Dr. Iyer – Thank you for fitting me in. I appreciate it. I will apologize in advance because I know
doctors hate when you come in with a long list of issues, but I feel that I am
a complex case, and I am sorry this may take more time than you had hoped
for. I hope you will listen and
understand all of my concerns and try to see the full picture, not just a list
of symptoms.
First, please take into account always that I am disabled
with mental health issues that include bipolar depression, severe anxiety,
panic attacks, agoraphobia, and Non-24 Sleep Disorder. These are important to remember as they are
always reflected and impact my physical health as my physical health in turn
always impacts my mental health, both to a severe degree. I want to be a good patient, but I also have
learned that I have to be my own advocate to the extent that I am able.
After our last appointment and the scheduled Upper GI Series
(which was extremely uncomfortable, nauseating, and verging on painful), I
heard from your assistant a week ago on Friday at 4:45 p.m. Maybe there was a miscommunication, but I
clearly remember her telling me that you would be referring me to a surgeon for
a hiatal hernia and that she would be calling me back at the beginning of the
week with that information. That left me
all weekend to stress and overanalyze and overthink and research. I know this is part of my disability that I
work on with both my psychiatrist and a therapist, but it is part of me.
What I learned was distressing and caused me to mentally
spirally downward while increasing my anxiety and causing my physical symptoms
of nausea, vomiting, and pain to increase, which has been happening for two
months and shows no sign of letting up.
Then on Monday your assistant called to say that you were
not referring me to a surgeon, which surprised me and concerned me. I do not want unnecessary surgery, but I also
do not want to continue to live my life with these miserable symptoms that are
affecting my mental health severely. I
have since read the results of the test which show a mild to moderate hiatal
hernia and severe esophageal reflux along with a rapid movement through my
system of the barium which seemed unusual.
She said you wanted to see me in 6-8 weeks, but I did not feel that I
could wait that long so she fit me in even though finding a driver for the long
drive here was a challenge. But that is
not your concern, I know.
So my primary concerns are, why did you change your
recommendation to refer me to a surgeon and then decide not to? I do think I would like a referral as a
second opinion and hope that does not offend you. I have started trying to make changes to my
lifestyle and diet to try to help with my symptoms but have not yet seen any
changes. In fact, the pain that I am
having has now increased from my upper abdomen into my chest, as well,
sometimes mimicking the symptoms I get when I am having a panic attack, which
then causes a panic attack. It has taken
me years to deal with my panic attacks and constant fear that I am having a
heart attack, and the combination of these has only intensified the frequency
and pain and fear.
My psychiatrist and I are also concerned that with the
constant constipation/diarrhea/vomiting that perhaps my medications are not
being absorbed properly and certainly not if I vomit shortly after taking them
which sometimes occurs at random times.
I do understand that the constipation and diarrhea are a separate issue
that may not be able to be resolved at this time, but just so you know, the
diarrhea is almost daily for hours on end every 10-15 minutes. The opposite happens if I miss a day of
diarrhea and have immediate constipation which causes straining and that
increases the pain in my abdomen/chest.
I did not fill the prescription that you sent in for Levsin
(I think was the name) as my research and discussion with my pharmacist indicated
that this was primarily for cramping types of pain in the stomach and
intestines and colon and the side effects, while I know I may not get, are also
nausea and vomiting. This is not the type
of pain that I am having. So I do not
have any medication to help with the pain.
I apologize for the length of this. I feel this is the only way to truly get the
help I desperately need. Can you please
explain your thought process on the potential for surgery, dealing with these
major symptoms constantly, and the treatment plan as it is affecting both my
physical health and mental health and has been for months now. I was already brushed aside and insulted by
one physician, Dr. Mahajan, and I really need someone on my side to help
me. I’m pleading with you. Where do we go from here? I just want to feel better, both physically
and mentally, and my psychiatrist doesn’t feel that she can adjust my
medications at this point with the symptoms I am having. Can you please just talk to me? I am not an idiot. I have a bachelor’s and master’s degree so I
am not cognitively impaired. I just need
to understand and have a plan of action to help.
Thank you for reading and/or listening to this long
summation. Again, I apologize for the
length and for the time and hope with all my heart that you will take all of
this into consideration in treating me.
I know my case may be relatively complex, and I need to have faith that
you are a strong part of my team. I can’t
just be seen as a set of symptoms to be monitored as I have been dealing with
so long, and my life has become a constant state of misery.
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