Paul's Heart

Life As A Dad, And A Survivor

Archive for the day “June 20, 2020”

Not The Reaction I Had Expected


Have you ever had a doctor yell at you?

I have had plenty of doctors give me lectures, and even my primary care doctor of thirty years has expressed frustration with me as her patient when I contradict the advice she feels is best for me.  But I had never had a doctor actually yell or scold me before.  And the strange thing was, it had nothing to do with my physical body, which given all the health issues I deal with, would have at least had some grounds to do so.

No, it was something that I had said to him, that set him off.  By the time he was done with me, I realized that I had deserved it.

In 2008, following my emergency heart surgery, and upon learning that I had many other issues related to the cancer treatments that I received back in 1989 and 1990, I became a patient at the long term survivorship program at Memorial Sloan Kettering Cancer Center.  I saw several different specialists to deal with all the things that had been discovered.

I was seeing the doctor I have been alluding to for a couple of things, issues related to my lungs and my immunity, and more importantly, pain.  I had made several appointments previously with him, and all seemed to go well.  Physical therapy was prescribed, and so were several medications.  The source of the pain was permanent damage.  The whole point of dealing with the pain and muscle issues, was more about management, quality of life.

For most of my fellow survivors, it is hard enough finding help to deal with issues that the common doctor does not understand, because they never learned about long term side effects from chemotherapy and radiation therapy, because, well, cancer survivors were not expected to live that long.  At least that is the way it seemed.

So, if like me, lucky enough to find a doctor that understands, and can help us to understand what we are going through, that is half of the battle.  The first thing the doctor did, was point out everything he knew.  Much of it, did not even require any kind of diagnostic tool like an x-ray.  The damage from my radiation therapy nearly twenty years earlier was obvious from a head that hung forward (I was often accused of walking like I was depressed) and though both of my shoulders had visible signs of muscle loss, the effects on one shoulder were far worse than the other as the resulting unevenness of both shoulders.  He ordered some lung testing including x-rays and pulmonary function testing, which revealed issues as well.  The only thing left for him was “quality of life” issues, pain and sleep.

From the very first appointment with him, just like I had heard from my other doctors, I was simply too hard on my body, physically and emotionally, for as compromised as it was.  My late side effects are progressive in nature, only going to get worse.  Which meant my pain levels, and my inability to sleep, would have to be managed.  And refusing to ease up on my work load, led me to end up on one opiode prescription, then a second, and a third.  Even on three different prescriptions, by the end of my work day, my body was in so much pain, I would add a sleep aid, which also gradually increased until finally on the maximum dose, which should have kept me asleep for twelve hours, only last for two hours.

From a patient standpoint, I was doing everything I could, and my doctors were doing everything for me.  But at a follow up with this doctor about a year later, I responded to a question my doctor had asked me, and his response to my answer involved “lighting my ass on fire”.

“So, how are you today, Paul?”

“Pretty much the same, perhaps maybe a little worse.  I know that I am struggling emotionally right now with all the limitations that are happening with me.  It doesn’t seem either that I am getting any relief from the meds anymore (clearly a concern of addiction and tolerance, after all, I was on four very powerful meds).  I don’t know doc.  Maybe I just need to accept what is happening to me, let it take its course.  I should stop complaining about what is happening.  It was the deal I made voluntarily when I agree to treat my cancer.  Even though we didn’t know this could happen, this is the price I ended up paying for my cure.  I could have just not gotten treated and let it run its course.  But I made this deal.  I deserve the issues I am dealing with.”

“How dare you?  I have never had a patient tell me that they deserve what side effects that they are facing and it is not right for you to be doing it either.”  His lecture went on for quite a while.  I was being scolded, but not in anger.  And it was not his feelings either that he was throwing at me.  He was concerned for me, realizing that I was clearly at a turning point and he needed to get me back on track.

When I say that I am blessed to have the best doctors, I do know that I do.  I continued to see him for several years until he left for another practice.  I recently saw him a few months ago, via a webinar, and he was glad to hear from me.  Even better, as my issues continue to progress, I have been able to improve my quality of life.  Major lifestyle changes have given my body physically and emotionally the breaks that it needed, to the point, I am no longer on those medications that only masked the pain and sleep issues, not resolve them.  I still deal with pain, but pain that no longer keeps me awake, and pain that I no longer allow to get to a point that I cannot take it anymore.

I have never had a doctor yell at me like that, and honestly, I do not ever want that to happen again.

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