"How to Tell Your Doctor a Thing or Two"

I love my p.t., Pam. She's always telling me the gossip in the sports world (which involves a lot of behind-the-scenes dirt on OSU's football scandals--yes, I used plural), stressing about if her football teams are going to win, and chatting about her rescue dog that is too timid for strangers. Really, my twice-weekly visits are a window into a world utterly unlike my own. So even when she kills me, causes two days of pain in the left side of hip and makes my body feel flu-like, I still can't hold it against her. She's likable.

But the doctor that she works with is a little rougher around the edges. She's hard to read. Rarely smiles. Bends me legs and stretches my hips in a matter of fact manner. She seems curt. And as a result, it's taken me awhile to open up to her. But today, I took some of my own advice from the Sociopolitical Issues in Women's Health class I teach: I "told my doctor a thing or two" (I just tried to see if the internets had a link to this foundational women's health movement pamphlet that I use in class but to no avail so you'll just have to trust me....).

She suggested an MRI. Not only am I not significantly improving, but I'm now experiencing sciatica. I pushed her. I asked how the treatment plan would change if the initial pelvic MRI were to prove something. She said complete rest. I said, "Well, given the MRI is going to cost me a $500 co-pay per slide, I would like to try the rest first". She agreed. If some of my symptoms go away, I will still need two or three more slides to see if I have another unexpected problem, like a tear that needs surgery.

Then she offered me "steroid burst" for five days. I thought for a few minutes while she stared at me expectantly. The burst would significantly help pain and inflammation. Finally, I told her I was scared of the steroids. "Why?" She asks.

"Well, I was on steroids a few years ago for some bad poison ivy and I couldn't sleep and it suppressed my immune system so much that I ended up with mono."

"Oh, yah, you won't be able to sleep. That's just a side effect. So I usually tell people to expect that and just get stuff done." Not sleeping is the worst thing for someone with an anxiety disorder like mine. In the midst of exam prep. I explained this. She said we could hold off and see how the rest does. And that some of sciatica is stress-related.

Then she asked what I do for pain. "I take an aleve sometimes, but to be honest, I'm nervous about too much pain meds."

"Why?"

"Because I had some bad internal bleeding a few years ago and I don't want to start something up again."

"What kind of internal bleeding?"

"A mallory weiss tear."

"Oh." She pauses. "What was that from?"

"I was bulimic for twelve years."

"So it was probably from that."

"Likely."

"You're not still throwing up, are you?"

"No." I could explain more here about the ups and downs of recovery but I'm exhausted. It's raining out. It's monday. And I have to go OccupytheOval at noon.

"Well, let's not have you on Aleve." She had been prescribing a high dose of aleve when I first started seeing her. Apparently, medical records don't transfer. "Let's do tylenol. Two tablets. Three times/day. And we'll change your routine with Pam."

And as I walked out, I felt like I had achieved something. I'm not taking meds I'm not comfortable with. In voicing my concern, the doc asked follow up questions pertinent to understanding my body a bit more holistically. And for now, I can hold off on an MRI and take the time to find some student loan money to cover the slides in a few months.

Perhaps today was a small victory against the medical industrial complex.