Doctor Frustration

Warning: The following constitutes generalizations with a sample size of “not very big”.

Medical Doctors, it seems, don’t really want to look at me as a whole anymore. They want to look at “the problem” and fix it. Or try. Or prescribe medication until it fixes itself. I am not interested in that; I need a long-term approach to a persistent problem; this seems to be an alien thought to the specialists I’ve been seeing.

Some background: I’ve had two back surgeries, one in 1991 when I was 17 and one in 2001 when I was 27. Both were discectomies, removing bulging discs that were pressing agains my spinal cord and causing debilitating pain. Since then, I’ve had chronic issues with my back, but not associated with the spine per se. The issues have to do with my frequent overstressing of back muscles which then put me on the sidelines for two weeks to a month.

Additional background: Last July I pulled my calf and this caused me to defer training for the Marine Corps Marathon. It wasn’t for about two months that the calf was healed enough to let me run. Now, after training for the Georgia Marathon, I pull the very same calf muscle1 and am now fed up. With both issues.

I’ve been a mostly self-coached athlete since taking up running and triathlon. I make efforts to do the things you’re supposed to do in my position: train your core, work on stabilization, improve hip flexibility and strength. Things are obviously not working. So, it’s time to seek some professional help.

Enter the doctors. They seem convinced of several things:

  • I don’t know what’s wrong with me
  • It’s “my back” or “my discs”2
  • It’s something that can be treated through injections
  • It’s something they need to refer to a spinal surgeon

Finally I gave up and said, “Just give me a referral to a physical therapist who specializes in athletes and sports medicine.” The second doctor seemed convinced that all of my issues were due to overtraining, which I suppose is possible, but there’s no way he could know that from a five minute talk with me and a very brief discussion of my training.

Thusly, I’m a bit frustrated with the medical community right now. When I made the appointments, I tried to tell the people involved what it was I was looking for (long-term plan and approach) and almost universally I got blank silence on the phone. They seemed to be taken aback that I wanted to vet the doctor I was making an appointment with before showing up. Doesn’t anyone do that nowadays? When I picked my primary care physician, I called the group he is a part of and told the receptionist that I didn’t want to see a doctor who didn’t run at least once a week. I wanted a physician who I could trust at least had an inkling of my habits and conditions.

Unfortunately, when I started looking around for someone to help treat my calf and my back, I discovered that “sports medicine” around here3 does not mean backs. It means arms, legs, elbows, knees, etc. Also, I’ve discovered4 that “sports medicine” and “non-operative” seem to be mutually exclusive. The doctors have seemed a bit huffy when the very first thing I’ve said is that I don’t want surgery or medication. The guy I saw yesterday said, “I can recommend a non-operative back specialist in our group. He only does injections.” What part of non-operative means “injections”?

I’ve tried to explain, up front, exactly what I want, and why I want it. I want non-operative, long-term care to take care of muscle imbalances and strains that are affecting my running. I’ve also tried to explain that I do indeed know a little bit about this stuff and that, no, it’s not my discs acting up5 because I know what that feels like, and it’s distinctive6. I’m also an experienced athlete with an unfortunate amount of knowledge with these particular injuries. Lastly, it’s my body and I have an investment in knowing what’s going on with it. What I don’t know, and the reason I’m seeing doctors, is how to fix it. Or if not “fix” at least “reduce”, “mitigate”, or “avoid”.

All of the above is my fault, however. From the very first moment I decided I need professional attention I’ve been tempted to just go to some of the sports physiologists that are associated with the triathlon club I’m a member of, or that hang around the Atlanta Track Club, etc. However, these professionals aren’t members of my insurance plan. I have no desire to spend money I don’t have to, so I would prefer to have the insurance pay the specialist I’m going to see. If I need to, though, I’ll bite the bullet and pay out of pocket.

So, right now I’m not too keen on the medical profession. I understand why they’re geared up the way they are (no time to spend with patients, paid by the procedure, paid by the patient) but that doesn’t make me happy about it.

  1. medial gastrocnemius, if you care []
  2. the first doctor I saw said, “your discs are hurting.” This after I explained my relative familiarity with lumbar anatomy and the several conditions I’ve personally experienced. Kthxbye []
  3. at least within my insurance plan []
  4. again, within the doctors on my insurance plan []
  5. Probably. I obviously can’t guarantee it []
  6. Truly. There’s nothing quite like leg pain or sensations due to inflammation around my lumbar region. Plus, if my lower back hurts, and it hurts because of a pulled muscle and not lumbar issues, then when someone palpates that muscle and I yell, it’s obvious where the problem lies []
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