What it is Like to be Perceived as a Difficult Patient (Or how I’ve never been happier to shoot green pus in my life)

It’s been feeling really important lately to get back to the blog – I love other social media sites but there’s just not enough space for me to meaningfully talk about a nuanced experience in 60 seconds or less.

After my last appointment, where I found out I still had the large vaginal bump that I thought I had had surgery to get rid of, and then my request to go to pelvic floor physical therapy with post surgical urine retention and increased pelvic floor activation* was denied twice by the same provider because she thought inserting metal rods of increasing sizes into my urethra was the better treatment option, I got a referral to see another specialist.

After the waiting period (because getting into see a doctor always takes more time than you’d expect) I ended up in another female urologist’s office. (Female urology is the specialty, not a characteristic of the provider, although she was also female.) I am sitting in the waiting room, taking in the sights. There are literally books on the importance of listening to patients and getting individualized healthcare sitting on the waiting room side table. I breathe a sigh of relief.

I go to the bathroom. I get called back. I speak to the nurse, and give her a quick rundown of my medical history, my surgery, my sketchy vagina bump, and my symptoms. I go to the bathroom. The specialist comes in. She shakes my hand. She sits down.

“I want you to know that Dr. (who did the Surgery) and I have very similar training. Sometimes I send my upset patients to her, and she sends her upset patients to me, but I am not sure that I can do anything different for you.”

I start to panic, recognizing the familiar feeling of being doubted. Thinking about it now just makes me angry, but when it happened then I was scared.

“I didn’t ever mean to become a difficult or upset patient,” I started. “It is totally possible that your assessment and recommendation will be exactly the same as hers, and that’s okay. I am ready for that possibility. But frankly, I didn’t feel heard or like my values were taken into account, and so it was time for me to find another doctor.” (now can you just put your gloves on so we can get this over with??)

We go through the same song and dance that I had gone through with several other providers, but I know the steps better now. Rather than try to verbally tell her where the nodule is, I use my hands to show her. As she is assessing, she starts to tell me that it feels like a periurethral cyst (a cyst near the urethra). She tells the nurse what she is doing (Milking the urethra. Actually called that. I vomited a little in my mouth.) and all of a sudden she says, “Oh!” in surprise. She calls for the nurse to bring her some sampling swabs. I am still sitting there in the stirrups. She tells me that as she was milking the urethra (ugh.) I began expelling neon green pus.

That’s right. I had Teenage mutant ninja turtles level toxic waste colored pus shooting out of my vagina.

Some people would be disturbed by this. Some people would feel icky and gross. Some people would feel queasy. I felt relieved.

I was relieved that there was an explanation for my symptoms besides me being crazy. I was relieved that of all days for me to pus out of my genitals, it happened on the day that I saw a doctor. I was relieved that this doctor who was sure there wasn’t anything wrong with me got a face full of pus. (Okay, that’s creative license; my range wasn’t nearly that good.)

“So what do you think it is?” I asked. “Honestly, I have never seen anything like that in 30 years of practice,” she said.

We part ways with the understanding that she is going to send my cultures to the lab. I also leave with a referral for pelvic floor physical therapy in hand, which I regard like Charlie’s golden ticket to Willy Wonka.

I don’t know exactly what I am getting myself into, but I’m hopeful that my luck is going to change.

* Basically, when I peed I wasn’t getting all of the urine out because after my surgery my pelvic floor muscles were overactive, which impacted the functional size of my urethra.