Last year my pediatric gastrointestinal (GI) doctor of over 20 years decided to push me out of the nest and transition me to an adult GI doctor. During my hospitalization in 2015, I fared well with the change in doctors as my new doctor and I started the song and dance of a newly established patient-doctor relationship.
My GI doctor specializes in short bowel syndrome. This is one of my conditions courtesy of my surgeries related to Familial Adenomatous Polyposis (FAP). At my appointment three months ago, my doctor explained that I still have the proper sections of my small intestine required for absorption of iron and B-12, therefore do not require these supplements. My hair stood on end, I knew differently. I've been taking these supplements since my first bowel surgery at age nine. I knew better. However, in a stubborn fit of wanting to prove my self-knowledge and gaining my doctors trust in my knowledge, I agreed to forgo my medications for a 3-month trial.
I wasn't able to complete the 3-month trial without restarting B-12.
I began experiencing exhaustion, sensitivity to light and numbness in my hands and feet. I began to worry about the security of my employment under these conditions as well as my ability to function daily. Two weeks before the trial period ended I restarted my daily B-12 microlozenges, which helped me return to my previous state of health. However, I did forgo iron for the entire three months.
Lab day came and it was a show down between my doctor and me. Who would be right? Who knew me better? He argued my iron and B-12 wouldn't drop much in the course of three months from where my levels previously had been. My B-12 was excellent at 793... but I also started taking the supplements two weeks earlier. With the results skewed, we'll never know how low it had been. I'm okay with that... I was more worried about my iron at this point. 9.4 with a saturation of 2%. Ding Ding, we have a winner! Without an ounce of surprise my body held true to its trends. I do require iron, so I was ordered to immediately restart iron tablets and would also start iron infusions.
I requested an ultrasound of my thyroid.
An annual screening is recommended due to the elevated risk of thyroid cancer associated with Familial Polyposis. My doctor found annual screening to be overboard but nevertheless consented. I'm grateful he proceeded to order my thyroid ultrasound for that day as a small solid nodule was found in both lobes of my thyroid. Although most likely benign, it will be important to continue monitoring these nodules as solid nodules have an increased risk of malignancy compared to non-solid nodules.
My body followed my expectations.
I'm hopeful that my doctor has gained trust in my self-knowledge and understanding of myself. My body doesn't follow textbook protocols and never has. The sooner my doctors realize and accept this reality the better it is for my care. Perhaps now he will listen to me more with less argument about what my body does.
Sometimes doctor-patient relationships require give and take from both parties. Any new doctor-patient relationship may experience a few bumpy courses as both parties are learning the ways of one another and progressing toward a mutual understanding. If you are finding yourself on a bumpy course with your doctor, be open with your doctor about your concerns and work toward a compromise together. Although my doctor doesn't always see eye to eye with me, I'm grateful that he has been cooperative with my medical requests as our relationship becomes cemented.
This post originally appeared February 18, 2016 on Life's A Polyp.