Recognizing Patterns

“I did an internet search for my symptoms and after doing a bunch of reading, this is what I think I have….” She pulled a sheaf of papers from her large purse and passed them over to me. 

Erythromelalgia.

I scanned through it quickly.

It wasn’t anything I had ever heard of before, but then her symptoms were not something that I recognized either. Hands that turned red and burned like they were on fire. They got better when she raised them up overhead or ran them under cold water. It had been going on for years. The pain was excruciating and now occurred at a more frenzied rate to the point she was afraid to leave her house.

“I think you might be right,” I told her. 

Now, if I were honest with you and with myself, I would admit that my pride didn’t want her to be right. I wanted to be the hero. I wanted to be the one with the answers, not her and certainly not Dr. Google, but here we were anyway. 

We did bloodwork to make sure it was not caused by something more serious and she started aspirin. Like magic, the pain was gone. Somehow, she still considered me her hero even after I told her I probably never would have figured it out on my own…

Several months later, a new patient showed up in my clinic telling me of the pain she was experiencing in her hands and feet. The pain came and went with no rhyme or reason. It burned terribly, kept her for doing things for fear it would appear.

“Do your hands and feet change colors?”

 “YES! They turn red and I have to elevate them or run them under cold water to get them to stop.” Over the years she saw half a dozen specialists and was diagnosed with all manner of things: Fibromyalgia. Anxiety disorder. Neuropathy. Malingering. 

She cried. She had clearly suffered and I suspect the implication that she was crazy was just as excruciating as the physical pain itself. 

This time I got to be the full on hero. “You are NOT crazy. What you are experiencing has a name and a treatment!”

And by golly, she got better.

I have patients who come in all of the time and say sheepishly, “I know I shouldn’t be reading online but…” 

But what if that first woman had not? 

Maybe I would have referred her to someone who could eventually figure it out. Maybe she would have ended up like the second patient spending years suffering, passed from one specialist to the the next, always told it was all in her head. Then when that second patient showed up, I wouldn’t have had an answer for her, either. 

Patients teach me new things every day, sometimes it is something simple… like keeping my pride in check so I can actually hear what patients are saying.

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132 thoughts on “Recognizing Patterns

  1. Your post struck me, Victo. I think these days with the quickness of some doctors to prescribe meds to alleviate symptoms, it’s important for people seeking medical attention, to be our own advocates. I have a story for you. πŸ™‚ Two years back, I began suffering from excruciating pain on the left side of my lower back. Totally clueless what was going on. Went to my family doctor and he prescribed Tylenol 3, which took a bit of an edge off the pain so I could semi-sleep. Also, tests to be done in the future. Couldn’t wait. Went to emerg and during the long wait, drank a bottle of water and by the time the doctor saw me , there was no pain. I was in heaven. Just recently, I had a similar pain starting and researched it, drank multi glasses of water and lemon and gone within a day.

    Liked by 1 person

  2. Victo, you are a crazy good writer, and I am convinced that you are a much finer physician than you give yourself credit for. Your good heart is there for everyone to see. I enjoy your stories and applaud your inventiveness in finding a healthy and anonymous way to vent. πŸ™‚

    Liked by 1 person

  3. Now, this is refreshing.
    As a young doctor practicing in Sub Saharan Africa, I am often faced with challenges of a different sort. Some patients come to you, with complaints like – “I feel unwell” but won’t be able to talk you what exactly they feel or do not feel. Asking them for further details- how it started, what it’s like, when it’s worse, what makes it better it worse and all that, is just an exercise in futility, especially considering that it is all too easy to put words in their mouth, as they wouldn’t want to disagree with the doctor for the most part.
    Somehow they feel that you as the doctor should know what is wrong with them and offer a solution.
    They absolutely expect you to play God.
    Also, don’t dare tell them that their symptoms will be relieved if they make some lifestyle modifications. For almost everyone, a clinic visit is incomplete if they haven’t been given a prescription pack. Even for those who never use the drugs as prescribed.
    You can imagine how clinic consultations go for me.
    I understand that the problem of Google MD is real and sometimes frustrating for medical practitioners, but believe me, I think it’s overall less challenging having a patient base that is generally well informed.

    In any case, more power to your elbow.
    May we never stop learning in the best interest of our patients.
    And lest I forget, you’re a hero!

    Liked by 1 person

    • Thank you! I have patients who present to my clinic with previously diagnosed issues but they don’t tell me they have these things. It is a test. Am I any good? Do they really have it? Gah. Kills me. One fellow recently was a new patient who denied any medical problems at all. His labwork however showed diabetes, kidney failure, and prostate cancer. I called him thinking I was going to have to break the news to him. All of a sudden he starts laughing and tells me he already knew he just wanted to know if so could figure it out. People. πŸ™‚

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