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Strangest interaction with a physician ever

CoachCabo

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About 10 days ago I had a visit with my new PCP at the VA. I went in at 0700 to do a blood draw for hormones, what I thought would be a blood panel and a urine tox screen as is protocol for getting an opiod Rx.

I made it to my 1130 appointment and waited, of course, and finally the nurse came out. I have had a good relationship with this nurse for years and he seems to be a good guy. He took my vitals and then asked if I wanted the COVID vaccine. I declined and he asked if I ever intended to get one. I said "No". He then asked if I wanted the Flu vaccine and again I stated "No". Then he said I was due for a tetanus booster. I found this sort of odd so I said that I would wait until my next visit. The vibe changed significantly from there on.

A bit of back story first:
My previous physician was incredibly knowledgeable about nutrition and supplements. We frequently discussed mitigation of some of my blood test numbers using things like Red Yeast Rice, CoQ10, Omega/EFAs and resveratrol, etc. He understood I prefer to take no medication and prefer to manipulate my health through more natural ways. He never spoke down to me or in an authoritative manner and seemed to enjoy discussing these sort of things as most of his patients were not exactly health conscious.
Unfortunately he became ill two years ago and I have had to deal with several stand ins who were very distant and detached, as one might expect with a physician who has no investment in their patients. Dr. Le became healthy again and to my disappointment, retired.

I finally see my new PCP who appears to be a healthy, fit guy in his late 30s to early 40s.

The start of our conversation is my mentioning to him that I saw a skin cancer specialist in Cabo who spent nearly an hour inspecting every inch of my body (pretty much) and that he burned several AKs off but prescribed Efudix cream, which is a chemotherapy drug, for the persistent ones. The nurse brought in the liquid nitrogen dispenser but the doctor seemed totally disinterested in it. I mentioned that when I last saw a dermatologist at the VA in Houston, she only looked at my torso, unlike the head-to-toe the Mexican doctor did.
This guy starts to tell me that studies have shown that burning off AKs was not proven to be necessary and only mildly prevents skin cancer. His suggested course of action was to use this chemical cream vs. burning off the spots right then and there.

Next to my blood work. He states that I have hyperlipidemia and asks why I refuse statins. I tell him why and he makes a scoffing sound and face. He also says my liver function is off based on my blood work. My previous physician KNEW that people who engage in weight resistance training have muscle damage which skews the numbers and it is perfectly normal (to an extent).

He asked if I exercise. Probably the stupidest question I have heard a professional ask. But, I take it in stride and tell him that I do 30 minutes fasted cardio every morning or at least 6 days a week and spend 4 days a week, for one hour lifting weights. He immediately blurts out "That's too much!" He continues with studies have shown that anything over 6 hours per week is counterproductive...repetitive motion, etc. I explain to him that I use the acute pain of training and muscle soreness to mitigate my chronic pain. He says a few things more about too much exercise and the like.

He uses the pain conversation to segue into my ongoing Norco Rx. He states that studies have shown that chronic pain treatment is not effective using opiods and that they do little to ease the pain. He then says that this new approach has nothing to do with abuse of these drugs and that the VA is no longer prescribing opiods for chronic pain. This part made me a bit emotional, not because I could see where he was headed to, to NOT renew my Rx, but because I immediately thought of all of my brothers and sisters who are dealing with incredible pain from horrific injuries and how they might fare in the future. I immediately think of the "22 per day" suicide rate. I got a bit choked up and told him it had EVERYTHING to do with abuse on the street. In the decades I have been dealing with chronic pain, I have seen the entire spectrum of "Free willy" prescribing to total "gate keeper" shut off, all depending on the politics of "medicine".

I made it clear that I didn't use Norco for chronic pain but for days that I just couldn't get "over the hump" of dealing with my pain in other ways. I told him "Fine, I will just learn to live with the pain...as I always have."

He then asked me if I take supplements. I said that yes, I take many supplements. Now if this guy was asking if I take steroids, he should have asked that. But he didn't. He could easily see my miserable hormone profile and saw that I wasn't taking them so I figured that he must really mean supplements. He was clearly against them as he said that his sister is a bodybuilder and doesn't take any supplements. I desperately wanted to scream "BULLSHIT!" but kept my cool, although at this point it was getting pretty hard to not start raising the bullshit flag. I informed him that I had not taken any supplements for two weeks in anticipation of my colonoscopy. He said that he sees 4 or 5 people a month that come in with liver or kidney failure due to supplements'
I told him once again that I mitigate my cholesterol using supplements and that my experience might be considered anecdotal but the number change is significant when I am on a regimented use of these supplements. He asked which ones and I told him.

On discussion of my hormones, he defers any discussion to my endocrinologist appointment in November.

I left the appointment sort of stunned and at a loss for words, which anyone that knows me is quite an anomaly. I am not sure why I didn't ask "Which studies?" every time he said that. I am not sure why I didn't ask for justification of most of his comments.

I later logged on to to the health portal and saw his notes:
"Hyperlipidemia and hepatic (something or the other) and hypogonadism due to bodybuilding" He makes several notes about "bodybuilding supplements" and a "mild tachycardia likely due to bodybuilding supplements". Never once was "bodybuilding supplements" discussed and he obviously made that assumption based on my use of supplements and my "hobby".

I also became aware that he had NOT ordered a blood panel even though he KNEW I was going in for a blood draw. He also KNEW that he was NOT going to prescribe an opiate yet he ordered the urine tox screen test (the only thing he ordered) anyway. For me, a 27+ year veteran who has NEVER had a positive piss test, this is incredibly insulting and the relevance escapes me if he did not intend to prescribe Norco. He certainly tried to prescribe just about everything else though. Statins, NSAIDs, etc.
So his assessment of hyperlipidemia was based on an 11 month old blood test! Incredible!

What is the take away from this? I don't know? Maybe to be vocal at your appointments? Maybe that you don't have to settle for whoever they assign you? I don't know.
I do know that I am going to request a different physician.

 
My doctor before Dr. Le was a USAF vet named Dr. Lee. He was annoyed with his younger colleagues who he was trying very hard to acclimate to the VA environment. He tied to explain to these younger doctors that they just need to listen and stop trying to be the almighty doctor (his words). He said that most vets just want to come in and complain about their problems and at the end of the appointment, IF the doctor was listening. the doctor would ask what if anything they could do for the veteran. Most would just reply "Nothing doc. I'm good."
The point being that instead of continuously burdening their families with their pains and problems, they just needed an outsider to vent to. No drugs. No tests. Just venting therapy.

This dude was definitely preachy and could have learned a lot from Dr. Lee. It is so valuable when VA staff "speak our language". Not a small thing for anyone who has served.
 
About 10 days ago I had a visit with my new PCP at the VA. I went in at 0700 to do a blood draw for hormones, what I thought would be a blood panel and a urine tox screen as is protocol for getting an opiod Rx.

I made it to my 1130 appointment and waited, of course, and finally the nurse came out. I have had a good relationship with this nurse for years and he seems to be a good guy. He took my vitals and then asked if I wanted the COVID vaccine. I declined and he asked if I ever intended to get one. I said "No". He then asked if I wanted the Flu vaccine and again I stated "No". Then he said I was due for a tetanus booster. I found this sort of odd so I said that I would wait until my next visit. The vibe changed significantly from there on.

A bit of back story first:
My previous physician was incredibly knowledgeable about nutrition and supplements. We frequently discussed mitigation of some of my blood test numbers using things like Red Yeast Rice, CoQ10, Omega/EFAs and resveratrol, etc. He understood I prefer to take no medication and prefer to manipulate my health through more natural ways. He never spoke down to me or in an authoritative manner and seemed to enjoy discussing these sort of things as most of his patients were not exactly health conscious.
Unfortunately he became ill two years ago and I have had to deal with several stand ins who were very distant and detached, as one might expect with a physician who has no investment in their patients. Dr. Le became healthy again and to my disappointment, retired.

I finally see my new PCP who appears to be a healthy, fit guy in his late 30s to early 40s.

The start of our conversation is my mentioning to him that I saw a skin cancer specialist in Cabo who spent nearly an hour inspecting every inch of my body (pretty much) and that he burned several AKs off but prescribed Efudix cream, which is a chemotherapy drug, for the persistent ones. The nurse brought in the liquid nitrogen dispenser but the doctor seemed totally disinterested in it. I mentioned that when I last saw a dermatologist at the VA in Houston, she only looked at my torso, unlike the head-to-toe the Mexican doctor did.
This guy starts to tell me that studies have shown that burning off AKs was not proven to be necessary and only mildly prevents skin cancer. His suggested course of action was to use this chemical cream vs. burning off the spots right then and there.

Next to my blood work. He states that I have hyperlipidemia and asks why I refuse statins. I tell him why and he makes a scoffing sound and face. He also says my liver function is off based on my blood work. My previous physician KNEW that people who engage in weight resistance training have muscle damage which skews the numbers and it is perfectly normal (to an extent).

He asked if I exercise. Probably the stupidest question I have heard a professional ask. But, I take it in stride and tell him that I do 30 minutes fasted cardio every morning or at least 6 days a week and spend 4 days a week, for one hour lifting weights. He immediately blurts out "That's too much!" He continues with studies have shown that anything over 6 hours per week is counterproductive...repetitive motion, etc. I explain to him that I use the acute pain of training and muscle soreness to mitigate my chronic pain. He says a few things more about too much exercise and the like.

He uses the pain conversation to segue into my ongoing Norco Rx. He states that studies have shown that chronic pain treatment is not effective using opiods and that they do little to ease the pain. He then says that this new approach has nothing to do with abuse of these drugs and that the VA is no longer prescribing opiods for chronic pain. This part made me a bit emotional, not because I could see where he was headed to, to NOT renew my Rx, but because I immediately thought of all of my brothers and sisters who are dealing with incredible pain from horrific injuries and how they might fare in the future. I immediately think of the "22 per day" suicide rate. I got a bit choked up and told him it had EVERYTHING to do with abuse on the street. In the decades I have been dealing with chronic pain, I have seen the entire spectrum of "Free willy" prescribing to total "gate keeper" shut off, all depending on the politics of "medicine".

I made it clear that I didn't use Norco for chronic pain but for days that I just couldn't get "over the hump" of dealing with my pain in other ways. I told him "Fine, I will just learn to live with the pain...as I always have."

He then asked me if I take supplements. I said that yes, I take many supplements. Now if this guy was asking if I take steroids, he should have asked that. But he didn't. He could easily see my miserable hormone profile and saw that I wasn't taking them so I figured that he must really mean supplements. He was clearly against them as he said that his sister is a bodybuilder and doesn't take any supplements. I desperately wanted to scream "BULLSHIT!" but kept my cool, although at this point it was getting pretty hard to not start raising the bullshit flag. I informed him that I had not taken any supplements for two weeks in anticipation of my colonoscopy. He said that he sees 4 or 5 people a month that come in with liver or kidney failure due to supplements'
I told him once again that I mitigate my cholesterol using supplements and that my experience might be considered anecdotal but the number change is significant when I am on a regimented use of these supplements. He asked which ones and I told him.

On discussion of my hormones, he defers any discussion to my endocrinologist appointment in November.

I left the appointment sort of stunned and at a loss for words, which anyone that knows me is quite an anomaly. I am not sure why I didn't ask "Which studies?" every time he said that. I am not sure why I didn't ask for justification of most of his comments.

I later logged on to to the health portal and saw his notes:
"Hyperlipidemia and hepatic (something or the other) and hypogonadism due to bodybuilding" He makes several notes about "bodybuilding supplements" and a "mild tachycardia likely due to bodybuilding supplements". Never once was "bodybuilding supplements" discussed and he obviously made that assumption based on my use of supplements and my "hobby".

I also became aware that he had NOT ordered a blood panel even though he KNEW I was going in for a blood draw. He also KNEW that he was NOT going to prescribe an opiate yet he ordered the urine tox screen test (the only thing he ordered) anyway. For me, a 27+ year veteran who has NEVER had a positive piss test, this is incredibly insulting and the relevance escapes me if he did not intend to prescribe Norco. He certainly tried to prescribe just about everything else though. Statins, NSAIDs, etc.
So his assessment of hyperlipidemia was based on an 11 month old blood test! Incredible!

What is the take away from this? I don't know? Maybe to be vocal at your appointments? Maybe that you don't have to settle for whoever they assign you? I don't know.
I do know that I am going to request a different physician.


This isn't just the VA. I've had to deal with this for years and years. My back injury 17 years ago lead to me becoming obese. Few years after my surgeries I started feeling off. This was something different than the back pain I had to deal with every minute of the day. Went to many docs that told me we don't see anything and it was from stress from my business and from being out of shape. Oh BTW no more pain meds wtf I've had 5 back surgerie!. Oh whatever, oh and your test level is way too low. We're going to start you on some test.
So started test and figured I'd dive into the gym at the same time. Just grind it out and ignore the pain. Things got worse but keep in mind my goal was to be fit at that time and not big. I got down to 225lbs at 6'4 I saw abs for the first time ever. The issue was my confidence went through the roof but my pain was still there as well as the odd feeling.
So I went back to the doc and they said well your hemoglobin was too high and ordered blood donations. I said but I had this feeling before the hemo issue. Aw just donate and we'll see how it goes. So a few months later I went back and it was I dunno. I went to 13 different docs and none had any answers expect your BP is too high. Yeah it's been that way fron after my surgery. The "get fit" didn't fix it. I was a machine eating perfect and working out, again not on gear just trying to stay "fit".
So I really started to get into lifting. I lifted light and focused on the pump and did high reps 6 days a week. I got up to 255 with the aid of some supps. I was feeling better until one day I found myself in the ER. My kidney function was now low. But the odd part was it was up and down they said this wasn't normal. Keep in mind I'd done 3 cycles of half of what I should had been doing. This put me in touch with my current doc. She is amazing and found that my hardware was making metal in my body. Or so she thought. You never know until you do surgery. So I had surgery last year and sure enough the hardware was recalled and my surgeon said he spent 45 min scraping my tissue to get the metal out. Metal poisoning.

My point is, keep looking for a better doctor. Someone that will listen to YOU and not tell you. Someone that will listen and then make a plan with YOU. They're tough to find but they're out there. Good luck brother! Keep fighting the good fight. There was many of days I wanted to give up but I was lucky my mind wouldn't let me. Stay strong and know if you find that doctor and you will, things can change for the better. Stay positive!
 
He said that most vets just want to come in and complain about their problems and at the end of the appointment, IF the doctor was listening. the doctor would ask what if anything they could do for the veteran. Most would just reply "Nothing doc. I'm good."
The point being that instead of continuously burdening their families with their pains and problems, they just needed an outsider to vent to. No drugs. No tests. Just venting therapy.

Sounds like a good guy that knew how things were.

This would probably sound bad anywhere else, but you know what I usually look for first in a doc? Age. If you can get one about 45-50, then they've been around long enough to know something and they aren't so far over the hill that they don't care any more. Second thing is personality (aka "bedside manner"). All of them are capable of writing a prescription, so they better know something and know how to get along with their customers.
 
Does the VA offer pain management specialist? This may be more appropriate then your PCP.
 
Kratom is natural and works as well as hydro's. I dealt with level 10 pain for years with only Kratom. It didn't kill all the pain but I could function. I did have to lift significantly less weight though. Heavy weights was making my back worse even with perfect form.
 
My daughter is a Captain in the Army and a physician currently serving at Walter Reed. She loves her job, but constantly tells me stories about what a complete shitshow it can be. Fortunately she PCS’s next year.
 
Medicine and especially pain med is definitely changing and unfortunately the ones that are suffering are the ones that really need the help. Anyone who is of was on any kind of doctor prescribed opiates will always be treated like 2nd class citizen scumbags now because overnight Opiates are the devil. Two years ago you could get an Opana 40 for a headache and you were considered normal. Now your lucky to get Tramadol post surgery. It’s a fucking joke.
My father who’s in his late 70’s had testicle surgery not long ago and whatever type it was didn’t allow them to completely close up his ball sack. Every two days I think a nurse would come to his house, drop his testicles out of his sack and clean them and whatever else. This went in for like a month until they were finally able to sew him up for good. Sorry I may be off on a few little details but the point is they refused to give him any type of opiates. His Doctor said he had too many patients abusing them and selling them. WTF my old man is two days older than dirt and his balls were being dropped out of his sack 4 days a week. Seriously?
 
IML Gear Cream!
Go to the Dept of Public Health website and file a complaint against him.

You may be required to fill out info online and also fed ex in a written document.

This goes after a medical professionals license and begins and investigation.

I assure you this is the fire in the ass of any medical professional they never want to see.

This is like going from 0-200 mph in the snap of your fingers.

I assure u this route makes things happen fast.
 
Medicine and especially pain med is definitely changing and unfortunately the ones that are suffering are the ones that really need the help. Anyone who is of was on any kind of doctor prescribed opiates will always be treated like 2nd class citizen scumbags now because overnight Opiates are the devil. Two years ago you could get an Opana 40 for a headache and you were considered normal. Now your lucky to get Tramadol post surgery. It’s a fucking joke.
My father who’s in his late 70’s had testicle surgery not long ago and whatever type it was didn’t allow them to completely close up his ball sack. Every two days I think a nurse would come to his house, drop his testicles out of his sack and clean them and whatever else. This went in for like a month until they were finally able to sew him up for good. Sorry I may be off on a few little details but the point is they refused to give him any type of opiates. His Doctor said he had too many patients abusing them and selling them. WTF my old man is two days older than dirt and his balls were being dropped out of his sack 4 days a week. Seriously?

Bro my last surgery I went in to get some Norco before surgery. It was 10 days worth. Doc was a ok writing it because he knew what he was going to cut on. I almost had to choke out the pharmacist. This clown was trying not to fill it. I asked if he even knew why I was getting them in the first place. I told him to call my surgeon if there's a issue. What I've learned it if you're in shape it's even harder to get this stuff. My pops is 70 and he gets 300 a month and they never question him. I'm like wtf! He has bad knees. These clowns have gone way to far. It's no wonder people are buying this stuff off the street and ODing.
 
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I hope that opiates are not the center of my story for people. I don’t take them but just have them around “in case”. If I ever need them there is zero chance of legally obtaining them here. I also like getting the Rx filled just because I can. I get nothing else from the VA besides CPAP supplies. Every trip North costs me about a $1000 just use the VA and it’s why I pay for my own bloods or specialists here. Much easier.

But for the Veterans I know who are really fucked up, hearing they are playing gatekeeper again disturbs me deeply.
It reminds me of a doctor who would only authorize a temporary handicap placard. She said I was “too young for a permanent one”. I lost it.
”What exactly do you see in my x-rays or condition do you see improving?”
Dudes that have the unescapable pain of 3rd degree burns are now supposed to use paracetamol? What exactly is going to get better for them?

Oh, I used to get 180 8mg dilaudid a month. Before that it was a shitload of OCs. I developed a problem but crawled out of it by myself. No gatekeepers then. And I was significantly less fucked up physically then.

It seems if I stayed in the wheelchair I would have gotten more empathy. You get no credit for beating the odds by your own merit.
 
I certainly didn’t take it that way at all. My father is a VET as well and I was simply saying that because of a problem the Doctors started people who need them are suffering. As with everything else these days it’s a fucking joke.



I hope that opiates are not the center of my story for people. I don’t take them but just have them around “in case”. If I ever need them there is zero chance of legally obtaining them here. I also like getting the Rx filled just because I can. I get nothing else from the VA besides CPAP supplies. Every trip North costs me about a $1000 just use the VA and it’s why I pay for my own bloods or specialists here. Much easier.

But for the Veterans I know who are really fucked up, hearing they are playing gatekeeper again disturbs me deeply.
It reminds me of a doctor who would only authorize a temporary handicap placard. She said I was “too young for a permanent one”. I lost it.
”What exactly do you see in my x-rays or condition do you see improving?”
Dudes that have the unescapable pain of 3rd degree burns are now supposed to use paracetamol? What exactly is going to get better for them?

Oh, I used to get 180 8mg dilaudid a month. Before that it was a shitload of OCs. I developed a problem but crawled out of it by myself. No gatekeepers then. And I was significantly less fucked up physically then.

It seems if I stayed in the wheelchair I would have gotten more empathy. You get no credit for beating the odds by your own merit.
 
I hope that opiates are not the center of my story for people. I don’t take them but just have them around “in case”. If I ever need them there is zero chance of legally obtaining them here. I also like getting the Rx filled just because I can. I get nothing else from the VA besides CPAP supplies. Every trip North costs me about a $1000 just use the VA and it’s why I pay for my own bloods or specialists here. Much easier.

But for the Veterans I know who are really fucked up, hearing they are playing gatekeeper again disturbs me deeply.
It reminds me of a doctor who would only authorize a temporary handicap placard. She said I was “too young for a permanent one”. I lost it.
”What exactly do you see in my x-rays or condition do you see improving?”
Dudes that have the unescapable pain of 3rd degree burns are now supposed to use paracetamol? What exactly is going to get better for them?

Oh, I used to get 180 8mg dilaudid a month. Before that it was a shitload of OCs. I developed a problem but crawled out of it by myself. No gatekeepers then. And I was significantly less fucked up physically then.

It seems if I stayed in the wheelchair I would have gotten more empathy. You get no credit for beating the odds by your own merit.

That was just part of my post, a small part. I'd think about finding a good doctor and that may lead to having to go few as many as it takes. Having been through what I've been through I shop for a doctor like I'm buying a home. I ask questions.
 
I'm so sorry to hear of your ordeal. Really good doctors are a needle in a hay stack to find.

Small example: I've been having unrelenting hip pain for 6 months now, its become very unmanageable for the last 3 weeks - I also have knee pain again. I went to Insall Scott Kelly who did my knee surgery in 2003. On the forms where it gives you a box for a description, I wrote in "in desperate need of an MRI (L) Hip"

Now Dr. Su (Young Asian Doc) orders xrays - xrays show arthritis in my knee again and "findings in my hip" but never told me what it was. He prescribed 'physical therapy', an anti-imflammatory and a pain killer which I didnt want and I told him that. So he gave me a steroid pack instead. He never asked me if I was active in my past but I told him, he shrugged it off. I asked him again what was going on with my hip, he says "you have mild arthritis" I responded "In no way "mild arthritis" will made my left leg go numb from my ass to my feet, and pain so bad I wanna cry" He said lets make a follow up appointment and see how the steroids work.

They cancelled my standing appointment - I found a hip specialist where I live. Appointment was easy to make - Doc came in right way (American, White and in his 40's) read what I wrote asked me if I played hockey when I was younger while he had me on the table stretching my hip out - I said yeah from when I was 10 - 30 how did you know. He laughed and said he was a hip specialist and has performed MANY surgeries on hockey players including teenagers. He told me flat out that I had a torn labrum in my hip - has no idea how the hell I have managed to be in the pain I was for as long as I was. Ordered me an MRI with contrast for my hip and an MRI for my lower back. My spine doc is in the same building (I have torn and herniated discs L5, S1)

I told him what the other doctor did he said "you'll get that with all these young immigrants coming to this country, it was a blessing in disguise the appointment was cancelled"

So that is the difference between a good and bad doc.
 
Sounds alot of how my 1st visit went when I was honest with my Dr. It went from I'm in good shape seem healthy to I'm a strung drug head who needs to stop abusing steroids and get my life together...I went to a different dr that now takes way better care and understands what's going on in my life. That fucker your dealing with is drawing fast conclusions to be correct and get the ball rolling on what he thinks is right period fuck everyone else and your ideas this guy just wants $ and do as he pleases play God with ppls health fuckn commi dr
 
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