“You know what I mean, you’re every Doctors’ nightmare.”
“But I’m right! And you know research shows that patients who are actively engaged in their treatment are more likely to receive benefit. Do you want me to get my migraine bible and read you the passage I highlighted in pink highlighter?”
“You’ve read it to me before. I’m going to make us a Gin and Tonic.”
For those of you at home, here is the relevant passage :
“…An educated patient is a patient who has the potential to experience optimal headache relief. You should know as much as possible about your headaches, your treatment plan, and the medications you take. Sometimes the amount and type of information a patient receives are defined by the doctor-patient relationship."
[p.g109. Conquering Headache. Fourth Edition. By Raport. Sheftell. Tepper.]
Let me take you back to the consultation, earlier in the day, that prompted Dad’s unforgivable comment. I’m not going to tell you who’s saying what – but I am the first person speaking:
“But isn’t it possible that the Tramadol, you prescribed, is causing the vomiting and diarrhoea. It is a known side effect.”
“It’s very unlikely”
“Yes, but the symptoms coincide with the commencement of the Tramadol!”
“I’d still be very surprised.”
“Ok, well are we going to think about doing an X-ray and Ultra sound now? Isn’t it time?”
“I’m going to start with a blood test.”
“But why not also do an X-ray and Ultra sound, to get as much information as possible. If it’s not the Tramadol, it could be early stage stomach Cancer? ”
“Darling, let the man do his job”.
The above conversation was, in fact, with a Vet. The patient, our 13-year-old blond Labrador, Bimbo (Mum thought the name would be hysterical!). But I’d just like to point out I WAS RIGHT!!!!! The severe vomiting and diarrhoea was caused by the Tramadol! I know my Opioids, people! And yes, I was being somewhat annoying but I was also trying not to sob throughout this consultation, I’m very attached to Bimbo. The Vet is really good, very lovely, careful and methodical and has Bimbo’s best interests at heart. (This is me apologizing.)
But I’d like it to be noted that in the process of cleaning up one bout of particularly runny diarrhoea I smacked my head on a shelf, not ideal for someone with migraine. So I had a particularly vested interest in getting to the bottom (ha ha) of Bimbo’s plight.
|Bimbo with a Valentine's Day rose...|
But back to the human species relationship with Doctors. Since my car accident in 1998 and the onset of my Migraines, I have seen many, many Doctors, Specialists and Nurses. I’ve seen some of the top Consultants in the country, both here and in the States. I have observed that we mere mortal patients have a tendency to treat these revered Doctors like Gods. This is understandable as our lives, our pain and our health is largely in their expert hands.
But we must recognise that they’re not infallible, they make mistakes, they’re humans too. A couple of years ago it struck me that I could refuse to be intimidated by another Doctor when I remembered that I too could have studied medicine at university. I got the grades. My peers at university were no more clever than I. They had just chosen to study another subject. I’m not denying that medicine is a calling, requiring a specific skill set, determination and passion but I’ll have you know I got A* for Science GCSE, I could have done science A-Levels! I also have three Masters Degrees, which surely adds up to one Medical Degree… um? The fact that these Masters Degrees are in creative subjects and I have chosen to heal the world through Musical Theatre rather than medicine should be irrelevant! My point is, it can be helpful to remember your friends from undergrad who went on to become Doctors when faced with a scary, patronizing Consultant. The Consultant standing before you was once downing shots in the student bar. Is he any different to your other friend who has now gone on to become a top Architect? Yes, your life is not in your Architects’ hands, but remembering that medicine is a subject that you could also have studied and a career you could have chosen, might help you feel less tongue tied and inferior in front of that Doctor who tells you your pain is ‘psychological’, or ‘no, that’s wrong, that pill couldn’t possibly give you that side effect’.
Of course our Doctors know a lot more about medical conditions than we do, but this attitude of reverence, and our blind faith in their abilities, does not always lead to the best outcomes for us, the patient. The course of treatment I’m currently on has purely come about through my own research and perseverance. I have a complex type of migraine (but don’t we all) and have had to really push Doctors and even find Doctors who were willing to treat me. I could give several examples of misdiagnosis and mistreatment that set back my progress, which is why I’ve become an advocate for education and active participation in treatment. Plus, the ‘good’ Doctors I have met over the years have encouraged this. I do, obviously, listen to my Doctors’ advice and expertise but all the time remembering that I KNOW MY MIGRAINE BEST. I have also known some truly compassionate, genuine and astounding Doctors to whom I am forever grateful. I even named my last kitten after one. So please don’t mistake this for a diatribe against all Doctors on the planet. I just want migraineurs to be aware that they have to be active participants in their treatment, they have to be as educated as possible in their condition, and have the right to question their Doctors.
Doctors will always have a bias to their own particular field and area of interest, which might not help your particular migraine. So don’t be afraid to question the prestigious man/woman in the white coat. Dad is probably right; I am most likely a Doctor’s worst nightmare, but I do my best to be as charming and amusing as possible to coat my steely determination to get better.
End of rant.
This rant/terribly interesting monologue – was prompted by two pieces I recently read:
1. An article in last week's Daily Telegraph with the Headline:
NICE are to issues guidelines for the treatment of headaches. The article goes on to say “The guidance will for the first time give GPs information on how to diagnose and treat the three most common types of headache; migraine, tension and cluster.” I’m very glad NICE are finally paying this topic some much needed attention and I can’t wait to read the ensuing report - but the article is wrong (unless I’ve misunderstood). GP’s already have a FANTASTIC management and diagnosis tool in the shape of the BRITISH ASSOCIATION FOR THE STUDY OF HEADACHE (BASH) guidelines. Anyone, with any sort of headache and migraines MUST READ them, right now. They’re a gold mine of information, you’ll learn a lot about the drugs you’re on and why, you’ll also pick up some useful tips and maybe get some good ideas to discuss with your GP about your treatment. If you GP hasn’t heard of the BASH guidelines, then maybe you should worry.
2. I also recently read an incredibly profound post from the blog “Diary Of A Benefit Scrounger” by a chronically ill patient, Sue, called “It’s all in your Head”. Migraine sufferers will relate more than most to this title, even though the post is not directly about migraines, but the dangers of doubt. I have quietly had to fight friends and Doctors over the years, fight them not to doubt the pain I was in and to believe that a major trigger was my neck (but that’s a whole other series of blog posts!) It’s an incredibly demoralizing (and ongoing) process.
Sue is currently in hospital, awaiting another operation, and suffering an unbelievable run of bad luck. Please read her post and I know you’ll be astounded that someone can write so eloquently when in such pain.
p.s Bimbo continues to flourish away from the Tramadol. We told the Vet that the women in the Saxton family (all of whom have migraine) don’t do well with Opioids so he better find another form of pain relief, which he is happily doing.
Next time: Migraine Comfort Tips & Rituals