Saturday, December 27, 2014

The difference a good doctor can make - and its not just medicine



I have been bogged down with bad bone pain for the last few months. Various trials and errors have yielded some benefit but nothing permanent or long lasting. I started getting severe localised bone pain at various places from time to time. Recently, I have been bothered with pain in my left rib. I was referred to an orthopedician, Dr. Veda Prakash of Care Hospitals, Banjara Hills for this. This doctor prescribed some tests. I had also mentioned to him about the Cam Impingement. He passed on my case to Dr. Praveen Mereddy, his colleague also in the same hospital who specialised in the hip area.

I met Dr. Praveen Mereddy yesterday. He did a great analysis of my X Rays, my MRIs and other history and concluded that the pain was more likely related to the mineral imbalance in my body and suggested that I saw an endocrinologist. The good part about Dr. Mereddy was that he took pains to explain his analysis to me. He showed me why he thought the pain was more related to the mineral imbalance rather than the cam impingement. He seemed apologetic about referring me to another specialist for this but I was convinced with his explanation.

Next stop was Dr. Srinagesh, the endocrinologist, also at Care. Another great doctor! Dr. Srinagesh analysed my history and zeroed in on the probable cause soon enough. He also explained to me in detail what the problem was and how it was acting. It all seemed very convincing. He also gave me his card and told me to call him or email him if I had any problem. After I went home, later in the night, I received a text message from him advising one more test which would help!

I was feeling really depressed yesterday and these two doctors really made my day. I actually felt cheerful after walking out of the hospital! And I hadn't even started the treatment!

Doctors can make such a difference. Even without beginning the treatment, they have the power to make you feel better! Just by treating you with respect, acknowledging that it is YOU who are suffering, it is YOU who need help and that is why it is my duty to educate YOU about the problem can make so much difference.

Little gestures, all it takes are little gestures. We patients have low expectations. History has made us like that. So, treat us with respect. Don't think all of us are dumb fucks. Well, truth be told, some of us are. But not all! Explain to us what you're thinking. Involve us in your decision. It is our body after all. Is this too much to ask?

Thanks Dr. Mereddy and Dr. Srinagesh for making my day. I want your treatment to work. For me, for you.

6 comments:

B said...

Hi Kamal,

Wish you a happier new year !

How is it going with this ?

Kamal Shah said...

Thanks Bhanu! Happy new year to you too!

Its too early to say about the bone pain.

Akhila said...

Dear Kamal,
Regards and respect to your doctors! They were so considerate.
I still want to know why did your doctor increase calcitriol and which test was recommended? BSAP? Can I know that?

Kamal Shah said...

Calcitriol was increased to get the 1,25 dihydroxy Vit D to normal levels. It has increased beyond the really low levels but still below normal. We need to get it to about 30 or so. To compensate the possible increased Ca absorption, my dialysate Ca has been reduced to 2.25 mEq/l.

Akhila said...

Thanks Kamal. Then why do you think we cannot do this to all patients with low PTH, just decrease the calcium in dialysate and keep giving calcitriol instead? Why do you think they Discontinue (DC) calcitriol and what is adynamic bone problem then? Doctors do not check 1.25 dihydroxy levels to DC calcitriol. For that matter then you could have done this many times all these years! .....Discussed this ? We are getting there ....

Akhila said...

To my knowledge,bones will become weak and soft with calcitriol as bone formation won't be happening greatly at this low PTH. Hence raising 1,25 dihydroxy level is of what significance I am not sure. Repeatedly using calcitriol and high calcium with low PTH may be the cause of the problem. If you are sensitive to dialysate changes,use that to your advantage to raise PTH instead and stop calcitriol. Bone Homeostasis is required first. Check with your Neph to confirm. Remember I am "only a dietitian"...:):) I never forget! If you think other way, even then my best wishes!