By: burgundy bug
Seeking Healthcare Treatment During a Pandemic
Source: The Burgundy Zine
Since the dawn of the coronavirus pandemic in the United States, the Centers For Disease Prevention and Control has reported a 42 percent decrease in emergency room visits for non-COVID-19 related reasons.
But, people don’t just stop having emergencies, do they? Not likely.
Even as some states inch their way towards the green phase, a recent Primary Care Collaborative survey reports face-to-face doctor’s appointments are still 50 percent below their previous volume.
So, what’s it like to be an individual pursuing healthcare, despite a global pandemic?
In all honesty, it’s been nerve-racking for me – especially since I’m being tested for autoimmune disorders. This means I’m potentially in the high-risk category for COVID-19.
An autoimmune disorder wouldn’t mean I’m more likely to contract COVID-19, says an article by Northwestern Medicine. But it does put me at higher risk for “serious complications.”
So I’m in a tug-o-war. I’ve been struggling with chronic health issues for three years now and this was supposed to be my year to finally figure everything out.
Pre-pandemic, I had doctors appointments lined up in April 2020, which were inevitably canceled as COVID-19 peaked in my state. I bided my time, figured I would wait until the eclipse of the pandemic to pursue treatment.
But my symptoms continued to worsen. At times, the chronic pain felt debilitating.
I’ve been stuck on this symptomatic rollercoaster for far too long.
A Bit of Context…
Since the summer of 2017, my life has largely revolved around the severity of my still-undiagnosed struggles with chronic health.
At times, I could suck it up and go hiking through the movie-esque trails of central Oregon. At other times, I was an addict to my mattress, barely able to peel myself from the comfort of my comforters for work or school.
Read: Behind the Zines: Let’s Talk About Vulnerability
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I can’t confidently say I’ve been 100-percent pain-free at any point in over 1,096 days.
Over the last few weeks, I’ve been at this rollercoaster’s peak of gut-wrenching aches and discomfort. I haven’t been able to leave my bed or move around very much; I can barely carry my laundry down.
Additionally, my symptoms have yet-again metamorphosed. What started as a burning pain in my upper-right quadrant that escalated to puking bile and blood has now become a constant stabbing-tenderness in my ribs with aches in my shoulders, hips, and knees. I’ve also started experiencing numbness in my wrists and hands.
So, I decided to bite the bullet. Pandemic or not, I can’t live like this anymore. I need to seek treatment.
Taking the First Steps: Telemedicine
Upon getting my primary care physician’s voicemail, I preemptively called my local orthopedic doctor’s office.
“Perhaps my issues are caused by something skeletal, rather than resulting from internal dysfunction,” I thought to myself.
At the very least, it was worth a shot.
After getting yet another voicemail, I was fortunate enough to speak with an on-call nurse through my father’s work. She agreed x-rays were a good idea, but had another suggestion that would completely change the course of my healthcare endeavors.
“Now, I don’t want you to be alarmed because you’re not technically in that age demographic,” she warned. “But you might want to get tested for an autoimmune disorder.”
Within a few days, I received call-backs from both my primary care doctor’s office and orthopedic doctor. My primary care provider scheduled a telemedicine appointment bright and early for the upcoming Saturday morning and the orthopedic office had availability within days – something that would’ve been an anomaly pre-pandemic.
The primary care doctor’s office also called back and questioned why I was seeing an orthopedic doctor when I was initially being treated for gastrointestinal distress. I expressed my concerns, but I still felt an air of skepticism hovering above the telephone line.
The First Telemedicine Appointment: “Am I Being Heard?”
Don’t get me wrong – I think my primary care doctor is a great person and the staff at her office are very kind and compassionate.
However, I can’t say I truly felt I was being heard during our telemedicine appointment. And I take some of the blame for that. We had quite a bit of catching up to do since I had last seen her over a year and a half ago.
Perhaps the way I presented my case made it difficult to understand that what I was going through now is different than when I first started seeing her.
Nevertheless, it felt like the doctor was so preoccupied reading my previous files that she didn’t really take my new, more-current symptoms into consideration.
She insisted on going through with the tests I had initially skimped on. The HIDA scan and Gastric Emptying scans I didn’t feel comfortable with. The tests I glossed over because I found a way to manage my GI symptoms.
Read: What to Expect During an Endoscopy
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I’m no doctor, yet (I’m a health sciences major), but I wanted to try something different this time around. I was already told by my GI doctor that if these tests came back normal (which they probably would), my situation was going to be chalked up as a simple case of IBS.
“Is it safe to get those tests right now, despite COVID-19?”
She assured me I had nothing to worry about and recommended I do the tests at a hospital in the city, which is the epicenter of COVID-19 in my state.
When I asked what to do to manage the pain in the meantime, she told me to avoid meat and dairy because those are triggers for gallbladder disorders, which she suspects might be the root of my problem.
I’m a lactose-intolerant vegan. I haven’t eaten meat or dairy in years. I told her that, and she recommended the FODMAP diet, which I’ve tried multiple times and have yet to benefit from.
“Just keep trying elimination diets,” she replied when I told her FODMAP doesn’t really work for me. I already have a very, very limited diet and my symptoms persist regardless of what I put into my body.
Yes, there are triggers, like fructose, that send me reeling with bile reflux, bloating, and pain – but I’m also in a constant state of pain that exists outside of the realm of my food intolerances.
Read: High Fructose Corn Syrup in the Impossible Game of Hide-n-Seek
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Plus, I have family members who had their gallbladders removed without being tested for gallbladder dysfunction only to find their circumstances worsen.
Another close relative of mine had been advised to have her gallbladder removed by a different doctor in this health network. Eventually, she ended up remedying her digestive distress through dietary changes – and never had her gallbladder removed.
I’m not saying that I don’t think there’s a possibility my gallbladder is involved in my puzzling circumstances, but I’m understandably doubtful.
Also, what the hell do they even do with all these gallbladders they’re ripping out? According to Stat Pearls, about 300,000 Americans have their gallbladders removed annually. My curiosity is tickled, to say the least.
The First In-Office Appointment Visit
Burgundy Bug struggles with face mask induced glasses fog
Source: The Burgundy Zine
Shortly after my initial brush with telemedicine, I was seen by my orthopedic doctor. The lobby was spacious, each chair meticulously separated by six-feet of space.
Only four or five other patients were in the lobby – a stark contrast from the once-packed waiting rooms I had grown accustomed to.
One patient had come in with her toddler, who shot me a glance. Forgetting that we were all wearing masks, I smiled at her and she continued to glare at me with wide-eyes, perhaps smiling too.
I couldn’t help but feel her mother wondered why I was staring at her child. I felt sheepish for attempting to smile under my baby-blue face covering.
An older gentleman across the waiting room coughed. Tensions rose. He coughed again, and suddenly the entire room darted their eyes towards him. The secretary even leaned over the counter to look at him.
I didn’t dare touch my phone while I was waiting. I didn’t touch anything. I didn’t even look towards the television because another patient had been sitting under the TV screen and I didn’t want it to seem like I was staring at them. I kept my eyes glued to the floor.
After what felt like an eternity – but was probably only 30-some odd minutes – I was called back. Before proceeding any further, a nurse shot my head with a temporal thermometer to confirm I didn’t have a fever.
The x-rays were just like any other x-rays, although I do have to say the technician was incredibly thoughtful. She was very considerate of my pain areas and did her best to avoid putting additional stress on my rib cage.
Burgundy Bug’s x-rays
Source: The Burgundy Zine
We then entered another very spacious patient room. I was advised to sit in a black chair that hugged the wall as the nurse typed my information into the computer quite a distance from me. Her demeanor was warm and I felt pretty comfortable, despite our mask-muffled exchange.
The doctor air-shook my hand and very carefully examined my rib cage as well as my neck. Again, another very compassionate individual. My neck appeared fine but there’s indisputable tenderness and inflammation in my rib cage.
For now, he said it was costochondritis. He also advised getting tested for mono and having my liver examined since the inflammation has persisted for so long.
I mentioned the nurse who had suggested getting tested for an autoimmune disorder and he said that was a “beautiful idea.” In fact, he was surprised I hadn’t already been tested for an autoimmune disorder.
He recommended his “go-to gal” for rheumatology and I doused myself in hand sanitizer a few more times before heading home.
Round Two: Telemedicine and Tests
His go-to gal wasn’t accepting any new patients, despite the recommendation. The other doctors at her location were also booked through the rest of the year.
I did some searching around, read some reviews, and found a highly-recommended rheumatologist listed on WebMD’s Physician Search who was currently accepting new patients.
Read: Love Thy Doctor: Recent Statistics Say Otherwise
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The secretary gave me the option of an in-office visit or a telemedicine appointment. I weighed my pros and cons.
Telemedicine Pros
- Reduces potential exposure to COVID-19
- Convenient
- Won’t have to worry about getting a ride to the office (I don’t have my driver’s license)
- Won’t have to change out of my pajamas
Telemedicine Cons
- Didn’t have the best experience during the last telemedicine visit
- Won’t be able to have a physical examination by the doctor
With a healthy dose of optimism, I chose a telemedicine appointment.
The doctor was very kind and spent almost the entire appointment just listening.
At one point, she asked me to raise my arms and show my knees. We exchanged gentle, mutual laughter as I navigated the awkwardness of maneuvering my knee caps into view of my webcam.
At the end of our video call, she ordered blood tests and said she would like to see me in-office in about four weeks.
Although the location she recommended accepts walk-in visits, she suggested making an appointment beforehand to “avoid waiting with potential COVID patients.”
W-wait… Potential COVID patients?
I was now entering the scariest territory of all: an environment of individuals who may or may not be there for COVID-testing. Individuals who could still be contagious.
Bart Simpson: *GULPS*
Source: Giphy
Blood Tests in the Time of Corona
I’m already terrified of needles. When I was 14-years-old, I bawled my eyes out at the pediatricians office before and after receiving routine vaccinations.
Even last December, I winced and clenched my chattering teeth as the IV was inserted into my tiny, bony left hand in the emergency room.
But as a nurse once said to me a few years ago, “I’d be more concerned if you were excited about needles.”
Plus, it’s a pretty common fear. According to Pharma Jet, approximately 50 million Americans are scared of needles – and one survey cited found 20 percent of those with trypanophobia avoid medical treatment that involved needles as a result.
Nevertheless, I went for my blood tests on June 24th.
The waiting room was a very small rectangle. There weren’t many other patients, but new ones kept coming in.
It very quickly became a game of musical chairs. Some individuals, such as myself, were too paranoid to even sit down. We opted to do the Cupid’s Shuffle around walk-ins and those who were already sitting.
“Cupid Shuffle” by Cupid music video
Source: Cupid – Cupid Shuffle (Music Video) | AsylumRecordsTV
A Brief Waiting Room Intermission
Again, I was too paranoid to touch my phone or anything else, for that matter. I locked eyes with the TV while I waited with my fingers tying themselves into knots. “Live with Kelly and Ryan” happened to be broadcasting.
Coincidentally, American actress Kelly Ripa was discussing the decline in birthrates and non-COVID-19 related doctor’s visits.
“People are saying the birth rates have fallen,” Ripa said. “What is that implying, that people are just holding the baby in until this is all over?”
I fastened an odd glance towards the TV screen and giggled quietly through my mask.
“People are not having heart attacks all of the sudden,” she continued. “Where’s all of the appendicitis going?”
Immediately, I thought of a video by third-year internal medicine resident Siobhan “Violin MD” I had seen on YouTube not too long ago.
“A Day in the Life of a Doctor: Coronavirus Pandemic Nightshift” by Violin MD
Source: DAY IN THE LIFE OF A DOCTOR: CORONAVIRUS PANDEMIC NIGHT SHIFT | Violin MD
“About three days ago, he [the patient] had chest pain, he was sweating, he was feeling fatigued,” Siobhan explains. “He didn’t want to come to the hospital because he was scared of coronavirus. First of all, he didn’t want to bother us and he didn’t think it was going to be that bad. So he waited.”
Later in the video, she goes on to say the patient most likely had a heart attack.
That’s pretty damn serious, if you ask me. I mean, can you imagine having a heart attack and not going to the emergency room?
It helped put my situation into perspective. I’m not in any life-threatening danger because I’ve been dealing with my situation for quite some time now. But that doesn’t mean I should neglect my health, nor should anyone else, due to the COVID-19 pandemic.
Anyways, back to the blood tests.
The Big Draw
After another mini eternity – which was only about five or 10 minutes in reality – my name was called.
I’ve never seen or read “The Hunger Games” series, but this kind of how I felt:
Katniss Everdeen: “I VOLUNTEER!”
Source: Giphy
I warned the phlebotomist that I’m terrified of needles. She remained calm and happily obliged to small-talk as she tried to find a small, ripe, blue stripe in my arm to prick.
“Did you drink any water today,” she asked.
I laughed nervously and told her that I had guzzled about three bottles of water over the last few hours but noticed my veins were still being shy prior to the appointment, too.
All of the anticipation led to the anti-climactic blood draw. I carefully kept my eyes away from the crease of my right arm and kept chirping on.
The needle was very small, non-invasive, and didn’t hurt very much at all. I was even a bit fascinated by how fast I managed to fill three or four vials of blood.
The phlebotomist did a great job, too. I didn’t leave with patchy purple excess bleeding in the area or any soreness.
i love phlebotomists who can make small talk pic.twitter.com/SmgvYUJ7Bv
— The Burgundy Zine (@BurgundyZine) June 24, 2020
Not too shabby. Not too shabby at all.
Going Forward
And now, I tap my feet and fingers as I wait in limbo for my blood test results. I also have an in-office appointment with the rheumatologist in July.
Hopefully, I’ll get some answers. My biggest fear is being given up on yet again due to inconclusive test results.
I don’t want to just fold and accept this is as my life, that I’m stuck this way forever. I haven’t even entered my second decade on this planet yet. I need some resolution. I need hope.
In all honesty, I began feeling particularly trapped last year. My appointments being canceled in April only compounded the claustrophobia of my predicament.
Taking up the conquest of my elusive health over the last few weeks has given me a sliver of faith. I’m still in pain, but knowing that I’m no longer the victim of a nameless, chronic condition has been invaluable to my mental wellbeing.
I may still be in the dark, but at least I feel heard and seen for now. I at least have something I can call the pain in my ribs – costochondritis – and I now have medication that slightly takes the edge off, although it does come with side effects.
For anyone else out there who may be shying away from seeking treatment during the pandemic, whether it’s for physical or mental health, don’t. Call your doctor, a new doctor, or find a specialist.
If you’re among the handful of Americans lucky enough to have health insurance, don’t take it for granted. And if you’re concerned about healthcare costs, do your research.
Read: Millennials Are Ghosting the Social Life and Burying Their Health, CVS Study Says
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Call your local state representative and find out what programs exist in your area. You’re not stranded and left to suffer alone.
There are resources available, they’re just not spoken of often enough. Some telemedicine services are even offering free health care consultations right now, CNBC reports.
Healthcare is central to self-care. You mustn’t settle on your health or a doctor you’re not fully satisfied with.
As Vanguard Communications CEO Ron Harman King said to me during our interview in February: “Don’t accept the first answer to anything, whether it’s looking for a physician or even a physician’s advice.”
“Doctors don’t like for me to say this, but if you have a chronic or potentially life-altering or life-threatening illness, you owe it to yourself to be a thorough shopper.”
Vanguard Communications CEO Ron Harman King
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