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Wednesday, August 15, 2018

Sometimes I'm Right

. . . and your prescriber is not.

CP: Honestly, it's not about who was right and who was wrong. I like my ego stroked as much as the next platypus, but at the end of the day the patient was helped, medical crisis averted, life went on.
Me: What are you on about now, CP?
CP: Helping people.
Me: Um. . . like, hooray or something? Want me to wave a flag? Should I call a press conference? Correct me if I am wrong, but don't we do this every day?
CP: Yes. Yes. Yes. And, yes.
Me: Why is this different?
Myself: Yeah. Why so special?
CP: Have we ever had a problem and when we told other people about it, they didn't believe us?
Myself: Like the fact that you talk to both of us in your head?
CP: Yes. I mean, no. We see patients all the time who are going through whatever ordeal is theirs at the moment and we don't understand them. We are tasked with helping them, but sometimes, sometimes the answers aren't there.
Me: So what do we do?
Myself: We listen and we dig and we offer support.
CP: Precisely.
Me: So what happened?
CP: We had a patient call us recently who had been experiencing breathing troubles. None of her providers could explain it. She knew something was wrong. She told her neurologist who ran tests. She complained about her new medication but was told "there is no way that medication does that". So she saw a new neurologist, who ran more tests, who also brushed off the potential for this newly prescribed medication to affect her this way.
Me: And they found what was wrong?
Myself: No, dumbass. It wouldn't be a good story otherwise. Keep going.
CP: She called me.
Myself: And then?
Me: And you said she was crazy.
CP: No. I told her that, while I had not seen instances of this medication causing these side effects (dyspnoea and crushing chest pain) and after asking her my litany of questions (did anything else change? did they rule out heart attack?)
{--for purposes of speeding this along, we had a lengthy discussion and she told me all about her tests and how long this had been going on, etc. . . --} I said it may be possible and that I would research it and call her back.
Myself: And then?
CP: I researched it and called her back. Were you not paying attention?
Me: Sorry. I thought you'd want a second to let people catch up.
CP: Thanks. Anyway, after a little digging, I was able to find a record of these effects occurring in a small percentage of patients.
Myself: And then?
CP: Dude. Seriously? Find a new movie to quote. And then she thanked me. She spoke with her new pulmonologist who didn't believe her either. However, this prescriber turned to the new prescriber in their practise and asked her opinion. She said she had never heard of it either. . . until she read a study in a journal last week about this exact scenario.
Me: Vindication for the patient!
Myself: And th. . . um. . . What next?
CP: She called to thank me. She said they were surprised I figured it out, but recognised I had a special set of skills.
Me: I love a good story.
Myself: Yeah. Can I have milk and cookies now? <yawns> I'm tired.
CP: Remember kids, just because no one has seen it, doesn't mean it isn't happening. Think of all the prescribers out there who spent decades of practise never seeing measles and now are scrambling to identify it.
Me: Sometimes it's the simplest explanations. We are so programmed to run tests when the simplest option would be to hold the new medication for a few days.
Myself: She stopped the new medication and her symptoms resolved over the next 2 days. Simple.
CP: And now I get pie. She promised me a fresh pumpkin pie this fall.

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