. That night I slept like I'd been drugged. Did the same on Saturday night, too. Sunday morning I finally remembered to take the Nasonex, and ta-dah! Insomnia.

Not only that, but my heart would race every once in a while. Like it was trying to leap out of my chest. That's fun in the middle of a team meeting, huh?

When I went back to my doctor for a follow-up a couple weeks later, I told her about the side-effect, and she waved it off.

"That's not the Nasonex. That's the Allegra."

Really? The Allegra I've been taking for ten years with no problem?

And then at the end of the appointment, she tells me she's prescribing the Nasonex, along with a year-long prescription for a 24-hour version of Allegra.

"I just told you I'm not taking that Nasonex." I said. She looked up, surprised. Like the furniture had just spoken. I described what happened again, and told her the bit about forgetting to take it for a couple of days and finally getting some sleep.

"That's weird," is all she had to say. And wrote the Nasonex scrip anyway, on the same piece of paper as the Allegra-24. I left her office feeling angry and disrespected. Granted, I'm no doctor, but I'm in this body 24/7, and I'm not a total moron. I think I might have some insight into what's going on with me.

Luckily the pharmacy I went to only fills what you ask them to. I never filled the Nasonex. And I vowed that I was never ever going back to that woman under any circumstances.

I ran out of refills on my prescriptions last November. I'd managed to stockpile a little by buying a refill every month whether I needed it or not, so I didn't have to go back to her. The medication in the last bottle expired last month. Time to find a new doctor.

A coworker recommended someone her Dad had seen for a physical. I think his own doctor was on vacation or something and this other fellow was part of the same group, filling in where necessary. She said he listened to her Dad, didn't run a million tests, and just seemed on the whole more laid-back and personable. So I did a little research.

Turns out he's a D.O., not an M.D. I've never been to an osteopath before. Wasn't even sure what an osteopath does, so I looked it up. Here's what Wikipedia said:

Osteopathy is an approach to healthcare that emphasizes the role of the musculoskeletal system in health and disease. It is practised in the United Kingdom, the rest of the European Union, Israel, Canada, New Zealand and Australia. Osteopathy is not to be confused with the historically related but now distinct field, osteopathic medicine in the United States.

All right. I clicked on the link to osteopathic medicine in the United States:
Osteopathic medicine is a branch of the medical profession in the United States, with some recognition outside the US (47 countries), including most Canadian provinces. Physicians or surgeons who graduate from osteopathic medical schools are sometimes known as osteopathic physicians and hold a professional doctorate, the Doctor of Osteopathic Medicine (DO), in contrast to the more familiar degree, the Doctor of Medicine, or MD. The existence of two degrees leading to equivalent status as a licensed physicians is not widely known.

And later on:

Osteopathic medicine is considered by some in the United States to be both a profession and a social movement, especially for its historically greater emphasis on primary care and holistic health. However, any distinction between the MD and the DO professions has eroded steadily; diminishing numbers of DO graduates enter primary care fields, fewer use OMM, holistic patient care models are increasingly taught at MD schools, and increasing numbers of DO graduates choose to train in non-osteopathic residency programs.

Clear as mud. My aunt has been going to a D.O. instead of an M.D. for years and was happy with the woman. On the strength of that, and figuring a new point of view was probably a good thing, I called and got added to his patient list. I told the receptionist (nurse?) that I was switching doctors. She asked who I was switching from, and when I told her, she said,

"She's on the same call list as we are. That means if you're ever in the hospital, she might be the physician on call for you."

"That's okay. I doubt she'd recognize me anyway."

When I told my mom I was seeing a D.O. I got an interesting reaction. All she said was, "Oh really?" My mom's moved away from a lot of traditional medicine recently. She goes to a reflexologist on a regular basis, and I believe it does her a lot of good. She was so much healthier after a few months of treatment with this person that my Dad started going too. At one point he had a colon full of polyps, and this woman worked up an intensive treatment called a "liver cleanse" that he went through for a summer and fall. It got rid of most of them by the time his next colonoscopy came round. Impressive.

Mind you, they still use traditional medicine for things like his heart. Oh, heck yeah. Don't want to fool around with the heart. I'm with them on that one.

But I digress.

Boy am I glad I did this. He came in and sat down next to me at a table (not across from me. Side-by-side (friendly) as opposed to face-to-face (confrontational). I do the same thing when I do reference work. People accept your help more readily if you don't come barging at them from straight-ahead), and started to chat with me. Asked all sorts of questions: where I'm from, how long I've been here, what was my major in college, what do I do now, where do I first I thought he was trying to put me at ease, but then I noticed he was writing down all my answers. I guess that's the "holism" thing kicking in, huh?

By the time we got to discussing what brought me here, I was a whole lot more relaxed than I'd ever been with the M.D. I told him about my allergies, and though I hedged a little bit about why I left the other doctor (I don't know why), eventually I decided to tell him that I lost confidence in my previous physician, and why. He didn't argue or agree, just nodded and kept listening while he looked up my nose and listened to my chest (at some point in the conversation I'd moved onto the exam table, but then off it and back to a chair after he'd listened to me breathe). Then he asked me to describe the worst asthma I'd ever had. I told him about this instance from a couple years ago.

He prescribed most of the same things I had been taking (not the Nasonex, thank goodness), and went to get me a sample of some asthma medication he wants me to take during October, or any time I think I'll be around something that will make things flare up (like up at my parents' cabin with the wood/coal stove). It's an inhaler with a very little bit of a steroid in it.

He came back with two boxes.

"I was going to give you this one," he holds out a box with a pink stripe across the top, "but then I remembered that they just came out with child's version that has a much lower dosage." He holds out the box in his other hand. It has a gray stripe across the top. "I was thinking that if the little bit of steroid that was in the Nasonex gave you trouble, maybe we should start you with the child's dosage and see if that works. If it doesn't, then we'll move you up to the adult's."

And the clouds parted, and the light shone down, and the angels sang. He listened to me! He heard and believed me! Hallefrickinlujah!

"It's one dose daily, and I think maybe you should take it before you go to bed, since night time is when it hits you worst."

That's true. When did I tell him that? Oh. OH! The dream. Dang, he listens with both ears!

Angels just sang another chord.

"Give me a call in a few days, tell me which one works for you and which pharmacy to call with the prescription."

And that's what I did. I'm on the child's. Didn't even open the adult's. He said to keep the sample, maybe I'll need it when I visit my parents.

It was so nice to leave a medical appointment feeling like I'd been heard.

I heart my new doctor.


Just Me said...

Had a DO since I was a tot and adored him. He'd still be my doc if he didn't have the gall to get old and die on me.

Last March I switched to a new doc because the guy who inherited my dead doc's records was way too free and loose with prescriptions and telephone diagnoses. I went to the new doc once and liked her.

I can never get sick again, however, because I can't remember her name. Waaah!

While she shouldn't have blown you off about it, sleep disturbance is not a side effect of Nasonex per (Indications & Dosage tab). They do not list info on drug interactions, though, and I'll bet it was kicking something into gear with the Allegra.

--V said...

I had gone onto some site or other that had comments from people who used Nasonex and were reporting side-effects similar to mine. Some were even worse. One woman reported that her three-year-old started to get downright aggressive, starting a fistfight with his parents because it was bedtime.

Also, that website you mentioned put in a caveat there could be other side-effects.

And then there's my DO, who immediately thought "steroid reaction." 'Cause steroids do that. Last time my bronchitis flared up, the warnings on that pack of whatever-it-was steroids I took warned of all sorts of things from sleeplessness to psychosis. Funny that I'd react to one steroid and not to another stronger one. But then I react to tetracycline and have no problems at all with sulfa drugs.

Hotch Potchery said...

Did you know in some states a PhD in ANY biology allows for someone to practice human medicine?

I am not claiming that to be true, but I did see it on Twitter last night and it was intriguing.