Be Your Own Doctor.

 In Anxiety and Stress, Compassion, Promoting Tolerance

A few weeks ago, my IBS and acid reflux emerged stronger than ever before. Unabated episodes of belching, extreme bloating, and burning in my stomach exacerbated daily. Lying on the couch curled up in pain, my parents and I called my primary care: I was eager to see a doctor. He told me we could arrange a telemedicine appointment as in-person visits were being limited to potential COVID-19 patients. 

The telemedicine call lasted for approximately 12 minutes. Acquainted with my condition in the past, my physician advised me to cut my fruit intake and to keep a food diary. He concluded the conversation by promising to follow up in two weeks. 

Each day, I only felt worse. This was shocking to me as my diet consists of all-natural and healthy foods, and through quarantine, my symptoms subsided tremendously. But now, anything I ate caused extreme inflammation and distress in my gut. As a highly active person who craves intense workouts, it was even harder: bouncing caused my insides to flare up: a fire in my stomach, as I like to call it. The 7 am runs that served as my morning remedy only aggravated my body. The burning consumed me entirely. Belching for hours-on-end left me dizzy and fatigued, which even made walking outside utterly exhausting. I couldn’t function; I simply couldn’t tolerate more. 

As the two week period came to a close, I was desperate for treatment. There was no follow up. 

We called the office several times, but my physician was unavailable. Messages were left via the front desk, but there was little to no response. We proceeded to call several different hospitals, but without a referral and time slots booked solely for COVID patients, no appointments were available until August. 

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My story is not unique. I know that many people live with IBS and acid reflux, and I’ve been able to cope with it for the past few years. But when a situation becomes unbearable–whether it be medically, socially, or emotionally– I’ve always been taught to relieve myself. Simply put, if something’s wrong, forge ahead and take action. Life is too short, life is too precious. 

But when all plausible solutions are tried and all fail, professional help is necessary. Deprived of attention by my primary care, I felt completely hopeless: how long will this go on? What if I have some underlying condition I don’t know about? Emotionally ravaged by my physical pain, I began to frantically research my symptoms. Stomach cancer? Pancreatitis? No way, Sabrina, cut it out– you’re paranoid. The wealth of information lingering on the internet is vast, nor is it specific enough alone. 

We decided to reach out to a close friend of ours who specializes in Gastroenterology. Not only did she pick apart my diet to the bone, but she showed tremendous compassion. She spent over an hour with me over the phone, explaining my condition to me in plain language with ease and reassurance. I felt cared for and even comforted while physically, I was experiencing tremendous discomfort. She advised me to have blood work done and linked us to a few specialists she had connections to. 

After three weeks, my physician finally approved the tests we filed for. The results trickled in over a few days, and according to my doctor, I had nothing to worry about. But I was still in pain. I couldn’t eat without belching for hours afterward. Was this not enough to be worried about?

—————–

Plumped on the couch one morning eating my gluten-free avocado toast–a true savior to my stomach–I came across an article in the New York Times by cardiologist Dr. Sandeep Jauhar. It was titled, People Have Stopped Going to the Doctor. Most Seem Just Fine. The piece illuminated the impact of the pandemic on our healthcare system, as routine appointments had been postponed due to the massive influx of COVID patients. The columnist revealed that most people who had their surgeries postponed, are in fact, doing very well healing at home. He discusses that much of the ‘care’ we receive today is indeed unnecessary. Billions of dollars, hours, and skills are being wasted on procedures that are often performed to checkboxes. According to The Atlantic, we waste over 750 billion–over half of the total budget–on what Dr. Jauhar considers “wasteful care.” Additionally, the cardiologist touches upon how medical companies are driven by ulterior motives fueled by liability and money. Statista cited that our healthcare system is the most expensive, yet most ineffective and unequal in the world. This system’s function lies not in treating the patient, but in filling pockets. Even when it comes to health, the foundation of human life, money and reputation come first. 

I couldn’t help but connect this to my primary care’s response after my first lab results came back. While they were ‘perfect,’ I was still experiencing the same symptoms: obviously, something was off–not perfect. The ‘perfect’ results checked boxes for the doctor and placed a blank sheet over my feelings: my belching, bloating, and burning were irrelevant and ignored. Back at square one, I focused on instant relief with a commitment to keep my diet clean and bland. My only choice was to be my own doctor–to know my body and heal myself.

That very morning I was relieved to discover that referrals to four gastroenterologists came through. But again, unfortunately, none of them could see me until August. Why was my physician referring me to specialists who couldn’t actually see me? 

The final receptionist my mom and I spoke with brought to light how truly crooked with greed our healthcare system is. “You know, since COVID19, specialists were furloughed and are not working at this time, they need to catch up on the appointments that have been postponed.” She proposed that, if we sought immediate care, we take a trip to the Emergency Room at the Children’s Hospital. Instantly I wondered, Why would I need to go to the ER for gastrointestinal reflux issues? But left with no choice, we did just that and hoped a GI would be available at the hospital. Upon arrival, I was shocked to see there was no line and proceeded to ask the woman at the front desk if any Gastro doctors were available. She shook her head no and continued by telling me that no specialists were currently working. The puzzle pieces finally clicked.

Why were all non-COVID patients being sent to the Emergency Room if specialists were not working? Why pay hundreds of dollars for appointment after appointment without a true specialist? Wasteful care fills pockets to the top. A visit to the ER is among the most expensive, as on-call doctors usually treat severe infections, broken bones, or other medical emergencies. But with conditions like mine–not true emergencies– an ER doctor would perform general exams that cost hundreds of dollars. According to their protocol, I would need a COVID test as well. All of these, for my condition, would be repetitive and useless. I would be prescribed pricy drugs that I have already tried with no success. Simply put, without a specialist, I wouldn’t get the help I needed. 

Deciding against seeing an ER doctor, as this would waste both time and money alike, my mom drove me back home. In the car, we repeatedly called my doctor’s office: no response. 

Fortunately, my health insurance allows me to schedule visits in other health systems than my own: we called one of the doctors my mom’s friend recommended. Since we belong to a different system, my medical records would need to be transferred. But this could only be done with the consent of my physician. After another couple days of nudging my doctor with repetitive calls, there was a possibility of me seeing a specialist–that is, only if the GI reviews my file and approves me.

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Three weeks after my blood work was done, we received the last two test results. These included my comprehensive metabolic levels, which would show the mineral levels existing in my body. Even when the results are perfect, my doctor has always sent a summary confirming my results. This time, however, a message accompanying the labs was absent. I noticed a few red flags– numbers that were out of the normal range– so I would have expected an explanation.

After sending an email through my portal requesting a note, I decided to do some research myself. Three of the values with odd levels had a clear connection to a couple of specific conditions. My symptoms aligned with them both. If my results indicated that something was off, why wasn’t the doctor following up to discuss with me? Why did I–the patient in this situation–have to go hunting for answers?  

In the heat of the moment, I called my doctor’s office and demanded to speak with him immediately. Only his nurse practitioner was available. Surprised that my doctor hadn’t submitted a general summary with my lab work, the nurse continued by asking me what concerns I had. I shared my findings from my research with her, but she doubted that I had such conditions because they sounded extreme. Regardless, she requested that I send her the article I read. 

The next day, she called me back after a meeting with the doctor. Promising that an official note would come from him shortly, she admitted that the article I had sent her was, in fact, eye-opening and very interesting. The possibility of me having one of the two conditions was likely: one was ruled out due to severity, but the latter seemed highly probable. The nurse explained that I needed to see a specialist as only a GI doctor could perform a test for this with a proper diagnosis. Was my primary care doctor ever going to tell me this? 

Only two days after this very phone call with the nurse did my doctor follow up with a message suggesting that again, I had nothing to be worried about. My labs were “reassuring.” He didn’t follow up about my symptoms nor did he ask how I was feeling. Despite my disappointment, I decided to move forward. 

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The link between the brain and the gut is strong: stress and mental instability trigger indigestion and pain. The first question doctors ask when you report symptoms of gastrointestinal discomfort is: are you stressed, worried, or anxious? My answer was ‘yes’ a couple of years ago. But now, as a high school graduate looking forward to my journey ahead, I’m happier than ever before. While I’m still clueless as to what turned my stomach upside down, the process of finding medical care was undoubtedly frustrating. Worry and uncertainty are at the root of anxiety. Searching for answers on my own surely induced tremendous emotional distress; my symptoms exacerbating daily could be attributed, in part, to this. The GI has yet to approve my visit, but until then, I’m on my own. He still hasn’t called back. 

Every obstacle in life prompts self-reflection and teaches us about society itself. Amidst a global pandemic, I was exposed first-hand to the warped reality of the American healthcare system. The Coronavirus, while ravaging our world with tragedy, has revealed and has fostered flaws in existing national institutions. Like Dr. Jauhar mentioned in his editorial, this chaotic period in history is a catalyst for change. Healthcare in this country certainly calls for reform. There is no excuse when doctors don’t follow up.

I am fortunate to have had amazing friends and family, especially those with medical expertise answering my questions and comforting me every step of the way. Honestly, without them, I would’ve been more lost, confused, and scared than I was. But how are people who live alone or lack a strong support system supposed to overcome these challenges?

I think most of us can admit that we trust our doctors among the experts we depend on for information and advice: I would like to believe that we should. However, this experience affirmed that I am the only person I can truly rely on. No matter how many times you explain your emotions or symptoms to somebody else, you are the only one experiencing and internalizing them. If we feel sick and uneasy but everything looks fine on the outside, we must persist for proper treatment. When you need professional help, and you feel failed by one doctor, call three more: not every medic with a Ph.D. or a title will have expertise in a certain field. Get second, third, and fourth opinions to broaden your scope. Get the help that YOU need. This is why, regardless of numbers and results, we must be honest with ourselves. You cannot expect anyone to respond nor to care. As individuals, we must take full responsibility for our actions, for our health, and our being. Be your own doctor: know your body, heal yourself. 

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