Now I Remember Why.......

[Hound dog]

at least one of the reasons I stopped going to this doctor's practice.

Nichole had her appoint today for the unusual symptoms she's been having. Growing stretch marks, severe muscle cramps, over extension of joints and dislocations, and the moon face.

She got the d@mn Nurse Practioner again.

Now I've seen many NP's who are awesome and do a wonderful job. This one, however, is a mega moron wishing for a promotion to stupid.

NP couldn't/wouldn't get past the stretch marks. Refused and ignored any of the other symptoms. Said stretch marks were from rapid weight flux. I said what rapid weight flux??? She said well, difficult child has gained 5 lbs since her last visit in APRIL! ??? 5 whopping pounds over 6 months is now considered rapid weight flux??? Well, golly lady then I must have a HUGE problem with it cuz I can do that in a period of 2 days!! ARGH!!!

Bare in mind this is only the 2nd time this woman has even seen difficult child. So what is she basing this so called rapid weight flux on anyways??? In actuallity Nichole has maybe gained and lost a total of 5-10 lbs in a period of 16 months! Any other weight came from her preg, and golly gee those stretch marks weren't there then or after! Grrrrr.

Oh, well. I guess the visit wasn't a total waste. Last time Nichole saw her back in April it was to have her thyroid checked and her blood sugar due to the same symptoms excluding the stretch mark issue. NP only ordered the thyroid check because of medications, refused blood sugar and a potassium check. Well, this time decided to do POTASSIUM AND BLOOD SUGAR levels. :slap:

Also had Nichole show her the over extendablity of her joints, and the way if she moves her wrists (and many of her joints) they crackle so loud and are very painful. NP says well some people are really flexable, and if it hurts don't move them! HUH? Gee ought to be interesting with difficult child trying to get thru life NOT moving her wrists! :faint:

Requested the doctor. No doctor available Nichole would have to make yet ANOTHER appoint. Only doctor who'd take her insur there is also a moron. Already heard the word going around the hospital. No thanks.

Only reason Nichole made the appoint here was cuz they could get her in faster. Guess now she's going back to her reg fam doctor who at least possesses a brain and actually SEES his pts whether their insur is medicaid or the best there is.

I'm proud of Nichole for no melt down in the office. I know she was coming close. Heck, I was coming close.

There are times when living in a small town can be a nitemare.

 

[AllStressedOut]

Have you ever used the symptom checker on webmd.com? I'm amazed at how often I get a diagnosis from there, go to the Dr. and get the same diagnosis.

I hope whatever it is, it isn't serious and I hope she starts feeling better soon.

 

[flutterbee]

Makes you wonder why some people go into health care, doesn't it?

I'm glad Nichole handled it well and is getting to another doctor. If this doctor finds anything, I'd be sure the NP gets a copy of the tests along with a note. But, that's just me. :smile:

 

[SearchingForRainbows]

I'm also glad N handled things as well as she did. I'de be absolutely furious:grrr:!!!

I'm very glad she is going to see a doctor who she trusts. I hope the doctor can find out what is wrong ASAP!!!

I'll be sending lots of positive thoughts your way that N gets better soon!!! WFEN

 

[sweetiegirlz]

There is a website link that offers reviews of doctors

and even get free music for it! LOL.

Of course, I don't know if NP's count on here.

It is a crying shame that people have to put there whole lives in the hands of someone that is not really competent to say the least.

Hope it gets better for you soon.

 

[Star*]

Lets see here.

Promotion from moron to stupid ?

Mom melts down and difficult child remains calm?

Call your Dr. back and tell HIS nurse practitioner that you would like a consultation on HER findings of the recent appointment.

That should get you something.

 

[wethreepeeps]

I am definitely not a medical professional, but your daughter's symptoms sound a good bit like a friend of mine who, along with her two daughters (it's genetic) was diagnosed with Ehlers-Danlos syndrome. She's in her mid thirties and was just diagnosed, after having problems with symptoms for a number of years, and being misdiagnosed with fibromyalgia, depression, and just being a hypochondriac.

 

[Marguerite]

Whatever underlying condition may or may not be responsible for the over-extensible joints, I am here speaking from experience - in our family we were told it is hypermobility of the joints. No other label, just that description. But it HAS been assessed by a referral to a rheumatologist, to make sure that it isn't related to something else and to also give strict advice on what to do. You do NOT say to a patient, "Well don't move the joints then!" because you HAVE to move them. You HAVE to be able to pick up a pen and write, you HAVE to be able to walk, move your arms, pick things up and so on. ALL THESE THINGS DO DAMAGE if you have hypermobile joints and you aren't managing the problem.

husband, easy child 2/difficult child 2 and difficult child 3 all have this problem badly. The others have a small amount. husband & easy child 2/difficult child 2 have a lot of joint pain and early arthritis. difficult child 3 is starting to get chronic joint pain (and possibly early onset osteoarthritis from this).

What we were told, with easy child 2/difficult child 2 - early onset osteoarthritis is almost guaranteed. If her joints ache, support them and rest them if possible. Strapping a sore joint to reduce its range of mobility is not only acceptable, it's desirable. She is very good at bandaging a sprain or strain. She's been doing it since she was 10 years old.

What we were told with difficult child 3 - try to strengthen his muscles to protect against the over-extension, especially in his hands. We were given exercises and recommended to get him to learn piano properly, because the way you hold your hands to play piano pulls the finger joints in rather than letting them splay out.

All three younger kids were given permission to use a keyboard instead of having to write, in class.

Nichole needs to see a rheumatologist, in my opinion. At the very least, she needs the nurse practitioner to step aside and pass her on to the GP. But by focussing on the things she could understand and ignoring the rest, the NP has made it easier to duck responsibility later. I bet Nichole's file says nothing about the extensible joints, at least not in the detail it should. Maybe "some pain in fingers" or wherever it was, is all that's written, if that. And such pain could be ascribed to bruising, over-used muscles, or even too much deliberate joint cracking.

difficult child 1 often deliberately cracks his joints to release the tension and ease the pain in them. He doesn't crack them overmuch or for show, only when they are really hurting. This tells me he already has arthritic changes beginning in his finger joints.

It needs to be checked out, but frankly, from here Nichole needs to look after her joints and take the pain seriously. Let the pain warn her to protect the painful joint. Invest in elastic bandages. You can wash them in the washing machine, you just hang them out to dry and then roll them back up ready for use. We have a dozen bandages round the house, all in various stages of use, washing, drying or readiness. husband has a wrist brace he wears when having to lift anything heavy with that hand. easy child 2/difficult child 2 has wrist braces to wear when she's stiltwalking, in case she jars her wrists on dismount. (her stilts aren't the "hold the pole" kind, hers strap to her knees and she just gets up and walks around).

Because easy child 2/difficult child 2 did look after herself, she was finally permitted to go "en pointe" in ballet class when she was 17. We had to wait until the ligaments in her feet had begun to tighten. But we made sure we got the medical all clear first.

We live a lot longer these days. This doesn't necessarily mean more youth; in fact, it means we spend a lot longer in old age. We need to work to keep ourselves as well and pain-free for as long as possible, but Nichole will have to work at it harder than most, if she has hypermobile joints.

Marg

 

[Marg's Man]

Marg mentioned that I have hypermobile joints.

The joints of the body are held together by ligaments which provide the flexible connection between the bones so that everything moves correctly. The actual bearing surface of the bone is a hard cartilage surface called a condyle.

If all is well the ligaments keep the surfaces of the joints in close proximity so they slide over each other within the limits of motion permitted by the bone's shape. If all is not well then the joints are only loosely held. The bones 'bang' against each other damaging the surface of the condyle. Also the joints can move beyond their normal range of movement which slightly dislocates the joints and further stretches the ligament/s involved. None of this hurts if it only happens occasionally but as you get older the continuing stresses add up and the damage builds until it DOES hurt - continuously.

It was explained to me as being like tieing down a load onto a truck or trailer with ropes. If the ropes (which are slightly stretchy) are tight then the load doesn't move and the natural stretch of the ropes absorbs the shocks of small movements but if the ropes are too loose then the load moves around and the ropes get worn by rubbing against surfaces they were not not supposed to touch.

People who have this condition can help themselves by understanding this taking steps to minimize the damage.
Support affected joints using splints, support bandages and so on when pain is bad.
Minimize damage by doing low impact exercises such as walking (NOT jogging), riding a bicycle, swimming. Building muscle strength - get advice from people in sports medicine, gyms on ways of doing this. The aim is to build strength not damage ligaments.
Keep affected joints moving but stay within the normal range of movement. So showing off how you can touch the back of your head with your heel. If you don't use the joints they will seize up as the arthritis progresses; this is the condition that the phrase "Use it or lose it" was coined for.

 

[Hound dog]

Marg and Marg's Man thanks for the info with the joints.

I'm actually going to have her sit down and read your response, too. It's becoming painful for her of late. Especially the wrists, but I recall her complaining with the ankles too.

What about the back? She's having alot of back discomfort, too.

I'd just like to know for sure what we're dealing with. If it's nothing serious I'll do a major happy dance. But I'll be releaved when her reg doctor examines her.

Hugs

 

[Lothlorien]

I work for an orthopedic surgeon. The issues you are describing sound vaguely familiar. You really should seek to see a specialist. However, I'm not exactly sure which one. Perhaps a few of them. An orthopedic can help surgically, but will not do all those. My doctor has done this surgery on a young girl who had this problem and caused her to dislocate her ankles frequently. She had a particular disorder, but can't remember what it was called.

Perhaps a rheumatologist? I don't know. If I speak to my doctor today, I'll ask him.

What do you mean by moon face?

If she's going for blood work....ask for rh factor and perhaps magnesium levels. Honestly, I think I would ask for the full blood panel, since she's gonna be stuck anyway. Specifically ask for magnesium because that's not usually on the panel.

 

[Hound dog]

Thanks Loth

As to the Moon shape face..... Well, while Nichole is somewhat chunky, standing at 4'10" and weighing about 127-130lbs, her face is quite rounded, what you might see in a much heavier person, puffy looking even under the chin. Looks odd, out of place for her body weight.

easy child weighs MUCH more than Nichole at the same height and yet her facial features appear quite normal. easy child is about 180 lbs.

Hugs

 

[Lothlorien]

I just sent him an email.

 

[Lothlorien]

He said to see an endoocrinologist. That was actually my second guess. He said to have her thyroid tested.

 

[Lothlorien]

I sent you a pm.....did you get it.

All the syptoms that you are describing sound like Cushing's Disease.

 

[Wiped Out]

Good for Nichole not melting down!!! I probably would have!

 

[Marg's Man]

Lisa,

I've just caught up with this one and have read Lothlorien's posts.

By all means get to some sort of doctor and get the causes of the hypermobility checked out. It can be an indicator of some other more serious condition. My own endocrinologist considered Cushing's Disease in my case before ruling it out and we are still trying to find out if there some other explanation

My post was simply some advice on how to manage the problem of hypermobile joints and should not be considered as either expert advice or a cure. Generally this should not change whatever the cause of the hypermobility but ALWAYS be guided by your doctor's advice.

Marg's Man