First Interview
Conflicts:MC faces a conflict of her autoimmune disease and all of the treatments that MC has tried and has the problem of not having quality of life. For example, in the first interview A asks MC a question about MC's physician.
A: Okay, How has your doctor described to you what your case is in regards to your condition as well as if he has or had any cases that is similar to yours?
MC: He has similar cases like mine, but they can take other medications that I can't take because my body rejects and the patients have a life, a quality of life better than mine. Because I have Lupus. If I don't have the problem of always going to the hospital, receive blood, have transfusions, ahhh, my bones hurt, I have poor quality of life.
A: Okay, can you tell me a story when you as a patient did not comply to the doctors requirement for your treatment?
MC: No, I haven't failed with any treatment given by my doctor. Just the Prednisone, I never liked that medication. I tried to take it, I'm not saying daily, but there were weeks that I would take it the full week, but there were other weeks that it wouldn't settle right with me.
A: While under treatment, have you ever disagreed with his regimen? If so, describe the reaction of the physician as well as yours?
MC: It's not the disagreement, it's the anger, that I feel inside. I do the treatment that my physician gives and it doesn't resolve my life, it's not one of my failure, it's the anger that I have inside of me. All of the trying, the medications, force myself and all of a sudden it goes back to zero.
Chronological:
A: Tell me a story when you were happy with the treatment, your physician prescribed to you?
MC: In the beginning when I first began taking the injections, what's the name?
A: Humira
MC: Humira, I was. I thought that I got to the moment of bettering my condition, but unfortunately it only lasted about one or two months then it went back to the beginning.
Turning Point:
A: How has your medical condition affected you as a person?
MC: Oh! A lot! It affected a lot, a lot. I'm not the same, there are day's I am desperate.
(MC begins to cry)
MC: What did I say?
A: You feel desperate, not the same, feel sad, very nervous
MC: (Sobbing) Yeah!
Agency:
A (interviewer) didn't respond to MC's answer.
A: hmmm...Tell me a story when you weren't happy with the treatment your physician prescribed to you?
MC: Someone with the life condition that I have is never happy because I live always being worried, it it's today I'll bleed or is it tomorrow the hemoglobin is low. If it's low, everything turns to be the same. It's transfusions, hospitals. It's a life that I have no quality at all, I can't do certain things that other people can do. I can't work. I have to do things much slower, yet I bleed. Many things I no longer can do, it's difficult.
A: Okay, can you tell me a story, when you as a patient did not comply to the doctors requirement for your treatment?
The hmmm and okay, both are indicators of A's way of not asking for new information based on the answers provided by MC. A wasn't in control when MC gave her answers.
Thematic: MC is emotional about her medical condition because MC always refers to have no or poor quality of life.
A: In your words, how would you describe your case in regards to your medical condition?
MC: Ahh, it's a critical medical condition because majority of the time. I'm afraid to bleed, end up in the hospital get blood transfusions. I need to do the treatment I need to do like go for Endoscopy's, cauterizations. All of this, I can't live normally, I don't have quality of life.
A: Okay, How has your doctor described to you what your case is in regards to your condition as well as if he has or had any case's that is similar to yours?
MC: He has similar cases like mine, but they can take other medications that I can't take because my body rejects and the other patients have a life, a quality of life better than mine. Because I have Lupus. If I don't have the problem of alway's going to hospital, receive blood, have transfusions, ahhh my bones hurt, I have poor quality of life.
Second Interview
Agency:
A (interviewer) was in more control, asking questions following answers provided by MC.
A: Describe your condition in more details? Tell me how your symptoms were in the beginning of your medical condition up to now?
MC: In the beginning I felt well. I didn't have problems, didn't bleed, didn't need blood transfusions, didn't have shortness of breath, I didn't feel pain on my bones.
(Silence)
I had a normal life like any other person. I worked.
A: How many hours did you work?
MC: I worked 30 years, I did my home life entirely. I would cook for the family. Little by little I became tired, I would become tired more.I didn't have any force to leave the house to go out and take a ride with the family. I had pain in my bones.
In the second interview A was in more control of the interview, asking questions that would be asked in the middle when MC provided answers to specific questions.
NOW/THEN:
A: How long ago did this happen to you?
MC: It was (pauses) two years ago, wait no, it was from 2011 into 2012. In 2011, I was feeling tired with pain. I didn't want to leave. I remember that we were close to Christmas time and I was with the family at the mall, buying gifts and I felt horrible. I remember that I had to sit on the floor because the pain was so much, painful on my bones that I even cried and from there (Pauses).
Conflicts:
A: Describe to me more of what you mean about being happy with this treatment?
MC: Oh, because I stopped having pains, my blood levels were stablized, my hemoglobin wasn't that low and I was in a better state. I was able to live my life freely. I still worked. After the day of 19th of December 2012, it was when everything happened.
A: And with this treatment of the Humira, how often did you do this treatment and for how long?
MC: It was once, one injection every two weeks for two months. But on the second month, half way through, I began feeling tired. I would become really tired especially after going up a flight of stairs, whatever little thing I would do, I felt tired. So I went to the doctors and the doctor said I can no longer take the injections because it wasn't helping, it was only harming me. And from there on, I kept going to the hospital, receiving blood transfusions.
A: Speaking about your physician, Tell me more of when you and your physician wouldn't see things eye to eye when it comes to your condition?
MC: When I don't agree with the doctor, neither is the doctor in agreement with my opinion; which in reality I don't know anything about medicine, but I feel. My body and system, what's wrong and sometimes he says it's mentally and I say it's not. And he says that I have to take medication to sleep and I hate sleeping pills.
A: How come?
MC: I don't like it, I never did. I feel sick with sleeping pills or relaxers. Just the state of being apathic and not have a sense of anything. The silence is horrible.
A: Explain to me a situation when you and your physician didn't see eye to eye?
MC:
MC: It was when I began taking Prednisone that makes your blood sugar levels go high. It was that when my blood sugar levels were becoming high and I didn't want my levels to be high. So I would avoid eating so my levels wouldn't be so high and he didn't want that, he wanted me to eat so he gave me insulin. But I was never satisfied in taking insulin because its been years with just the pills and never did it pass the levels of 130, the max 150, if that. But with Prednisone it started going to the 300 levels and I didn't want to take insulin. The doctor kept insisting that I needed to take it to help my blood sugar levels. I took it, he began increasing the insulin dosage, more and more until I started feeling sick. That was when I told my physician that I can't handle this much of insulin, I feel sick. But you have to take it and I would say No because I feel sick.
MC: It was when I began taking Prednisone that makes your blood sugar levels go high. It was that when my blood sugar levels were becoming high and I didn't want my levels to be high. So I would avoid eating so my levels wouldn't be so high and he didn't want that, he wanted me to eat so he gave me insulin. But I was never satisfied in taking insulin because its been years with just the pills and never did it pass the levels of 130, the max 150, if that. But with Prednisone it started going to the 300 levels and I didn't want to take insulin. The doctor kept insisting that I needed to take it to help my blood sugar levels. I took it, he began increasing the insulin dosage, more and more until I started feeling sick. That was when I told my physician that I can't handle this much of insulin, I feel sick. But you have to take it and I would say No because I feel sick.
Thematic: Same symptoms as before comes up when A and MC talk about trying new medications. It's thematic because in many parts of the interview MC mentions, "same, back to the beginning."
THEN/NOW: When MC describes to A what her medical condition is. She refers to back from the beginning to now. When it all started and how it is now while under treatment.
In the first interview A was leading MC in answering the questions, A wasn't responding back with follow up questions. MC due to the state of being she was in, it took a couple of minutes to take awhile to answer. A would also help MC with names of medications that MC wasn't able to remember. MC falls into the desperate patient, who wants a treatment that will last in the long run. In the first interview MC was very emotional compared to the second interview.
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