She sees difficult patients, but is a difficult patient herself

The patient is a 27-year-old Caucasian woman: slender, well-groomed. She is sitting in the office of her urologist, and she is unconsciously twisting her hands as she interrupts the doctor, having finally worked up the nerve. “I know you told me to expect some pain for a while after the lithotripsy. But I’ve been having pain in my bladder, even when I don’t think there are any stones. It started two years ago, before the stones. It feels like pressure, and it really stings when I urinate. It especially hurts when I’ve taken naproxen or loratadine, or if I have caffeine, or if I get dehydrated at all. The only thing that seems to help is drinking a lot of water, and then the pain goes away after I urinate again. What do you think is happening?” The patient, from her description of her symptoms, appears to have interstitial cystitis, one of the dreaded “functional” disorders. Since she is talking with her urologist, who performed a shockwave lithotripsy on a pear-shaped 8-mm calcium oxalate kidney stone some six months ago. She does not mention any other diagnoses. Her past medical history is significant for migraine headaches, depression and anxiety. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Education Primary Care Urology Source Type: blogs