A Funny Thing ... Ankles and Insight

A funny thing happened on the way to the surgeon that I think not only shows why my fight to change my records is so hard, but lack of attention to details by the medical community, in general, that is stunning.

I knew someone once who said “we accuse others of our faults”. I never subscribed to that—until the other day during an appointment with a doctor. Of course, when it comes to the medical profession, I am a more than a little suspicious these days.

A little background on the story—in January 2013 I fell at work. The injury hasn’t healed and led to the visit with Dr. Surgeon and his refusal to fix my knee. The fall also injured my ankle and I spent most of last spring and summer in physical therapy with the PTs saying “the swelling should be getting better”. It never did, and I was referred for an MRI. Somewhere along the way, the paperwork got crossed and the MRI for my ankle got lost and I ended up with my knee scanned and the appointment with the warm and caring (not) Dr. Surgeon who told me to get a cane.

Fast forward to two weeks ago. After going over it with my family doctor, a referral to a podiatrist was arranged. I made the appointment somewhat hesitantly, considering all that’s happened lately. The receptionist was friendly, so when I arrived it was a little less scary. I also had someone with me, just in case Dr. Ankle Guy turned out like Dr. Surgeon.

After filling out the paperwork, we were ushered back and a few minutes later Dr. Ankle Guy came in. He seemed friendly, smiled and shook our hands. He asked if we’d seen “the game” because if you live in the Northwest and didn’t watch the Super Bowl it amounts to a crime.  I said I was working and he laughed. He said he was glad there were two people there because patients only hear twenty percent of what a doctor says, so there was a good chance we would remember forty percent. I laughed because he seemed nice and I was more at ease than I have been in a long time—even though I was in more pain than usual since I didn’t want to take ibuprofen and mask symptoms/swelling in the ankle that he would need to see.

I described the fall, and told him about the pain, swelling and other fun things (it sounds crunchy sometimes). He poked and prodded at it. He asked if it felt strong, I said no. He tugged at, I grimaced. He moved it around, it crunched. He hmmed and nodded and all those other mysterious doctor things they do when examining a patient.

Here comes the fun part.

He leaned back and smiled. It’s swollen, there is some structural issue going on with it. I nodded, glad that I wasn’t crazy. There was something wrong! (Which would be bad in most cases, but anyone who has read my blogs knows this is not true in my case.) He was still smiling when things took an odd turn. He said he suspected my doctor had sent me there for an MRI, but since the injury was on the 26th of January, I had to expect pain and swelling and weakness in the joint. So, says he, and MRI is NOT warranted …

I broke in and said January 26th 2013.

Without even missing a beat he said “So an MRI is definitely warranted. We need to see what’s going on. We will get an x-ray today, then get an MRI as soon as we can.” My ankle was given a more thorough going over. More hmmms and ah has.  He didn’t really say much more, except hoping it was something deep rather than something with the ligaments. After shaking our hands again, he left to order the tests.

I like Dr. Ankle Guy, he seems like he knows what he is doing, but after his pronouncement that patients only hear twenty percent, I wonder how he managed to miss the fact my injury was in 2013. I will say, unlike other doctors, he was willing to correct his mistake. He did listen to me, and once he realized it was an OLD injury, he was very attentive.

All of that is very nice. However it doesn’t change the fact he missed the 2013 that was not only in my chart but was on the sheet I filled in when I came in. The sheet he had in his hand. The sheet I wrote “Fall in 2013, right knee and ankle” and on the other side “Ask me about my files” hoping to cut off the Three Little Words at the bud. It seems I didn’t need to, because he hadn’t read it at all.

In the midst of this fight for my health, for my right to be treated fairly, it was a blow that a doctor that did listen (finally) nonetheless hadn’t paid any attention to what I had just handed him. It makes the whole idea of writing a long amendment to my records and putting it in front of a tribunal pointless. How can you fight this kind of inertia? This lack of attention to details that could, in fact, drastically change the treatment options for a patient? There is a big difference between an ankle sprained two weeks ago and an ankle that is still damaged and swollen more than a year later.

And that, in comparison to everything else is a small thing. Does it hurt? Yes. But, unlike so much else, I think I am getting help this time, in this small area. Whether or not it gets all the way better, I don’t know yet. I still have a knee to contend with on that leg.

I guess what is bothering me is how easily things are missed, and how easily things become blown out of proportion. Risk Management told me that they can only remove information if it is for the wrong patient. I said, well, maybe the doctor who put the Three Little Words in my file had the wrong patient. It was a very busy night. She said that kind of thing didn’t happen that often and then, here I am, telling you about a doctor that didn’t look at a file or a handwritten information sheet that was crucial in diagnosis and treatment. He was gracious about it, embarrassed, and even blushed.

Not so with Risk Management. They said they were calling me back. I have heard nothing. They said they would forward notes from my regular doctors to Dr. Surgeon and see if he will AMEND (not remove) the Three Little Words. I haven’t heard a thing. I was supposed to have a referral for a second opinion on my knee. They were making the appointment, then said “oh, we need to run your file past the doctor first.” And, you guessed it, no call back.

It’s killing me. I am not being overdramatic. I have been getting increasingly ill over the last few weeks, my chest pain is a nightly terror. I still haven’t called 911. Even after an appointment with my family doctor, and a prescription for antibiotics, I am not feeling better. So, this leads to some ugly things—at least in my world. What if I need a referral? What if I need to go to the hospital? What are the chances that anyone will look at me? I have a long list of verifiable illnesses on record, and still they just see Three Little Words.

I am lucky with Dr. Ankle Guy. His lack of attention probably saved our patient/doctor relationship. He at least was willing to admit a mistake.

But all those others, the ones who haven’t called, the ones who haven’t changed their minds, the ones who ignore a list of verifiable illnesses—what do I do? I am so terrified by all of this that when I threw my back out a week ago, and could not walk, I refused to call for medical help. I didn’t want it to look like I wanted pain medication. I hesitated to report any illness to my doctor—until I was forced to—because I don’t want any black mark on my record. Nothing that looks remotely like the Three Little Words.

I am slipping into despair. Those Three Little Words are coloring everything in my life. I live in fear of doctors’ visits—who knows what has been going on behind the scenes. I live in fear of hospital stays.

Fear, I think that sums it up. It’s become a witch hunt. I am branded, followed and harassed. I am denied the care of the rest of the population. And, now, after the visit with Dr. Ankle Guy, I know that no words I write to refute my records will matter. They will see Three Little Words, finalize the witch hunt and leave me with nothing.

And in this case, nothing is really something, because it’s costing my life.

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