I went to the doctors office today because I had a migraine for the past three days and thought I was going to die. This headache was literally the worst headache of my life. I get there and can't see my normal doctor so i'm stuck with the PA. I am describing my pain when he asks about my allergies so I tell him what i'm allergic to. He then asks what if any drugs i'm allergic to. I tell him, pseudoephedrine, then he asks what happens when I take it. This is where I start to get angry, what does it matter what the side effect is? What like you don't believe me? My heart starts racing and I just don't feel well after that. What like you don't believe me cause you've never heard of it? Besides, its written in my chart that you're staring at, A--. So then he asks what medicines i'm on including any herbs, I say yes and tell him that I am on high dosages of two particular herbs that I have started as alternative treatment because traditional allergy medicine wasn't working. These are herbs are working by the way, better than anything ever has! His tone completely changes. He says, in a somewhat condescending tone, well we don't like to have patients take herbs because sometimes they contain "real" medicine, as opposed to fake medicine I guess, and its unregulated and we can't know exactly what they're taking. He then declares matter of factly that I have a sinus infection to which I say, "but i'm not congested at all. I don't feel any swelling and I don't feel any drip, are you telling me its possible to not feel any of these symptoms and still have a sinus infection?" He says,yes. I don't know if I buy it, I am neti potting everyday and can actually smell for the first time, well, ever! He says I want you to see an ent to see what medication he might be able to prescribe or maybe he can sensitize you, I'm like, I have an ent in Texas that I work with, but I guess a world renowned ent isn't good enough if he's not on the Upper East Side. So, don't know if I want to get the prescription for antibiotics. I trust my normal doctor so maybe this guy is just an aberration. I just need to vent. Also, why are doctors in this city such snobs? Do they mean to be this way or are they just complete jerks? Side note, please excuse the bad grammar and possible spelling typos. My head still feels like it has a heartbeat...

But not everything he did was wrong. In fact, while he may well be an asshole, he did a lot right.

First of all, a PA is NOT a doctor. He is a very minimally trained (compared to an MD) health care worker who has been trained in flow-chart medicine, not actual diagnostic reasoning. PAs can be very good at what they do, but they are not trained to deal with complex problems or problems that don't fit the flow chart they have memorized. I certainly wouldn't want a PA dealing with my asthma, sinusitis, etc. As a singer, I need someone who is prepared to think outside the box.

Meeting any health care worker that makes you feel small is possible, so I'm not saying that he rubbed you the wrong way because he was a PA, but because he rubbed you the wrong way. It could just have easily been a doctor.

All the questions you were asked were good questions to ask. I would have asked all of them, and maybe some more that you might have considered irrelevent. I'm sorry you felt like he was being rude about it.

When people say the are "allergic" to a specific drug, they are often using the word incorrectly, which is why he asked what happens when you take it. There is a difference between an allergy (which means you are itching, have hives, or your throat is swelling shut) and an adverse reaction to a medication, which is what you experienced. You are not technically "allergic" to pseudoephedrin, you just don't tolerate it. This distinction is important for some important drugs that a doc might want to prescribe to a patient, to save their life for instance, even if the drug made them feel like crap.

And we have to ask about herbal medicines, and we (all of us) have to be very careful. An aquaintance of mine saw a patient who had waited for years for a new kidney, and gotten one. He was busy enjoying his new life and new kidney and was taking some sort of herbal supplement. Unfortunately, the supplements he was taking totally neutralized his anti-rejection drugs, so this patient's new kidney was destroyed within months of the transplant. The world of supplements is really complicated, because (as this PA pointed out) there is some really powerful stuff out there that has an enormous impact on the body but it's mixed with some really expensive snake oil. The trouble is, as western practitioners, we simply don't know enough about how they interact. I suspect that your PA's reaction might have had a bit of fear in it.

And it's good to tell him that you're already seeing an ENT, but there's no way that he (or any other doc, who is not in the field) will have any idea who the world renown people are. He has no idea who your ENT is, and has no idea whether you're actually seeing them, or whether you're lying through your teeth. And patients do lie, so whenever you go see your doc, they are ALWAYS asking themselves if they believe you.

I don't know about the sinus infection. It sounds like he was following the wrong flow chart. I'm sorry he pissed you off with his question syle, but any health care worker taking a history should have asked all these questions and more.

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*I am not a doctor, and any opinions I express on this forum are my opinions only, and should not be confused with real medical advice given by a licensed professional. If you are concerned about your medical condition, always see a doctor!

I guess what bothers me is that I told him that I'd previously taken Clarinex, Zyrtec, and every other drug he singled out and that they had not worked for me. This is the reason for the alternative herbal use, which by the way is working. Does this guy seriously think that I would go through the trouble of researching and taking an herb if I hadn't exhausted the limits of what western medicine as done for me? I guess its not so difficult to sit in judgment of someone when you haven't been through what they have. It must also be hard to face that the field you have studied and embraced for so long could possibly be broken or even inefficient at best. My ent in Texas has me neti potting which I didn't tell this fool about lest he tell me the neti pot is some Indian conspiracy,lol. I understand the aversion to herbal remedies, but just because the treatment isn't blessed by the FDA means nothing, many a people have died on their watch. I have decided to take the antibiotics because I feel awful and just follow up with my normal doctor later next week if I don't feel better. What angered me is that he kept suggesting inhaled steroids, nasonex and the like and I told him my ent had told me that as a singer I should not take these because there would always be a rebound effect 100% of the time to which he responded, yes but is that effect worse than the symptoms and I said, for me yes because most people don't need to sing in the sixth octave and I do. These inhaled steroids mess with my singing and that is unacceptable. He then told me that perhaps I was given some misinformation, to which I just smiled and said, well I did see a doctor in here in NYC and he wasn't very comforting either, he gave me misinformation as well and told me to just avoid certain foods, drugs and situations. So there, they're all quacks and I'm stuck with them until I can get back to Texas which won't be for a while. I am not trying to be obstinate and I understand why he asked the questions but his bedside manner was most offensive, that and the fact that he wrote off my ent, but I get it, my ent is far away and I should try to find one in New York, but the doctors here are not really racking up any points with me. Anybody out there know a good ent who takes Healthnet insurance.

Yes, I agree. It is certainly good to be cautious with herbal remedies as you never know how they may affect your body. On the other hand, pharmaceutical drugs aren't exactly the safest either. I guess we should just handle with caution anything we put into our bodies.

Firstly, I have heard of sinus infections without any symptoms. I had one years ago and my mother had them for years. The migraine could be a result of an infection, I had heard of that.

Secondly, I don't know what a PA is.

Thirdly, be very glad that this person took all this time to review your medical history. I know its annoying when we are sick but, this person was trying to get the "full" picture.

I would rather they ask me questions than do what my GP did a few years ago, prescribe a medication that had aspirine in it and I am allergic to aspirine (hives and closed throat). It is a good thing the pharmacist noticed the error.

I agree with Tenordoc, doctors are verifying the words allergic reactions more and more these days.

As for natural remedies, I do believe in them but, I have also broken out in hives from taking herbal medicines that I thought were going to cure me. My reaction to herbal medicine was after weeks of taking it. So, maybe that is why he was asking you that.

I hope you feel better and if not, that you can get in to see your regular physician.

NT

"Competitions are for horses, not artists."

~Bela Bartok

>>>I went to the doctors office today because I had a migraine for the past three days and thought I was going to die.

You have every right to be cranky, not that being uncranky is an option under those circumstances.

>>>I am describing my pain when he asks about my allergies so I tell him what i'm allergic to. He then asks what if any drugs i'm allergic to. I tell him, pseudoephedrine, then he asks what happens when I take it. This is where I start to get angry, what does it matter what the side effect is? What like you don't believe me? My heart starts racing and I just don't feel well after that. What like you don't believe me cause you've never heard of it? Besides, its written in my chart that you're staring at, A--.

Sorry, but that's an important question. What kind of allergic reaction is important. And it's good that he asked.

>>>So then he asks what medicines i'm on including any herbs, I say yes and tell him that I am on high dosages of two particular herbs that I have started as alternative treatment because traditional allergy medicine wasn't working. These are herbs are working by the way, better than anything ever has! His tone completely changes. He says, in a somewhat condescending tone, well we don't like to have patients take herbs because sometimes they contain "real" medicine, as opposed to fake medicine I guess, and its unregulated and we can't know exactly what they're taking.

Well, he might have worded that better but "natural" remedies do contain chemicals that can have side effect and can cause reactions with other medicines (both pharmaceutical and "natural". They are all chemicals. The problem with some of the herbal remedies is that the dosage is not standardized and you don't really know what kind of concentration you are getting. Again, it's good he asked. They didn't for a long time and then had problems with gingko reacting badly with heart medication (as both are blood thinners), etc.

>>>He then declares matter of factly that I have a sinus infection to which I say, "but i'm not congested at all. I don't feel any swelling and I don't feel any drip, are you telling me its possible to not feel any of these symptoms and still have a sinus infection?" He says,yes. I don't know if I buy it, I am neti potting everyday and can actually smell for the first time, well, ever!

Yes, you could have a sinus infection. Neti helps clear the nasal passages and can unblock the opening of the sinuses, but sinuses are spongy tissue and neti isn't really rinsing that out. Your sense of smell is unrelated to your sinuses. It's very easy to get an infection in your sinuses.

>>>He says I want you to see an ent to see what medication he might be able to prescribe or maybe he can sensitize you, I'm like, I have an ent in Texas that I work with, but I guess a world renowned ent isn't good enough if he's not on the Upper East Side. So, don't know if I want to get the prescription for antibiotics. I trust my normal doctor so maybe this guy is just an aberration. I just need to vent. Also, why are doctors in this city such snobs? Do they mean to be this way or are they just complete jerks? Side note, please excuse the bad grammar and possible spelling typos. My head still feels like it has a heartbeat...

I had this problem with a doctor in Texas. I went two him two different times and he put me on Humibid (now known as Mucinex) and by the end of the week I had full blown bronchitis both times. What a quack. (Yes Dr Stansny I'm talking about you...maybe if you worried about your patients as much as you did your affair with La Bartoli I wouldn't have gotten so sick...and yes I did say that out loud).

I'll be honest. I have gotten the best care from GPs and NPs in this city. No BS and they actually listened to what I told them (like what meds I know don't work for me) and everything was fine. The specialists? Who's that quack that used to write for CS? Big waste of time and money (HUGE waste of money btw...$300 for a scoping?)


Houndentenor

"Get the trash off the street and back on the stage where it belongs." -- Bette Midler

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Dr Jahn

Stu the crazy bass from down under


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Polar bears for Obama!!

There is one herb which interferes with almost every pharmceutical known to man, from mood related drugs (which is what this herb is recommended for), heart meds, blood pressure meds, HIV meds.... Taken with these it has been known to be FATAL!!!

Stu the crazy bass from down under


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Polar bears for Obama!!

nt

is St John's wort, a commonly used herbal supplement. But unless you read all the info on the medications you take, you would probably never know that SJW is HIGHLY pharmacologically active, and can potentially be deadly due to the way it affects dosing for other drugs

Stu the crazy bass from down under


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Polar bears for Obama!!