Tuesday, April 20, 2010

"Return" of Good Health


I was bamboozled! Tricked! Hoodwinked! Deceived! Coerced into taking drugs I didn't want to take and into having procedures I didn't want to have. Not to mention the emotional strain I was put under and the financial losses I incurred. It has happened before. How did I let it happen again?

I have been
dealing with "pneumonia" all winter. I was first diagnosed with "walking pneumonia" last December after going to see my doctor for a routine check-up. (All I wanted was to have my vitamin D levels checked and in California you need a doctor's order to do that.) The doctor "heard something she didn't like" in my lungs and sent me off for a chest X-ray. I admit I had a little cough in November which I assumed was my asthma acting up. Then in between the office visit and the X-ray, I went on my vacation to Morro Bay and hiked every day! The cough went away (which is what you would expect if you know your Buteyko). But the X-ray showed an "infiltrate" in the lingular region (left side) and between the radiologist and my doctor's physician's assistant (my doctor was on vacation herself by then), it was decided that I had the walking pneumonia. I was put on a round of antibiotics.

I promptly caught a cold because the antibiotic allowed a virus to take hold. I rarely get colds. When my doctor checked me again, my lungs were clear but a follow-up X-ray showed no change. A CT scan was suggested. I objected. To coerce me into having the CT scan she started talking about "tumors" and how it's best to catch lung cancer in its early stages. Never mind that the infiltrate was on the left and what she heard that she didn't like was on the right. When I asked what the symptoms of cancer would be, she said recurring pneumonias. She is an internist, but pulmonary is her specialty. I figured she knew what she was talking about and eventually, I agreed to the CT scan.

The CT scan showed that my lungs were full of junk (that's my word not the doctor's). There were these little 2mm, 3mm, 8mm "nodules" all over the place, there was a patch of partial atelectasis (where the avioli partially collapse) and other things. The nodules were too small to be cancer, I was told, but they needed to be watched to make sure they didn't grow. No mass, no tumor. My doctor asked about a stuffy nose—no—post-nasal drip—no—lots of throat clearing—no—out of breath?—no again. I didn't dare tell her about
oil pulling which I am sure she would not have given any credit for keeping my nose clear. I did try to tell her about Buteyko and when I said he recommended shallow breathing—wrong word—she promptly opened her mouth and took several quick breaths. Like that? No.

I tried not to let my fears get out of control, but that is what they did. After that, every time I went to see my doctor, my asthma would act up. I would wheeze, clear my throat a lot, cough, and generally fill up with phlegm. My blood pressure and pulse would go up as well. I just couldn't seem to calm myself down. I was prescribed an inhaler (I haven't used an inhaler in five years). I tried to explain that I really felt fine and didn't have any trouble at home, only when I came in to the doctor's office. I was told the inhaler would help with the "tightness" in my chest which I didn't feel.

Then at the end of February, I caught another cold. And it was a doozy. Worst cold I have had in years. I thought I was doing a good job of keeping it out of my chest and after two weeks felt I was recovering. That was when I started going on
daily two-mile walks to bring up my CP. But another doctor's appointment came along and I literally filled up with mucous as I sat waiting in the examining room. I argued with my doctor over medication. She wanted me to start an antibiotic again. Because of our disagreement, she did also suggest I might be more comfortable with a more holistic doctor. I was thinking the same thing myself, but didn't know where to begin to look for one. I am all for science-based medicine. What I am against is drug-based medicine, or invasive-procedure-based medicine. I am against treating the symptoms and not even looking for a cause.

When I went home I had too much time to think about things. This time, the congestion did not go away as it usually did and then the pain in my chest returned. The pain in my chest has been diagnosed as a muscle pull, pleurisy, or GERD depending on which doctor I asked about it. I have had it before, same spot, when I was treated for GERD. It went away eventually, but took a long time. It was a Friday and my doctor is not in her office on Fridays. Her nurse practitioner suggested I go to an urgent care center which is what I did. The freshly-minted young doctor at the urgent care center put me on another antibiotic since that is what I said my own doctor wanted to do. No X-ray, no blood test to see if I had a raised white blood cell count.

By Sunday morning I was absolutely miserable! But it wasn't my breathing that I was having trouble with, it was my stomach. I also had a very bad case of oral thrush. When I called the urgent care doctor, I was told that this was a side effect of the antibiotic and that if I couldn't tolerate it, they would have to put me in the hospital where I could get the antibiotic by IV. That shut me up. He suggested taking an antihistamine for the stomach problem. I asked my own doctor on Monday morning at what point should I get myself to a hospital and she said, when you can't breathe. I could breathe just fine, it was my stomach that was killing me. Fortunately, I only had to take that antiobiotic for 5 days.

Back to my own doctor on the following Wednesday who prescribed four medications, a different antibiotic, prednisone, a pill for the stomach yeast infection, and lozenges for the oral thrush. I had to make up a chart to know when to take each of these meds. The antibiotic made me spacey and the prednisone made me hyper. I was on the antibiotic for 10 more days and my doctor wanted to extend it even further (5 days extra), but because of a mix-up with her office staff, my pharmacy didn't get the new prescription until after I had already stopped the original dose. I never took the extra dose.

Coming off the prednisone was not easy. I tapered it down as I was told, but my first full day off of it, I crashed. No energy and huge stomach problems, but my lungs were fine. I tried all my own home remedies for the stomach upset: taking probiotics (see Dr. Ayers blog about antibiotics and gut flora), DGL, enzyme tablets with meals, drinking ginger tea, sipping lots of water with sweet lime squeezed in it, and avoiding sugar. All of these helped to some extent, but I would have a few good days and then several bad days and it didn't seem to follow any pattern.

At the next office visit, I tried to ward off the usual reactions by taking a couple of puffs of the "rescue" inhaler an hour before. Didn't help. If anything, it made things worse. Now I was told that if I didn't get things under control, I'd have to go back on the antibiotic. I was prescribed two new meds. I begged her not to give me anything with a steroid in it because I still thought the stomach problem was a candida infection (lots of doctors don't recognize too much yeast in the gut as a problem and candida loves steroids). She gave me a pill for hay fever and allergy symptoms (neither of which I have) and a new inhaler that is usually prescribed for people with COPD (Chronic Obstructive Pulmonary Disease). She thought she should warn me that the first medication has been known to cause depression. The second medication causes glaucoma, and both cause stomach upset. Great. But she also recommended a pulmonologist for me to see for a second opinion.

When my stomach still didn't settle down, I started taking these meds because when my stomach was upset I would get congested. I found that at those times I had reverted to chest breathing. Then I called my gastroenterologist for help. He put me on "industrial strength" Zantac. For two whole days, I felt great. Then all the stomach problems started to return.

That brings us to last week when I felt so bad that I had my neighbor drive me to the ER where I spent a grueling day waiting for over 6 hours to be seen by a doctor (my doctor was not in her office even though this was Tuesday and I couldn't get an earlier appointment with the new pulmonologist). I was mostly feeling miserable with my stomach problems but I was afraid that the pneumonia was coming back and if they put me on antibiotics again, my stomach couldn't tolerate it. They took another chest X-ray and said there was no pneumonia and the doctor in the ER came to the conclusion that I had really bad GERD. GERD I was told can cause congestion.

On Wednesday, I saw my gastroenterologist. He thought I had some kind of a viral enteritis. I told him that I would have one or two good days followed by three bad days and he said that's the way it goes. He didn't see any need for more scoping and tried to cheer me up by telling me my lungs were clear and that the blood work done in the ER showed there was no infection.

Then on Thursday I finally got to see the new pulmonologist. As I sat in his examining room, I thought about the fact that he was recommended by my doctor. I noticed that the walls were adorned with all the usual posters from pharmaceutical companies extolling the merits of all those wonderful inhalers. I expected him to tell me more of the same but instead he waltzed in and he tells me my lungs are fine! (A 9.5 out of 10, he said.) He showed me the CT scan on his computer and told me that the "nodules" that the radiologist found all throughout my lungs are nothing more than my own blood vessels seen end-on!!!! I was incredulous!! The atelectasis was gone. The "infiltrate" was "nothing." He said the only thing worth worrying about is a very small area of the right lung that he wants to check in 4-6 months or even a year. He then told me to stay away from doctors.


I have stopped all meds and am going to be looking for a new primary care physician. And I am making a rapid (miraculous even) recovery from the GERD. By the way, the radiologist had the nerve to charge my insurance $2300 for the analysis of my CT scan. The pulmonologist said that's what's wrong with American medicine. So I have my health back, and my life! My brother (the family skeptic) said I should have gotten a second or even third opinion much sooner. It's questionable now whether or not I ever had pneumonia. I never had a fever and all the stomach problems were due to the meds and a lot of worry.

Kurt Harris, one of the doctor/bloggers, on his blog PaNu made a comment that: "The biggest myth in all of medicine is that doing something is always better than doing nothing, with the corollary that there is always some marginal non-negative benefit to every test and procedure. I believe this is profoundly mistaken. The average medical service diagnostic or therapeutic, may actually not only not have a positive net benefit, but may have a net negative one." He calls a lot of testing (such as for lipid profiles, for example) "just fuel for neurosis." Amen.

So now you understand the hiking binge. I have not really been able to assimilate all of this yet. When I have a problem and don't know what to do, I go for a walk (or I write about it). In a way I have had a journey and come back. I have found a new sense of myself and it has prompted me to make a few decisions about my future. I have found that I have wonderful friends and neighbors willing to help me out when I need it. I'd like to say that next time I will trust my own instincts more, but it would seem that the tremendous influence a person in authority can have over me might override that. I hope not.

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