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Fatigue and AnemiaFatigue and Anemia
           
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good numbers but feeling tired
Jan 3, 2003

Dr. Bob, I wish you could be my doctor. The guy I've got doesn't listen to anything I say. He zooms into the room says "Hi, how are you doing?" while looking at my latest laboratory results. I try to talk to him but he just zones out staring at my chart and then interrupts me and says "OK, your numbers continue to look good. See you in three months". Then he zooms back out the door. The whole visit takes about 2 minutes and not only does he not examin me but he doesn't even make eye contact. I talked to the nurse but she just said the doctor is very busy and that my numbers look good. What should I do? Mr.Goodnumbers

Response from Dr. Frascino

Hello Mr. Goodnumbers,

This is becoming an all to familiar scenario. OK, let's try this. Next time you have to visit this guy and he "zooms" into your examination room with his obviously insincere "Hi, how are you?" as his nose is buried in your lab work results, stand up and say in a very loud voice, "I'm undetectable, thanks," and start walking toward the examination room door. In order for this to work, you must give a "full-throated, ferociously committed" performance and be truly indignant! This should certainly get this guy's full attention. Now here's your big chance. Stay standing and say, "For the last x number of visits, you have zoomed in and out of here in 2 minutes, staring only at my 'good numbers' and totally disregarding the fact that I'm the person attached to those numbers. You don't listen to a thing I say or even examine me. I have a list of questions and issues I need to discuss with you regarding my HIV infection. Are you willing to be my doctor and care for me as a person, and not just a bunch of numbers?" Have your list of issues and questions written out in advance. If he responds appropriately with an apology and promise to work with you, sit down and present the list to him. Then ask him (or tell him) how long it's been since he last examined you. If he doesn't have time to examine you that day, set another appointment date for the near future (not 3 months) for a full physical examination. Ask for a copy of all your lab work and get copies of all future lab work. Keep your own records of dates of physical exams and results of important lab tests, such as CD4 counts, viral loads, resistance tests, and hemoglobin levels, as well as a written list of all your medications and dosing instructions. Be sure to ask your doctor about any lab values that fall outside of the "normal" range on the lab sheet.

If your doctor does not begin to behave more appropriately, you really do need to find a more compassionate HIV specialist. As Dr. "Zippy's" patients begin leaving him, perhaps he'll realize his "care" has been less than optimal. Quality of life is equally important to "good numbers," when we are coping with a chronic disease such as HIV. Physicians often need to be reminded of that essential fact!

Happy Holidays and Best of Luck!

Dr. Bob


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