My Trouble Finder

20171006_083642[1]
The Author Did Manage to Get up From This Yoga Pose Unassisted
My day’s highlight came early. The secretary of my Primary Care Physician (PCP) phoned me to remind me of my upcoming appointment with him.  Immediately I cringed. Uh-oh, it’s time again for the good doctor to look for unpleasant issues with my body.  It’s his job, his livelihood.

So at the appointed hour, I showed up at the PCP’s office, braced to hear everything that’s the matter with me.  The handsome Southern Orange County doctor scooted into the examination room where I sat after my current weight and vitals had been established. He scoots because a water skiing accident in his youth smashed his tailbone, so I heard.

He started the session by reporting to me the results of the pre-visit blood tests.  Most results are good, he declared with a smile.  But your kidney function test numbers aren’t so good.  We call those numbers Chronic Kidney Disease (CKD) Stage 3.  Stage 3? I asked with feigned shock.  That sounds awfully close to Stage 4.  My lung cancer is stage 4. Does this mean my body is in various stages of decay? He replied, I won’t say that. The previous test results were the same, which means the CKD is stable.  Aha, I said. That would be me: Ms Stable.  Besides, he continued, with CKD your blood pressure should be out of control, but it’s great, and you don’t have other symptoms. We’ll take another blood test in a month and monitor the CKD.

He looked at my weight on the chart.  Let us see if you have lost any weight, he said.  Not me, I disagreed right away.  It’s just perfect right now for a string bikini.  He responded: You’re the hippest senior I see.  No other senior comes in here for a check up carrying a loaded backpack and wearing Z-Coil shoes.

He kneaded my neck, searching for swollen lymph nodes.  Nothing there, he announced. Then he ordered me to sit on the examination table: Get up here, Slim.  He raised the back of my aquamarine blouse to do some stethoscope motions on bare skin.  A strawberry-ice-cream-colored bra greeted his eyeballs.  Sexy bra, he said, and laughed. I’m not big on color coordinated underwear, I confessed, and we laughed.  Having found nothing wrong with me yet, he proceeded to drill a small flashlight into my nostrils.  You should have allergies, he insisted. But I don’t, I said. He saw nothing and gave up.

Tell me before we say goodbye if there’s anything wrong with you, PCP enjoined with a sense of urgency.  Under pressure I felt I had to say something: Bunion. Ten years ago I spent a lot time pondering what to do with the bunion on the outside of the big toe of my right foot.  Then came the lung cancer Stage 4 diagnosis and eight months to live prognosis.  Suddenly the bunion issue became the least of my concerns. Now it’s front and center again.  He was quick: Good!  I’ll refer you to Dr Paa (fictitious name; “paa” is Filipino word for feet).  He will advise you to either change your shoes or your foot. I exclaimed, I like it! He took advantage of my enthusiasm, I still want you to get a colonoscopy.  He was so totally pushing.  The last gastroenterologist I saw said nothing needed to be done.  Okay, I grudgingly agreed.  I’m retired.  I’ve nothing else to do.

In conclusion, PCP’s nurse gave me a pneumonia shot and a flu shot.  Then PCP gave her instructions: (a) Get approvals for a new gastroenterologist for the colonoscopy, a podiatrist for the bunion, and the opthalmologist for the annual eye exam.  (b) Prepare a requisition for kidney and liver function blood tests to be performed in mid-November.   Finally, he turned to me and said, Next time bring all the medicines you’re taking. I just feel better when I see them. My turn to think.  I suspect he remembered that instead of the calcium pills prescribed by him, I had bought calcium gummies.  I had complained that the calcium pills were too big and like horse pills.  Get the petites, he had ordered. He probably wanted to be sure next time that I am in compliance.

PCP was determined to keep the retired senior babe shuffling.

Is your PCP like my PCP?

 

 

 

 

 

 

 

 

 

 

An Appointment With the Gastroenterologist

20170703_111159[1].jpg
The Digestive System – One of the Great Equalizers in the Human Race
Between my Oncologist (Onc) and my Primary Care Physician (PCP), I have had more appointments with specialist doctors than I can remember. It’s probably a good thing because I’ve learned a lot.  Now I can decide which branch of medicine I’d major in when I grow up.  At the same time, going to and from these doctors and writing about them give me something to do, write about, and share with those who give a hoot.

The latest medical specialist who examined me was a gastroenterologist (GE), a doctor specialized in the human digestive system, which includes the esophagus, liver, stomach, gallbladder, pancreas, large intestines, small intestines, appendix, rectum, and anus. It makes me wonder, After dealing with those body parts steadily, does the good doctor eat soul food such as chitlins or the Filipino dish called “dinuguan?”

I am not a hypochondriac preoccupied with my and only my own health issues.  My Onc had sent me to GE after the liver MRI specialist already declared there’s nothing wrong with my liver, in agreement with the CTscan radiologist.  But no!  My Onc had a need to  know why a portion of my common bile duct is distended, even after I told him I’ve had that since the CO-1686 clinical trial three years ago and Dr Brevity never got excited about it.  But Onc insisted, so off to GE I shuffled for my appointment.

What can we do for you today? asked the 20-something intake aide.  I thought you’re going to tell me, I replied with a smile.  She flipped through my record.  It’s hard to find something if one does not know what one’s looking for.  I asked her, Are you the Physician’s Assistant (PA)? The PA, like the Nursing Practitioner, is the closest thing to being a doctor.  Oh no, she said.  With nothing else to do, the intake aide asked me my weight and height, told me the PA will see me in a few minutes and then took off.

The wait for PA was more like 45 minutes.  I suspected she was studying my medical records.  PA, a 35ish Chinese beauty, came in seemingly happy.  She had figured out the purpose of my appointment!  It’s your common bile duct, she said. How long have you had that condition? Three years, I answered. She asked, And you’ve had no symptoms? Like, your urine is not cola colored? Your stool is not pale? To all her questions, I answered “no.”  She instructed me to lie down face up on the examination bed. She poked hard at various points on my tummy to elicit a scream or screams.  No screams occurred because nothing hurt me other than her painted fingernails.  Finally exasperated, she said, I think an invasive procedure to find out what’s wrong with your common bile duct should not be done.  It will do more harm than good.  But I’ll ask GE. He has the final say on this matter.  I’ll phone you as soon as I find out his decision.  Great! I exclaimed. I resisted the urge to do a somersault to celebrate.

Do you drink alcohol? She asked as a parting shot.  I answered, Yes, once a week at a dance in the retirement resort.   It sounded like an innocent confession.  Of course I minimized the fact that the dance event features a live band and BYOE or Bring Your Own Everything, which is wide open to interpretation, as in bring your own everything from the cellar.  Thank goodness the dance is only from 6:00pm to 9:00pm.  With the resort’s bus limo service, I make it to my manor upright every time.

The next day, PA phoned and told me GE said there’s no need to do anything with me.  I said, Yes! and pumped my fist in the air.

Let me know what you think about GE or the weekly BYOE dance.