First results are in
Five months after the initial appointment, I’m finally able to get details of the first results from Anytown DGH, although I’m already aware of some of them because my GP is much more helpful than Dr J’s secretary, who steadfastly refuses to give out any information whatsoever, but is perfectly happy to pass them on to my GP without my knowledge or consent.
While I can understand a desire to protect patients from the stress caused by being given adverse test results without explanation of the context of the result(s) and what they may mean for the patient, it is surely symptomatic of a one-size-fits-all approach to the soft skills in healthcare in the UK, which I find annoying at best and in most cases frankly insulting to the intelligence of many patients. It is a serious mistake to assume all patients are idiots, incapable of understanding anything but the brief information they are given by health professionals during consultations, tests and follow-ups. A lot of patients have access to an ever-increasing amount of information (and not just from the internet) – and a lot of these patients are more than capable of distinguishing between coherent and objective medical information and some of the less savoury propaganda published by snake oil salesmen pushing their latest product. When intelligent people are treated in this manner, is it any wonder that the public trust their doctors less than their parents and grandparents did and even the BMA say, of a MORI poll commissioned in 2001 “a third of people say doctors pay too little attention to the feelings of patients and 59% say hospital bosses disregard patients’ rights“?
Anyway, back to the results. The OGTT was interpreted as showing signs of Insulin Resistance aka Impaired Glucose Tolerance aka pre-diabetes. This wasn’t exactly a surprise, as I took my own blood glucose monitor with me to the hospital (in part to anticipate the result and in part to calibrate the monitor’s results against the hospital’s results) – and I’d already discussed it with the diabetes nurse at my own GP’s practice. The question (for me, anyway) is whether this is a causal factor in my condition or simply a symptom. Dr J believes it is causal, as the Dexamethasone test result was ‘normal’, but I’m not so sure. I repeated the OGTT at home a week or so after the Dexamethasone test and the results were significantly different. Dr J, however dismissed my assertion that the Dexamethasone may have had a positive effect as coincidence, despite the fact that after the Dexamethasone test, my blood glucose stabilised at a lower level, my PMS and menstrual cycle improved (for a couple of months) and I experienced a short-term, limited but noticeable, improvement in both cognitive function and overall energy, even though the abdominal pain seemed to suffer a little: effects I would have been surprised to experience from a single, low dose of the corticosteroid.
Dr J claims my symptoms are nothing more than obesity and depression. I’ve experienced depression in the past, and what I feel now is very different. For a start, I’d describe myself as homicidal rather than suicidal. Depending on your view of genetic dispositions to certain forms of behaviour, this probably isn’t a good sign for someone whose surname and place of birth indicates some connection to a reiver family. Besides, even when I was depressed, I don’t believe the antidepressants I was prescribed had any effect whatsoever – leaving the crappy job I was doing at the time and using the period of unemployment between then and starting a new job (where I actually felt valued! Strange feeling after 3 years in a callcentre) was far more beneficial. As for anti-obesity drugs, well where do I start? Given my appetite isn’t exactly wonderful in the first place, anything that causes it to decrease probably isn’t a good idea and I have serious doubts about the efficacy of any drug that purports to modify the amount of macronutrients absorbed from food: the quality and composition of my diet has changed significantly over the past decade or so yet the rate of weight increase hasn’t. Given the amount of medication I’m already taking for pain relief, I’m really not happy about feeling pressured into accepting further prescription medication without even a cursory attempt to persuade me that the medication will be of some use and will not hamper any further attempts to discover the underlying cause of my condition.
Although he disagrees with my assertion that there could be any kind of adrenal link to my condition, Dr J has agreed to leave my next appointment open until after my abdominal CT.
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