[Giucy]

Ok, long story short. I have ADHD, medicated by ritalin.
I also need foot surgery for hallux valgus and Morton syndrome. Up until there, things are going worse, and GP wrote a letter for the orthopedic surgeon.
However, I can't seem to find one willing to treat me.

One of them asked me, by email, to bring not only the letter from my GP (very normal) and a letter from my hospital psychiatrist prescribing ritalin.
I am not only speechless, but also very angry.
My GP told me that it was a subtle-not-so-subtle-way for denial of care. She (my GP is a woman) says that the surgeon is afraid of having to deal with drug addicts buying ritalin at black market.

So, in surgeon's mind, ritalin = drug addict and trafficker, lazy, weak-willed and that everything will disappear if ADHD patients were willing to move their butt for some therapy.
Some doctors assumed that because I take ritalin, it would mean I'd had a hefty criminal record for drug trafficking. A doctor cannot get my criminal record unless I am court-ordered to see him. Since I see him on a voluntary basis, he cannot get my criminal record.
And what is the relevance of knowing my criminal record for a foot surgeon ? I do. not. get. it.
Why all those assumptions ? Ah yeah, because medias here portray people with ADHD as overdiagnosed, for an overprescribed med they sell on the black market. I cringe on this !

WTF has my ADHD has anything to do with needing a foot surgery ?
If surgeon needs to check for drug interactions, he does not need a letter from my prescribing pdoc !
I see him only once a year, prescriptions are renewed and side effects are monitored by my GP. Seeing my hospital psychiatrist would mean 4 months of waiting list.
For what ?
I wish I could scream for such an absurd situation.

I just need right now to feel heard, not fixed. I need support to deal with this discrimination.
Feet pain severely limits my walking, and I struggle to find an orthopedic surgeon competent with foot issues who accepts to deal with my feet issues, not making a mess out of nowhere because of ritalin. This is the consequence of orthopedic surgeons refusing to deal with my feet because they are obsessed only by ritalin.

After my surgery, I think about reporting that surgeon to the French medical board. I have an email, so the surgeon won't be able to say "I didn't say it". I also now bring a recorder to the doctor. It looks like paranoia, but I need to back up claims to the medical board.
In the meantime, I'll make an appointment with the university doctor, who really gets denial of care for people with ADHD to get some help for finding a surgeon.
I must not accept it, and those surgeons need to be held accountable for suc discrimination. Feeling like a sorry excuse of a human being is the scar left with denial of care : "you don't have the right to get medical care unless you are willing enough to go to therapy and detox with ritalin", that's what is implied with such denial of care.
I need support and the courage to munster my guts and report such discrimination to the medical board.

I cringe on all this.
Such a widespread stuff, and surgeons react as if I was a drug addict because of ritalin ?
Being denied basic medical care because of ritalin makes me SCREAM !!!!

[sideblinded]

Wow what an absolutely absurd situation. Ritalin may have some problems but when given at the correct dosages and especially the longer acting ones don't have a bad track record at all. I am so surprised to hear that your doctor is so afraid of it. I am sorry that you are going through all of this. I wouldn't know how to fix your situation even if you wanted someone to. I just think this is horrible. I have been on Ritalin and Adderall and my pdoc kept handing them out with no problem. Maybe media is the problem. Maybe doctors read too much. Geeze.

[Giucy]

Maybe media is the problem

I agree wholeheartedly on this one.

I forwarded the surgeon's email to my pdoc.
Pdoc was absolutely flabbergasted. He was quite ironic about the surgeon. He does not even see the relevance for such letter.
My pdoc encourages me to report discriminatory behavior to the authority. He says that no matter the fact you take ritalin, such behavior from a doctor is unacceptable. He stated last time I saw him that even if I had a criminal record, it has no relevance with asking to be treated for a somatic complaint.
Ritalin is a completely legal medication, sold in pharmacy, and doctors have no bearing to make judgments because I take such a med. Such docs must absolutely be held accountable for such behavior.

Now, I made a firm decision to report such behavior to the French medical board. Doctors need to know that they are not above the law, no matter how much they dislike it.
But first, I need to find a surgeon for my feet who'll treat my feet, not for a good character assessment. Much easier said than done !

In the meantime, I have no reason to accept such absurd request. No way : it's a matter of self-respect.

[-jimi-]

Self respect is important. I get so angry when health care pulls this crap. AHHHHH!

I feel for you. But glad you have some in health care on your side.

I'm also refused care because of things to do with mental health. I know it would help me if I pushed this but I can't be bothered.

But I hope you do everything you can to right the wrongs.

Originally Posted by -jimi-

I hope you do everything you can to right the wrongs.

I do as well with this.

This situation is outrageous.

[avlady]

i feel sorry for you, the stigma is following you, and at your own doctors office!!!

[Giucy]

Thank you for your words.

I take comfort that since everything was said by email, this blatant discrimination will be easy to prove to the medical board.
It won't be word against word, only written words.

I'm also refused care because of things to do with mental health. I know it would help me if I pushed this but I can't be bothered.

What about buying a hidden recorder and bring it to the doctor ? That could help you to prove the illegal refusal of care.
I think about buying one and bringing it to the doctor. Testing the functioning with my GP and then, every time I go to the doctor, recording everything.
My GP is completely ok with this idea because it can help backing up my allegations when it needs. Such a recording can be admitted as evidence provided certain conditions.

[OwlReally]

Giucy, I see you live in France...I've heard from several friends with ADHD who live in Europe that the stigma over there against mental illness and ADHD meds is very strong. I really feel for you--I live in the US and I'd say doctors here are maybe one or two clicks more accepting, but some are quite awful, and the general population has the idea that if you're on ADHD meds and not a small child you're either a junkie or (if you're a woman, so a lovely dose of sexism there as well) that you're using stimulants to lose weight. I had a pharmacist lie to me about when I could pick up my prescription and then yell at me when I told her that she'd told me the specific date, tell me I was a liar and she "wasn't giving me my pills and that's that" when I pushed her on her mistake. (I probably should have backed off but I was having a bad day and I ended up just switching pharmacies.)

I know if I walked into that pharmacy with a leg brace or a chronic physical illness like MS nobody would question my needs for meds and it drives me nuts. I hope you get a good surgeon who can help you.

[waggiedog]

Hello there Giuch. Boy oh boy can I relate to your problems or what?? I've come up to this solid medical brick wall many times with my mental health issues, be it Dr's, GP's, but especially the PSYCH DR's!! However, in the end they all band and stick together and you are up the creek in a chicken wire canoe!! YES, I've had big problems with the pharmacy too. Not for ADHD or the same med, doesn't matter, once you've been seen not to act in that ''certain little quiet thankfull mental patient'', and you dare to ask questions, BRICK WALL. Then they kinda write you off in the medical world. Going private is the only way, but you have to be extremely wealthy, most of us are not. I've had Dr's actually lie to me, saying a certain med has been struck off, but your friend continues to be prescribed that med and they don't even need it. I'm now going through the ringer again with my 80 year old Dad, who I live with and I care for. I KNOW negligence has occurred for 5 months and due to this Dad could be in line for leg amputation, so so NOT FUNNY...................But nobody would listen or help us. I've just got home after taking Dad into hospital to emergency, he's got a THIRD infection and they KNOW IT!! Ther KNOW they've ****** up bigtime. However, they will still pull together and either keep him in hospital and treat the huge vascular ulcer or they will send him home with promise of fast care and never heard from again. NO, I don't live on a desert island, I live in London, UK!!! You know, the great british NHS perfect system????? I have had to really push on to try and get him decent pain relief, they couldn't even do that!! I'm not medically trained, even though I happen to know a lot about meds etc (my own interests), but it's been left to me to experiment with pain meds to alleviate the very very severe pain. Today I increased up to the max but it just so happened the nurse who saw the infected ulcer were worried and shocked ~~ they have lost control of the extended necrotising dead flesh, it's fastly beginning to look and smell like gangrenous flesh. Anyway, this just means you are not alone, even in our supposed modern advanced countries. I UNDERSTAND exactly your position hun.

[Giucy]

Originally Posted by OwlReally

Giucy, I see you live in France...I've heard from several friends with ADHD who live in Europe that the stigma over there against mental illness and ADHD meds is very strong. I really feel for you--I live in the US and I'd say doctors here are maybe one or two clicks more accepting, but some are quite awful, and the general population has the idea that if you're on ADHD meds and not a small child you're either a junkie or (if you're a woman, so a lovely dose of sexism there as well) that you're using stimulants to lose weight. I had a pharmacist lie to me about when I could pick up my prescription and then yell at me when I told her that she'd told me the specific date, tell me I was a liar and she "wasn't giving me my pills and that's that" when I pushed her on her mistake. (I probably should have backed off but I was having a bad day and I ended up just switching pharmacies.)

I know if I walked into that pharmacy with a leg brace or a chronic physical illness like MS nobody would question my needs for meds and it drives me nuts. I hope you get a good surgeon who can help you.

I feel for you !

Fortunately, pharmacists never did this. I think that being a student in law helped : they feel afraid when they see that I can bring their own crap to the authority.

The weight-loss thing never happened to me, but I felt it may happen. The junkie stuff, so yes !

Cross my fingers for you to find a decent pharmacy.

[Giucy]

@waggiedog Unfortunately, we're not alone !

My suggestion will worth what it worth, but did you think about a charity like Patient line ?
Also, maybe a charity like Mind could be helpful...
I don't know if you tried them, but maybe they can bring some help.
We are stronger in many than alone.


And I found that the key is setting boundaries with doctors, the strictest you've ever seen ! It's difficult because we get told that we have to rever them as authorities, so changing mindset is hard.
However, setting and maintaining the strictest boundaries possible has been the key for regainin some sanity with doctors.

I am lucky to have a good GP, and feel for you about the crappy one.

Today, I'll call a doctor to whom I was her patient,. It happens that she is a member of the medical board where I live.

[Giucy]

After some pretty bad news, some good news !
After having rained cats and dogs, some sunshine and a rainbow

So, I went to see the doctor member of the medical board.
It was not a good visit.
She told me that I was completely delusional, that the lawyer telling me about discrimination wanted only to suck my money, to quit thinking as a legal lady....
She could immediately see on my body language that I didn't buy any word of that crap !
I now better understand why I didn't want her anymore : she hates when patients rebel against the authority, whatever the issue. She is attracted by power on patients, and she won't present herself for the medical board election.
I respect myself too much for putting up with that crap from doctors, lawyers, whatever....
No wonder that even in HS, I was labeled by her as "difficult patient unwilling to abide with authority".

In the meantime, a friend gave me the name of a competent orthopedic surgeon for feet issues.
I called the clinic. The secretary wanted me to talk directly with the doctor, instead of having the answer from her or another secretary. She accepted my request instead of labeling it "by a difficult hysterical patient".
This is a good sign
I am cautiously hopeful that it'll work in my head. In my heart, I am happy because I have a strange feeling it will work.
I prefer being cautiously hopeful not to be disappointed if finally, it does not work with her (the orthopedic surgeon is a lady).

I also told my GP about my shrink's answer. She was answering to it as "ok" with an implied feeling "it confirms that such request smells very badly about the practitioner".
She told me that if a doctor says that my thinking is delusional about discrimination, then, such doctor does not know me and does not know the true meaning of delusional thinking !
She ended the call by telling me she has confidence in the way I call BS for what it is and take action.

Having my GP and my pdoc helped me not to feel nuts, and not agreeing with seeing myself as "psychotic delusional stupid patient unwilling to follow the rules because she is a bad person".
I told it before, but I hang on pdoc' and GP's benediction to report bad behavior from practitioners.
Both always remind me that "no matter they are doctors, psych patient or not, doctors are not above the law even if they hate it". Neurologist and the university doctor told me exactly the same thing, hardly word per word.
These encouragements feel like a lifeline not to become completely nuts. It also keeps self-hate from disrupting daily life.

So, I am neither good nor bad. I can function, and enjoy some cooking shows without an ounce of guilt.

I have a glimpse of hope that it will be ok, that I'll find a surgeon and be treated as a person and not as a stereotype.
So little, and so much at the same time.

[Giucy]

Wow, what a hectic day yesterday !

So, the lady surgeon called me back in the evening.
When she knew about the orthopedic surgeon asking a letter from the shrink, she was outraged. She told me that :
1) we need to take care about this when we know we need surgery
2) if there is a problem with this med, we can change the type of anesthesia
3) she looked at the Vidal for this med and in her opinion, there's no concern about ritalin for surgery : we don't need a letter from a specialist to look at the Vidal (French book for medication, similar to the Compendium in Belgium or Switzerland) !

The cherry on the cake is finding that her fees are very reasonable despite she is located in a posh place and she has a lot of experience. My friend thought she didn't practice any more, but turns out she does practice.
I was pleasantly surprised to know that her fees are very fair.

She asked me surgeon's name. When she knew his name, she was not surprised : for her, that surgeon is so afraid of being sued and increasing insurance premium that he prefers covering his butt. She did not like him much as a surgeon, to say the least !

I really feel her as a doctor. So, on Monday, I call her secretary to book an appointment.

Still cautiously optimistic in my head, but it sounds crazy hope in my heart. I don't want to be disappointed, but I cannot help feeling faith that it'll work.

[MotherMarcus]

Wow ! That's quite an ordeal. When do you go in for surgery ? I've had surgery on both feet ( not at the same time ) so I know at least what to expect.

[Giucy]

Originally Posted by MotherMarcus

Wow ! That's quite an ordeal. When do you go in for surgery ? I've had surgery on both feet ( not at the same time ) so I know at least what to expect.

I don't know yet if surgery will be in order.
The need for surgery is likely, but is not certain yet.

Seeing surgeon on Friday 20th.

[Werewoman]

I have ADHD and PTSD. I choose not to take meds for the ADHD, but I take Klonopin for the overwhelming anxiety that is part of my PTSD symptoms.

I not only rarely, if ever, tell anyone about my ADHD, I also don't tell anyone about my PTSD and I especially don't tell anyone I take Klonopin. I'm not sure I would tell a healthcare professional for fear that they either will refuse to treat me or treat me like a drug addict.

I realize there are people out there who abuse Klonopin, but there are also those of us who need it to function on a daily basis. If I get addicted to it, I will deal with it when it happens, but for now, treating my anxiety is more important to me than worrying about something that so far has not happened yet.

I applaud your efforts and most of all your courage to fight back against the prejudice you and the rest of us taking such meds don't deserve.

Take care and keep us posted on how things go with your feet.

WW

[Giucy]

The stimulant for ADHD does the trick to treat my anxiety.
Benzo gives me some memory troubles worse than the anxiety itself, and older antihistamines turn me into a zombie.

Unfortunately, things can change only when we fight back against prejudice. Here, it took at least five decades to have equal opportunities laws for people with disabilities, and we still have a long way to go for full inclusion.
Passion for righting the wrongs is what gives you the strength to fight back. It was also the key for being passionate with law when I was 8 years old. In HS, I was nicknamed Antigone (in the Greek tragedy). Still carrying Antigone in my purse to remember this fight, even at my smallest level.
The more we keep quiet in front of prejudice, the more you give it space to flourish. It becomes a vicious circle.

I know it's easier said than done, but the first step to eradicate prejudice is speaking up, beginning at your smaller level. Like psychotherapy, it may be worse before it gets better.

I know it sounds cliché and cheesy, but you find the courage to fight back against prejudice by reading inspiring stories.
Most inspiring ones have been Antigone, but also Françoise Rudetzki, Miep (she hid Anne Frank and her family during WW2), Isadora Duncan. Think also of Nelson Mandela, or Martin Luther King, but also on less known but equally inspiring people.
They are a source to keep going when you feel like giving up.

[Giucy]

Sorry for being late about the news.

So, I saw the surgeon yesterday. Based on the MRI and the physical exam, she concluded that my feet issues are due to a nerve that has not enough space.
No wonder ibuprofen, paracetamol and the OTC analgesic don't work ! We'll probably need Tramadol, but I'm terribly afraid of becoming addict to Tramadol. My dad has had substance abuse issues : becoming an addict is my first fear with this kind of meds.

So, she ordered me to put Emla on the painful area to see if it works.
We also tried a low dose of prednisolone (5mg) : great for the pain, but behavior was horrible.
Emla by itself works as a charm, but is quite expensive.

So, at the next appointment, we'll review the treatment. She thought about an EMG (electromyogram) before infiltrations to know exactly where is the painful area on the nerve.
And the last resort will be surgery.

She took my pain very seriously, unlike previous docs who tried the same stuff already tried and didn't work at all while thinking that my mental state was all in my head. Nope.
She was quite surprised that even in unbearable pain, I couldn't express much. Mom explained to her that even when I am in great deal of pain, I won't be able to express much of it.
The surgeon understood that we must go right off the bat towards the unconventional directions. I am relieved on this outcome, being heard and her willingness to fight against pain.

She wanted also to be sure that meds were not the culprit. We looked at ritalin's side effects, but nerve pain was not listed. Also, I have always been very sensitive on feet since I was a toddler, so ritalin and/or aerius are unlikely the culprit.
The surgeon was very surprised that my regular meds were only ritalin and aerius, because such pain classically comes with much heavier prescriptions than mine.

At the end, right before we left, I showed to her the e-mail from the surgeon who asked me the letter from my pdoc and my pdoc's answer.
Her non-verbal showed she was flabbergasted. She then asked me if it was the first time I had such responses. I replied to her that it was not the first time it happened, but it was the first time I have evidence beyond the hearsay.
Still, she was appalled on this.

Cherry on the sundae, she does not charge more than what Social Security refunds.
Usually in France, doctors with her reputation and her experience charge more than Social Security rate.
The clinic is located in a posh place, but their politic is a Social Security tariff rate and welcoming even very poor people (people with CMU or AME, many healthcare professionals refuse to treat them).

A very good outcome and a crazy hope !

[MotherMarcus]

YAY ! Amazing progress. Keep us in the loop.

[nefess]

I had kind of the same thing happen to me with my regular doctor. When she was going to prescribe me Straterra after the first medicine had horrible effects, I asked for Adderral instead. because my cousin had taken it and he did really well on it. I had no idea at all that it was a controlled medicine or that some people take it for a 'high' or whatever. I was totally 100% clueless. She accused me of drug-seeking and made me cry. I was really hurt by it, and it caught me totally off guard. It's really sad that the medicines that we need in order to function well in life would make people think those things but I'm learning now that it happens )))):

[Giucy]

Some update about telling to the authorities.
Before doing anything with the medical board, I wanted to go towards the Ombudsman of rights.
They have a specialized section for dealing with discrimination and everything with them is free of charge.
Its biggest advantage is that whatever I decide to follow a criminal, civil or administrative procedure, the Ombudsman's recommendations are considered as a valid evidence. My job is bringing a set of arguments that makes discrimination believable ; the Ombudsman of rights' job is obtaining explanations from the surgeon.

Since "the children' shoemaker always go barefoot" (I am a student in law), I preferred making an appointment with a delegate rather than dealing alone with this situation. I also refused listening to mom's advice because her best intentions translate into misguided advice based on assumptions.
I wholeheartedly accept that her wish to help me is sincere and that she genuinely believes that her assumptions are correct in her mind. OTOH, the facts show that her assumptions are untrue.
It sometimes leads to heated discussions because she takes offense when I refuse listening to her advice. First, she gives advice I didn't ask and second, her advice are completely incorrect.
It's already bothersome receiving advice I didn't ask, I am even more pissed off when the advice is incorrect and mom adamantly insists that the advice is correct "because I am your mom so I know better how it works".
Being my mom does not make her advice more correct, no matter how much we love each other.
The biggest positive change in our mother-daughter relationship is on my side, being more competent in acknowledging good intention when I criticize a negative result while on her side, she understands much better that criticizing the negative result of her advice/action is independent of having a strong loving mother-daughter relationship.
This progress seems small, but my inability to separate intention and result was actually one of my biggest hurdle for meaningful relationships. This skill took years to master, one baby step at time.
I digress, I digress...

So, the appointment took place on Friday.
I brought my smartphone with enough battery because I had to show emails. The stress level skyrocketed in the waiting room because I was afraid of not being believed.
The actual appointment was overall positive.
I explained about being asked a letter for a first appointment to an orthopedic surgeon for feet issues and showed him the surgeon's email. The delegate's first answer was that it was not a discrimination since the surgeon did not say no, but asked a letter from my hospital pdoc.
I replied that although the surgeon did not say no, he gave a prohibitive condition to get medical care for him since seeing my hospital pdoc means four months of waiting list. I also informed him that as my PCP as my current surgeon find that such request without even meeting me is very odd.
I made also the delegate read my email to surgeon for better understanding the issue. The delegate congratulated me for having written such a clear and straightforward email to surgeon.
I also showed my hospital pdoc's answer to surgeon request.
The delegate asked me why did I ask such a question before making an appointment. I answered truthfully that I ask this question because I don't want to risk being mistreated again by a doctor only because I take ritalin.
I added that medical encounters are a major stress and that I've been diagnosed with PTSD after having faced a hospital doctor threatening with throwing things at me in his office (he also yelled and insulted me, then asked how could he be responsible that I was crying).

After having gathered all the relevant info, he concluded that even if discrimination was not his speciality, the emails I provided made him conclude that we have clues for discrimination.
First, the delegate informed me that since surgeon didn't even meet me and that my email does not say anything about the prescribing doctor nor why I take this med, he felt very uneasy about how the surgeon's reply pulled the psychiatrist out of the air.
Second, the delegate felt that asking such a letter before even meeting me, even assessing anything about my feet issues, let alone deciding anything about surgery, was quite odd.
Third, the email where my hospital pdoc fails to understand the relevance of such a letter for foot surgery was a very strong element for delegate's opinion.

Finally, the delegate referred me to another delegate specialized in discrimination issues.
I see this delegate on Wednesday. I remain cautiously optimistic about this delegate :-/

[Giucy]

Sorry for the late update, tons of work to catch up with uni.
Thanks God, the material to learn was mostly revisions for material I was already self-taught before going back to uni. That was a very good surprise indeed

So, after having seen the first delegate, I was sent to see another delegate more specialized in discrimination issues.
I showed to her the surgeon's and pdoc's emails.
At the end, she told me the exact same thing as the first delegate I saw : we have enough clues for blatant discrimination.
Like the first delegate, she thought that mentioning the « psychiatrist » for the surgeon was odd because I didn't say anything about the prescribing doctor, nor the reason I take ritalin.
Also, by reading my pdoc's email, she understood that the letter was irrelevant to my feet issues.
For her, surgeon asking a letter irrelevant to the issue only because I take ritalin was strong clues for discrimination.
After having forwarded surgeon' and pdoc's email, she decided to transfer my file to the headquarters.

I could have decided to write directly to the headquarters before seeing the 1st delegate, but I preferred asking advice to a more objective professional.
Being directly inside the situation may blur my judgement, so it can be easy to make costly mistakes. And even when my legal reasoning is solid rock, emotions take the upper hand to the point I cannot convey the message to the authority.

A few days later, I received the acknowledgment receipt from the headquarters.

Now, we need to wait. You can have to wait for one year to get the final answer.
The final outcome is not in my hands any more now.