Doctors in search of a disease
By ROBERTA SOTONOFF
Published May 30, 2006
It's a given: As you get older, more of your time is spent in doctors' offices.
This is a new thing for me. Good health has blessed most of my life. But, for the past 18 months, I have been intermittently plagued with a severe cough. My quest for a cure leads me through a medical maze.
My journey begins with a visit to my internist. This man is really concerned with my overall well being. On my numerous cough-related visits, he has reminded me to wear a seat belt, tested my thyroid and recommended a bone density scan. His suggestion for a sigmoidoscopy - a colon test in which a tube is inserted on the opposite end from where my cough originates - leads me to ask him:
"Do you really think my cough is that deep?"
He tells me that "a person my age'' needs to consider all of these things.
"What about this hacking cough?" I counter.
Oh, that. He prescribes yet another cough medicine.
Finally a new symptom, hair loss, appears. He recommends a complete physical and visits to some specialists.
A dermatologist concludes my hair will regenerate.
"It's nothing serious, just telogen effluvium," he says.
Telogen effluvium? My affliction sounds more like some botanic discovery than something that causes clogged drains.
After a few months, little hair sprouts do join my long tresses. Without attending one meeting, I have become a recovering telogen effluviac.
Having solved that problem, my attention is again focused on the cough. Much of my time is spent in the office of specialists. When my symptoms go beyond one specialist, I am sent to another.
The waiting period for one particular medical guru is seven weeks. About 10 days before my appointment, his office sends me an eight-page packet containing his resume, a two-page explanation of his specialty and philosophy and, of course, the obligatory insurance and medical history forms.
A doctor friend tells me that this is a new wave of medical practice: Marketing firms that make up these packets even suggest the inclusion of background information about the doctor's office manager. I am not quite sure how this information will aid in a diagnosis, but it explains the $210 initial visit fee. The services of public relations firms do not come cheaply.
Finally I meet this marketed medicine man. His dress reflects the glossy look of a magazine clothing ad. After a short conversation and a quick examination, he assures me I do not have the suspected serious illness.
This news would have been cause for great celebration, but something happens. Totally lacking in scale-side manner and oblivious to my feelings, he weighs me while I am wearing shoes and all my clothes.
The lunch I had just eaten must have made me look pretty bloated, for the scale's marker is set at 200. Dr. Marketing pauses, but the balance does not swing to level.
The doc slides the marker to 150. At my height, 150 pounds would make me a dead ringer for a barrel, maybe even a target for tusk poachers.
Reluctantly the marker is lowered to 100. Though Dr. Fancy Dresser has elated me with his diagnosis, the scale experience has made me physically and emotionally ill. I now have the need to see another specialist, Jenny Craig.
And still my hacking cough remains. The search for a definitive explanation continues. For weeks I am poked, prodded, pinched and, most of all, tested. There are tests that turn me every which way and subject me to ingested fluids or injections.
The intensity of the search for a diagnosis is fierce. Hospital personnel begin to recognize me as a regular. The cost of my medical bills makes me feel that a new hospital wing could be named in my honor.
Still my symptoms aren't fitting a disease category. The term "the practice of medicine" takes on a whole new dimension.
After seeing five doctors, the votes roll in: two for one particular disease, two for another and one abstention.
"Who abstained?" asked the specialist to whom I had to return.
His search for a cure to my cough continues. He tries various drug therapies, which by virtue of their ineffectiveness eliminate myriad maladies. I become the prime candidate for the "drug of the week." My medicine cabinet is a stockpile of nose drops, inhalers and pills.
I next seek the help of an allergist.
"It's nothing serious," he assures me over the din of the screaming, rashy, sneezing children in the reception area. "I see these symptoms all the time."
Two weeks later, I find that my symptoms have not disappeared, but the allergist has. After seven unreturned phone calls, I give up on him.
Next I try the Mayo Clinic. I realize that if all the prospective patients survived their one-year wait, it would probably take two years to be evaluated.
It is during this time, while my body and pocketbook are trying desperately to endure this ordeal, that everything around me gets sick. Our dog's physical problems require extensive blood work, an ultrasound and surgery. My husband begins to limp. In one day, a washer-dryer repairman, an electrician and a carpenter come to cure my house.
A compulsion to flee my "sickie" environment overcomes me. I board a plane and escape. The cough doesn't cease, but I am having such a great time, I don't care. I figure I'll learn to live with it.
Sooner or later they'll figure out what's wrong. In the meantime, no worries: I'll spend my money and time enjoying life.
Roberta Sotonoff is a freelance writer who lives in Glenview, Ill.
[Last modified May 30, 2006, 08:17:59]
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