I *heart* my GP
Oct. 28th, 2005 02:34 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
baratronTrundled off to the doctor's this morning - he was running a mere 20 minutes late, quite impressive for him. He is thoroughly horrified by my experience, and agrees that everyone concerned should have damn well known that I was "anxious" in advance. He said doctors should always tell the patient before doing something with a needle, because it makes it hurt less! It's not just me being unreasonable! He is also mystified by what appears to be a new idea that you can't give the patient anything to relax them prior to getting to the anaesthetic room, as it doesn't just help mentally, it also helps to get muscles relaxed.
Mostly, he was angry: that his patient that he'd spent a lot of time on getting sane & happy had had a horrible experience at the hands of so-called medical "professionals", and was all upset again, as well as still being ill. When I was leaving, he gave me a cuddle. Some people would call that unprofessional, but I call that comforting another human being in distress (he did ask first!). (I hate the fact that in teaching, you're not allowed to touch the kids even when they're very upset and clearly want a sign that you care.)
Current plans are as follows:
1) Try a gallstone-dissolving drug to see if it does anything. If I've got to wait anyway, I might as well try it. The worst it can do is nothing.
2) He will write to the consultant to find out what the wait will be and confirm whether I can get anything to calm me down prior to surgery.
3) If the gallstones don't dissolve themselves, look into just hoicking them out rather than the whole gall bladder. This is done under local anaesthetic, thus mitigating my worries. (The existing consultant refused point blank to do that, arguing that I'd only end up back there in 5 years with the same problem even when I explained I would happily stick to the low-fat diet).
4) If replies to 2) & 3) are non-helpful, get referred to a different hospital. He understands exactly why I don't want to go back to Kingston.
Meanwhile, I will be:
5) Talking to friendly anaesthetists of my acquaintance to find out what current NHS practice really is.![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
bfo suggested her friend Mhairi, and Richard has a paintballing associate called Puffy. If anyone else has a pet anaesthetist, do let me know - even dental anaesthetists might be helpful.
6) Looking into costs of going privately. The New Victoria Hospital (the nearest private hospital) charges £4000 for laparoscopic cholesystectomy (sp?), but it's not itemised. I don't know whether, for instance, already having the results of two ultrasounds would reduce the work they'd need to do and thus the cost. I haven't looked at the cost of gallstone removal yet.
7) Sorting out a blood cholesterol test. I forgot to ask this time. Gallstones are basically caused by high cholesterol levels. But I'm vegan (thus eating very little cholesterol) and I eat tons of soya (which is supposed to reduce cholesterol levels). So it could be caused by the Efexor. Before the trauma of this, I was extremely sane - in theory, I probably could reduce my dose from 225mg down to 150mg without going nuts, if that would stop further gallstones forming.
8. Looking vaguely into medical hypnosis, although I'm almost as afraid of that as I am of general anaesthetic. (I am a control freak. What's new?)
My mental state has improved not least in part because I rang up the owner of a restaurant we used to go to all the time, and explained why we hadn't been in for so long. We went down there and he pointed out all the low-fat choices, and asked the kitchen to make some of my favourite foods without fat. I'd thought about trying this before, but just didn't have the energy to expend on explaining why I couldn't have fat - in retrospect, this was a bit daft - I would have gained emotional energy from being relaxed & pampered. Damn.
Cooking at home is all very well, but it's tiring, and Richard & I have always eaten out - even when we couldn't really afford it, we still ate out once or twice a week, and just made cutbacks in other areas. Eating out is pleasing on so many levels: eating good food, that you can't make at home, or can't be bothered to make at home; sitting together talking, or just in companionable silence for an hour and a half, rather than eating in 20 minutes with the plate on your lap; making time to physically go somewhere together. If we can start eating out again, even if it must be less often than before and involve fewer restaurants than before - that will make a helluva difference.
Richard had garlic bread, and I got plain bread - lovely organic wholemeal bread, that until recently I would have turned my nose up at. But I found I actually appreciate the texture of it now. (My tastes have changed a lot over the past few months - I find even the thought of potato crisps nauseating now, and can't imagine that I'll ever start eating them again. Still crave tortilla chips occasionally, but there must be a trick to making your own.) My main course was savoury pancake with four beans and potato filling. I always count the beans to make sure :) Actually, there were five types this time - kidney, cannellini, runner, butter and black-eye beans. Sometimes there are chickpeas as well, and then we have the whole question of whether chickpeas are a bean (Americans call them garbanzo beans), and should they be included in the count? Richard had nut roast with creamy wild mushroom sauce, roast potatoes and saute vegetables - something that we haven't been able to have at home for months. For pudding, I had fruit sorbet - lemon, mango and blackcurrant, while Richard had a double espresso. All in all, we came home thoroughly relaxed - well, until I had a flashback to the anaesthetic room :/
I have, btw, lost another 4kg of mass since two weeks ago. I'm just mentioning this. Still don't want congratulating, but it's impressive how an ultra-low fat diet plus lots of stress can make you lose "weight" ;) Whether the low-fat diet without the stress would do the same thing, I'm not sure, but it's probably worth trying. When I have copious free time (read: enough mental/emotional energy), I'm going to type up all my recipes and put them on my web site for other people to enjoy. If you can make fantastic chocolate brownies that are totally fat-free, why bother with the unhealthy kind?
Mostly, he was angry: that his patient that he'd spent a lot of time on getting sane & happy had had a horrible experience at the hands of so-called medical "professionals", and was all upset again, as well as still being ill. When I was leaving, he gave me a cuddle. Some people would call that unprofessional, but I call that comforting another human being in distress (he did ask first!). (I hate the fact that in teaching, you're not allowed to touch the kids even when they're very upset and clearly want a sign that you care.)
Current plans are as follows:
1) Try a gallstone-dissolving drug to see if it does anything. If I've got to wait anyway, I might as well try it. The worst it can do is nothing.
2) He will write to the consultant to find out what the wait will be and confirm whether I can get anything to calm me down prior to surgery.
3) If the gallstones don't dissolve themselves, look into just hoicking them out rather than the whole gall bladder. This is done under local anaesthetic, thus mitigating my worries. (The existing consultant refused point blank to do that, arguing that I'd only end up back there in 5 years with the same problem even when I explained I would happily stick to the low-fat diet).
4) If replies to 2) & 3) are non-helpful, get referred to a different hospital. He understands exactly why I don't want to go back to Kingston.
Meanwhile, I will be:
5) Talking to friendly anaesthetists of my acquaintance to find out what current NHS practice really is.
bfo suggested her friend Mhairi, and Richard has a paintballing associate called Puffy. If anyone else has a pet anaesthetist, do let me know - even dental anaesthetists might be helpful.6) Looking into costs of going privately. The New Victoria Hospital (the nearest private hospital) charges £4000 for laparoscopic cholesystectomy (sp?), but it's not itemised. I don't know whether, for instance, already having the results of two ultrasounds would reduce the work they'd need to do and thus the cost. I haven't looked at the cost of gallstone removal yet.
7) Sorting out a blood cholesterol test. I forgot to ask this time. Gallstones are basically caused by high cholesterol levels. But I'm vegan (thus eating very little cholesterol) and I eat tons of soya (which is supposed to reduce cholesterol levels). So it could be caused by the Efexor. Before the trauma of this, I was extremely sane - in theory, I probably could reduce my dose from 225mg down to 150mg without going nuts, if that would stop further gallstones forming.
8. Looking vaguely into medical hypnosis, although I'm almost as afraid of that as I am of general anaesthetic. (I am a control freak. What's new?)
My mental state has improved not least in part because I rang up the owner of a restaurant we used to go to all the time, and explained why we hadn't been in for so long. We went down there and he pointed out all the low-fat choices, and asked the kitchen to make some of my favourite foods without fat. I'd thought about trying this before, but just didn't have the energy to expend on explaining why I couldn't have fat - in retrospect, this was a bit daft - I would have gained emotional energy from being relaxed & pampered. Damn.
Cooking at home is all very well, but it's tiring, and Richard & I have always eaten out - even when we couldn't really afford it, we still ate out once or twice a week, and just made cutbacks in other areas. Eating out is pleasing on so many levels: eating good food, that you can't make at home, or can't be bothered to make at home; sitting together talking, or just in companionable silence for an hour and a half, rather than eating in 20 minutes with the plate on your lap; making time to physically go somewhere together. If we can start eating out again, even if it must be less often than before and involve fewer restaurants than before - that will make a helluva difference.
Richard had garlic bread, and I got plain bread - lovely organic wholemeal bread, that until recently I would have turned my nose up at. But I found I actually appreciate the texture of it now. (My tastes have changed a lot over the past few months - I find even the thought of potato crisps nauseating now, and can't imagine that I'll ever start eating them again. Still crave tortilla chips occasionally, but there must be a trick to making your own.) My main course was savoury pancake with four beans and potato filling. I always count the beans to make sure :) Actually, there were five types this time - kidney, cannellini, runner, butter and black-eye beans. Sometimes there are chickpeas as well, and then we have the whole question of whether chickpeas are a bean (Americans call them garbanzo beans), and should they be included in the count? Richard had nut roast with creamy wild mushroom sauce, roast potatoes and saute vegetables - something that we haven't been able to have at home for months. For pudding, I had fruit sorbet - lemon, mango and blackcurrant, while Richard had a double espresso. All in all, we came home thoroughly relaxed - well, until I had a flashback to the anaesthetic room :/
I have, btw, lost another 4kg of mass since two weeks ago. I'm just mentioning this. Still don't want congratulating, but it's impressive how an ultra-low fat diet plus lots of stress can make you lose "weight" ;) Whether the low-fat diet without the stress would do the same thing, I'm not sure, but it's probably worth trying. When I have copious free time (read: enough mental/emotional energy), I'm going to type up all my recipes and put them on my web site for other people to enjoy. If you can make fantastic chocolate brownies that are totally fat-free, why bother with the unhealthy kind?
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no subject
Date: 2005-10-28 01:48 pm (UTC)I would really love to see your fat free recipes, as I need to lose mass rather badly (it's making me actively uncomfortable again :-()
no subject
Date: 2005-10-28 02:16 pm (UTC)Getting a decent psychdoc really is so much down to luck. My depression became treatment-resistant thanks to my previous GP, who'd given me Prozac for a month and when it didn't work said "oh well, you don't have biochemical depression then". Not "maybe Prozac isn't the right drug for you, let's try something else"! But I've had this rant before, many times.
I agree that if you are currently not depressed, it is probably because the antidepressants are working. If you are an otherwise-healthy adult, and you have had more than 3 bouts of serious depression lasting several months at a time, the usual maintenance/prevention treatment is to keep you on the lowest possible dosage of antidepressants that keeps you stable. One episode of depression can be situational, two could be caused by "stuck thermostats" (when your neurotransmitter levels get messed up and don't reset when the cause of stress has been removed), but by the third one it's clear that something is Broken. I understand patients being unwilling to take drugs for no real reason, and doctors being unwilling to prescribe long therapies - but if a drug works without too many side-effects, and it's not going to eat your liver, it seems far more sensible to keep someone stable so they can carry on going to work and having A Life than let them risk getting totally broken again. The cost of emergency treatment if you get badly broken is far more than the cost of a year or a couple of years' worth of antidepressants - I think a single night in hospital is supposed to cost the NHS £1000, or something equally ridiculous.
The chocolate brownie recipe (http://www.livejournal.com/users/baratron/324206.html) is online already. If you don't care for banana puree, you can use applesauce instead. You can also cut the amount of sugar down considerably, from 120g to 80g or less, and use even stronger unrefined sugar than dark brown soft. I'll try to type up some of my other recipes for you.
no subject
Date: 2005-10-28 01:53 pm (UTC)re piont 7 unfortunatly cholesterol isn't just diet (and drug) related, my Dad has consistantly high colestrol in sipte of haveing an inbuild aversion to most high colesterol/fatty foods - now he's old and offically "at risk" he's been put on satins although he's otherwise very healthy. Because of his high levels i asked to have mine screened when i was having some other blood tests and luckly it was low (acatully i was told it was "very good for west yorkshire"!). Could satins be a sensible option for you - or are they yet another thing you can't have?
i offically have a cold now so i'm not going to be in london this weekend
no subject
Date: 2005-10-28 02:01 pm (UTC)Sorry that you have a cold - but perhaps it is better that you have an actual Virus, rather than the usual low-immunity glandyness? At least you know how long a cold will last, whereas glandyness can go on indefinitely... ?
no subject
Date: 2005-10-28 01:59 pm (UTC)Glad you enjoyed your meal.
no subject
Date: 2005-10-28 02:24 pm (UTC)So sorry you had a terrible experience & didn't get to have the surgery done.
~Maggie from GSC2
P.S. - may I be added to your other f'list, please?
no subject
Date: 2005-10-28 02:30 pm (UTC)I lost track of the time, & didn't think you'd be up yet :P
dialect AND taxonomy!
Date: 2005-10-28 03:52 pm (UTC)no subject
Date: 2005-10-28 04:08 pm (UTC)no subject
Date: 2005-10-28 05:33 pm (UTC)BTW, I was also told that many times gallstones dissolve, which is probably what happened with mine. I hope those kind of meds will work for you.
no subject
Date: 2005-10-28 09:06 pm (UTC)I was led to believe that small gallstones (gravel) are more likely to be calcified - but I now don't remember who told me that. Certainly, mine are small and gravelly - and I have lost many between ultrasound 1 and ultrasound 2. Well, we'll see.
no subject
Date: 2005-10-28 05:55 pm (UTC)The other suggestions are well worth looking into for maintainence and possible permanent solutions. I am not sure how statins would help you though as I believe they are one of those once started have to be continued for life things.
If you or others take up
Your restaurant guy sounds ace. I hope you'll be able to eat out a bit more from now on as that is so good for your mental health :)
no subject
Date: 2005-10-28 09:13 pm (UTC)It's made easier by the fact that round here, NHS hospitals specialise. So there are a limited number of hospitals that would do gall bladder surgery.
There are lots of ace people of my acquaintance. My livejournal friends list and the people I know from various web forums are all included in that :) But yes, this particular restaurant really is good for difficult diets. The standard menu states whether items on it are wheat-free/gluten-free/vegan/organic, and as everything is made in-house, it's easy enough to make alterations for individual customers. The owner and the waitstaff who run the place when he's not there all have fantastic memories, and remember which of the regulars are vegan or coeliac or whatever.
Mind you, asking for modifications to be made to meals does get you remembered. Just about everyone in Kingston's Wagamama knows I don't eat egg, even the ones I haven't told!
no subject
Date: 2005-10-29 06:31 pm (UTC)no subject
Date: 2005-10-29 07:27 am (UTC)Sounds like you have a great GP though. Such creatures are a rare delight. I'll see if I can find an anaesthetist and ask about pre-med procedures.
no subject
Date: 2005-10-29 11:41 pm (UTC)One of the reasons my GP is good is that I have successfully trained him to appreciate that I can understand reasonably complicated scientific/medical jargon :) Also, he shows me the MIMS book before prescribing anything, so I can check for myself whether there are any obvious clashes with other medication.
It strikes me a lot of my problems with the medical profession come from what I might call "opaque doctoring" - the idea that only the doctor is allowed to know what's really going on, and the patient must be presented only with a black box. "I know best because I'm the doctor". I cannot deal with people who treat me like that at all. The medical professionals I've got on with (nurses, doctors, psychologists and physiotherapists - physios in particular are brilliant) have all done the opposite, "transparent doctoring", where they've explained to me why a procedure is necessary in full, with the detail at an appropriate level of science for my existing knowledge, and without being patronising. Perhaps food for thought for your student medics, if you feel like writing any more ranty letters? :D
no subject
Date: 2005-10-30 10:34 pm (UTC)I agree with you about some of the problems with the medical profession. I'm lucky that half of my conditions are so obscure that people ask me for the best sources of basic information about them. I've never had anyone medical tell me that my conditions don't exist, although there's a permanent state of debate about what I should be labelled as :)
no subject
Date: 2005-10-29 12:52 pm (UTC)I don't know what the pre-med was exactly but that would seem to suggest that the no-pre-med thing is indeed bollocks.