Category Archives: doctors and practitioners

Three months of reiki

Adventures in Nutritional TherapyMore and more health writers and bloggers, including the Low-Histamine Chef and Donna Jackson Nakazawa, author of The Last Best Cure, have found stress reduction to play a big part in their health recovery, and since my stress tolerance is pretty much in the toilet and getting worse, I decided to go get me some.

I needed something reeeeallly passive. Meditation, yoga, and nature walks were too much for me. So were about half the service offerings at my local spa. Infrared sauna, various types of massage, and the flotation tank all require removing my contacts without a sink or mirror, or doffing and donning winter clothes in a tiny space, or showering in a tiny shower. I couldn’t deal with any of that.

I decided on reiki, which in theory moves and rebalances energy in the body. Sometimes the reiki practitioner’s hands are touching the (clothed) body, sometimes not. I had two sessions a week for two months, then switched to once a week. It’s a lot of money, and as far as I know no health insurance company covers it. But I do believe it got me through the winter without killing anyone. Here’s what I’ve noticed:

  • First and foremost, it’s basic human touch free of expectations or strings or weirdness — y’all know what I’m talkin’ about — which is therapeutic right there.

  • I always look forward to it, but more so if I have nothing else scheduled for the day.

  • My sleep has not improved, but I do almost fall asleep on the table. I can’t nap, either, so that’s saying something. What happens is a lot like the sensation you get on a plane where you’re about to fall asleep and there’s a WHOOSH-CLICK and your body wakes you up again, presumably to spare you the humiliation of drooling in front of strangers. I find that I nod off only when Reiki Lady is holding her hands above a particular foot-long strip of my torso, which I discover when I open my eyes.

  • I can completely relax my body much more quickly than before. If you’re into meditation you might be familiar with the concept of relaxing to the point where you go numb. Now I can do it in about 10 minutes, where before it would take 40.

  • Reiki Lady occasionally incorporates craniosacral therapy to my head. I can now not only feel how the muscles in my shoulders, neck, and jaw are connected, pulling, and relaxing, I can also feel pressure and tension patterns throughout my skull. Imagine a May pole, where all the streamers are muscles or tension patterns that have gotten wound up and distorted and twisted, due in part to the stupid way I sit at my desk. During reiki sessions, I become more and more aware of the presence, movement, and release of each streamer. This took a lot of sessions, however.

  • As for energy movement … Of course where you’re being touched (through your clothes) you feel tingly. But there is something else, too, that I didn’t start to feel until my fifth ? session, although I don’t think reiki practitioners believe you have to feel it in order for reiki to do whatever reiki does. It was subtle and fleeting, but occurred at each session after that. After about four more sessions, it changed a bit. I don’t really have the vocabulary to describe it. Somewhere in and across my upper body, a pulse or wave changed position, angle, and amplitude. How’s that? It could be that you could get this experience just from meditating regularly. I don’t know.

  • As for my stress response … Last winter I overextended myself in terms of physical, emotional, and cognitive energy, and I was still angry and stressed well into summer. I swore I would not go through that again. I overbooked myself again this winter, mostly with home repair projects that couldn’t be put off, but am rallying much more quickly after each annoying task.

Image: Still from The Phantom of the Opera (1925) by Universal Pictures. Film is in the public domain.

Annoying #$@! people will say re: your mystery health issue

Adventures in Nutritional TherapyAfter you’ve spent a few months/years wandering through the medical system with a complaint no one can help you with — hair loss, psoriasis, fatigue, dizzy spells, insomnia, whatever — you start to hear the same refrains from supposedly well-meaning doctors and civilians.

“Are you sure it’s not just depression/stress?”
Translation: “America’s healthcare system is the best in the world, so I think I’m safe in saying that anyone who thinks a doctor can’t solve his particular problem has some sort of mental dysfunction. Besides, I heard it on a commercial for some prescription drug.”

“You should try my doctor. He’s really good.”
Translation: “You can tell my doctor is good because he’s speaks really confidently. He uses medicalese I don’t understand, proving that he’s completely up to date on all the developments of any health situation ever. I’ve never had a problem he couldn’t fix — like that sinus infection last year, OMG! I am special and privileged and expect my random PPO-plan GP to be better than your random GP or specialist.”

“In cases like that, the cause is usually genetic.” (Doctors)
Translation: “When you get something your mother/grandmother/great-uncle had, why should we be expected to know how to fix it? Oh, they didn’t have it? Well, they probably did and you just don’t know it, because health problems we can’t fix are usually genetic. We only bother with first-generation health issues. Once it crosses to a second generation, it’s no longer our purview. It’s like, I dunno, a judgement from God or something. I never really thought about the huge logic fail with this argument before. No one ever questions my judgement, and I wasn’t warned in medical school that any patient ever would, so I am not in the habit of using my reasoning skills.”

“You have to stay positive.”
Translation: “I don’t want to hear about your health problems. I only asked to be polite and so that you’d reassure me that I don’t have to worry about you or about the possibility that it could happen to me. In America we’re supposed to be friendly and upbeat all the time, especially women, and if you don’t play along you’re violating the social contract.” (See also this Beyond Meds post.)

“You have such a good attitude about this!”
Translation: “I’m trying to force you to say something gracious and thankful and get the subject on another topic because I can’t contribute to this conversation since it’s out of the realm of my experience. At least you’re not talking about how frustrating this problem must be. I’m willing to not blame you for your own health problem but this is a gentle reminder about how I want conversations to go in the future.”

Image: Remix by MRhea.

Disguising nutritional therapy to defraud patients

An older and, now that I look at it, somewhat insensitive version of this post appeared on my other blog, Blessed Depth.

At my last job in the big corporate world, I heard a rumor that one of our big cheeses — the one we trusted, the only one who bothered to tell us that yes, the new office in India is indeed the death knell for you all — had “lost” two family members to a cult.

Eventually I got to know him well enough to ask him about it and was surprised to hear that it came about during his wife’s search for treatment for depression. She had suffered from it all her life and felt horribly guilty, he said, for passing it on to their daughter, now grown. The wife had been seeing a certain doctor for months before the big cheese noticed that she had gone through an amount of money greater than my annual salary.

His brief account of his wife’s, and then their daughter’s, involvement with this doctor’s practice matched several characteristics of cults that I remembered learning about in school. One or both of them gave large amounts of money to the organization; distanced themselves from relatives and friends who did not approve of the organization (the big cheese no longer had contact with either of them); relocated to be near the organization; and deferred to organization leaders when making decisions about their personal lives. An internet search revealed that the doctor was being investigated for fraudulent medical practice.

When I visited the doctor’s website I discovered it was something I myself might have researched at the nadir of my depression, when I was spending half the day searching the internet and the other half curled up in a ball on my parents’ guest-room floor. His practice advertised itself as an alternative medical center for environmental allergies, and offered the usual alternative treatments like magnetic therapy, reiki, acupuncture, allergy testing, etc. In fact, the center offered more services than I’d ever seen at one place.

On the home page, in a long list of steps describing how new patients were evaluated and treated, I found what I thought was the “hook.” Step one was an interview by a staff person. Number two was supplementation with an unspecified assortment of vitamins and minerals, to make sure the patient had basic nutritional support. The tone was almost apologetic, as if it were a legal precaution and the staff was embarrassed to have to bother anyone with it.

I am not the only person who’s discovered that just a big dose of B-complex from the drugstore can make a difference in mood in a few weeks. If the new patient actually took those “just-in-case” supplements and then underwent another treatment at the same time, she might feel just better enough to notice and might attribute it to that other treatment. If you are miserable enough, have suffered long enough, know nothing about biochemistry, and believe that depression is a mysterious mental process that only experts can understand, a slight easing of it would be like a miracle and it would be easy to convince you to try one treatment after another. Without insurance coverage, it could quickly add up to tens of thousands of dollars.

I was reminded of something another depression-sufferer I knew had once said: “I’d cut off my right leg if I thought it’d make me feel better.” If someone delivered you from life-long mental torture, how clear would your thinking be about him? I wondered if I would have gotten sucked in by Dr. Whozits if I had stumbled across his innocuous website ten years before. I hope not: I had heard about my grandfather’s supplement experiments on himself my entire life (he died at 94 after collapsing on a golf course), and my mother was quite the one for the scientific method, so I’m assuming that if I had taken the supplements, eventually something would’ve dinged in my head about cause and effect. Luckily, I didn’t have the money to get there in the first place.

My second alterna-doc disaster

When I was unable to convince my regular alterna-doc that I was hypothyroid, I made the mistake of returning to the only other major alternative medicine practice in town, a Den of Incompetence I had sworn never to visit again. Dr. Dumbass had left the practice and I convinced myself that my earlier experience was just a fluke.

My thyroid symptoms had worsened significantly and I had made the startling discovery that my healthy diet was the culprit. It turns out that drinking raw kale juice every day for a year is a bad idea, even for healthy people. I printed out the articles I had found, including the one from a British running association’s website that said one should only drink raw goitrogens once a week, and went off to my appointment.

The new doctor was a native Korean. I told him my theory, described my symptoms. “No,” he said. “Food has nothing to do with it.” I showed him the articles. He didn’t even look at them. “Put your papers away,” he snapped. “You need to educate yourself.”

Only 15 minutes into the office visit and Snake Oil, Inc. was back on my shit list. Visions of me maligning Dr. Shithole up and down the North Coast danced in my head. And I still had 15 minutes left in the appointment.

The moron began blathering about my older test results and diagramming the pineal gland with arrows and chemical equations. None of it disproved or proved anything thyroid-related. After waxing pompous for a while he said, “I think you have a problem with your thyroid.” He wrote a prescription for 1 grain of Armour, which is a pretty big dose to start a person on. It would have given me heart palpitations, not that I knew it at the time. I discovered later that I could barely handle 1/4 grain.

Then he said, “Why do you not wear makeup? Don’t you want to get married?”

Having never been addressed in this manner in my entire life, I began sputtering. I don’t know what I said. He followed that gem up a few minutes later with “You should not be so choosy. After all, you are not a princess.”

Back I went to my stand-by alterna-doc, determined not to take no for an answer. I probably would have considered taking hostages at that point. When I described the raw veggie juicing debacle and showed her the internet info warning about it, she said, “Really? I didn’t know that!” Which you have probably noticed in your own experience is a rarity among doctors. I left her office with an Rx for 1/4 grain of Armour, and after three weeks I felt much better.

For the next several years no medical practitioner who crossed my path escaped without hearing the story of the Pencil-di$%ed Pseudo-M.D. of Misogyny, may the fleas of a thousand camels infest his armpits. Even the coolest cucumber of them all, the reigning queen of CAM-dom in my area, could not control the skyward lift of her eyebrows after I shared that anecdote. Her nurse practitioner was less restrained and sort of shrieked. Another osteopath, younger and less jaded, actually used the F-word, which I found very satisfying, but I’m that kind of girl, if you haven’t noticed. They all made the whole miserable experience almost worth it.

The disaster of my first alterna-doc experience

When I first realized that nutritional deficiencies cause health problems, I had a brilliant idea: I should get tested for nutritional deficiencies! The problem was that in 1999 none of the traditional doctors I had seen believed in deficiencies or that gluten played any part in health problems for people who tested negative for celiac, as I had.

My mother, ahead of her time as usual, had been visiting a local alternative medicine practice for a few years, and mentioned that they gave a huge panel of blood and other tests to all new patients. The founders of this practice, three M.D.s, had impressive credentials and had all worked for decades at high-profile medical institutions. Sadly, the doctor I saw was not one of them.

Because of my experience with this jackass, I was thereafter reluctant to trust anything any other alternative medicine practitioner (AMP) ever said. Although I continued to see other AMPs, it was almost always for a treatment I had already investigated on my own, or to have them order a test I knew my traditional doctor would fight me on. Only very rarely, when I was utterly desperate, did I ask an AMP for treatment suggestions. I haven’t decided yet if this was a good thing or not.

My first impression of Dr. Jackass was very promising. He listened to everything I had gone through and was encouraging and commiserating. “Sounds like you’ve made amazing progress!” he said. This was new to me — a doctor who didn’t criticize my experimentation or contradict my observations.

I made it clear that I had no insurance, which back then in the AM-phobic days wouldn’t have covered much of the tests or the appointment anyway, and a limited budget. He was sympathetic. I already knew that the tests and appointment were going to run about $800.

He recommended allergy testing, using that contraption with a brass rod you hold in your hand. I did that right after the appointment. I saw no correlation between the machine’s results and my own experience with food, including wheat or gluten, which the gadget said I had no problem with. But since this was all new to me I decided to suspend judgement for the time being.

After that, a staff member and I went over the ingredients labels of the supplements the doctor had recommended, about seven bottles of private label vitamin and mineral combos. If I recall correctly, they were nothing untoward — just basics like Bs, calcium, etc. and maybe some of the more common adrenal herbs. Mme. Staff Lady and I found that the majority of the seven or so bottles contained gluten. Of the three or so that were safe, I chose two.

Mme. Staff Lady left to ask the doctor if alternatives were available for the others. From across the hall I heard him have a TEMPER TANTRUM. He slammed files down and shouted that the whatchamacallit machine said I wasn’t allergic to wheat so the ingredients didn’t matter. Anyone in the waiting room or the large therapy room or even out by the elevators could have heard him.

Mme. Staff Lady returned, obviously used to all this, and proceeded as if he hadn’t said anything. Later my mother said she had witnessed the same thing and that the doctor seemed to have a 30-minute limit on pleasantness. “I think he might have a personality disorder,” she said. I neglected to ask why she hadn’t brought this up before.

At the follow-up appointment he was charming again. No mention was made of his crazy time. I don’t remember exactly what he told me about the blood test results — it was probably adrenal-related — but he definitely did NOT point out the non-existent iron, abysmal vitamin D, or shameful thyroid levels. I puzzled all that out several years later.

He had a few more supplements to recommend and left me in the exam room while I perused the labels. Then he popped in the door again and said something like, “This is just an idea, but a lot of people are getting great results with this.” He handed me a bottle of human growth hormone. The price on the lid was $120.00. Back then I didn’t know nothin’ from nothin’ about supplements but even I knew that you did not mess with human growth hormone unless you were a body builder or Sylvester Stallone.

At that point I decided to have nothing further to do with this outfit. I said, “No.” He shrugged sort of sheepishly and left again.

Once more to Mme. Staff Lady to check out. Once more a temper tantrum across the hall, but this time it was about some administrative task another staff person had asked of him.

Over the next several years, I visited a lot of AMPs in the area — basically anyone who didn’t list voodoo as a treatment offering — and I made sure they all heard this story. None of them were surprised, and several of them offered the same opinion: that the original three founders had a great idea back in the 90s, but something went amiss once they retired or semi-retired. In any case, someone at that practice was supremely inept at judging character, because when I heard that Dr. D—head had left, I returned for another visit, and the new doctor was worse. But that’s a story for another post.

Getting the most out of a doctor’s visit, especially for chronic, unexplained illness

Updated January 18, 2017

After a dozen years and scores of doctor’s appointments to investigate various angles of my health annoyances, I have discovered that the majority of doctors will do the same time-wasting things over and over. This is especially maddening when I am dealing with a complementary/alternative medicine (CAM) practitioner not covered by my insurance. Here is a list of suggestions for dealing with this.

I suggest you treat appointments like you’re running a business meeting with the head of another department you know nothing about for a project you’ll both be working on. You have no reason to be embarrassed by the fact that you don’t know a great deal about his subject, and the other person has no reason to be surprised if you do not. You both have certain things you need to impart and learn in a very short time and your time — yours more than his — is very valuable. You won’t be shy about talking about costs, since the usual social inhibitions against discussing money do not apply when it comes to a businessperson protecting her operating budget.

Which isn’t to say that the doctor in question will play along with this approach. I have yet to be disabused of the notion that the majority of doctors become doctors because they want to be right, not because they want to help people. They’ve been taught their entire educational and professional careers that they hold an unusual, coveted body of knowledge, that they are members of one of the most intelligent strata of society, and that patients need to be protected from their ignorance — we’d gnaw off our own fingers if band-aids hadn’t been invented.

None of these are true anymore. So:

1. Don’t worry about being polite, being liked, or being agreeable.

2. Have an “elevator speech” ready (as they say in career advice circles) of what you hope to accomplish in the meeting, and a brief rundown of your history. When he asks what you’re there for, start the speech and do not let him interrupt you. Keep it short, though. Figure out beforehand what the salient points are.

3. Interrupt him if he’s talking too much on a tangent.

4. Don’t take hemming-and-hawing as no. Doctors are often ambivalent about ordering non-standard tests, for example, but if you state simply and repeatedly that that is what you want, they’ll usually cooperate. They have rarely refused me and will usually do what they can to find the appropriate insurance code for coverage, if it is possible. (Ms. West mentions this as well.)

5. Watch out for the following tricks used to stop you from asking questions or to deal with the doctor’s discomfort at what Dr. Marie Savard refers to as the “new paradigm of a partnership with you” that you are forcing on him. Don’t be sidetracked. Yank the conversation back. Ignore him and continue your questions, or repeat that you are there to get information.

  • Over-explaining. A favorite tactic is drawing diagrams of molecular chemical reactions.
  • Sharing his theories about the causes of obesity or autism or another topic unrelated to your health issue
  • Telling a joke
  • Complimenting you on your intelligence, etc.
  • Laughing at your ideas

6. Manage your expectations.

  • Don’t expect him to be interested or impressed by anything you’ve done.
  • Don’t expect him to express sympathy.
  • Don’t be surprised if he expresses disapproval at something else you’re trying on your own or with another practitioner. If you are not there for feedback, ignore him, interrupt him and continue questioning. Remember, doctors are a lot like cats: they don’t like doing things that aren’t their idea.

7. Ask him to prioritize for cost purposes whatever treatment suggestions he offers. I’ve never met anyone who was unsympathetic or uncooperative on this point.

8. If he wants to run tests, ask him if any of them can be avoided. Also ask if any can give false positives based on supplements you take. For example, getting a vitamin B12 test if you’re taking B12 supplements is pointless. If you had a recent physical with your regular, traditional doctor, ask if any of those results can be used.

In all these years I’ve been pleasantly surprised by a compassionate, interested practitioner maybe three times. The healthcare system is flawed and broken and unwieldy and pretending it isn’t is just another way to waste your energy.

The awesome Monica Cassani of the blog Beyond Meds has a post on this subject, emphasizing the dangers of being an obedient patient.