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My Most Recent Doctor's Appointment
By Gary F. Zeolla
I had my most recent doctor's appointment with my PCP (Primary Care Physician) in October 2013. In this article, I will describe what happened at that appointment. I think it will be instructive as to what the state of health care is in the USA, and how my personal habits are affecting my health. But first, some background.
I go to an office where there are four doctors. But those doctors change quite frequently. I've probably had at least half a dozen different PCPs in the about 20 years I have been going there. My last appointment was last September. That appointment did not go well. The doctor did not seem to care enough to try to understand my problems or to take them seriously, so I was planning on finding a new doctor's office. But I received a letter from the office in the summer telling me that the doctor I had been seeing had left, so I would be getting a new doctor at my next appointment. So I figured I might as well stick with the same office and give the new doctor a chance.
When I called to make the appointment, the receptionist asked me if I wanted a male or female doctor. I told her it didn't matter, as long as a female doctor would be willing to do my prostate exam. She didn't respond to that, but just scheduled the appointment without telling me who I would see.
Unless some acute problem arises, I usually only go to my PCP once a year. The reason for this I'll explain later. But I usually make the appointment in the fall. That way, I can get my yearly physical exam and flu shot at the same time.
One thing I like about my doctor's office is I usually don't have to wait very long to get an appointment or to see the doctor when I am at the office. But this is not the case with all doctors. There have been times when I have had to wait weeks to get an appointment with various specialists, and I have waited for up to four hours in the waiting rooms of some specialists.
But I don't think this is necessarily a difference between specialists and PCPs. I know others who regularly have to wait weeks to get an appointment with their PCP, and have to wait up to an hour once they get to the doctor's office before actually seeing the doctor. At this particular visit, I barely had time to fill out a form for my flu shot in the waiting room before a nurse called me and led me to an exam room.
I knew the nurse as I had graduated high school with her many years ago. But I didn't recognize her, until she told me who she was. This was in part because I knew her by her maiden name, while her married name was, of course, on her name tag. But the main reason I didn't recognize her was because her appearance was much different from when I knew her in high school.
Back then, she was a cheerleader, with a very slim and shapely figure, that all the boys wanted to be with. But now, she was significantly overweight. I will never understand why it is that so many health care professionals are overweight. Of all people, you would think that such people would know the adverse effects being overweight can cause.
Ironically, the first thing she did was to weigh me and take my height. Much unlike her, I have never gained any significant amount of weight since high school, except for in the form of muscle when I was powerlifting. If anything, I am underweight now, but more on that in a moment. But my main point here is that the first step any person can take in maintaining good health is to not become overweight.
She then took my blood pressure and heart rate. I was pleased that my blood pressure was only 100/ 72. For someone who is 50-something, that's pretty good. Normal is considered to be 120/80. Both diet and exercise can affect one's blood pressure. So obviously, what I am doing in that regard is working well for me.
My heart rate was 72. Normal is from 60-80, so that is within the normal range. So again, I am doing okay in that regard. However, it is significantly higher than just a few years ago, when I was powerlifting. Then my heart rate was usually in the 50s. Back then, I was working out at a vigorous intensity and always included some cardio exercise along with my weight training.
But now, due to my worsening health, I can only doing low-intensity weight training, about an hour four times a week. But that limited amount and intensity of exercise seems to be enough to keep my blood pressure and heart rate at or below normal levels. So even if you cannot work out at a hard intensity, do what you are able. It will make a difference in your general health.
The nurse then gave me my flu shot, which took just a few seconds. Given my healthy habits, I'm not at much risk of getting the flu. But I have gotten the flu three times this century. All three times were because I was temporarily not following my normal habits. That would take an entire article to explain, but suffice it say, there are times when events can temporarily derail healthy habits and lead to a case of the flu. So I think it is wise to get a flu shot even for someone who normally follows healthy habits.
My New Doctor
After the nurse left, I only had to wait a few minutes before my new doctor came into the exam room. It was a male. He was friendly enough, but as soon as I started talking to him, it was obvious he had not reviewed my medical records before seeing me. I found that to be incredulous. As I said, I've been going to this same office for about 20 years, so they have all of my medical records. So you would think a new doctor would take the time to review the records of his new patients.
But since he hadn't, I had to try to explain to him as clearly as possible what all of my health problems are. Most of all, I tried to impress upon him how seriously my problems affect me, and that they are making my life miserable. I was hoping he would take me seriously and recommend some kind of possible treatment.
Most of all, I emphasized to him about the extreme problem I have with allergies, or more correctly, multiple chemical sensitivities. I tried to explain to him how this problem was forcing me to live an isolated life. I told him that just sitting in his office was making me very uncomfortable and tried to explain to him what kind of symptoms I get when I'm in an allergic state, which would be too difficult to explain here.
I also told him that I had been losing weight over the last few years. The reason for this is two-fold. First, due to my worsening fatigue from fibromyalgia, I am no longer able to work out with any degree of intensity. As a result, I have lost much muscle over the last couple of years, and am now lifting far less weight than I was just a few years ago. Also, I am allergic to many foods, and can only eat foods that only have natural ingredients and usually also are organic as any kind of chemicals in foods can cause me problems. So my food choices are very limited.
But he just kept tapping on his notebook PC without commenting. He then had me sit on the exam table and did the normal checking of my heart and lungs with his stethoscope. Everything was normal. Then he looked into my throat, eyes, nose, and ears with an otoscope (the little device with a light on it). His only comment was that there was some wax build up in my ears. If he had actually read my records he would have known this is an ongoing problem for me. The year before, I had my ears irrigated at my yearly appointment as they were so clogged I could barely hear. But he didn't recommend the irrigation this time.
But what he did recommend shocked me. He told me to drink Ensure® to get my weight up. I knew at this point he hadn't been paying attention when I was explaining my health problems to him. If he had, he would have known that there was no way I could consume an unnatural product like that. But when I tried to explain this to him, he just brushed my objections aside, and said that it was what he always recommended to patients that needed to gain weight.
But surprisingly, he didn't do a standard prostate exam. He said that he thought they were too "subjective" and preferred to depend on the more objective PSA test. It made me a little uneasy not to get a prostate exam done, although, admittedly, a bit relieved as well. Any man over 50 knows what I am talking about here. But he gave me a script to get a standard blood exam done, including a PSA test. And that was the end of the appointment. No real recommendations as to what to do about my many health problems.
The doctor either didn't care enough to try to deal with someone like me with rather unique health problems or he had no clue as to what to do about them. But it left me wondering if I would have been better off with a female doctor. Since the doctor didn't do a prostate exam anyway, maybe a female doctor would have been more compassionate.
In any case, when I was checking out, the doctor told the receptionist to schedule me to come back in three months. I told the receptionist to forget that. I would call when I was ready for another appointment, and that won't be until next fall. The reason should be obvious: he did absolutely nothing to help me, so why should I go to him again in three months? A basic yearly exam and flu shot is about all I can expect from our medical system.
The Blood Test
One thing I do not like about my doctor's office is they do not draw blood there. So I have to go to a specialized blood lab to get the blood drawn. Fortunately, there is one just across the parking lot from my doctor's office. But it is only open until noon. So I always schedule my yearly exam in the morning so I can go and get the blood test in the same trip. And I've learned to prepare for it by not eating breakfast, as they always do some test that requires a fasting state.
But here is where I always have to wait. At the lab, you take a number. And usually, there are several people ahead of me when I get there, and generally I have to wait about an hour. But I have found that if I go later, about 11:00 am, they are usually less busy than in the early mornings. So I schedule my doctor's appointment so as to get there at about that time, which was what happened this time. And I was pleased when I got there to see that only one person was ahead of me. But for some reason, I still had to wait about half an hour. But then it only took a few of minutes for me to register and get the blood drawn.
A few days later, the nurse called me with the results of my blood test. She told me everything was normal, including my PSA. However, she said my total cholesterol was "near 200" so I should watch that. But then I asked her for specifics, namely what my LDL ("bad" cholesterol) and HDL ("good" cholesterol) were.
My LDL was only 109. Anything under 150 is considered to be okay. But the reason my total cholesterol seemed high was my HDL was a whopping 89. I say "whopping" as anything above 35 is considered to be protective of heart disease. My triglycerides were a very low 48. Anything below 100 is considered good. So in reality, when you look at the details, my blood lipids are not only okay but very good.
As such, it made no sense for the nurse to have initially told me I had to "watch" my cholesterol, and I told her that. She did not try to correct me. But be on guard for this. Sometimes medical personal will only give a cursory look at lab results. But sure to get the specifics and know what they mean yourself.
But with my blood pressure and blood lipids being very good, it shows that despite my many health problems the eating plan I am following is working very well for general health purposes. I outline that eating plan in my book God-given Foods Eating Plan. That book also includes a chapter on "Starting and Progressing in an Exercise Program" if you need suggestions in that regard.
I have to be careful here, as I don't want to get in trouble with the company that makes Ensure. But the next day, I did a quick search on the Web to see what the ingredients in this product were. And just as I suspected, it contains several ingredients that I am allergic to.
But more importantly, it looks to me to be a rather unhealthy product. The first ingredient is water, but then the next three ingredients are different forms of sugar. It also contains soy and canola oil, along with artificial ingredients. I discuss in my book why all these ingredients are not healthy. So I really cannot understand why doctors would recommend such a product. It is also rather expensive. So there is no way I would consider consuming it on a regular basis.
But what really shocked me is that a couple of days later I got an automated call from my pharmacy that my prescription was filled. I hadn't called in a prescription, so I called the pharmacy to find out what it was. It turns out that my doctor had actually written me a prescription for the pharmacy's own version of Ensure. I'm not sure if my insurance would have covered the cost, but it seems rather unlikely to me that it would. But either way, I told the pharmacist I didn't want it, so she should just put it back on the shelf.
My most recent doctor's appointment was a complete waste. I did get my flu shot, but as I said, that is something I probably really don't need. But beyond that, it is apparent that the medical establishment is ill-equipped to deal with problems like mine. That is why I only go once a year to my PCP. But I do think it is wise to get a yearly physical just to be sure nothing is wrong that I am unaware of.
My Most Recent Doctor’s Appointment. Copyright © 2013 by Gary F. Zeolla.
The above article was posted on this Web site December 8, 2013.
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