Friday 25 October 2013

Advocate for Your Health

Are you an advocate for your own health care?  Before you answer, I’m not going all health food guru here.  I’m the person who sits on my ass all day with my token Tai Chi and the dog walk exercise regime.  When you go into your GP, do you advocate for your health or do you allow yourself to be talked out of what’s wrong with you?

I see.

This week, another story about another woman with a sore belly and only after two years of not getting better, were tests done.  By then, the cancer had metastasised and it was too late for her.  She was in her twenties and died a few weeks after her wedding.

Oh my, did she not go to her doctor?  She did.  And that’s what I’m thinking about today.

So first, my sad tale.  No, first I want to say that I grew up in a medical family and married into one, which brings probably more than the average number of doctors into my social world.  This isn’t anti-Western medicine or NHS, although both those things contribute to the situation.  How could they not?  They ARE the situation.  That would be like saying cow’s milk had nothing to do with some people having lactose intolerance.  It’s not the milk’s fault but it is the problem.

Now back to me.  I wasn’t a pretty young thing who should be in the best of health at the time I went to my GP over a pain in my thigh.  I was American.  That was the excuse she gave me.  My expectations of the NHS were out of order.  Without doing any tests, she told me that I had arthritis (in my muscle, thinks me) and the pain wasn’t bad enough (I couldn’t sleep through the night) and I probably needed a hip replacement (how do you know without an x-ray) which I couldn’t have for fifteen more years.  Go away, girl.

A few years later, I moved and went to another GP who immediately referred me to the best orthopod in the area (according to my gasman husband) who did the x-ray and found a congenital defect in the hip socket which should have been dealt with YEARS before the anti-American GP.  So all those disturbed nights, all those New Year’s dances I sat out, all the miles of flowerbeds I weeded by scooting on my bum shouldn’t have happened. 

But I’m alive, aren’t I?  My new hip is the best thing since sliced bread.  And to be honest, having to watch my lunatic family dance during New Year’s was a hoot.  The thing is, I once listened to private stories for a living and I can tell you that my experience with the anti-American GP isn’t that unusual.

First, let’s think what a GP in the UK has to do.  See six patients an hour.  Yup, in ten minutes, greet, seat, listen, maybe examine and diagnose, turf out of the office and document a patient’s complex medical situation.  When I went to my GP because I wasn’t bouncing back after surgery, he looked surprised and said, Oh you’ve had surgery?  Then read my file.  This was the same person who busted his ass to get me the area’s best surgeon.  But that’s what he does.  Six times an hour.  He can’t remember everything.

Don’t go in all shy and hope for the best.  Go in with a concise description and perhaps your concerns.  Share whatever medical history you think is pertinent.  When we lived on base, our GP routinely verified a situation with the spouse.  Patriarchal, you think?  He did it because in his experience, people tended to underplay their suffering.  So ask the people who live or work with you how they perceive your symptoms.

GPs also have targets to meet or avoid which have financial impacts on their surgery.  So to practice medicine at the speed of light with Damocles sword over your purse, the default position is that the most common answer IS the answer.  In other words, you won’t be referred for abdominal surgery after your first complaint of a tummy ache.  If you’re young, you could have Crohns or cancer or an abscess or have eaten a dodgy take-away.  Don’t be fobbed off because you are young if the symptoms don’t go away.

If you have a history of mental illness, that will be the first stop for some GPs.  It won’t matter if the symptoms manifest physically.  You’ll be told it’s panic, anxiety, take a pill.  I have had clients with a mental health history who experienced severe allergic reactions that interfered with breathing and were told it was psychological, even when the client could identify the allergen and the attack responded to medication. 

Mental illness isn’t stupidity, and in my experience, usually not attention seeking.  Don’t be fobbed off because you’re tired of being told you’re nuts.  They’re just rude and you need proper care.  (And besides, who among us isn’t nuts?)

If you’ve suffered trauma, that does not make you a hypochondriac.  Abdominal pain?  Because you were raped.  Back ache?  Because you were raped.  In the wrong body?  Because you were raped.  No ovarian cysts, compressed discs, Gender Identity Disorder for survivors of trauma in some GP surgeries.

 Our bodies DO store our histories and emphatically store our traumas, but in my experience as a trauma therapist, conversion disorders (non-medical pain, paralysis, etc., because of trauma) aren’t as common as I’ve seen them diagnosed.

And while I’m on my soap box, trauma survivors – letting a doctor drug you up isn’t the answer.  Too many women after twenty-five years of a zombie life on medications, eventually sat across from me only to find themselves two years later, back inside their lives, medication free or greatly reduced, doing things they never thought they would do again.  GET A GOOD TRAUMA THERAPIST.  Or even a good enough one.  You never forget your trauma, but you can get back to your life.

Your doctor is not the enemy, but accept that it’s a relationship.  The anti-American GP was recommended to me by a colleague who had a great rapport with her.  If you and your GP don’t fit, ask for someone else in the practice.  Switching practices risks getting branded as a malcontent, but if that’s what it takes, be honest with the new GP. 

Your GP has limitations, only a few that I’ve listed here.  A GP isn’t a mind reader and certainly not a god.  You have to be active in your health care, even when you feel like crap.  It’s important.  You are important.  Be civil but speak up.  Ask questions if you don’t understand.  Go back.  Do not let social discomfort keep you from getting the best care.

If you are genuinely being discriminated against for any reason including race, mental health, trauma history, sexual preference, don’t ignore or accept it.  You will not get top notch medical care if you collude with the idea that you are somehow less-than.  And, you probably aren’t the only patient in that surgery experiencing that prejudice.  If you don’t have the internal resources to survive the complaints process, then move on to a GP without that prejudice.

Writers live in our heads.  When our body isn’t functioning up to snuff, we may ignore it.  If our GP doesn’t think the problem is worth exploring, we tend to believe it.  But don’t believe it if your problem doesn’t go away.  You’re creative.  And the only advocate for your body is you.  Find a way to be the best advocate for your own health care.

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