www.incontinentsupport.org

Yesterday, I was sitting in my recliner chair watching cartoons with my 4 year old daughter. All of a sudden, she jumped up in my lap. Her little foot caught me in the groin area and she accidentally stepped on my surgical site where I had surgery to repair an inguinal hernia in 2014. As soon as she put pressure I felt an immediate pull. I have implanted mesh to correct the hole in my abdominal wall where my intestine was protruding through. Anyway, the pain was immediate. I became worried that when she jumped on me, that she separated the mesh in my body from my abdomen reopening the hole. I told my wife who told me to immediately call my doctor. My primary doctor is the faculty chair for a family practice office which has residents who are learning their craft. I saw one of these residents last night as my primary doctor is hard to see spontaneously so last minute appointments are usually handled by the residents. When I met this new doctor, apparently she didn’t read my huge chart to check on my conditions. Urine and fecal incontinence are listed on the home screen as well as all my other issues. With a hernia, the physician had to check my abdomen and groin. So I laid on the table and pulled my shirt up. She checked my stomach which was fine. Then she asked me to pull my shorts down to check my groin. As soon as I did, my diaper was exposed. Her response was “whoa!...what’s going on down there?! Now, I don’t know how new she was or if she’d ever seen an incontinent person before, but she was extremely surprised. I’m only 35. It really sounded like she did not by any means expect that. She asked me about it. I told her I have autonomic dysfunction which affects multiple systems of my body causing everything involuntary to malfunction. This includes breathing, heart rate, blood pressure, digestion, ability to sweat and regulate body temperature, and bladder and bowel control. I saw this as an opportunity to educate. I schooled her and taught her things she did not know. She asked about spinal modulation (interstem). I told her with that MRI’s are not possible. I also told her how Botox works. She honestly did not know these things as urology is not her thing. I told her I’ve tried multiple meds which caused heart arrhythmia’s so I had to stop taking them. And I’m not a good candidate for surgery. I told her that I was cared for by a whole team of doctors including one of the leading research hospitals in the world, The Mayo Clinic. My condition is not very common. She agreed my health is extremely complex. So without any other treatments, she agreed that diapers were my only remaining option. In the end, she thanked me for the lesson, referred me for an ultrasound after physical examination, and sent me on my way. It was an eventful evening.

Most have been a shocker the why she said it, but good on you for taking the time to educate her.

You should have sent an invoice to cover the cost of the medical education you gave that doctor. Hopefully she will remember what you taught her and apply it to future patients.

Well done, Don for educating her. It was good of you to be patient...

That being said, you highlight a point that bears thinking about. She didn't read your chart. Every doctor's office makes me fill out the paperwork, etc. The nurses ask you questions, but then the doctor comes in and clearly has not even glanced at it. Now, I am not talking about asking the same questions to see if a different answer arises from the patient, I mean there is not even a brief familiarity with what was presented. I am seeing this more and more, and it disturbs me.

You have to be your own advocate and you need to read up on the "issue" before going in, knowing the behavioral, pharmacological, and surgical possibilities. Heck, if I am being brutally honest, you need to read up on what interactions your drugs will have with the ones prescribed.

As a priest visiting patients in hospitals, I had no less than 4 last year in a small town in Iowa, that were saved by a doctor who saw their issues were because of drugs interacting with one another. I had a parishioner who was a chief pharmacist who told me she routinely had to call doctors to either change or cancel a script because of potentially life-threatening complications if mixed with a current prescription.

Wow. That does sound surprising, but you handled it like a champ! Great job, Don!

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