An R_x for Talking to Your Doctor

Be brave. Talk to your doctor. / iStock

LIKING MY DOCTOR  too much was my biggest mistake. For at least half of each visit over our decade together, we chatted about having kids with learning difficulties, McLean School vs. Lab School, then colleges — large and cold like Michigan or small and warm like Elon.  We rolled our eyes together through menopause, and when we had similar bouts of arthritis, she took my pain seriously and sent me to a good specialist.

But one July, after three visits and unreturned phone calls in between — all spent failing to convince her that I felt worse than ever before in my life, and being advised simply to take more Advil — I realized the chatty repartee wasn’t working. Having grown up terrified by the story of The Little Boy Who Cried Wolf, I could not bring myself to moan in her presence as I had for hours at home for more than a week. Determined to set the record straight, I marched into our next appointment, forced myself not to smile in the polite, friendly way I had been taught to do, and spoke as firmly as I could muster. “I am not succeeding in telling you how sick I am,” I said, prepared with the evidence: “Every night I go to bed around midnight, knowing I will wake up half an hour later, which I do, and then I pace for the rest of the night, wide awake. The pain in my bones, muscles, joints is so bad that I lie on cold packs whenever they are cold enough, send them back to the freezer and wait for them to get cold again.”

Dr. G. looked startled. “Yes,” she said, taking a step backward, “that sounds serious.”  She agreed finally to the Lyme disease test I’d been begging for since two weeks earlier when I’d developed flu-like symptoms — which in summertime suggest Lyme (though recently H1N1 has become another possibility).  But having no characteristic bullethole-shaped rash and no tick, I’d been consigned to the large group of people who believe they have Lyme but cannot persuade doctors to treat them.

Although the Lyme test results wouldn’t be available for five days, a raised, red rash covering my entire body the next morning persuaded Dr. G. far better than my words to start me on doxycycline — which I’d also been begging her to do (I cannot understand why obviating the risk of antibiotic overuse is more important than alleviating the miserable symptoms of people who suffer from Lyme as I did). For sleeping, she now prescribed extra-strength Ambien, which produced no more than my usual half-hour, maybe because my problem was not insomnia but Lyme disease; and left for her weekend on the Cape.

 My next mistake in doctor-patient communication came that afternoon when, in intolerable pain, thinking maybe bone cancer or imminent death, I went to the Sibley Hospital ER.  I was certain I would be admitted and put on a morphine drip.  When asked to rate my pain on a scale of 10, I gave it a 10, which a nurse friend later explained is for drug-seekers; to get medical attention, you need to say 9.  After six hours in the waiting room — at midnight on a Friday — the Sibley doctor suggested I might be depressed.  How about sleepy?  Looking pretty tired too, she released me.

A night later, I had my first communication success. Realizing that what really hurt were my muscles — not sharp pain but an indescribably agonizing ache, I waited for the first light of dawn in the hope of getting a better reception, and made a final cry for help.  Ready to be as firm as I had finally been with Dr. G., I reached the on-call doctor for her practice, whose sweet young female voice sounded desperately sleepy, and told her, “I can tell you the long story — pain, no sleep, probably Lyme disease — but I know what I need. It’s muscle pain.  I need Valium.”  A pause.  Then I heard a miracle: “Okay,” she said. “I’ll phone it in!”  Success — though with no idea why: Had Dr. G. given her a heads-up about me? I got the Valium, took one and slept for hours.  I felt better.

When the Lyme tests came back positive, Dr. G. called me — first at home, then on my cell, really trying hard to reach me.  She sounded amazed, even impressed: “They were all positive!” she said repeatedly. My muscle aches lasted for months, subsiding slowly: Apparently the longer the wait before Lyme is treated, the longer the symptoms last — another reason, I would think, to give doxycycline early.

But the insomnia persisted — which leads to a final communication tip: Don’t let doctors know your age. Before the Lyme disease, I’d never had trouble sleeping: On lazy vacations, I could easily put in a 10-hour night, and actually envied insomniacs who stayed up reading into the early morning.  When I told my new doctor about the insomnia, he said, “Well, women over 50…”

The women in my yoga class agree about this problem. When our Iyengar-class star — a woman who stands on her head, on her hands, and probably on any part of her body — suddenly had neck pain, a true aberration for her, the doctor said, “Well, women over 50…”  In both cases, sudden symptoms in younger women would have had the doctors scrambling for explanations and/or treatments.  For us “women over 50,” doctors should at least find better words, because in the age of information one thing that’s hard to hide, change or fake — especially from one’s doctor — is age.

–Mary Carpenter