"Who's on First?"

Many times watching Michelle navigate her trip through health care is like watching the famous Abbott and Costello comedy routine, "Who's on First?" Is it too much to ask to put communication at the forefront as we fool ourselves into thinking that there is such a thing as "coordination of care" without making a trip to the Mayo Clinic!  Unfortunately, that prospect is at best...abysmal, so keep the expectations realistic if  the problem is more complicated than hypertension or gastrointestinal reflux.

Case in point...Michelle's latest medical mystery is causing her body to make too much or failing to get rid of, her cerebral spinal fluid.  This is the crystal clear liquid stuff that roams up and down you spinal cord and bathes your brain needed for a proper functioning nervous system.  If the pressure is too high, the problem is called "pseudotumor ceribri" or better described as "idiopathic (meaning we haven't a clue) intracranial hypertension."  In lay terms and may you never have to come to these terms...it feels as if your head is ready to bust open at the seams. Throw in double and/or blurred vision and its most severe manifestation, a total loss of vision. The fluid is actually pressing and "squashing" the pituitary gland.  That is not good, since the pituitary gland is the "high school jock" of the endocrine glands.  It always sits at the "cool table" and has a way of messing up the body's hormone balance.

Usually to get some answers, one gets their ticket punched for a visit to the ER (oh...what joy!) for a lumbar puncture...or in the old days, as most know it, a spinal tap (now is a good time to toggle over to a YouTube video).  The procedure is quite impressive, unless your the one being used as a pin cushion, because in an emergency situation it has to be done "blind" without the guidance of a fluoroscope  (a fancy machine that helps guide the needle in). And please note...the ER doctor was fabulous at the procedure.

So...why don't more physicians talk to more physicians and get a few answers for their patients? After all they belong to the same "fraternity!" They have sacrificed and worked hard and certainly relate to the obligatory mandatory suffering along the way, right?  However, here is the rub and it is very abrasive...and extremely frustrating. Many times these doctors are extremely proprietary, meaning if I am a neurologist, it must ONLY be a neurology problem or if I am a gastorenterologist, the answers can ONLY be found in the intestinal wall. And...I am not so good in "sharing" what I have so deftly discovered.

In a perfect world, we would not care about these "turf wars" and if a pediatrician tags out to a thyroid specialist, make sure the chart notes tag along. I don't really care who forwards my daughter toward optimal treatment. I am not throwing stones here...okay, maybe a bit. The patient may suffer because of the battle of egos. Over the years and  in the span of sixty doctors, I have seen maybe a half dozen primary care and specialty providers think out of the box when it came to Michelle's medical management. Of late, it has made a tremendous difference in Michelle's quality of life and I am eternally thankful.

So...best wishes in your personal health challenges and trials.  How refreshing is it to see any specialist act special and make the investment by pulling out all the stops, and truly care.  I'm fine with an endocrinologist acting a little like a cardiologist, if necessary.  I wish you luck on finding out, "Who's on First!" And remember...take as directed.
Blake