Warning - longish rant
Finally, after years of dealing with major depression and anxiety disorders, it turns out that there was nothing wrong with me except trusting my endocrinologist when he said everything was fine wrt HRT (hormone replacement therapy).
In what is a probably a fine example of medical malpractice, he had me, after 5 years, on 1/4 the starting dose of estrogen. Son! Of! A! Bitch! Of course, low hormone levels lead to all sorts of risks, including depression ... as well as increased bone decalcification, lack of concentration, continual lack of energy, earlier onset dementia and Alzheimer's, higher risks of cardiovascular disease, etc.
Only after accidentally obtaining my actual blood test results, which I had earlier received by mistake, did I find the error. Had to involve the hospital where he works, and he admitted to me he doesn't check estrogen levels "because they vary over the course of the day." Well, that's why we have standard protocols, including standard dose recommendations, dummy!
From the physician's code of ethics:
44. A physician must practice his profession in accordance with the highest possible current medical standards; to this end, he must, in particular, develop, perfect and keep his knowledge and skills up to date
His actions in seriously under-dosing were not "current medical standards", not in my book.
46. A physician must make his diagnosis with the greatest care, using the most appropriate scientific methods and, if necessary, consulting knowledgeable sources.
If you're going to ignore blood tests, you'd better have a damn good excuse, or better yet, maybe it's a good idea to fall back on standard practices?
47. A physician must avoid omissions, procedures or acts which are unsuitable or contrary to the current information in medical science.
So, no ignoring standard practices.
48. A physician must not resort to insufficiently tested examinations, investigations or treatments, unless they are part of a recognized research project and carried out in a recognized scientific milieu.
49. A physician must, with regard to a patient who wishes to resort to insufficiently tested treatments, inform him of the lack of scientific evidence relative to such treatments, of the risks or disadvantages that could result from them, as well as the advantages he may derive from the usual care, if any.
It's called "informed consent" for a reason. I was never informed that he was not going to go by established standards of treatment, and certainly would not have consented to it if I had been given the particulars.
55. A physician must not decrease the physical, mental or affective capacities of a patient except where such is required for preventive, diagnostic or therapeutic reasons.
That includes not making bad judgment calls that result in physical and mental symptoms of depression, interfere with concentration on a day-to-day basis, make it impossible to work, etc.
85. A physician must refrain from issuing to any person and for any reason whatsoever a false certificate or any information, either verbal or written, which he knows to be erroneous.
That includes saying blood levels were fine when he now admits he ignores estrogen levels in blood tests that were clearly way too low. WTF???? That's the whole point of HRT - to get estrogen levels to the point where they have a therapeutic effect, not just acting no better than a placebo.
The proof is in the pudding.
What motivated me to look for errors was that nothing over the last few years had offered a real fix to the depression - all sorts of medications, alone or together, in various doses, just didn't work, and the PTSD, which I had dealt with for years, had destabilized 3 years ago. When I recently found myself once more waking up one morning right back in the middle of a really "dark place" wondering why I didn't just kill myself and be done with it for good, just hours after I had told one of my sisters that I thought things were finally, maybe, hopefully, getting better, I figured that since nobody could find what was really wrong, it was time for me to check assumptions, one of which was my endocrinologists' saying that hormone-wise, everything was good. Once I found my mistaken assumption, I quadrupled the dose that night, and woke up better than I had been feeling in years. Makes sense, since hormones act very quickly. A surge of adrenaline in response to anger is immediate. An overdose of insulin will put you on the floor within minutes. And PMS? 'Nuff said. Hormones are strong medicine. (And estrogen is a noted anti-depressant, even in tests of one 4mg patch on male test subjects).
So I'm left with a few questions, one of which is - will my ability to code ever return? Despite believing it won't, I've still fired up the old editor every so often, hoping ... after all, after the sexual assault and flesh eating disease, I drew a blank every time I sat in front of the computer for quite a long time. I told people it took 5 months for it to suddenly just "pop back into place", but it turns out that it was much longer - there was an additional intervening year that "sort of got lost" , and I only figured that out in going over the events to write this last part. Oops. Guess it messed me up more than I remembered. But maybe "losing" that extra year was a good thing.
Only time will tell. But damn, it's sure a fine start to 2017. Hope I'm not the only one who can say that. Take care everyone.