August 24, 2008

When Doctors Disagree: Toe To Toe

The mistakes made by doctors are innumerable. They err habitually on the side of optimism as to treatment, of pessimism as to the outcome. --- Marcel Proust

As a kid, I thought of doctors as gods, practitioners of a noble profession. Experience shows these experts in health care have limits. Like everyone else. I just had a strange experience. A molehill got misdiagnosed and became a mountain.

Pain Without Gain
The pain in my left foot started months ago. Like Snake Plissken in Escape from New York, I paid no attention. Until I had difficulty walking. A growth on the side of an inner toe caused pain and swelling. To compensate, I burdened my other toes and other foot with extra weight and unnatural movements. That caused side effects.

Time for medical treatment.

Doctor 1
I went to a neighborhood walk-in clinic, waited and eventually saw a doctor. He diagnosed a callus. He cut away the top layers of dead skin ("tell me when it starts to hurt") and advised me to return if the pain remained.

A few days later, I went to IKI Canada, the centre for pain-free living. I go every 4-6 weeks for a general tune-up. My therapist, Julian Hirabayashi used Ki energy, acupuncture and other techniques to remove the swelling and rebalance my body weight.

Doctor 2
I wasn't cured, though. I returned to the walk-in clinic where a different doctor was on duty. She confirmed the growth was a callus. She poked from the top and sides ("does it hurt here?") but provided no treatment. My condition seemed too minor for her. I was to get a pumice stone.

Something was wrong. The pumice stone caused more pain. Progress was slow. I tried a special file. This worked faster but caused bleeding since too large an area got treated. I waited for the foot to heal before continuing treatment.

Doctor 3 (Specialist 1)
Because of other issues, I was getting orthotic shoes. When I went for foot impressions, the doctor looked at my aching foot and confirmed the earlier diagnoses.

Doctor 4
To reduce the pain, I'd been limiting my walking and wearing looser footwear. I wasn't getting better, though.

I went to a different doctor. He said I had a wart!?! This made more sense. He cut away at the top and applied cold to start killing the virus. He advised that I go to a specialist to get treatment with uber-icy liquid nitrogen.

I got an appointment about three weeks later.

Doctor 5 (Specialist 2)
The health centre could treat me but would not: I lived outside their zone. Something to do with how the province funds them. I should been screened out when I called for the appointment. Three weeks wasted. Plus an hour waiting and filling out forms.

As a courtesy, the doctor examined my foot and gave me a list of private foot care facilities. I got an appointment the next day.

Doctor 6 (Specialist 3)
After filling out paperwork that even asked for ages of children, my foot got examined. The recommended treatment? Surgery. No one mentioned this option before. It seemed ideal based on the location and advanced stage of growth. I paid $300 and got treated right away. That was a few days ago. I return for a checkup in a couple of days. Months of agony and misdiagnosis are ending.

Three Lessons Learned
I'm no doctor. I'm barely a good patient. Still, I'm dismayed that a minor ailment got misdiagnosed three times. If there were doubts, why not refer me to a specialist. I learned three lessons.
  1. good advisors are hard to find
  2. a bad diagnosis means a bad prescription
  3. you suffer when mistakes get made (time, money, inconvenience, pain)
Health = wealth.
Stay healthy.

No comments: