Doctor Morning

I am nothing if not self-absorbed and so you get to peek into my day today.

I had a couple of doctor appointments this morning; first was a follow up to my blood pressure with the GP.  Eff-stick nurse’s aid took my blood pressure and squeezed my arm so hard I had to hold my breath.  Then when the numbers kept changing, she squeezed some more, “Just to double check….oh, that’s a little high.”  Ran out to get the doctor.  I’m sure they were ready to cut my head open to find the aneurisms.  Turns out it was like 180/108.  Pretty effing high. Well crap.  We chatted a few minutes, asking me pointed questions to see if I was stroking out.  I told him quite directly that his employee was squeezing the sh*t out of me via my arm, so he took it again.  It was a LOT better; in fact, my blood pressure is good (considering I’ve forgotten to take my medicine since the appendix removal) and overall, I’m remarkably healthy.  I made sure to refill my prescription for the blood pressure medicine and I took a pill before I came in to work.  Good thing, since the only back up I have in the office told me today that she’s leaving. 

Yes, gooooood thing I started taking that medicine again.

Before arriving to the office, however, I had another follow up eye doctor appointment.  Just to see if that darn ocular pressure is behaving itself.  Turns out it was as high as Jeff Spicoli – pressure for a normal person should be 20.  In me, on average I run 27 so that’s normal for me.  Today, I was running 35.  That’s bad.  I got a visual image of my ocular nerves curling up like burnt hair and smelling twice as bad, so I expressed concern.  My very cute and married doctor doesn’t want to put me on medicine yet, but he does want to do a more comprehensive visual field (cereal bowl) test. 

I didn’t realize that I needed a referral from my GP for the appointment, so I called to see if I could get one.  They need 72 hours notice and the cow on the other end of the line refused to help me out.  I muttered “Thanks for nothing.” and hung up.  I’m sure my spike in blood pressure at that moment wasn’t helping the ocular pressure any.  Cute married doctor told his receptionist to bill a certain way so I didn’t have to pay so much out of pocket. 

There is goodness still left in the world. 

As I say, I got into the office to several telephone messages, emails, a little boss drama and the happy news that the woman acting as the other secretary in the department is leaving and her last day is tomorrow.  I haven’t taken any time off of work since the appendicitis.  I think maybe I need to and not worry about everyone having to deal in my absence.

I suppose sometimes God just likes to toss a few spitballs my way. “Let’s see how she likes this one…” in his low rumbly thunder voice, “Ohhhhh, she swears too much.  Tsk tsk tsk.” 

More Glaucoma

Ocular hypertension is back. Stupid ugly scary back and I have to get it checked out.

But now…NOW…I am being forced to acquire a primary care physician. Sorry. Wait. Let me back up. I went to the eye doctor on Saturday, bending over finally and giving in to Father Time by getting fitted for bifocals or more nicely put - progressive lenses. Remember a few posts ago I talked about my old glaucoma diagnosis? Remember how I said I was told I didn’t have glaucoma and I could go my merry way? No more drops? No more two visits a year? No more cereal bowl in a dark close carbon-dioxide laden room?

Gasp/Breathe/Gasp/Breathe/Gasp/Breathe Breathe Breathe breathe breathe.

OK. OK. Sorry. Whoooo. Sorry. Sorry.

Pressures are high. Really high. Like take away her driver’s license and slap a handicap sticker on the car she’s going blind high. So high that even I was worried.

The fun begins. This is no longer within the scope of my vision plan. We are now entering the land of the medical benefit access. HMOs. PCPs. Acronyms out the hoo hah. And oh the complexity. Understand, before I can stop myself from going BLIND, I have to:

• Call the insurance company to understand the process and my benefit (HMO)
• Go on line and find a physician in my plan (PCP)
• Call the physician’s office, ensure they take my insurance and are taking new patients (ASAP)
• Make an appointment for an initial examination with the PCP who is an MD
• Take time off work to go to initial appointment (SOL)
• Endure weigh-in, blood pressure check, temperature check, invasive questions about my menstrual cycle, my last pap smear, my most recent mammogram, whether I smoke, how much I drink, when I last had sex, my seat belt utilization, and what my turn ons include (SPaFGimMIGTSM)
• Tell them that all I want right now is a referral to my specialist (DO)
• Get referral from my PCP to see my DO (OMFG)
• Call my DO to set up an appointment

Meanwhile I call my previous DO, to get my MR (medical records) to transfer to the new DO so that we are prepped and poised with all information at hand should I GO EFFING BLIND BY THE TIME I GET IN TO SEE HIM.

All that was after calling my HMO and going through the automated voice response system.

• Femme bot: “Are you a member or a provider?”
• Me: “Member”
• Femme bot: “Thanks!” (I love the enthusiasm that is interjected into the femme bot on the other end) To better serve you, please say your Plan ID or enter your social security number into the keypad”
• Me: "Blab la Blab”
• Femme bot: “Thanks! Now, say or enter the primary card holder’s date of birth”
• Me: “Blab lab blab”
• Femme bot: “I’m sorry,” (she really sounds it too) “that date is not in my system. Please say or enter the primary card holder’s date of birth”

Unfortunately, at this point, someone came up to my desk and needed my assistance, so I had to hang up. It went much more smoothly the next time I called.

• Femme Bot: “Are you a member or a provider?” “Customer Service”
• “Thanks! To better serve you, please say your ID or enter your social security number into the keypad” “Customer Service”
• “OK! Let me get you a customer service representative to assist you.”

Nooooow we’re talkin’.

Glaucoma

Just over 15 years ago, I was diagnosed with glaucoma. Bit of a surprise under 30 years old, but there you go. I had been having some severe headaches increasing in frequency, so I went to my doctor. I told him I thought it might be my eyes (I knew I had high ocular pressure, I just never followed through with a thorough enough exam) and I was poo-poo'd. "Do you have insurance?" "Yes" "Then lets do a CAT scan." Niiiiice.

It was my eyes. I poo YOU sir.

Thus began 15 years of testing, treatment, drops, bi-annual visits and a variety of tests to calculate the certain degradation of my ocular nerves.

I'll tell you right now, I don't like the puff test; I always blink. I've learned how to steele myself for it though. The "blue circle" test is rough too - where they put drops in your eyes to numb them (forcing you to wipe away yellow goo for the rest of the day) and then they place this blue circle of light right on top of your eyeball to test the pressure of the ocular fluid inside your eyeball. It's no fun, but I just focus on the yellow glop. It doesn't take very long.

When I was first diagnosed with glaucoma, I went to a state of the art eye place - office was top notch - tests were superior (although the blue circle is the blue circle is the blue circle). There is a test that they give to see if your peripheral vision is depleting - a visual field test. I'd sit in front of this huge white salad bowl and was told to only stare at the center of the bowl. Like our hearing tests when we were in school, I'd have to click each time I saw a light appear somewhere inside the salad bowl. I liked the salad bowl test and prided myself on its successful completion.

As sometimes happens in life, my health plan benefit changed and I could no longer go to my fabulous top notch eye place. See, it was the only place I had ever been for glaucoma and I figured all tests were created equal.

Noooo. No no no no no.

Then I went to a doctor in local hospital. His "salad bowl" test was more like a cereal bowl and it was in a room that was the size of a large office desk. The cereal bowl was pushed up against my face, (and on top of said large office desk) so that when I breathed, I could feel my breath coming back at me, hot and steaming, redolent with carbon dioxide. In a small room. A small, enclosed, dark, hot-from-my-breath room. The test takes at least 7 minutes; maybe 10 and if you don't do the test right, you have to do it again. Phew. That was hard. Breathe. Must breathe. Phew. Phrew. I'm done. Phew. No wait. I didn't do the test right. For the first time in 10 years, I had to do the test again! Noooooo! I had to do it again!

I've never been claustrophic and I've never had a panic attack. OMG OMG OMG - my heart rate increased, I started to sweat, and I began to panic. I am not exaggerating when I tell you that I needed to scream. I got through it, but told the nurse I had to walk out of the office for a minute and just breathe.

I had to take the effing test again. I thought I was going to cry. It was a monumental act of self control to not go beserk and get through the test.

I can still feel the closeness of the machine on my face. I can still remember what the panic felt like in my chest and my legs. How I wanted to scream and cry all at once. I've never felt more ridiculous in my life and I will never take that nice salad bowl test for granted again.

As a post script, cereal bowl doctor told me that in his opinion, after 10 years there was no ocular nerve degeneration therefore no glaucoma. I just have a high tolerance for high ocular pressure.

No more cereal bowl.