The kind of doctor I like

I follow the blog of Dr. Kevin, MD on Facebook.  I don't read every single entry, but I have picked up a little medical knowledge there from time to time.  I noticed in an entry this morning there was a video speech by Dr. Abraham Verghese, author of Cutting for Stone.  The video is eighteen minutes long, and I only intended to watch a little of it to see what he sounded like.





The video is excellent, and I watched it all. 
My bloggie friend Margaret is the one who recommended "Cutting For Stone", and I am so glad she did.  It isn't what I would call an easy read, but it's a great book.  Thanks to the video, I know more about its author and what makes him tick.
I have to tell you, I've always resented being shuffled off to a doctor who was born on foreign soil; I wanted an American doctor with no accent, thankyouverymuch, one who acquired all his or her learning in American schools.    
Abraham Verghese has changed this opinion, first with his book, and now with this video.   
Yes, books can change a person.  

The Old Lady and the Young Doctor

In this post I will be talking about urinary tract infections (UTI's), so if that isn't what you want to read about, just move along.  
Shortly after Cliff and I got married, I began to have strange symptoms:  a burning sensation when urinating, abdominal cramps, etc.  I went to the doctor and found out I had an ailment that is quite common with women: Cystitis, otherwise known as bladder or kidney infection.  In my case, being a newlywed, the doctor informed me it's usually called "honeymoon cystitis".  You can perhaps figure than one out.
Over the next couple of decades, long after the honeymoon was over, I continued to have recurring bouts of bladder infection.  I'd take a round of antibiotics, I'd get over it, and eventually it would recur.  I even went to a specialist about the problem once.  He found no particular cause, so that was money wasted.  
Once I reached my forties, the problem ceased, except for a rare case once every few years.  Usually I could fix it on my own by drinking gallons of water for several days.  
Now, this is where you may want to move on.  But I think this story will give you a chuckle if you stick around.  
A week before my knee surgery was scheduled to take place, I went in for pre-tests.  A couple of days later I received a phone call from my orthopedist's office telling me I had a UTI, and that they would call in a prescription for me.  I couldn't have knee replacement surgery if I had a UTI.  I thought it strange that I didn't have the usual symptoms of a UTI; I know them so well.   
The antibiotic worked and my surgery went on as scheduled.  
Now I'll back up:  For about a year, my urine had a strange smell.  That's all.  I didn't have the discomfort associated with bladder infection.  I went to Google and you can imagine the phrases I typed in; they all led to UTI problems.  Well, with no symptoms I was sure that was not what I had.  I decided the strange smell of my urine must be age-related.  It's amazing the weird things that happen to you as you get older.  
But after taking that round of antibiotics before surgery, my urine started smelling normal again, for the first time in months.  So I made a mental note, and also mentioned to Cliff, that I was going to see a doctor next time my urine smelled funny.  
A few days ago I noticed the smelly urine again and I made an appointment.  Cliff and I are now seeing the new, younger doctor in Dr. G's practice, since Dr. G is our age and won't be there forever.  
I've had lots of experience with UTI's, and I remembered that back in the old days the doctors wanted me to get a urine sample as soon as I got up in the morning.  There were some rules to follow to collect said sample, and I followed them to the letter.  I don't have a lot of small containers around, so I used a pint mason jar.  I'm such a hillbilly.  I sealed it tightly and slipped it into a freezer bag and carefully put it in my purse.  I wasn't about to have another urine spill like the one we had on our camping trip.  By the way, I noticed the urine in the jar looked a little cloudy.  
At the doctor's office, the nurse checked me in and asked why I was there.  I proceeded to tell her about my stinky urine and about my experience before the knee surgery.  No, I told her when asked, I did not have any other symptoms.  
I swear she may as well rolled her eyes; I can tell when somebody thinks I'm a danged fool.  
I told her I had brought a urine sample from home, but that I'd be glad to get a fresh one for her if she'd rather.  She preferred the latter; I collected it and delivered it to her, telling her that it was probably pretty diluted, since I'd been pouring down water all day.  
Pretty soon the doctor came in with a student doctor at his side.  Once again I went through the story of the stinky urine.  
"Well," he said, "the sample we tested shows no sign of a problem, and I wouldn't want to give you antibiotics for it if there's nothing wrong.  I'm curious about this "odor" you're talking about."  
"I can help you out," says I.  "I happen to have some in a mason jar in my purse."  
He backed up, holding his hands out in front of him as though he had been attacked, saying, "Oh no, no!  That might upset my stomach this early in the morning!"  
And he calls himself a doctor?  
Actually, I think he was performing a bit for the student doctor at his side.  
Then he asks, "Has your urine been discolored or strong-looking?"  
At that, without saying a word, I pulled the jar out of my purse and said, "Here, you decide."     
Taken aback, he said, "Well, it does look rather dark-colored."  
He didn't even mention the cloudy appearance.
Finally he said they'd send off the sample I gave at the office and "see if anything grows".  
I joined Cliff in the car.  
"How'd it go?"  
"I don't have bladder infection."
"Just as I figured."  
I pulled the mason jar out of my purse and said, "Does this look cloudy to you?"  
"Yes," he answered.  "It does." 
I worried no more about it and simply resolved to do the two things that will best clear up a UTI:  Drink a lot of water and make sure to empty the bladder completely on every visit to the bathroom.  
Today I got a call from the doctor's office.  The lab results showed that I have a UTI, and they've called in a prescription.  
I certainly hope this humbles the young doctor just a wee bit. 

Doctors

Cliff got up before dawn today; he's practicing for retirement.  
He asked me if I could find a website for Dr. Gallion, the man who did his CABG surgery four-and-a-half years ago.  
I did find a website HERE (scroll down to see the doctor's picture) but it wasn't very impressive, considering Dr. Gallion walks on water.  He went to school at Baylor, in Texas.  If you go to his office, you'll see classy ladies in high heels, dressed to the nines.  Funny stuff, really.  Cliff still smiles when he thinks about the ladies who work for the man who walks on water.  

This is how I remember the good doctor:  he was telling us that Cliff's surgery was successful.  
Keep in mind that Cliff went to see a nurse-practitioner on Tuesday with what he though was indigestion; was referred to a cardiologist, Dr. Nager, the next day; and was scheduled for surgery on Thursday, with doctors who usually require an appointment months in advance.  
But they squeezed Cliff in.  
Oh, Dr. Nager's group is on a website too.  You'll find him HERE.  

This is how I remember Dr. Nager, explaining to Cliff the results of his angiogram.  He didn't make a big impression on us, our first meeting.  But it took him to get us to that man who walks on water.  So I've learned to love him.  He's the one Cliff sees when he needs to check in with a cardiologist.    
Cliff thinks I should write a letter to Dr. Gallion to express our appreciation, and to let him know about the wonderful results of yesterdays stress test.  I did write him a letter of appreciation shortly after Cliff's surgery, and I probably will do so again.  Do you suppose doctors read such letters?    
Here's where it all starts to sound like that old story, "The house that Jack built".  
Cliff would never have seen Dr. Nager had he not gone to our regular clinic to see a nurse practitioner about what he thought was indigestion.  I don't have any pictures of that nurse-practitioner.  
I wouldn't have set up an appointment with that nurse-practitioner if my friend from the outskirts of Washington, DC, had not visited.  I do have pictures of Joanna.

It was cold when she was here, and Cliff didn't really take her for a ride.  They just posed, and I took the picture.  
See, I mentioned to Joanna that Cliff was having indigestion; she said we should have that checked out, because her brother-in-law went to a doctor for "indigestion", and was sent directly to the hospital for heart surgery.  
Which is exactly what happened to Cliff.   
And that's the house that Joanna built.  
So perhaps I need to write four letters.  

A trip to the cardiologist

We haven't visited the cardiologist for two or three years; Dr. Deblase, our primary care doctor, did all the same procedures as the specialists, and when I asked him if Cliff needed to go elsewhere, he said no.   
And then Dr. Deblase got cancer and eventually died.  
So Cliff has been pretty much in the hands of nurse-practitioners since then.  One of them has had him cut back on his Lipitor twice in the last year; that's great, as long as it's really the right thing to do, because Lipitor is very expensive.  But I decided it's time Cliff saw his heart doctor, just to make sure.   

This is the guy he's going to see; here he is in 2006, telling Cliff after his angiogram that he's going to need open heart surgery.  
What's that?  Well of COURSE I took pictures!  
Before this was taken, when we first met this guy, we were not impressed.  There had been a new program installed in the computers where he worked, and he spent most of his time mumbling at the computer and trying to figure it out, rather than dealing with Cliff.  
Cliff took a nuclear stress test, then returned to the room where I was; we waited together for the results of the test, planning where we'd go out to eat after this doctor was through with him.  
Our plans were interrupted when he came into the room with charts in his hand and said, "Well, there's a problem."  
Those were some life-changing words, let me tell you.  He wouldn't even let Cliff drive to the hospital... and we'd been riding around on a motorcycle for months!    
We neither one like going to the cardiologist's office.  You have to make an appointment about three months ahead of time, and the people at the front desk are often rude.  However, I remind myself that without that doctor, or one like him, Cliff would probably be dead.  I might be, too, if Cliff had had a heart attack while we were on the motorcycle. 

Because that doctor contacted this heart surgeon, Dr. Gallion, who, a mere two days after the angiogram, was doing four bypasses to Cliff's heart.  In this picture, he's telling us the surgery went just fine, thank you very much.  I hope Cliff never needs a heart surgeon again, but if he does, this is the man I would want in charge.  All the nurses, and former patients of his we talked to, seemed to think he walked on water.
I guess I should pause for a moment and give thanks for specialists, one and all.

Winter is getting the best of me

Forgive me for my ramblings being uninspired right now. Since Christmas, we've had snow, fog, and rain, and very little sunshine... perhaps three days' worth, all told. Yesterday the temperatures weren't bad for January, but it rained off and on the whole day. Now, any time I devote that many words on my blog to the weather, you know it's pretty bad.

On another note, Cliff starting eating properly right after the first of the year and has already lost ten pounds. I just jumped on that bandwagon last Monday, and so far I'm doing pretty well at sticking to the plan. I do avoid the word "diet", because really it's a full-time thing for us; we had just gotten side-tracked. It's so easy to eat too much of the wrong things when it's all around us, and so tasty, too.

I always cook the "good stuff" around here, my usual chicken, fish, and bean recipes. But we got on a steady down-hill run of eating out too much, not to mention the holidays. Then there's the petty side of me that sees Cliff eating everything other people cook, and thinks, "Hey, I want to cook that good stuff too! I'd rather make you nice, chewy, three-hundred-calorie brownies than make my lower-fat one-hundred-calorie ones."

And I do just that. Take THAT, you diet cheater!

Remember, I was raised as an only child, since my sister got married when I was two. So when I fix low-fat, nutritious meals all the time and then Cliff shows no restraint away from home, I throw an inner tantrum and bake a pie or two, make all the stuff I haven't been able to cook for a while (hello there, biscuits and gravy) and we're off eating like pigs again.

I'm just being honest here. Yes, I do have a dark side. I don't know how Cliff has managed to spend forty-three years with me.

When we're "eating right", we patronize Subway (too much sodium, but otherwise OK), with an occasional visit to Olive Garden for their soup, salad, and breadsticks. Or we'll split a meal at a Mexican place. No matter where you eat out, you're going to get overloaded on sodium; that's good motivation to eat at home.

We try our best to avoid buffets, for obvious reasons.

Speaking of Olive Garden, there's a new one under construction at Blue Springs! That's much closer than the one we've always patronized.

It seems like we're visiting a doctor all the time these days; we both have to go back to get prescriptions renewed next week. I can't believe three months goes by so fast! Maybe this time the nurse-practitioner will give me a prescription for a years' supply of blood pressure pills.

Yep, this is the most boring kind of entry, where I talk about nothing but weather and diets and doctor visits.

How the mighty blogger has fallen.

the television series E.R.: A poll

I've mentioned here several times that I'm watching the old episodes of E.R. on TNT; I record them on the DVR and watch them in the evening when Cliff's at work.

Keep in mind that I started with the episodes from 1990 or 1991; and I'm just now up to 1993.

But I've fallen in love with several doctors from those episodes, and I've been wondering which ones the longtime E.R. fans loved best.

I was going to make the poll "choose the hottest doctor on E.R.". But I've decided to make it "favorite doctor". This way, men will feel comfortable voting (as if any men other than relatives read my blog).

Now, I'm sure other doctors came along after 1993, but they're not included because I haven't met them yet.

I will tell you that if I had made the poll "hottest doctor", I'd vote for Dr. Kovac; he reminds me of Elvis... with a sexy accent. He isn't my favorite, though.

And now I'm going to set up my poll.

Silly me

I let all those bad ratings for Home Depot delivery get me upset for nothing. Except that I didn't get the call last night telling me when they'd be here, they did fine. Oh, but it wasn't Home Depot doing the delivery; it was GE. The guys were so good even Cliff was impressed at the careful way they removed my old washer and put in the new one.

Our blood work from yesterday showed my total cholesterol is a little high; everything else was fine. We were taking our walk when they called back with Cliff's results; they left a message for me to call the office, and that made me a little nervous. Normally if everything is OK, they'll leave a message telling us the results.

Turns out Cliff's cholesterol is too low! I didn't even know that was possible. So we get to cut his daily Lipitor in half, and they'll see how his blood-work looks in three months. This was cause for me to do a happy dance, since even with insurance, the Lipitor costs $1 per pill. Oh yeah, $90 for a three-month supply. And so far there's no generic for it. With Cliff holding down a good job, it's no problem; but if and when he retires (he says never), we'd be pressing the doctor to substitute something else.

We had B.L.T.'s today, with tomatoes from the garden. Life is good.

So, are we getting THAT old?

Cliff and I have noticed we're going to doctors of one sort or another quite regularly these days.

I visited my dentist last month, followed by an appointment with an oral surgeon. Then there was a visit with my orthopedist to figure out what to do with my knee. I have more appointments scheduled with my dentist next Friday, and the next.

Yesterday I had knee surgery, so of course there's a follow-up visit with the orthopedist in two weeks.

Cliff sees his heart specialist (routine yearly visit) December 27.

Good grief, Gertie.

Thank God for health insurance.

Moving right along....

Figuring it best to get that rather questionable Wordless Wednesday moved on down the page, I'll do a "this-n-that" entry.

First of all, my husband and I are a little miffed at the staff at our local doctors' office.

Cliff recently had a bit of a minor physical problem. We saw the nurse-practitioner about it, and got the problem fixed. She asked that he come back in two weeks and get a blood test to make sure his good-bad cholesterol ratio was where it should be (to see if the recent addition of Niaspan is doing its job), and to make sure his blood count was in the proper range; recent tests showed him to be slightly anemic. Also, she said, it was time for the every-three-months blood test to make sure his liver is standing up to the Lipitor he takes.

The nurse came in first, of course, asking why we were there. We told her, including the fact that Cliff hadn't eaten since the previous night.

Then the nurse-practitioner entered, asking, "What brings you here today?"

Duh. You told Cliff to come back in two weeks, lady. For a follow-up, and for the blood work. We mentioned that he was fasting.

Enter another nurse, and blood was taken.

Unfortunately, not all the blood vials that were needed were taken, evidently.

When we got back home, there was a message on our answering machine asking Cliff to come back, that they needed a "fasting blood test".

He was fasting when he was there!!!

I guess nobody's perfect. But in these times of high gasoline prices, I wish they'd be a little more vigilant and listen to their patients; it's over fifteen miles, one way. We should have made the appointment with Cliff's actual doctor, who has had heart issues himself and pays very good attention to what we tell him.

Yeah, so he's going back today, just to have blood taken.

We have learned lately not to tell Cliff's siblings every little symptom he has, even if they ask. They get on the telephone, diagnose him, decide he's dying, and get all worked up about things. Then he gets a phone call from his brother in Kansas, saying, "Why didn't you tell me?"

Tell him what? Geesh.

In other news, looks like our heat wave is over. And there's rain in the forecast. So far all we've had is sprinkles, but at least that settles the dust a bit.

I can smell autumn in the air.

Doctor's and nurse's blogs

I'm fairly new to Blogger, having journaled on AOL for years. I set this blog up just in case AOL disappears at some point. However, through this site I've found some interesting new people. Yeah, just what I needed, in addition to the fifty or so journals I already read on AOL.

Some of my favorite new reads are by doctors and nurses; these give me a whole new insight into the lives of people that I normally see only in their professional capacity. I'm enjoying reading their opinions and their patient stories. I like being reminded that they have lives outside their offices.

I'll drop a few links here for those readers who might be interested. All of these have many links to other medical blogs, and you can hop from one to another for hours, if you so choose.

Maybe it's just me who finds these so fascinating.

Nurse Ratched's Place

In My Humble Opinion

Kevin, M.D.

oncRN

NHS Blog Doctor
(He's in Great Britain)