Opus, or “you look angry”

Too many doc appointments this week.  Here’s how that ended up being the case.

In January, I saw Oral Medicine at one of the BATHs at the request of my primary care, who I had presented to several times with a mess of a mouth.  What it was is still really anyone’s guess.  I’ve blogged about it before (several times 1, 2, 3).  So in January, it was not active.  Come back when it’s active and we’ll biopsy it.  Actively messed up mouth coincided with free time to go back to the BATH in July, when I had that time off between jobs.  So off I went, got biopsied by the Oral Medicine Hair Band (the person who had originally seen me was on leave).  A call my first day at work with the results.  “Non specific inflammation, no thrush/candida”.  He says try some steroidal mouth rinse.  Ok, but I DO get thrush and I’m a little concerned about steroidal mouth rinse.  He tells me to only use the rinse when I’m symptomatic, and to take a fluconazole (200 MG which he called in) once a week when I’m rinsing.

In the meantime, I have pain after sex and pain after walking and pain pain and more pelvic pain…not as bad as in the Spring but bad enough.  So I call the GYN doc and tell him about it, and about the EDS diagnosis and say I’m wondering about a referral to the Pelvic Floor Dysfunction folks.  He is a little confused, not sure he gets it, says I should talk to my GYN surgeon.  He says he’d like to help but he really just doesn’t know anything about that or know who to refer to.  Oh and he notices I haven’t had a routine exam and pap smear in for-frickin-ever.  Wanting to play nice with the GYN (because I need him on my side) I schedule it for August 14th.

I start feeling palate pain that same week when I called the GYN, and so on August 3 I try the mouth rinse.  I take the fluconazole.  I do the mouth rinse two more times the next day.  The day after, I wake up with a ragingly sore throat that continues into Monday.  I call the Oral Medicine hair band doc back late Monday afternoon, get the office voicemail and leave a message summarizing the meds and the subsequent, continuing sore throat.  Monday ends.  No call.  I didn’t expect one Monday because I called so late.  Tuesday comes and goes.  No call back.  Wednesday, I call from work in the AM.  I’m in a lot of pain by then, my throat is killing.  I have a little white streaking and a patch on a tonsil that might just be phlegm, and my pharynx looks burned.  It is blistered.  I am told that they didn’t get my message.  I’m told that Dr. Hair Band is out of the country now and that no one (in my insurance plan) can see me until next week when Dr. Hair Band is back.  On August 16th.  I push and finally get the office staff to agree to ask someone to call me back.  Dr. Hair Band’s associate calls me back, tells me that although she can’t call in clotrimazole for me without seeing me, she can tell me to take the 200 MG dose of fluconazole EVERY DAY until I see Dr. Hair Band on the 16th.  Sweet mother of god, do you have something against my liver woman?  I want to yell into the phone.  But I have already expressed my displeasure with the office staff member over the missed message (“you called Monday?  Did you leave a message on the doctor’s voice mail?” “No, I left it on the main number’s voice mail”  “Well if you left it on the doctor’s voicemail that’s why no one called you back.  He’s out of the country”)  and my blood sugar’s bottoming out so I get off the phone, feeling totally fucked about. My throat is killing, I’m nearly out of clotrimazole, and so I start taking the fluconazole.

The sore throat lasts and lasts.  By the weekend, I’m starting to also feel crappy – “malaise” is the word for it – which sucks because it’s my husband’s birthday.  I push on, start the next work week, go to the GYN, who freaks out when he hears the dose of fluconazole.  “And they thought that was better than giving you clotrimazole troches?!?” he asked with no small amount of horror in his voice.  Yes.  I believe they are soon to be my former Oral Medicine doctors.

Then on to the Oral Medicine appointment two days later.  The Oral medicine appointment is for 2:00.  I get there, offer to pay my copay and am refused “you do that after” the office staff member tells me, then returns to her personal call and crossword puzzle (I am not kidding).  I wait 20 minutes.  I go up and ask how behind they are running since I had planned to go back to work after.  She bellows for someone.  Someone comes out, seems irritated by my question, then goes into a room for a second, comes back out and says “5 minutes?” to me, then adds “he didn’t really answer me”.

I wait about 5 minutes, then go in, give a history to the residents which includes the part about calling and not getting a return call, get a preliminary exam and then no shit I wait another half hour for the attending.  All totaled, it was an hour and 15 minutes before I saw the attending.  He breezed in, offered a lame and casual apology for “the delay”, then said “So tell me what happened” and I start to tell him about the physical stuff, the mouth rinse, etc.  He interrupts, says “No.  Tell me about the call.  I heard you called and no one returned your call”.  Ok, so I tell him about that and he starts to go down the same path “well if you left a message on MY voicemail…”  Oh holy cow.  Yes, I know.  And no, it wasn’t YOUR voicemail.

We then talk about my mouth.  Finally.  It’s not thrush. You were on fluconazole.  “What if it’s resistant?”  That’s rare.  He says I can just use the mouth rinse sparingly. I tell him I did use it sparingly.  He says “You seem angry” with a smirk on his face.  Maybe he’s one of those people who thinks he can smile disarmingly but what it came across as was smarmy and smirky.  “I’m not angry but I am upset.  I’d have preferred to have been seen when this was first happening, and I had to leave work to come here today and was hoping to go back.  But it’s been a very long time and I won’t be able to make it back now.  So I’m upset.”  “I didn’t know that” he says.

He offers magic mouthwash, which I have been mixing myself at home anyhow from left over (old) lidocaine, benadryl, and maalox.  “That would be great, thanks.”  He tells me that I can take the 200 MG of fluconazole for three or four days after I use the mouth rinse the next time.  I told him: I know you don’t think that it was the mouth rinse but I feel very much that this started as a consequence of using that so I won’t be using it again.  I would prefer to just treat the mouth stuff conservatively, with the anesthetic rather than try that again.

I get out to the front office and it’s a fucking zoo.  There’s a guy in a wheelchair on one side of the desk whose assistant and what looks like a med student are trying to hold something in his mouth to “stop the bleeding”.  There’s a hard of hearing elderly woman in the waiting room who is giving her entire life history to the staff member who has been delegated (with not a little hostility from the crossword puzzling, personal phone calling assistant at the desk) to give the woman her “new patient” paperwork.  “I’m not a new patient.  No, I’ve been coming to this hospital for 30 years!” the patient yells.  “What are you doing?” the Puzzler calls out to the other staff member.  “She’s trying to tell me something…” the staff member says.  “You’ll be there all day!  She has an assistant with her.  Have her help and get back over here!”

“Hi, is now a good time for me to pay that copay?” I ask, really and truly enjoying the mess The Puzzler has found herself in.  I’m pretty sure she’s the one who gave me the royal run around about the voicemail a week ago.  My day is fucked, I can’t go back to work now.  I may as well just stand there and add to the chaos that is that seriously effed up office.  “Oh I got a bill,” I say, digging in my massive tote bag, which I shove up on the counter, sending things rolling.  “Here….I guess I must not have paid last time.  Can I pay that now too?”

On the way home, I started feeling crappy again, with nausea and chills.  When I got home I checked my temp and it was 99.9.  Still feeling chills and crappy today so I called my primary care and saw him this AM.

Thank fucking god my primary care is not a dick.  After this week, my tolerance for medical malarkey was very slim.  He also didn’t think it was likely it was infectious, but he did not think it was nothing.  He did a culture, and said “‘I’m really suspecting the allergies.  Have you seen anyone about taking the metal out of your face?”  I told him that I’d mentioned this to Oral Medicine doc, who blew it off and told me that if my mouth mess was from allergies to my amalgam fillings, it would be only on my cheeks and gums, around the metals.  “He didn’t give a crap about the metal allergies, and I just haven’t had time to find a new dentist – I was trying to take a doctor break.”  We talk about dentists and the fillings, he tells me Palladium allergy and fillings is a big topic in dentistry these days.  I tell him that I think it’s like the lyme disease thing.  It’s gotten all controversial because there are people out there who have some ideas about mercury and fillings and as soon as I mention the fillings it’s like the dentist just hears ‘CRAZY’ and stops listening.  He says  “Lead with ‘I have a palladium allergy”.  He then runs off to research steroid allergies.  LOL.  I get a four page print out from him on it.  He asks about aspirin allergies, tells me it’s cross reactive with ibuprofen.  “You’re an opus,” he tells me.  I say “yeah, I noticed on my chart here it says ‘Volume two’.  Sorry,”  “No, I LIKE this stuff.  It’s interesting.  We’ll get it figured out.  It’s a team effort, and it’s good to have you on the team.”

He asks if I’ve ever taken Singulair, prescribes that, says to double up the Allegra, and take more benadryl at night – just for a while and see if it helps.  And get the metal out of your face.

And so that’s how I ended up seeing three doctors this week.

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  1. I like the sound of your GP. good instincts

  2. Oh wow. What a runaround. What is it with medicine? They can’t be nice. They can’t handle basics like phone calls. Yeesh.


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