A visit to the doctor

[elfs]

I went to the physician this morning to have her look over my knee, which has been giving me terrible pain and the ocassional scary moment. My last doctor, Molly, has since moved home to Oregon so I don't have access to her. Instead, they gave me to a new woman, a tall, thin woman who reminded me a bit of Ann Coulter.

I had a few complaints. My knee, primarily. My general morning dragginess despite reasonable sleep patterns and practices, and my allergies have gotten worse recently.

I'm not sure I like the new doc. She recommended a battery of tests, including one for low testosterone (moi? Well, I suppose anything's possible), said that I probably hurt the knee while hiking and vigorously resisted my suggestion of an osteopath. "See if it still bothers you six months from now." She also resisted my suggestion of modafinil for the dragginess. In all, she basically went with a script and didn't really talk to the patient all that much, other than to confirm her decision of the most conservative course possible.

Molly would have treated me like an adult, talked seriously about the ups and downs of modafinil, then said I was an adult and could make my own decisions, and written the prescription anyway. She would also have forwarded my request for an osteopath, dammit.

*Sigh.* I hate doctor shopping.

Comments

modafinil

[rainsom.livejournal.com]

I take this on a PRN basis. I don't sleep well and often an so tired I doze whenever I stop moving. It doesn't always work well, but does more often than not. I don't feel jittery, just more awake, less zombied out.
My insurance won't pay for it at all though. I am lucky enough to get samples and I work on making them last.
I think if my insurance could just see me doze off while waiting to cross the street, they might see the necessity of it.
Maybe not I'm usually "the glass is half empty and some one has been drinking out of it" type person.

[danceswithlife]

Six months seems like a long time for an active person to wait to have severe knee pain treated. For all you know, something in your exercise regimen may be contributing to the pain, and possibly, further injury.

Just a note from someone who has worked in insurance for twenty-five years...some osteopaths are primary care physicians. If you do a search of your plan's data base you might be able to find one, and then you wouldn't need a referral :-) especially since you weren't thrilled with this doc. For some very good reasons, IMHO.

BTW...it was probably your age that triggered the testosterone test :-) It's a current trend.

[edichka2.livejournal.com]

Depending on the school in which s/he trained and on his/her personal bent, an osteopath may not have much more special knowledge or interest in joints than your average MD in the same area of practice. As I understand it, some osteopathic schools are "old school" in emphasizing bony manipulations, while others are nearly identical in curriculum to MD schools.

Or did you mean an orthopedist?

I certainly agree that six months is too long (by about five and a half months) to wait and see -- hell, I'd call that a blow-off. I guess if you were my patient, I'd have recommended a fairly aggressive course of NSAIDs (with appropriate cautions and assuming no contraindications), RICE, an appropriate brace perhaps, and probably physical therapy. If the history or the exam showed red flags, e.g., locking or significant instability, I'd have gone straight ahead with an MRI, and an ortho referral depending on the MRI results.

As to the fatigue, I'd have started with tests as well, including thyroid and, yes, testosterone -- at least if I didn't know you. *ahem* I'd probably resist the modafinil request as well, at least until test results were in, other reversible causes of fatigue had been addressed, and, frankly, until I knew you a bit better.

My clinic is taking new patients, but I suspect it's a bit far for you. :-)

G'luck,
- Eddie