…The world may never know.
I’m not quite sure what it means for me to say that today I feel depressed, considering a couple months back I was diagnosed with “depressive disorder, not elsewhere classified.” But after an appointment with my rheumatologist today, depressed seems the best way to describe my state. As a rule, I typically feel pretty goddamn normal. That is, until some asshole reduces me to angry tears.
Today’s appointment was scheduled as a two-month checkup to make sure my Cymbalta was still working and my fibromyalgia pain was bearable. The nurse weighed me and took my BP, then asked how I was feeling before the rheumatologist came in.
“Well, I’ve been better. I don’t know if you noticed, but my weight shot up 12 pounds since the last time I was here.” He clicked a few keys on the laptop and pulled up my records.
“Oh, yeah. I do see that now.”
“Well, I’ve never been terribly skinny, and I’ve been known to put on a few pounds over the years. But that’s abnormal for me. You can see it on my chart. I’m not sure if it’s a side-effect or part of the fibro or what. I wanted to ask about it.”
The nurse recommended that I bring it up with the doctor. He hadn’t heard that Cymbalta could cause weight gain and thought maybe the rheumatologist would want to check my thyroid levels again just to make sure I was within range. Sounded like a plan to me; the rheumatologist came in a few minutes later to ask me how I felt.” He was scribbling shit on my chart already.
“I’m doing mostly…”
“You’re doing good?” he interrupted. “Mood OK? Pain OK?”
“I think so, yes, I replied. But I have a few questions for you.”
“Sure,” he said. So I brought up the weight thing, and told him about my recent, uncharacteristic gain.
“Oh well, I’ve heard two or three pounds maybe, but never 10 or 12 on Cymbalta. You need to exercise more.”
“I’ve been exercising more and I bought a pedal desk for working on the comp…”
“That’s good.” He scribbled something else. “Stop eating food with calories.”
I had no response for that. Stop eating food with calories? Really? Immediately I saw the old women from that hilarious Esurance commercial flash through my mind. “That’s not how this works,” the one says. “That’s not how any of this works.” Maybe it was just that he was a non-native English speaker.
I attempted to add some explanation. “You see, it’s not normal for me. That full signal I used to get after a meal? That doesn’t happen anymore. And I’m constantly hungry to the point that my brain is distracting me with…”
“Exercise more. I mean, I could put you back down to 30mg of Cymbalta, but then you would be in a lot of pain.” Whether he meant it to or not, his tone came off as threatening.
“But what about my thyroid? Are you saying there’s no way any of this could possibly be caused by a dosage that needs tweaking for my…”
“No. Absolutely not. Exercise more and start eating things without calories when you get a craving. You might need to enroll in a weight loss program and see a dietitian for counseling.”
At this point I was fighting back tears. It takes me some time to flip my thick skin switch, and I wasn’t expecting to need thick skin at my motherfucking rheumatologist’s office. So I was emotionally a little off-kilter.
“Stop eating so much,” he said one last time. But at this point my back was to him. I was getting my purse and putting on my coat while mouthing “cocksucking, motherfucking asswipe cunt whore.” Once my coat was buttoned, I grabbed the yellow paper from his hands. “See you in three months,” he said.
The fuck you will, I thought. I left without even the chance to ask him about the pain in my big toes or the odd, tender bump high on my sternum between my boobs — and whether he thought it might simply be costochondritis (which seems to be prevalent among those diagnosed with fibro) or whether it might need to be investigated further.
I couldn’t get to my car fast enough. When I slammed the door and started the engine, I started sobbing.
A few days ago I got a letter in the mail that my primary care doctor, who works in the same clinic as my rheumatoglogist, was moving her practice. I was going to be looking for a new PCP anyway. This seems like the perfect time to switch health systems. Second opinions all the way around. I don’t expect doctors to be all-knowing gods, but they damn sure better let me finish a sentence.
I can’t believe I paid a $50 co-pay — UPFRONT! — for a lousy three minutes of interruption and judgment.
Update 2/13/15: A Patient’s Open Letter to Christie Clinic
Update 2/19/15: Christie Clinic Responds to My Open Letter