Last Monday, I spent enough time at the track to put in 2.5 miles. I didn’t want to be late to my 8 am appointment with my nurse practitioner so I didn’t stay long enough to make it three miles even. First, I found a bathroom and made sure I was comfortable, bladder-wise, and decent.
Making my way into town, I parked in front of the office. It was still a few minutes until 8 but I figured I’d go see if the doors were unlocked yet. They weren’t. I went back to the car and waited until 8. Back to the doors and they were still locked. I pounded on the door but there was no sign of life inside. Maybe my appointment hadn’t been recorded?
By that time, I was getting a little anxious. Was I at the right entrance? I walked all the way around the building and up a hill back to the front door. Knocking again didn’t alert anyone. The pharmacy across the street was open so I went in and asked the pharmacist to call the clinic and see if anyone was home. He obliged and let them know I wanted in.
This trip to the front doors was fruitful. The doors were unlocked and I signed in. The office was full of people I didn’t know. Some I had seen before but I didn’t know their names. There was one familiar face but she was only there to wind up the practice for the retiring doctors.
I sat down in one of the retro orange chairs and looked around the waiting room. It could definitely use some fixing up but that will have to come when the new occupants are established.
Soon, a young man I’d seen before came and called me back. He took my vital signs announcing that my temperature was 96.8. I asked, “Not 98.6?” He said I’d be surprised that not many people registered “normal”. My blood pressure was a little high but that was understandable since I’d recently come from the track and had a hard time getting into the building.
Showing me to an exam room, he put my chart on the door and closed it. There was a speculum warmer on the counter and I remembered how grateful I was the only time I encountered a speculum in that office. I was also glad my reason for being there that day wouldn’t involve such equipment.
I read the notice on the wall across the room that said if I were to require a CT scan, to check with the front desk because my insurance might not pay without pre-approval. They got that right.
Just about then, the woman who had signed me in opened the door. Had I paid my co-pay? No. She waited until I wrote a check which she took and brought me a receipt. I don’t offer money unless asked.
The door opened again and this time it was my nurse practitioner. I’d seen her on several occasions in my former PCP’s office and had known her prior to that when she worked at the hospital.
She listened to my heart, lungs, carotid arteries and seemed satisfied. I told her my PCP had written an order for a TSH after changing my dosage. The lab wouldn’t accept an order from him since he was no longer actively practicing. That’s when she said she would need my records from his office. I presented the manila envelope. She leafed through the pages and said, “So he put you on .1?” according to the note of my other lab results. No, I’d objected to that. It would have been twice what I was taking so he wrote a prescription for .075 for 30 days. That was why I needed another test and a prescription if it came back okay.
There was a puzzled look on her face. She said that once a person is established on a dose as I had been for years, it rarely changed. Looking on into my record, she saw where I had been to the naturopath. Her eyes lit on the word “Parkinson’s” and she looked at me with a shocked expression on her face. I showed her my hand and she had me get up and walk across the little room and back. Then she said, “You’ve researched this, haven’t you?” Well, yes. “You know that one of the symptoms of Parkinson’s is no arm swing.” Yes. I had swung my arms. I always swing my arms. That wasn’t something I was faking.
Then she saw the lab results with my elevated H&H and the note CO exposure, question mark. She asked about it and I told her when I’d had horrendous headaches about the same time the tremor came on. Did I have lab work to detect carbon monoxide? (Carboxyhemoglobin) No. By the time it was suggested as a possible cause, nothing would have shown up. Had I had a CAT scan? No. If she ordered it—she stopped as I was shaking my head. “You wouldn’t have it if I ordered it, would you?” No. I wouldn’t. “Is it your philosophy that if there’s something there you don’t want to know?” I said yes, that’s my philosophy. I’ve seen too many people suffering more from the treatment of something serious than from the condition itself. I told her she knows I’m a non-compliant patient.
“Have you had any vision changes?” Yes, I can see to read even fine print without my glasses now.” She was amazed and said, “I don’t know what to think about you!”
She shook her head as she wrote on the CAT scan suggestion, “Patient refuses.” “Girl! You are going to be the death of me. I’ll lie awake at night wondering what might be in there.” I pointed and said, “Brains, I hope.”
Scanning further, she saw that my vitamin D was still on the low side and said I should be supplementing. I told her I take it twice a day. Well, the B-12 looked okay. That’s because I shoot myself in the leg every week. She shuddered and wrote, “Patient on home B-12”.
With order in hand, I left the office. First thing, when I got to the hospital, I registered and had my blood drawn. When I got the results, this is what they showed:
She wrote me a prescription for .075 that I’ll have filled tomorrow. My naturopath wants to have another telephone consult with me around Christmas. Other than that, this should be it for doctors and nurses for a while.