biopsy

[kaysixteen]

Nothing I have said here is wrong, nor a problem with me.   I want to call them and find out about the biopsy results, but i am going to take a pass, because I do not want to deal with the surly office staff.  But recall that I have something wrong with me, which the doctor either cannot or will not begin to treat until she gets the biopsy results.  It is not cancer.   But the fact that whatever it is is thus an annoyance rather than a potentially life-threatening malady does not alter that fact, nor make me pleased that I cannot get these results for another week.  And nothing would convince me that someone dealing with a serious acute illness, who needs meds now, and probably just wants to go home, take them, and go to bed, should have to wait, oh, say 8 hours to get the scrip sent.   My health insurance co sends a quarterly report to me regarding all the med charges I have had that quarter, showing not only my copays (which have already been paid) but also what the doc gets from the insurer.   This woman has been very very well compensated for the work she has done for me.

This practice, BTW, stopped, about three or four years ago, allowing patients to use the bathroom.   They now force them to use the communal bathroom in the corridor, a goodly walk.

[nebo113]

If I can't pee in the office bathroom, I would have left that practice long ago.

[kaysixteen]

Biopsy came back today positive for psoriasis.   I am now about to be treated, doc prescribed two meds.   I will have to wait till tomorrow to start them, as her new prescription policy preclued the pharm getting the scrips in time to fill them today, but that is another story-- anyone have any personal experience with this condition?

[mahagonny]

No, no experience. I wish you success and the minimum amount of strife as you undergo treatment.

[jimbogumbo]

Two family members. Standard. treatment was steroids, but there are tons of new drugs currently on the market and being heavily advertised. My sister has psoriatic arthritis, and if I were you and had the co-issues you've described I think it would be really important to get tested.

Best wishes- it's really tough to get a good diagnosis and treatment regimen with so much going on.

[kaysixteen]

I get that psoriatic arthritis exists, but I have never had any symptoms of any sort of arthritis, thankfully.

[AmLitHist]

You probably already know this, but just a reminder, Kay:  head them off if the doctor tries to give you steroids, which are wonderful--but a no-no if you're diabetic (as I think I recall you've said you are).

[kaysixteen]

As an addendum, I got a text message from this practice a day after seeing the doc there.   It is a robo invite to fill out an online customer service-type survey.  I have not opened it yet, and am wondering whether it would be worth it to do so, and whether I could possibly fill it out and maintain my anonymity, since this is a small, one doc practice.   Comments?

[mahagonny]

I think that I would not. With me, every time I saw the doctor after filling out the survey I would wonder if he's thinking 'did Mahagonny write those bothersome comments?' I'd be thinking of the limitations of communicating by written word, particularly with someone I don't know well.

[dr_codex]

Biopsy came back today positive for psoriasis.   I am now about to be treated, doc prescribed two meds.   I will have to wait till tomorrow to start them, as her new prescription policy preclued the pharm getting the scrips in time to fill them today, but that is another story-- anyone have any personal experience with this condition?

One family member. Not familiar enough with the details of what she has tried in the way of treatment, but I know that there have been multiple treatment protocols (including steroids), and several different dermatologists. PM me if you think it would be helpful to get her take.

To the general issue of when, how, and how hard to press for information: my five-year-old was diagnosed with something this week that requires immediate treatment. Well, I should probably say "diagnosed". We don't know for sure, because the lab never ran the requested follow-up test to confirm what appeared in an initial screen. By now, the blood work is too old to run, and the decision about medication needs to be made. As a result, I had to authorize medication that will have side-effects, both short- and long-term, because waiting for a confirmed diagnosis before starting treatment could have devastating -- life-threatening -- consequences.

Now, I don't know if the lab processes follow-up tests by "batching" them or not. I don't know who dropped the ball. I can read on the charts that the request was made. But they just never f***ing did it. At all.

Thankfully, the side-effects have so far been mild. But I don't know what the long-term effects might be.

And I'm mad.

I get it that working in a lab has been brutal for the last 2 years. My mother-in-law does that work, and she hasn't skipped a day, and I'm very proud of her. I get it that some kinds of offices are swamped, and that they cannot process what they deem less than critical tests as quickly as possible. But if you are going to take everybody's money to process lab panels, and then just do nothing when they produce significant results, why bother?

Some of you sound like the kinds of squeaky wheels that get good care. I'd be open to any suggestions for how to complain about non-performing labs. What kind of complaint might be filed, so that the next patient isn't killed due to negligence?

[mamselle]

Frame concerns as positively stated, fact-based, and use the word "potential," as in "potential for serious side-effects, including (if true) mortality" quietly, and with conviction.

Don't rant.

Don't exaggerate.

Don't start waving sheaves of Mayo Clinic printouts in their face(s) (but do read, mark, and understand them as reasonably as possible, and let the facts you do understand from them inform your voice in the conversation.

Ask for interpretations and listen if you've clearly misunderstood something.

Remember you're not likely to have much affect on the practice's practices by yourself.  Your current situation is the one to focus on. Have strong positive requests to ameliorate the current situation as fast as possible (including having the bloods drawn and re-run as soon as possible, before the drug levels of the new Rx have any more effect).

Be calm.

Keep the negotiating temperature low.

As Zharkov used to say, "read 'Getting to Yes,' by Roger Fisher" before you say anything...then figure out exactly what outcomes are possible, what ones you want to see/can live with/don't want to see, and figure out how to reach an agreed-upon path to get you there."

If the possible side-effects are serious, keep records of changes you've noted, days and dates, correlations with doseage, and the trajectory of urgency as you've observed it.

All good thoughts.

M.

[clean]

Last night's Dr. Pimplepopper had a 9 year old seek treatment for psoriasis.  A drug suitable for children and targeting psoriasis was named.  IF you catch the rerun or perhaps find it 'on demand' it may be of interest to you. 

[nebo113]

Last night's Dr. Pimplepopper had a 9 year old seek treatment for psoriasis.  A drug suitable for children and targeting psoriasis was named.  IF you catch the rerun or perhaps find it 'on demand' it may be of interest to you.

Gotta love a Distinguished Senior Member who watches Pimple Popper!

[kaysixteen]

This psoriatic experience really is depressing.   I am set to return to the dermatologist Weds for a two week follow-up to see how the treatment is progressing.   Problem is 1) it really is not exactly progressing and 2) I confess I am concerned that I have not been given great treatment here.   According to wikipedia, there are multiple types of psoriasis, and she did not actually tell me what type I had, though based on the wiki explanations with corresponding pictures, I do think I know which one it is.  But I am really concerned about the treatment I received, because it consists of two separate cremes/ lotions to put on outbreak areas, one over the other, supposedly twice a day.  Owing to the pharmacy having to order one, I did not start till a week ago Friday, but already, one of them, which was given to me in an extremely minuscule tubule, is almost gone, with no refills available, and I have already been rationing its use.   Some of the outbreaks have cleared, but other psoriasis pinpricks keep on popping up all over the place--- it would never be possible to creme up all of them, and in any case, the itching continues, across a good amount of skin surface irrespective of whether there is any psoriasis to be seen.   So I have to ask the doc  some very pointed and hard questions, but I am not necessarily sure how to do so.   I am also seriously considering moving on from her, and her office policies and surly staff are not operating in her favor (no other doc practice I have experienced is anything like this).

[mahagonny]

Sorry to hear this. Is this creme/lotion stuff anything that could be bought online without a prescription, so you could stock up, I wonder.