Wound care saga continues
 

Warning- this is long and relatively uninteresting.


I promised an update on the continuing problem of my toe. I went to the wound care facility for the first time yesterday. It was not impressive, depressed part of the city, feeling of being under permanent renovation, waiting room smelling strongly of staff lunches. I was more nervous than I can remember, my blood pressure was up 22 points each over the previous day's reading at my PCP.
We waited a very long time for the doctor, 40 minutes after he had popped in and said he would be right back. My husband had to track him down as I had my braces back on and was ready to run, fight or flight in full control.

I have a phobia of doctors, started in childhood, and aggravated by the fear that a new one will object to my pain medication. So far everyone sees severe SFN and figures the medication is necessary and appropriate. Not today. "why are you taking morphine?"

The sarcastic answers to that one all rushed to the front at once. I managed to say something about the pain from the neuropathy. He kept asking me what kind of neuropathy it was. I tried, my husband tried, nothing we said seemed to be what he was looking for but he gave no clues-
Small and large fiber peripheral neuropathy?
Length dependent?
CMT type 2?
Hereditary neuropathy?
We described the skin biopsy results, the EMG results, the visits to Johns Hopkins, nothing was sinking in.
He left the room and we turned to the nurse, apologetically but firmly, saying that we really did not see the point in continuing the process with a doctor who was both prejudiced against me because of the morphine and completely ignorant of CMT.
She was very kind, said she noticed his reaction to the mention of morphine and that it was unacceptable. She also told us that he was a general surgeon, not the podiatrist we had been told we were meeting, and that we would see the chief of podiatric surgery at the next meeting. I still wanted out but she had talked me off the ledge in more ways than one.
When the doctor returned she must have communicated something to him, I did notice that she rapidly wrote something on paper and showed it to him when he walked in. He was much nicer. Much,much nicer. We do have very good insurance after all but that is no excuse.

He said the callus was terrible and that I shouldn't be going for walks at all. The wound was small and clean. My ankle seems to be improving slowly. Rather than the hyperbaric therapy they are going to put artificial skin over the holes and cast my foot. Each week they will remove the cast and re-do the procedure. It should heal in 4-6 weeks, but he does not think I will ever be able to walk very far without the callus building up.

My husband has been saying all along that they should just caulk the thing and that does sound like the plan. I have no confidence in this facility but it does sound like a plan and I need a plan since my podiatrist is leaving the practice in November, being the second one to do so since this started.

I have a great deal of shame about being on the pain medication, rather I carry a great deal of shame from childhood and this is one of many triggers, and I am always afraid of being treated like a drug fiend by new doctors. It rarely happens but I worry nonetheless and it happened yesterday. I was really upset. My husband was scared by how upset I was and kept telling me to take a Valium. He said he can't remember seeing me that nervous. I still have an eye twitch today and am a little shaky.

I want to clock this fella in the eye.

I am sorry you had a crummy appointment with such an ignorant doctor. But I am grateful for that nurse and a course of action for your wound.

My best always,

Jon

Oh, Susanne...:hug:

I know exactly how you feel.

I completely understand your fears and apprehension with new doctors. I know all about those looks and comments in regards to narcotics...with their little to no understand of the reason why I am being prescribed. I'm sorry you had to experience this.

I do think the 'plan' is worth trying and I hope you start to have some improvement on your foot. I would think you will know in 2-3 weeks if this approach is going to be helpful...as you should start to see some signs of improvement by then.

Please keep us posted.

This honestly made me shed a tear as I read it. There should be no shame that you are taking a needed medication. But I can tell there is probably nothing anyone here can say to change something that has been ingrained in you since childhood. Just know that we understand and support you. :grouphug:

And - best of luck in your ongoing quest for healing, both physically and emotionally.

Dang It Susanne....
 

Susanne,

You know I understand how our past affects our present - and sends us into a negative spiral for days. Do not allow this ignorant oaf to affect you so badly this time, try to accept the love and support of your hubby and your friends here. Let justified anger win out this time, then calm down (easy to do) and look forward to your next appt with a competent Dr.

Dave.

Thank you all for taking the time to read all that and respond. It helps so much as I know that you understand what this is like. Why are there so many truly nasty doctors out there? Why can't they take the minute or two it would take someone who got through medical school, even by the skin of their teeth, to read our diagnosis? They keep saying computerized medical records will fix all this but I have yet to see it. Twice I have been given a serious diagnosis on my way out the door by a doctor who could not wait to get rid of me.

Dave, I will try and take your advice. My husband deserves a break and for me not to ruin the weekend by withdrawing into a sad, self-indulgent, bundle. The plan is different enough to give me some hope of success. Everyone's comments here have helped so very, very much. Imagine how much a doctor could learn from this forum. So many of the posts reveal how little doctors understand or are even interested in PN.

Thank you again,
Susanne

Suzanne

Like everyone else I want to kick this doc's rear end - even from way down here. I'm so glad you and your Hubby found the courage to discuss his attitude with the nurse and that she at least took you seriously and handled it professionally.

Have you considered discussing the anti-morphine reaction you sometimes get, with the doctor that prescribed it, and asking him to write a professional letter explaining the prescription, which you can carry with you to new doctors.

I know how much you had been anticipating this new treatment and I hope it brings some results. Take care.

A few ruins it for the many
 

First, I hope that the Oxygen saturation and "calking" of your wound is the x-press ticket to healing. My son is a ER nurse at a medium sized med-surg hospital and he tells me of the lies, stories, including family and friends in for the "score". So often that real patients have to wait and staff time wasted trying to sort the abusers from the patients. I am not condoning your Drs reaction but over time I could see how they could become callous. The laws have recently changed and perhaps that will take pressure off the folks that are trying to help us. A few ruins it for the many. Good Luck, Ken in Texas.