Recently a friend of mine, I’ll call him Ed, had a surgical procedure to treat his gastroesophageal reflux (GERD) which intense medical therapy could not control.  He was having severe, almost continuous heartburn and nausea.  The procedure was done by means of an endoscope that went down his mouth, through his esophagus and into his stomach.  Ed experienced considerable relief after the procedure. But several weeks later he started having a different kind of pain that started in his mouth, went down his chest and down through his abdomen below his navel.  When Ed explained this to his surgeon, I’ll call him Doctor Adams, the doctor said it couldn’t be due to the surgery and he was stumped.   He could only suggest Ed continue his pain medication for the time being.  My friend felt the doctor didn’t take him seriously, and so he went from doctor to doctor.  It wasn’t until his pain became more localized to his right upper abdomen that he felt one doctor who believed him, ordered tests that showed the problem was his gallbladder.  Ed then had his gallbladder removed and now is recovering smoothly.  What happened?  What went wrong?  Why did Ed have to search for another doctor to help him?

The answer is that the pain Ed first experienced didn’t match any pain Dr. Adams expected.  In fact, it sounded weird.  While Dr. Adams  may have thought the pain was all in my friend’s head, let’s give him the benefit of the doubt and assume that Dr. Adams believed Ed but didn’t know what was going on and decided to wait to see whether the pain would go away on its own or become more identifiable.  But, if that’s what he was thinking, this is where his communication with Ed broke down.  He didn’t explain his thinking to Ed and tell him that even though it wasn’t clear what was going on at the time, he wanted to keep in touch with Ed especially if any of his symptoms changed.  Instead Ed left the doctor’s office feeling like Dr. Adams didn’t believe him.  So, even as his symptoms became more localized, Ed was not inclined to go back to Dr. Adams.

The lesson to be learned is for both physician and patient to maintain open lines of communication in challenging cases like this one.  The physician needs to encourage the patient to report any new, changing or worsening symptoms.  Just as important, the patient needs to understand that the initial symptoms of a condition may be vague and confusing but with time they become better defined and point more clearly to the ultimate diagnosis.

How comfortable are you with your communications with your doctors?  Have you ever had problems similar to Ed’s?

For Your Health – Dr. Bob