Dr. Richard Hudson -- Switching Doctors
Hey all. I've been seeing Dr. Richard Hudson in Atlanta, GA for about two years now, but it seems like every visit/interaction with him and his office gets worse. It's a 4 hour drive for me to get to him (making it an 8 hour drive, total), so it's hard to manage. I actually went up there once for an appointment on a friday only to find out that he ( Read more... )
PART ONE -
My first month with Dr. Hudson was honestly a disaster. In 5 weeks, I had 4 visits to his office, 3 phone calls, and my partner had to pick up things. Since then, it has gotten better and better. While I don't exactly consider it a pleasure to go to his office, I no longer think he is trying to kill me. Seriously, in Jan I actually emailed my therapist and was begging for another doctor and that I was going to give him one more chance. He passed his second chance with flying colours and is slowly starting to restore my faith in doctors.
Dr. Hudson's problem seems to be that he wants to discover things for himself and if he doesn't have previous medical records, he will discount what the patient remembers and that he is perhaps overly cautious and overly aggressive in treating possible problems. I would probably be the same way if I was a doctor so I really can't blame him. Unfortunately, that doesn't work for everyone. For example, I have a complex medical history and I have extreme hypersensitivity to many medications. I have several neurological and psychological issues too which makes everything a delicate balancing act.
I started seeing him in December and I have to drive 2 hours each way to see him. First visit, he was ill (which I understand) and he nearly went to the ER. The second visit a week later, I was diagnosed with ADHD (which I have been diagnosed with 3 times in the past but was unmedicated) and tachycardia. I told him I didn't have tachycardia and that I am really scared of doctors, sometimes my vitals go wacky around a doctor, and that I suspected possible white coat syndrome. He actually spent 2.5 hours with me which was a little strange but hey, my medical history IS confusing as hell and in the past no doctor would ever spend that kind of time with me as I was usually sent directly to a nurse and never saw a doctor when I was going to family doctors. I still walked out of there with something like 6 prescriptions (including 3 boxes of free T gel even though my T levels were never checked). I still have no idea how my other lab reports came back since he spent 2.5 hours just trying to deal with what he thought he saw. Plus the way I used to bind made him think I might have asthma and I told him my breathing test was nuts because of how much I was binding since I could squeeze 34DDDDs into a B cup. (Over the course of the month, and three breathing tests, he saw that my breathing test was 97% unbound, 84% partially bound, and less than half capacity when fully bound. I never saw such fear in a doctor's eyes when he saw my breathing was at half capacity. And to think the first test was the 84% which is what he was originally worried about and I told him it was the binding! Told ya so!)
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So I took the beta blockers for the tachycardia, turns out I was right and I nearly ended up in the ER within a few days. I called him at night on Jan 2 and he got back to me quickly. I arrived the next Monday at his office without an appointment (he told me to and apparently he took my file home over the weekend) and then he gave me another prescription for another beta blocker which was almost as bad as the first and I called him again. And I told him I was showing possible signs of hypoxia and that I wanted to stop it. He was convinced I wasn't showing signs of hypoxia and he didn't think the medication could do what I was experiencing. Later, he learned it could do exactly what I said was happening. We stopped that medication and I called him back the next week and left a message. An hour later he called back, and said we would wait on the pulse given it was becoming normal. It wasn't until I gave him a chart showing my morning and afternoon pulse for a month (late Jan) that he agreed with my guess of white coat syndrome.
However, he did find out that given my reaction to the drugs, including the way too high dose of Ritalin that I was on at the time that I absolutely had to stop, that I was one of those people who are just incredibly sensitive to medication. Another thing that I told him previously since I knew that some medications I go nuts on, but since he had no previous medical records of mine, he didn't know if I was just really reluctant to be on medications. He switched me to Strattera which my partner picked up samples of and that was a worse drug and ended up lowering my seizure threshold and gave me absence seizures again.
By Feb, I met the intern (I assume you mean the NP student?) and the visit was wonderful with the exception of a 5 minute rant by him because I need to stop acting like a doctor and act more like a patient. (He was trying to arrange a free hysterectomy and I said my current medical history would not support that.) I thought that his rant was more funny than anything because I should have been a doctor as my family goes to me first before they talk to their doctor to get my opinion. But during that visit, he actually gave me compliments and told the student that he trusts what I have to say as I am very intelligent and seem to be able to articulate exactly what is happening fairly accurately.
My last visit wasn't very eventful even though I did have reactions to several more medications, but I told him what happened, what I think happened, what I did, how I did it, what I was doing now, etc and he was happy with everything with one exception. He was not happy that I had a medical emergency when I was being weaned off Strattera. Then I got the "Look of Death" and was upset with me for not calling him to tell because then he would have weaned me off much more gradually! But everything else was very close to what he would have advised me to do. He now wants to see me every 2 weeks because of my hypersensitivity to medications as we want to get this straightened out, plus it allows him to keep an eye on my transition without making the insurance suspicious since now my insurance knows I am hypersensitive. If you are listed as going there for an ADHD followup, that might be all he does if he sees a lot of patients that day or if there are patients like me who have a very complex medical history or nearly died on him (currently I have nearly died 3 times since Jan because of my reactions to medications, plus I went into shock in pre-op for my top surgery). If he has time, he will do more with you.
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And yes, he can be condescending. He is a doctor. 99% of doctors are like that and I tend to do that myself to my sick family members (and no, I am not a doctor, but I understand where they are coming from as patients tend to think their problem is "just a fluke"). In my experience as someone who has been to a ton of doctors, specialists, surgeons, and have a ton of friends who are doctors, I have only met two in my entire life who never ever acted like that. My top surgeon never ever patronized me. My neurologist also never patronized or did anything of the sort. Everyone else has at some level.
Like most other doctors, if you prove to Dr. Hudson that you are competent and know what you are talking about, it’s amazing how fast he starts to actually listen to you and most of the attitude gets dropped. On the day he reupped my ADHD diagnosis, which I told him that I had been on Ritalin a long time ago for about a week so I wasn't surprised that I still had a severe case ADHD, he told me that based on my therapist's letter where she stated my education (2 bachelors and a masters), I was probably highly intelligent which is why I was able to go without drugs for so long. I still had a pretty severe case of ADHD though, but he didn't realise that I had good medical knowledge too which he learned later. He knows I can go without ADHD medication so he has never told me I would fail my classes if I didn't take the medication. He knows I have found ways to compensate for most things like every other ADHD person on the planet.
The one thing that drives me batshit is that Dr. Hudson wants me on IM injections. I don't want to be on the shots because I tend to have a seizure if I get injected with something. He at one point thought that I was wrong and that I might have been mistaken that I have a seizure disorder since most are absence seizures unless I am being injected. Nope. Trust me. I know what is going on. Hence why I see a neurologist. I wanted the patch or gel. He humoured me for the gel even though he has never successfully started a transition on gel. I can't take Androgel though as I had a nasty reaction. I am ok on Testim, which he keeps getting me coupons for so maybe he understands. I told him about compounded gel and the cost, now he is going out and trying to find out how to write a prescription for me so that I can go specifically on compounded Testim. I am happy about that because he seriously could be an asshole about this and say "Shots or no T at all", but he isn't.
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I really doubt I am going to have the problems I had the first month again. He always remembered to give me prescriptions although sometimes he writes one prescription, then tears it up and rewrites something else. First time I saw him, he did that like 5 times. His office doesn't call me, they never have, but they said that they call only a few patients to remind them. I am having a small billing problem with them from the December visits, but that is getting taken care of. And I also learned why they have such a problem answering their phones (no one has access to their voice mail!), that is a problem they are getting fixed either this week or next week. I didn't know that until last week. But it makes sense.
As for the rest of the staff, I think Jean is possibly one of the best nurses that I have ever met. I want to clone her and require every medical office to have at least one person like Jean on their staff. I also like Goldie (I think is her name?) a lot. His person who does billing is also nice. There are a few people at the front desk who seem to rotate and the only reason I don't like them is because they call me Ms Marsh instead of Mr and I am going to ask why next time. The NP student is very nervous and I enjoyed scaring her a little bit when we first met because she hadn't seen a trans person before. The student is gone in May though so I don't get to scare her for much longer. The only thing they ever misplaced was my therapist's letter twice. Luckily I brought my original several times. My surgeon's office also misplaced their letter too so that might not just be Dr. Hudson's office. I think my therapist just has the ability to make her letters disappear.
My partner, who met him in December, is really creeped out by Dr. Hudson. I think he is convinced Dr. Hudson is an alien or robot or something because he didn't listen to either one of us although I guess I can understand why. Really, he didn't know me from Adam so there was no reason to actually listen. I don't think that my partner will ever go to Dr. Hudson as his doctor unless he absolutely had to and he cannot believe I am starting to warm up to him after my month of hell. But, he (Dr. Hudson that is) is starting to listen and he is starting to understand what is going on and that I was in fact very aware of what is happening to me. I am starting to have enough confidence in Dr. Hudson now to the point where I will refer other people to consider him if they are looking for a new GP even if they are not trans. I always do warn about the attitude though and to be sure you prove to him that you know what you are talking about if he gets all cocky.
The Dr. Hudson I experienced last week was about a 180 from the Dr. Hudson I experienced in December.
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Remember how in part 1 I said my visits to Dr. Hudson kept getting better and better? It really has particularly on this last visit. I think a lot of respect between us has developed and he was actually very sweet. Maybe this is the first step towards dealing with my medical phobias since he rarely tries to inject me or draw blood. The past two visits I actually showed a 100% normal (for me) blood pressure not the elevated one that I usually show. If we could only get that pulse down... He is doing so much in order to help me and he is really going above and beyond the call of duty here. Not only for the trans stuff but the ADHD too.
The staff she'ing me is still annoying and if he doesn't fix the flickering lights in his exam rooms, I will fix them myself.
In all seriousness, if I could spend the next 5 to 10 years with him as my doctor, I think I would be happy. If I'm lucky, maybe that will happen. Otherwise, I will be sad when I leave his practice since I now rank him in my top 10 doctors of all time (#1 among my former PCPs) and he has a shot at making it into the top 5. He almost makes me want to be a family doctor myself.
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When I saw him last week, he said he always listened to his patients. I told him he didn't seem to do it that first time and I reminded him of our first visit and told him that is why my partner was so uneasy. He said that the signs I showed were so rare for white coat syndrome that he didn't know what to make of it! Probably only a few percent showed what I did and that I specifically have to tell people in the future that I have white coat tachycardia. He said that I do tend to come on a little strong though.
He implied he had actually been worried about me inbetween visits. The man called me "charming." He even LAUGHED with me. (I told him I had a trans friend who was deaf and that I would introduce them when he comes down, but that my friend was going to tell him I was a perfect angel all the time. Then he laughed and said obviously my friend would be lying.) I did bring that Trans Signs youtube video to show him because I knew he would like that.
He wasn't particularly pleased with the fact the person at the front desk didn't make the appointment that she was supposed to for me (with Dott), but he was happy that I figured everything out on my own. He knows I am very likely to lose insurance soon so everytime I go in, he is writing things so that I get much more ADHD medication than I need so I can stockpile for when I don't have insurance. He is going to try to write my T gel the same way so I can order a large amount of gel at once. Basically anything to keep me relatively ok and functional until I can regain insurance.
He was really excited with my most recent ADHD results, perhaps too much. He was more excited than I was. And was just shocked at me being almost 2 months on T gel. I'm the first person he has ever tried to successfully transition on the gel. He doesn't like that my voice has not started to break, but has commented on the facial hair. I told him I had that before, but he swears it is much darker than it was and a little fuller. He also told me that I should write a book on transition. I keep good internal notes and he sees what he sees. And he is going out of his way to try to hide everything as much as possible from insurance and to save me money.
I still don't like him as much as I like my top surgeon (who is my #1 doctor of all time), but I have a lot of respect for him now. His heart is really in the right place. This is the Dr. Hudson that I had heard so many positive things about. He did say to stop saying to people that he almost killed me with the Inderal.
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