Saturday, March 31, 2007

And a Cast of Thousands.....

Over time, I have come to share my own health challenges relatively frequently here on Digital Doorway, from the humbling experience of being a patient, living with Multiple Chemical Sensitivity, long-term struggles with depression, and adventures with chronic pain. As my own healthcare becomes more complex and challenging, my personal, experiential understanding of my patients' struggles also becomes more keen.

As I have related before, the majority of my patients have multiple co-morbidities, many symptoms of which mimic, exacerbate, or otherwise interact with the other co-existing conditions and symptom constellations. The presence of multiple chronic illnesses and related symptoms generally leads to the individual in question navigating an increasing number of providers and medical specialists. As I have described in previous posts, I spend a great deal of my professional time assisting my patients with coordinating their complicated care, often serving as the liaison and conduit of information between multiple providers who may or may not freely choose to communicate clearly with one another in a timely manner. In many ways, I am the outside agent who helps the left hand of the medical treatment team to know what the right hand is doing. When there are more than two hands---which is generally the case in most instances---my work is multiplied, as is the room for mistakes, miscalculations, and poor (or absent) communication. The resulting day-to-day action draws on both the worlds of tragedy and comedy, with no lack of soap opera intrigue for those who like that sort of thing.

Lacking my own care manager vis-a-vis my multiple medical challenges (as do the majority of patients, really), I juggle multiple appointments, tests, and various treatments. Reviewing the litany of upcoming medical appointments in my Palm Pilot recently, I was struck by the growing cast of professional characters who I have enlisted in my own production known with the working title of: "Keith's Health Care; Being A Play With Too Many Acts, An Ever-Increasing Cast of Characters, and Far Too Few Intermissions." Most of the cast play themselves quite well, needing precious little coaching from the wings. The trouble these days, though, is that the curtain seems to always be up, and the plot just never gets resolved. Who wrote this thing, anyway, and where did that orchestra come from?

The Cast
(not necessarily in order of appearance)

Nurse Keith----played by none other than Nurse Keith (Who else could do it? Maybe a cross between Ben Stiller and Woody Allen?)

Primary Care Physician----important and consistent, sometimes seems superfluous

Psychotherapist----newest cast member, but sure to be a star

Oral Surgeon----hopefully making only a brief cameo, never to be seen again

Physiatrist----kind and professional but limited in scope, may fade to background

Psychiatrist----useful and insightful; only makes an appearance every six months, thank God

Dentist----infrequent cast member, as well, but still important, along with rotating hygienist

Environmental Illness/MCS Specialist MD
----the indispensable cornerstone of current care team

MCS Doc's Nurse----very important resource for information and support

Gastroenterologist----will debut in May, hopefully for a very brief appearance

Neuromuscular Therapist---someone I always look forward to seeing, even when it hurts

Chiropractor----currently on the back-burner, but a casting-call may soon be advertised

Acupuncturist----character in development

While the reviews are slow in coming, some positive press has been seen in the blogosphere. Some feel there are not enough holistic providers in the cast, while others think allopathic medical providers should dominate the ranks of the dramatis personae. Parts of the script may need re-working, while some critics have panned the whole effort as self-indulgent and wasteful. Nonetheless, the cast will push forward with the current season, mixing comedy, drama, tragedy, farce, as well as Theatre of the Absurd.

So dear Readers, feel free to add your reviews to that of the others, and join us at any time for another installment in this post-modern journey of human existence. The show runs daily, and admission is, as always, simply a small payment of your precious time and attention.
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