Dr. Huddleston: A Presumption, I Presume?

Here is the back story, in short.

If you are a regular reader of my blog -- and bless you if you are [Free Parking for a year behind the Animal Husbandry Facilities PLUS Backstage Passes to Gounod's Faust and Dressing Room Access to Bianca Castafiore and her Entourage] -- then you know that I have CRPS.  Whoopy-Dee-Doo!

Having been told by the best of the best that there remain few treatment options, having skimmed the crème de la crème, so to speak, I set out to treat the disorder by trying to quench any fiery symptoms that insisted on flaring up.

Such as the screaming ninny, crazy-making spasms.

Armed with my new insurance, I began the shift from the known quotient of my team of physicians over the last twelve years to some newbies -- who look marvelous on paper.  Luckily, from an Infectious Disease and Orthopedic standpoint, I have retained my former excellent docs.

Not so for the Nutty Neurologists.

I dutifully requested a neuro referral, which was quickly granted.  I studied the roster and saw one that looked particularly promising, given the specific troubles I've been having.  He touts himself as a movement disorder specialist and researcher.   One Daniel E. Huddleston,  MD.

My first appointment with Huddleston was to be on 12 May 2014.  As a few of you know, I was in the midst of several family health crises, one of which trumps my problems, your problems, and possibly even the situation in Syria and the Ukraine.

Fred and I were weary, and his ADHD kicked in that morning, and despite allowing extra time, a wreck and getting profoundly lost all worked together such that I arrived 21 minutes late.  But, no excuses. The Huddleston refused to see me.  I believe I dissolved in tears, as the effort to get there had taken much out of moi, and the brain of moi desperately wanted to be elsewhere, anyway.

I was offered an appointment with a perverted sadist, the famed Dr. RJW.  That unbelievable encounter was commemorated recently in a post titled "Jose Ochoa, Famed Medical Turd, Has Doppelgänger in Metro Atlanta."  Read it now, if you have not already.  Dr. RJW decided that I had, not CRPS, but "postherpetic neuralgia," or shingles, and opined that I "could not live in this much pain," wanting to throw mine arse in the hearsepital, so as to reinvent the wheel and make wheelbarrow loads of cash.  Strike that last sentiment.  He was more likely not a greedy doctor, just an incompetent one.

This morning, as I waited to hear pathology reports and bad puns from Grader Boob and his new reality as a cancer patient, I thought I'd ease a little tension by tending to some overdue business.

First, cancel the follow-up appointment with the incompetent Dr. RJW, and attempt to reschedule with the self-aggrandized Daniel E. Huddleston, MD.  Not knowing how this new system works yet, after I successfully cancelled with the one and scheduled with the other, it seemed appropriate to make sure The Huddleston was amenable to seeing me, given my 21-minute snafu on 12 May.

The new insurance monolith has a nifty email system that enables patients to contact physicians.  I'm sure it is the bane of their existence.  But, I'm appreciative of it, as an email is infinitely preferable to phoning, sitting on hold, and listening to bad bad music.  It also beats the crap out of having to go somewhere...

And so I present you with the history of my correspondence with the Hubris of Huddleston, going back to 11 May, the eve of what shall forever be known as the "Neuro Exam Rape."

I will shade my parts in the healing shade of green and back Dr. Huddleston's purple prose in labile lavender.

To:
Daniel E Huddleston, MD
From:
L. Ryan
Sent:
5/11/2014  8:28 AM EDT
Dr. Huddleston, I have my 1st appt w/you tomorrow morning - should have composed this email much earlier. I want to let you know ahead of time what my most pressing concerns are, as KP appts seem to be clock-driven! I've had CRPS for 12 years, 1st as CRPS type 2 in my right leg and left arm, then, with "spread" to the left leg and right arm, as well as part of the face. Pain is obviously a problem, but other things supersede pain issues at the moment: horrible, distressing spasms/cramps/dystonia/what-ev-er that last many hours at a time; general disorientation as to where I am in space (where is my arm?! is that my left or right leg?!); hands and feet not responding as I hoped (or "clutziness," and getting "stuck" while trying to walk), and lastly, high BP that I think is related to CRPS, and for which I'd like to try (per a KP pharmacist's suggestion) clonidine or nifedipine rather than what I am on. I hope this email is not irritating, I wanted just to help organize my first visit.

The next day: Neuro Exam Rape by Dr. RJW, after Huddleston refused to see me, as I arrived late.

Today, hope springing eternal, I made another appointment, at which time it seemed only fair to double check his willingness to see me.  Ergo, this email:

To:
Daniel E Huddleston, MD
From:
L. Ryan
Sent:
5/21/2014 12:25 PM EDT
Attachments:
CRPS, legs 
Scheduled to see you 12 May 2014, I was late and lost the opportunity. Instead, I saw Dr. Wilensky. That proved unsatisfactory. I have suffered worsening of CRPS symptoms as a result of an aggressive exam. I opted for you, to begin with, because of your stated interest in "movement disorders." I rescheduled with you at the Southwood location for 21 August. Please let me know if you are amenable to seeing me. I've had CRPS for 12 years. Dr. Barry Mccasland, no longer available under my new KP insurance, finally classified it as "total body." My main problem now? Spasms that are painful and debilitating. Dr. W increased my baclofen dosage and that HAS helped, but I fear taking too much. I will proceed with the plan to try again to see you on 21 August, unless you object. Thank you very much for your time and consideration. Attached is an image of my legs, site of most spasms (from foot to hip, small of back).

 I did not expect a response, really, and certainly not within hours, but there it was, and here it is for your reading pleasure:

RE: Trying again to see you

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To:
L. Ryan
From:
Daniel E Huddleston, MD
Received:
5/21/2014  4:01 PM EDT
Hello Lisa,

I would like to help you, but need to be able to see you and examine you in the office to do so. I do consider CRPS in most cases to have a psychogenic basis or at least a significant psychogenic contribution. Often this is not the answer patients are looking for, particularly when they have seen multiple providers. Again, I haven't seen you so cannot draw any conclusions at this point, but this is an issue I don't shy away from because it is frequently the "elephant in the room" and is a potential route to improved quality of life for many patients. For skin changes (which appear to be a concern based on the photo you sent), I would also recommend that you consider seeing dermatology. I look forward to seeing you at your appointment with me. 

Best,
Dan Huddleston, MD

Let's see.  He's another Jose "The Turd" Ochoa fan, plus he decides that I am "doctor shopping." Why else would I see "multiple providers"?

I looked into the abyss.

L. Ryan
Sent:
5/21/2014  4:21 PM EDT
Would it make a difference to know that there are documented lesions, that I began with "causalgia"? Psyche/soma is no elephant in my environs, but I also do not wish to waste my time. That said, I will probably cancel. I've been through an evaluation with Anne McKenzie-Brown at Emory, subanesthetic ketamine at Shepherd, put up with a doctor who wanted women from his church to apply an herb wrap cum prayers... I don't think I need to put up with much more. My case is complicated with an untreatable osteomyelitis, and other junk. 
No need to think about it. I'm done.

And, Dear Readers, I am.  Done.

I will dutifully see the Pain Management Folks, dutifully follow up with the Primary Care Doctor whose knowledge of CRPS extended to... "Wait!  I know that.  That's like RSD.  Reflex something-something. But more importantly, what the heck is wrong with your legs...?"

One day I will laugh about it, you say?
No, Friend, those days are over.














© 2013 L. Ryan