Tag: family

So, why did you come in to see me?

Just remember. This is supposed to be funny, but with a side of truth.

You know, my life is full and interesting. I get to help people every day and do what I love. That makes me one of the luckiest people I know. I will never forget that. I used to think, before I actually went into medicine, that every patient that would walk in that door wanted to be there and would be ready to be a part of their own healthcare team. Weirdly, that is not the case. This is true for a large portion of my patients, but for some, I am not so sure.

As I reflect over the last 20 plus years, I realize that there are several types of patients in my practice. Let’s review.

There is the patient that you inadvertently become friends with and become attached to. To some extent, this happens to me all the time. I always try to bond with my patients in attempt to care for them better. I try to get insight into their lives to help them through whatever issues they are trying to solve. They always tell you in medical school never to get attached, but sometimes I can’t help it. In my mind, it is a reflection of the depth of my caring. I am always careful to respect doctor patient boundaries though. It’s not like I go party at their houses or anything.

There is the patient that doubts literally everything you say. I mean everything. For every plan you come up with, they have a counter plan or they doubt that it will work. They question your every move. They constantly re ask the same questions to see if they can trap you into giving a different answer. I realize that most of the time, this has nothing to do with me. Often, these are patients that have been bounced from office to office without actually getting the help that they need. Or, worse yet, they have had a bad experience or suffered malpractice and this makes it very difficult for them to trust any doctor. I try to take that into consideration when working with them.

There is the patient who thinks THEY are the doctor. You know the one. They grew up with family members or friends that are physicians and they know just enough to be dangerous….to themselves and your 16 plus years of schooling are not going to change their mind.

There is the entitled patient, who thinks only of themselves and becomes indignant when attention is not focused on them. These are the patients that become irate when their pap smear is interrupted because I have to run to the hospital to save someone who is hemorrhaging. The “big picture” is somewhat lost on them. They want special treatment and have tantrums when things do not go their way, regardless of the reason. I try to set very clear communication and expectations with these folks, but sometimes they get upset nonetheless.

There is the patient that “never goes to the doctor.” This is the patient that hasn’t been to the doctor in years because they haven’t had any symptoms. This is the patient that doesn’t trust doctors and has to make sure you know it by repeating the first two statements multiple times during their visit. However, if this same patient suddenly has an issue that they determine to be urgent, you had better drop everything and address it right away. Never mind that they have neglected their health for years. It is up to you to fix it….and quickly……so they can go back to never coming in for check-ups.

Let’s not forget the self-diagnosing patient. We all know that with the help of Google, our friends, our family and the chiropractor, we can figure anything out on our own, even before reporting to the doctor’s office. Those are the folks that come in convinced they have a rare tropical disease because Doctor Google said so after they typed in their symptoms. It is often very difficult to talk them out of it, but I try. Half the time, they are apologizing for looking stuff up in Google, as they are insisting that it has to be correct!

There is also the patient with overbearing family members. In my case, this most often presents and the teenage patient with the anxious parent. The parent is often on a covert fact-finding mission to discover if the teen is sexually active or not. They talk over the patient, and try to fill in all the details to show how concerned they are, but then don’t really seem to want to hear what the teen has to say. I get that they want to make sure the patient gets what she needs, but this behavior only shuts down any potential successful communication that I was hoping to have the patient.

There is a final category. This is the one we spend our whole careers hoping to encounter: the patient that reminds you why you went into medicine in the first place. This is the patient that appreciates what you do for them and how you care for them. This is the patient that is nice to your hardworking staff. This is the patient that follows through with what you recommend. This is the patient that talks with you not at you at the office.

The bottom line is that my job offers infinite variety. All of these patient types keep me on my toes and my mind fresh and ready for anything. They each have their own advantages and challenges. It’s not exactly how I thought it would be, but I wouldn’t change a thing.

Dr. Katz

It’s Easter

To me, first and foremost, Easter is about the resurrection of Jesus. I get it. But, also for me, there is a lot of other things to celebrate on this day too. There has been so much rebirth everywhere. From the minute details of the daffodils blooming to the emergence of myself and my husband from illness to the rejuvenation of old relationships: there is a sense of fresh start everywhere.

Second chances are everywhere, if we take advantage of them. I think this applies not only to religion, but to life in general. I have to admit, there has been so much change to take in that sometimes it’s overwhelming as well as wonderful. I am sometimes not sure how to process it all. I make sure to never let it overwhelm my sense of gratitude, but I am noticing that there is still an underlying sense of anxiety and “waiting for the other shoe to drop” again in my every day life. It seems to be affecting my whole family as well. I think it’s just normal with everything we have been through lately.

I realize that I need to make a conscious effort to keep moving forward, and to help my family move forward with me. We need to make the absolute most of and learn from these second chances. We need to focus on what gives us joy, even if it is something as small as watching my grandchildren hunt for Easter eggs or as monumental as hearing that my latest scans are clear.

So, as you gather with family and friends today to celebrate our Lord, also take time to celebrate each other and life in general. Take nothing for granted. Embrace every opportunity. Learn from each other and your own mistakes. Savor every moment.

Have a happy and blessed Easter.

Dr. Katz

What do you look for in an obgyn?

This question actually has multiple answers and is a more complicated process than selecting a primary care physician. The usual selection criteria apply of course: 1) Is the doctor in your network? 2) Are they local and easy to get to? 3) Does their availability(office hours) fit your availability? 4) Do they have good reviews? 5) Do you know anyone personally in your family or friend group that already sees them so that you can get firsthand feedback?

These are good to go by when attempting to select any physician, bearing in mind that reviews on google can be written by anyone anywhere, even if they have never been in the office in question. Having family feedback is good as well, provided that you know the whole story surrounding their comments. ( i.e Grandma Martha hates Dr. X, but also has multiple no show appointments and owes the office a lot of money that they are rightfully trying to collect) You see what I mean? Even the seemingly best source of information does not compare to your own personal experience.

Having clarified all that, I feel that selecting an obgyn adds yet an additional level in selection complexity. Finding the right obgyn means finding someone with a communication style and listening skills that make you feel comfortable enough to discuss some of your most personal and potentially embarrassing issues. I mean, you can’t go discussing your vagina and hormones with just anybody. Hopefully you are able to find somebody that listens and “gets you” at the same time.

This is the kind of thing I strive for the most….the listening part I mean. It is so so important. Many of the women that I see are frustrated because they have spent years dealing with unresolved issues because they either did not feel comfortable mentioning them to their previous physicians or they were dismissed. This should never happen. Every single patient deserves to be listened to and, in my opinion, if they have an issue that you are not prepared to deal with, they should be referred onward to someone that can. The patient should never have to suffer due to your lack of comfort or familiarity with their particular problem.

I received a compliment once from a patient that I did not understand at first, but now I consider it one of the best compliments I have ever gotten. She said that coming to my office was like coming to a girlfriend’s house. At first I thought, what the heck does she do at her girlfriend’s house? My face must have registered my confusion for a minute because she went on to explain what she meant. She meant that I was able to make her so comfortable at my office that she was able to disclose and discuss anything and everything that she wanted to. That is my job, my sacred mission, and what it’s all about. Have a great night everybody!

Dr. Katz

Now the whole family has cancer!

I have been pummelled lately with the adage that when you have cancer, your whole family does to and everyone that cares about you. At first I was like NO WAY! and THAT’S RIDICULOUS! No one else has tumors all over their body! No one else is getting poison shoved into their veins. C’MON! And then, I took a minute and got over myself and realized that that is not what that statement means. It doesn’t mean that everybody else is going through all the physical aspects of the cancer. It means that they are on their own emotional journey because the cancer is affecting someone they care about and they feel kind of helpless about it. They are having their own whirlwind of thoughts and feelings all the time as well. They have sorrow and sadness and anger all at the same time too. They need counselling too. The anger to me is actually sadder than the plain old sadness. I notice with my own family that I get caught in the crossfire of all of those feeling more than I care to. It is strange though, because, even though I get a lot of anger directed toward me, it doesn’t mean that they are actually angry at me. The way they describe it is that they are angry about what is happening to me and they don’t know how to express it. Well, combine that type of misdirected miscommunication with a dose of my current oversensitivity( and me being off prozac to boot) and we have a real mess on our hands at times. Suffice it to say, we are keeping the therapy offices busy right now and it still doesn’t always work out the best. It is a work in progress to be sure. Having said that, now that I have a better understanding of what that statement means, I can make better attempts at not taking their emotions personally. So maybe, if they can try a little harder not to misdirect and I can try a little harder to understand that they are going through stuff too, we can do a little better together.

Nobody told me about the guilt!

I had no idea just how much guilt comes with chronic disease. This may not be true for everyone, but it is definitely true for me. I just can’t seem to balance the whole “just concentrate on getting better” side of me with the side that is worried about everybody else, my business, other people’s schedules, my patients, and just generally letting people down with all of my limitations. Sometimes I think it takes me more time and energy to process all the guilt and worrying than it would just to be sick. I get it. That sounds ridiculous, but it is the truth for me. It is just a tough balance for me.

You know what I think would be a good idea? We should sit patient’s down, after they have had a chance to digest the news of their new diagnosis, and hook them up with a mentor or counsellor to sit them down and help them start to wade through and plan for all the other complications and stuff that comes with any chronic illness. It might make it less overwhelming than just having everything smack you in the face as it comes, while you are busy trying to “just concentrate on getting better.” I get that some cancer patients have patient navigators, but the main role of these individuals is to keep the patient on track in terms of appointments, tests, and treatments. This is useful to be sure, but the real trick is managing all the outside life stuff that is on top of the tests, etc. I say we start offering life navigators too because, in most cases, the damage that is done with all the life fails, failed relationships, missed work, and unpaid bills far exceeds whatever damage the cancer inflicted.

Dr. Katz

Bye Bye Gourmet Dinners..or…how are these mofos gonna make it without me?

Now remember, this is just for fun….

I can see it already. The countdown to chemo has started. 5 days from now I will receive my first 5 hour installment of a combination of poisons and immunotherapy. Yippee! Bring on the side effects! Let’s get this show on the road! One step closer to a cure!( I hope) Bring on the easter egg look! Now we are really getting somewhere! Finally moving in a positive direction!

It all sounds “good” doesn’t it? Just what I have been anxiously waiting for all these months with all the delays etc. Feeling weirdly nervouscited, terrified, and good about it all at once. But then, I flashed back to the conversation that my chemo nurse had with my husband at our last visit. He was trying to be funny and made a silly remark about how my the quality of dinners at our house has really elevated since I have been home so much and that at least there was one benefit of me having cancer. The nurse kind of glared at him and said, “Mister, you can kiss those gourmet meals goodbye for now because I can guarantee that she won’t have the energy to do it.” He looked kind of stunned. Literally that thought had not occurred to him until that exact moment…lol I could see his wheels spinning; No more chicken cordon bleu. No more baked ribeye with a parmesan crust. OMG! I couldn’t help myself. I started laughing. Seriously dude? Last time I checked, more than one person in our house knew how to cook. Someone else can run frantically home at lunch and throw something in the oven with the timer for later. I started to visualize the mounds of take out containers in the filthy kitchen of unwashed dishes. I started hearing the pitiful whining of human beings wasting away. Then I realized that gourmet dinners were not the only thing that was going to go the way of the dodo. OMG! I was going to have to concentrate on myself and getting rest and not taking care of everything for everybody. Oh my lord who was going to keep track of everybody’s schedules without me nagging all the time? Were they going to have to be responsible for making it to their own appointments? Find their own rides? Was my daughter going to have to finally get her long overdue driver’s license? Were the dogs ever going to be let out to go to the bathroom? Was the house just going to be awash in filth all the time? Were any bills ever going to be paid on time? Oh man! I really started snowballing. I was in charge of a lot more than I ever stopped to consider. Mind you, I had already started the family on my own version of achieve your independence boot camp, but was it going to be enough? Lol….I guess we will have to wait and see. I’ll get back to you.

Dr. Katz

Sometimes it’s hard not to get jealous

Being a cancer patient definitely has it’s challenges. I think we all can agree. Feeling sick, fatigue, nausea, loss of appetite, hair loss, shortness of breath are the things that we tend to think of first as the top issues that cancer patients face. However, there is another challenge that insidiously creeps it’s way into your life: envy and resentment. It’s not good. It affects your mood and your relationships. It is just as unpredictable as the cancer itself. It can make you wallow in self pity, even when you don’t mean to. It can make you lash out at the people that care about you and are trying to help you. What am I talking about exactly? I am talking about that feeling of jealousy and resentment that creeps up on you over time that you misdirect toward anyone in the way. What do you become jealous and resentful of?: anyone that is living a full life and doing what they want when you can’t! You become like that puppy dog at the window hoping to go for a ride in the car somewhere, anywhere. The real you spends your time encouraging everyone around you to keep living and do what they love, even if you are sick. Then the other you starts muttering under your breath, crying and cursing them as they leave you. It is completely ridiculous I know and it’s unfair both to you and the people in your life. It basically boils down to emotional abuse for all of you. Nothing good can come of it. I have done it myself.

However, as I sit chastising and judging myself for doing it, I also have to realize that some of these confusing emotions have to come with the territory. It is only natural for you to feel out of control emotions in a pretty out of control situation. I mean c’mon, the cancer is already unpredictably calling most of the shots when it comes to day to day physical living. Why wouldn’t your emotions be all over the place? I think the key is not that those emotions are there, but what you do with them. You can’t erase your feelings, but you can try to control yourself so they don’t run other people over like some kind of freight train. Don’t bite the hand that feeds you. Don’t lash out at the people trying to help you. That won’t help resolve the feelings and only leaves you feeling bad about yourself. That certainly won’t help you heal any faster. Here is where therapy has come in very handy, at least for me. I highly recommend it and I think every patient facing serious illness should have it. It is a much better option to let out those feelings to a paid professional who is trained in how to help you deal with them, rather than blasting your family who is only trying to help you. It might just save your relationships.

Dr.Katz

Man! It’s lonely being a patient right now!

Yet another reason to hate what changes Covid has brought to the world. It seems like no aspect of our lives has gone unchanged or untouched. A lot of it has been inconvenience like not being able to go to concerts and having to wear masks everywhere, which a lot of us complain about, but yet our lives have still gone on. Other restrictions have been down right tragic like not being able to see loved ones for gatherings, accompany them to the doctor or even visit them in the hospital when they are sick. Even with some of the restrictions lifted or modified, it is a lonely lonely time to be a patient right now.

It is study proven that family support increases the likelihood of successful treatment and recovery, whether that be from surgery, addiction, or cancer. So, what have we done? We have completely eliminated that extra advantage with the Covid restrictions. I feel like we have failed patients because we didn’t even consider other options. Patients have had to go alone to complicated doctor appointments. We all know that it is always better to have more than one set of ears to listen, especially when it comes to complicated diagnoses and instructions. Patients have had to go through chemo treatments alone with no one to pass the time with. Sometimes those sessions last for 8 hours. For a while, patients were languishing in the hospital with no visitors, unless their case became terminal, at which point all communication opportunities and precious time were already gone and families experienced twice the loss: the loss of the loved one and the loss of the time they could have shared. When I was in the hospital in January, there were patients that had been on the oncology floor for almost a month with no visitors, fighting for their lives with no family support.

Back to reality. Of course, I understand the concern for spread of the virus and the potential consequences. But now we have rapid tests for covid. We could test visitors and assess for positivity in a potentially expedient manner. I know what you are going to say. The tests could be false negative. Yes that is true. Nothing is 100% fool proof and there could be risks. I understand how serious it is. However, my educated crystal ball says that we are going to look back on this time period and notice that recovery rates for all hospital-based illness went down by at least 25%. At this point, I am just not sure that the tradeoff has been worth it. None of those lonely patients will ever get that time back.

Dr. Katz

Don’t treat me like a china doll!….unless I ask you to…lol

Just remember before you read this…..it is for fun only.

Yup. It’s started already. One little diagnosis of cancer and everyone thinks you are immediately transformed into a broken china doll that can’t do anything for herself. I swear to God even the dogs treat me differently. Frannie is constantly looking at me with a weird sort of sad, worried expression on her furry face. She is stuck to me like velcro at all times and watches my every move. She doesn’t even rudely jump on top of me anymore. She just sort of slinks up on the couch and gingerly slides in next to me. Hmm. Interesting. They say that cancer makes you smell differently to a dog. So, maybe someday when my cancer stink is not as strong she will go back to jumping on me all the time and being ridiculous. Wait? Do I really want that?

My family makes me alert them to the possibility that I may actually want to bathe or go to the bathroom by myself, in case I should fall or something. However, to be fair, I did splat on the floor a time or two before so I really have to give them that one. Ok. Ok. They also don’t want me lifting, pushing or pulling anything….ever! But then they aren’t available when something needs to be lifted pushed or pulled. Ugh! What choice does a girl have? This is why Christmas decorations will be up until 2022. I am sure of it.

Now these same folks that want to treat you like a fragile little thing also don’t seem to mind when you sneakily did something that works to their advantage, like make them a gourmet dinner because you literally had nothing else to do! But, that’s only human I guess. Who doesn’t like good food?

Now, don’t get me wrong. It’s not all bad being let out of certain things. For example, watching everybody load the horses into the trailer themselves and pack everything while I just lounged in the car? Pretty fantastic. Not having to be the one to actually drive everybody everywhere and sometimes I just get to ride along? Also not complainin. If only I could pick and choose tho! It would be great to be able to decide on the spot when I want to be waited on hand and foot versus when I want to tear around like Wonder Woman. Just sayin. I completely get that there are things that I simply cannot do at times. Sometimes I am so weak and tired that I feel like the energy was sucked out of me with a funnel. These are the times that I desperately need help and I thank God for my amazing army. Then, other times I want to grumble and do what I want anyway because I am feeling resentful and frustrated at the limitations. The bottom line is, I just need to learn to be patient with my peeps and with myself. They are all trying to help and they are definitely better at it than I am at helping myself. For now, all I can tell you is that I’ll work on it. Have an amazing day!

Dr. Katz

Do rose colored glasses really help with mourning?

Funerals for family members are always tough and potentially gut wrenching. Emotions fly all over the place. Some people sob. Some people yell and get angry. Some people sit silently with a stoic facade, as if the outward appearance of strength will magically help themselves and others. Everybody searches for that perfect blended strategy that will allow them to both express their own emotions and comfort others at the same time. Some people are fortunate enough to have a ton of amazing stories of the deceased to share. We find ourselves grabbing for our rose-colored glasses, just in case our memories aren’t what we hoped, thinking that it will lesson our pain.

Ideally generations are able to gather and even broken bridges are able to be rebuilt over the realization that life is short and precious and time should never be wasted. However, this hope for relationship rebirth and mending of fences is truly only dependent on one thing: either party’s capacity for change and accountability. It is unrealistically painful to expect any sort of new outcome without it. As much as we would like to waive our magic wands and affect instant change, it doesn’t work that way. Change and healing are two sided entities that require movement and effort by both parties. I think that affecting change and healing in families is just that much harder because of the increased level of intimacy and emotional attachment. We tend to think that blood ties both bind people together and excuse all actions eventually with mutual exclusivity. I could not disagree more. There are some hurts that cannot heal regardless of shared genetic material, and that just is what it is. I am a firm believer that blood ties do not justify all wounds. We preach self preservation and value every day in order to empower ourselves and embrace the world around us so that we can be healthy both mentally and physically. Why wouldn’t this apply to relationships with family members? Should there be a separate set of rules for families? In my opinion, the answer is simply, no.

Dr. Katz