Friday, March 25, 2011

Doctor Dread - Chapter 2

*I apologize for the length of this.  I'm writing it out for myself.  Don't feel bad if you glaze over and fast forward to the end!*

In Wednesday's post when I first mentioned this more serious topic I was going to talk about, I said that I was seeing my primary care doc at 5:30 that evening to touch base, get some prescription renewals and a slip for blood work.  That was only a part of the story, and it turns out the appointment didn't happen...because I cancelled it.

Being a nurse has given me a comfort level with doctors that I think many people don't have.  I am able to think of the questions I want to ask during an appointment without writing them down prior, as I advise many friends to do who claim to forget everything they wanted to discuss because they are somewhat intimidated by docs.  I also know relevant information to report about symptoms or whatever is going on with me.  I worked in an Allergy, Immunology and Pulmonary specialty for 14 years while my children were younger and learned a tremendous amount that specialty.  Have big time allergies and occasional asthma myself, that was a very good thing, and I still really know how to take care of myself in that realm, as well as how to advise others.

Prior to that lengthy job in an office setting I was the Clinical Nurse Specialist for a GYN Oncology doc for 3 years.  Another phenomenal learning experience professionally and personally.  I got to know the doc so well he taught and trusted me to do a lot of procedures that were really beyond my scope of practice - which I loved.  He became a close friend and actually walked me down the aisle in my wedding, as my own father passed when I was 11. 

All my years of nursing (I graduated in 1975 so it's been awhile) have given me a competence and confidence in my profession that of course has overflowed to my personal life, since we all need to see doctors from time to time.  (Also, my career as a nurse has become a big part of how I define myself - so there is much ego swirling around my thoughts and feelings here - just as a disclaimer.)  So it's important to me that my primary care doc is someone I respect and like, and feel respects me as well.  Until about 18 months ago, my PCP was a doc (named Walt) I actually worked with for quite awhile, who had also done a stint during his residency at the Allergy Practice I mentioned above, while I worked there.  He came to know and trust me in the work setting, which informed his demeanor with me when I saw him as his patient.  He knew I was a little neurotic about health issues and one of those people who takes every symptom to be a potential death sentence!  This is more common among health care professionals than you might thing.  But he also knew that I know my stuff and I know myself pretty well. 

Walt's practice was set to be bought by one of the local hospital corporations who owned that attached hospital.  If that happened, they were going to make Walt join a huge Internal Medicine and Family Practice that had about 15 docs already.  It was something of a factory and he decided to not be bought out but rather rent the space he'd be provided and stay independent (with a nurse practitioner).  This meant his office staff had to be fairly slim, and what happened was that for the last year I was his patient, there was one woman to answer the phone, make appointments, do referrals, check people in and out, and who knows what else.  She was lovely, but literally a one-armed paper hanger trying to do way too much.  I became frustrated because one day I went to an appointment for which I'd needed a referral and had asked for it a week in advance, and when I got to the referral.  So I decided I was going to change docs - not so much for the medical aspect but because I didn't like the glitches that resulted from an overtaxed office staff.

I went to another big practice I used to go to many years ago and started seeing a doc new to the practice.  He was nice enough and I liked him okay and thought he was competent.  But to make a long story less long, I have gradually grown to not care for him - mainly because he's as flat and unconversational as can be.  If he was a surgeon or a specialist, that'd be fine, but I need to feel like I can talk to my PCP and that he listens and gets that I'm not senile or a drug seeker.  I never told him I was a nurse, but showing up in scrubs a few times eventually caused him to look at my info sheet and see my occupation and ask me in what specialty areas I'd worked, so I have EXPECTED he'd at least know I have a clue about something. 

What started me not liking him after seeing him for several months (only a few times) was going in when I had a killer sinus infection last year and he wanted to give me an antibiotic that I knew from repeated attempts wouldn't take care of it.  I knew what worked because it had worked for years - and I only needed it 1-2x annually.  He said he didn't want to start with "such a big gun", and I told him not to give me the one he wanted because it wouldn't help.  I said that at age (then) 55 I knew my body, my asthma and chronic sinus issues, and knew what worked well and fast.  He begrudgingly gave me what I wanted, but it's been a very weird vibe since then, and every time I've made an appointment to see him since, I dread it and just get through it best I can.  He's pleasant enough, but I don't feel comfortable being myself with him...which translates to not being funny, self deprecating about my health anxiety, etc.  In general it just isn't a good fit.

Last week I made a decision to return to my beloved Walt.  His office has since moved, and I hear his office staff has increased and tightened up.  Making the decision and then making the official change with my insurance has given me a huge sense of relief and I've already scheduled a physical with Walt for April 7th.  However the change doesn't become official until April 1 on my insurance.  Because of the occasional numbness I started having in my big toe 10 days ago, I'd decided I'd see the other doc one more time just to get a lab slip, refills and B/P check and report about the toe numbness.  But the thought of seeing him just made me antsy and I chickened out at the last minute and cancelled.  I didn't say anything about switching docs - just cancelled.  It would have been a bit of a hassle anyway, getting my lab results sent to Walt.  So on April 1, I'm going to go to the current practice and ask to have my relevant records copied and sent to Walt.  There can't be too much accumulated in 18 months of pretty good health.  I will also go to Walt's office on the 1st and get the lab slip so I can have the blood work done before the appointment.

In the meantime, I'm going to "borrow" the glucometer from my job and track my fasting blood sugars and 2 hour post meal readings.  I started today, but because I didn't have the meter at home and ate oatmeal with flax, I just did a 1 1/2 hour post meal reading that was 110.  Not too bad, though below 100 would be better.  I was halfway expecting it to be sky high and am grateful (and relieved) it isn't.  I'll be checking it and keeping track for the next few days at least, and if it gets really out of whack, you can bet your life that I'll see whichever doc I'm "authorized" to at the time.

This concludes Chapter 2 of this subject.  Tomorrow I'm going to get more honest about my fear and health anxiety, including how it originated for a very lost and sad little girl Leslie.

**added 45 minutes after posting** - I just rechecked my blood sugar and now it's 95 - a little over 2 hours after eating the oatmeal.  This is sounding pretty good, so maybe I haven't lapsed into uncontrolled status.  But don't worry - I'm following through with doc visits and all.  My big toe numbness must be a progressive neurological disease*****KIDDING.  (i hope)


  1. I am very much like you in terms of "Dr. dread." This also originated in my childhood. I have cancelled more Dr. appts. than I can count. I was grateful that the one I was supposed to go to in April was cancelled and rescheduled for a later date by the Dr.'s office! Great post!

  2. So glad you're taking charge of this! My "beloved" doctor just left this month so I am faced with finding a new one, I LOVE this doctor, he's cool and he KNOWS me. I so GET what you're going through. Hope it all works out!

  3. Okay, I'm going to trust that you know yourself well enough that you can put this off. Amazing what a difference a doctor can make.

  4. I was a medical secretary in a previous life (1970's before becoming a mommy), and I know EXACTLY what you talk about. Completely and fully. :)

    Is your blood pressure ok? If that and the blood sugar stay around 100 give or take 10 pts., I think you'll most likely be fine waiting until 4/1. But any reason you can't get the records switched over sooner, and just make the visit ON 4/1?

  5. To Sunny - My B/P is well controlled on the med I take for it. 2 weeks ago was 110/70. April 7th was the first available appointment for a physical that was after 2:30 when I get off work. I probably could get the records transfered sooner. Thanks!

  6. Leslie, your numbers sound perfect. Really. 110 and hour and !/2 after oatmeal is exactly what it should be. So glad to hear it! :D

    You can find normal glucose ranges if you don't have access to that info by googling it.

    What a relief!


  7. I love, love, LOVE my doc! But yeah, if I changed practices Id really struggle with being intimidated. :(

  8. Hey, Leslie! I didn't want to spout off wrong info, so I waited until I could find my MD guidelines for NORMAL--not normal for a diabetic--glucose levels. (You probably already know, but you know how helpful I can be.)

    Fasting should be 80 to 100
    1 hour after eating--170 to 200
    2 hours after eating--140 or less
    4 hours after eating should be back to =/<100.

    :D Later gator!


  9. I am always glad for my nursing background every time I go to the Dr. Dr. are poeple too. They put their pants on one leg at a time.

    You know your body! Take care . I will be anxious to see what's up.

  10. Hi Leslie! Great doctors are hard to find. Mine is okay, but 45 minutes away. I'm trying to find one closer.
    I started a new blog (same stuff just new blog) over at Please come over and follow me!

  11. Hey girl. I completely understand the doctor switch situation. You've got to feel comfortable. April is coming right up, too, so you'll be fine. Do go, though, when you can. My situation started with numbness & tingling just 3 weeks ago . . . . Hugs.