Shooting in the dark: a personal account of managed care

I had a great relationship with the VA for the first 10 years. I had the same doctor for 10 years and there was great continuity of care. She went on to bigger and better things, and they brought in a new doctor who saw me a few times and then retired. Since then (for two years), I have never seen the same person twice.

Now, the lucky thing is, I'm not sick. I have hypertension and am overweight. I also take great care to research my own health solutions and use alternative care as much as possible. So it hasn't been terribly critical for me, but I wonder about the people for whom it is critical.

I think I may have mentioned before that I became concerned about my blood pressure several months ago. It was worrisome when I was daily staying at 145/95, despite my medication, which is said to be the "gateway to dementia." Then it jumped to 155/105 daily for a long stretch, then 165/115. I was getting scared. I went to see my "doctor" (or whoever was there at the time), and they jumped on the bandwagon and ordered a bunch of expensive tests for me -- MRIs (suspecting to find a stenosis of the liver, they said). They sent me to see a cardiologist. They wanted me to have stress tests.

The cardiologist laughed. After an EKG he pronounced that my heart was in exactly the same condition it was 10 years ago, and that I had suffered no heart damage whatsoever despite my longstanding hypertension.

So the Women's clinic upped my meds -- again -- and I went home. (I didn't go for the MRI -- it was ridiculous to cost them all that money when I knew they were shooting in the dark.)

So after my appointment, I went to see my son & family. I was telling the tale to my daughter-in-law who also knew that I was borderline diabetic (as do my doctors, of course). She listened to my story and said, "I just read an article on Dr. Mercola's site. I'm betting that you're insulin resistant, and the article was about the connection between insulin resistance and hypertension.

So, I went home and took Dr. Cassi's (my daughter-in-law who is just a very wise woman and not a doctor at all) advice to take 2 cinnamon capsules every morning and to start walking. My blood pressure came down 30 points the very first day I took the capsules and walked for 20 minutes. Within 3 days, my blood pressure was normal. Some days it stayed at 116/72.

Okay, fast forward. For 3 months, I walked and took the cinnamon caps (which control blood sugar) and started modifying my diet. Four months in, we had moved to Bisbee, and I was tackling those hills daily. I went to the VA for a follow-up appointment and was shocked to find that despite four months of serious diet modification and ramped up exercise, I hadn't lost an ounce. I was mortified. So one of the doctors (again, one I'd never seen before) hearing me exclaim about my weight brought me in to "counsel" me. So I got all the "calories in/calories out" "count your calories, reduce by 15%" lecture.

I asked her how reducing my calories in half and going from completely sedentary to walking up hill and down 20 - 30 minutes a day didn't work. Her response, "Ah, you probably are only burning 100 calories doing that." But clearly, I could tell by the way she looked at me that she didn't believe me that I was exercising and cutting calories. She then reviewed all my hypertension meds and gave me yet another one.

I came home that night, took the new "pill," and by bedtime, my blood pressure was 180/119. I struggled with it for 3 days, then when it just kept going up and up no matter what I did, I went to the ER here in Bisbee.

The doctor sat down with me and listened to my story. "Do you have a local doctor?" he asked. "You need to get some more personal care." I couldn't deny that the way things were going, to never see the same person twice was not good. "Otherwise we're just shooting in the dark," he said. He listened to me talk about my disappointment to find I'd not lost a bit of weight despite all the modification. He looked at my heart rate on the monitors. Resting heart rate: 48. He looked at my meds list again.

"Here's the problem," he said. "They have you on such a huge dose of Atenolol that no matter how much you exercise, your heart rate is not going to go high enough to raise your metabolism." Now everything started making sense. I remembered when they first put me on the Atenolol and it wasn 't working, they just kept raising the dosage. When it still didn't take care of the problem, they just started adding a bunch of other meds to it. Instead of removing or replacing the Atenolol, they just added to it.

"You need to have them get you off the beta blocker." Two EKG's and blood work later, he determined that I likely didn't need the Atenolol at all. I put two and two together. A beta blocker is for the purpose of lowering blood pressure, stopping chest pain, and giving a greater possibility of surviving a heart attack.

Well, with the two new EKG's and the VA cardiologists assurance that my heart was just fine, I decided that my heart was not at risk and that it was even possible that it was overprotected. I wasn't having chest pain (angina). I didn't take the latest med they had added at all (That would have made 4 different meds). First I stopped my evening dose of Atenolol. When my blood pressure stayed normal for several days, but my heart rate was still only in the 50's and only up to 70 after exercise, I cut out a portion of my morning dose, too. I dropped all together from 75 mg a day back to 25.

When I got back from my morning walk this morning, my heart was pounding. What a great feeling! I took my pulse, and it was at 100. My target heart rate for exercise is 114, so I'm getting there. Two hours later my resting heart rate is 65 instead of 48. That's more normal.

So, the moral of this story? Be your own best advocate. Do your own research. If you have to have care of any kind, find a doctor who sits down with you, who listens to you, who makes connections, who can analyze the evidence before him or her and see what the problem is. I think I would rather drive to Willcox to see this ER doctor a couple of times a year, paying for it out of my own pocket, than continue with the VA for anything major. Don't get me wrong, the VA has been good to me. but when "managed" care means "never see the same doc twice," it may be time to take matters into your own hands -- and by that, I mean doing your own research and getting better advice. True, I took myself off the Atenolol, but I had had my heart tested thoroughly by two different doctors who assured me that it was fine, and the recommendation from the ER doc. I don't recommend you taking yourself off of anything, ever. I'm acutely in tune with what is happening in my body, and I monitor my BP and pulse several times a day.

All the fight going on about the health care bill, managed care, "death panels", etc.? The bottom line is that you know yourself and your body better than anyone. Do your own research, make sure they listen. Making connections is what thinking is all about. When your doctor is not making rudimentary connections with what has gone before, they're not thinking -- they're stabbing in the dark. And know when it's possible that causes can be diet related, lack of exercise, stress related, and yes, even psychosomatic. Psychosomatic doesn't mean there isn't something wrong - it simply means that the cause is coming from something other than a disease pathology. And actually, that's good news.

The Sword and The Stone

The older we get, we tend to feel as though by now surely we "should" have resolved all those stubborn childhood issues. We've struggled with them at length, placed them aside only to have them rear up again and again.

For as long as I can remember throughout my adult life, I have had high blood pressure (even when I was young and thin) and a stiffness in my neck and upper shoulders that defied even repeated treatments by a gifted acupuncturist.

I ended up in the ER twice in one week when, after 3 months of concerted lifestyle and diet changes and nice, stable lowered blood pressure it started skyrocketing again. I have little stress in my life, a whole lot of peace, and really, the normal things that bother people with hypertension have little effect on me anyway. It doesn't elevate with stress, caffeine, etc. So the second time I was worried, and so were the hospital staff. But after 6 hours of intense tests -- 2 sets of blood work, 2 EKGs, a chest x-ray and a CT scan, they pronounced that I seemed in perfect health.

A friend whose wisdom I trust mentioned that Louise Hay had said that hypertension could be caused by unresolved childhood trauma. I wanted to roll my eyes. What was I still holding on to? I couldn't even imagine. I mentioned in an earlier blog that after reading Eckhart Tolle, I had been able to let go of a huge issue that had haunted me for 40 years.

So I decided to see a hypnotherapist. I met Mark Ruhl and his wife Jo'Ann when she did a couple of radio shows for me last year. I was very impressed with them, and decided at that time that if I ever felt that I needed a hypnotherapist that I would make an appointment with Mark.

I was a bit apprehensive. I really didn't feel like dealing with a bunch of dredged up memories, and how important could they be by now anyway? It also flashed through my mind about the "false memories" people say have been created in therapy. I nearly canceled the appointment. But something in my core told me to go anyway.

The greatest relief was Mark's methodology. I don't know, of course, what he does with anyone else, and I didn't tell him of my apprehensions. But he chose, instead of plumbing my memory for possibly forgotten traumatic memories, to simply help me find and remove what he referred to as "attachments."

Once in the uber-relaxed, hypnotic state, which to my pleasant realization was more like a deep meditative state than a "going under" like we've come to expect thanks to Hollywood, he simply asked me to scan my body for any "resistance" and to describe it to him. Where was it? What color was it? What shape was it? Did it come from within me or from without?

The first resistance I felt was, of course, in my neck and upper back. When he asked me what color it was, I told him like a sickly, phlegmatic yellow. But that soon morphed into a bright hot, golden glowing metal and took the shape of a sword which seemed to be stuck into the nape of my neck with only the hilt sticking out, and the sword running down where my spine should be.

While I was visualising the sword, in an instant, Artio, my Bear Goddess of Berne, my patroness, guide and teacher appeared in a flash by my side, simply reached up and pulled it straight up and out of my body. It happened so quickly, I caught my breath and began to cry. She looked at me, not remonstratingly so much as teasing and asked, "Do you know how long I've pursued you to try to take this thing out? But you never let me get close enough."

It was amazing. The weight was gone, the stiffness was gone, that thing that had so long been a source of headaches and tension and irritability was gone.

"You may have once needed it," Mark told me, "but it has served its purpose and is no longer necessary." Then he asked me to take as long as I like and fill the void with something of my own choosing. I saw it being replaced with a smooth, round, translucent green tourmaline rod. Interesting that now that I look it up in my Crystal Bible, it tells of green tourmaline or verdelite as "an excellent healer and help for visualization. It opens the heart chakra, promotes compassion, tenderness, patience, and a sense of belonging. This nurturing stone brings balance and a joie de vivre." In reading the remainder of the description, which is too lengthy to record here, I am stunned at the characteristics which it enhances and heals -- all things which correspond directly to things I've so long struggled with. I think I had some guidance from somewhere, within or without, to promote that particular substance for replacement.

The second "resistance" was a bit less dramatic, it was a flat, round rock, dull grey, in the small of my back. I sensed it had been placed there. Because this came from outside instead of inside as the sword had, he said I had to decide whether I was ready to let go of it, and to tell it to leave. I said yes, quickly, but the truth appeared to be different. I witnessed hands grappling for the stone -- ones to pull it out, and others pulling it back, holding it there, unwilling to release it. The struggle took a few minutes, but the removing hands won. When he told me to take my time and fill the void, I filled the whole lower lumbar region and into my hips with a healthy green tree trunk holding branches and leaves which I then watched as it grew down into my legs and feet, and upward, spreading across my back.

The session's work complete, and feeling an incredible lightness of being, I left. That was Saturday morning. Sunday night, I had the most lovely dream. You see, part of my going to see Mark was also my consternation at the fact that despite all the calm and peace in my life, I was having anxious, fearful, and often times violently threatening dreams. I would awake from my dreams exhausted.

In this dream, I perceived a threat of incarceration if I didn't escape the place I was being held. I remember, however, that there was no fear in it, simply an understanding of what I needed to do, and a sense of urgency about it. I went downstairs and found a swimming pool. It is interesting to note that this particular swimming pool that I found is one that often crops up in various scenarios in my dreams. Nothing attractive about it -- more like a chamber filled with chlorinated water than a place to have fun. But I dove in and went directly to a corner at the bottom of the pool where there was a door. I opened the door and found myself on a narrow strip of beach -- white sand with beach grass poking up through it. And beyond, the wide sea. I ran resolutely across the beach and dove into the water and swam. And swam, and swam, and swam -- every stroke making me feel safer and more confident. The basic scenario was repeated several times before I woke, always a bit different, but always ending up with me swimming for miles with a purpose and a destination. Finally as the dream receded, and I surfaced, I heard my own voice in my head saying, "I am free. This is freedom."

All day today I have felt an incredible lightness. But not in the usual euphoric, overenthusiastic way my overcompensating ego often works. Two different people mentioned today that I seemed to be in a really good mood. But it felt natural and whole.

It seems to me that it takes a village -- not only to raise a child -- but to live a life. I think of how this all came about -- one friend suggests a possible cause for my malady -- another has the skills to draw it out. People like me, who are self aware, tend to think we shouldn't have to have "help," that it's something we should be able to fix within ourselves. Well, true -- no one can fix it but us -- but sometimes the skills and compassion of others, of wise women and healers, are the gifts we need to allow ourselves.