The good, the bad, and the meh

I’ll start with
the good.

– People who wrote with nice, practical advice for talking to new doctor people if you’re a “hot mess” of a patient.

– My husband, for being amazing to talk to and at regarding this shit.  And for surprising the hell out of me by assuming that when his brother and sister in law come to visit in July, they’ll be staying at a hotel.  I mean, I went to have the “here are my limits, let’s strategize about how to address them with your family” talk and he pops out with “They’re staying at a hotel.  I already told them.”

– My therapist, for helping me figure out what gets in the way of effectively communicating what I’m feeling, physically and emotionally, to medical care providers.

– Myself.  For researching the hell out of my new primary care doctor because folks, I think we have a winner.  A handshake, an engaged and approachable manner, a sense of humor (“you know, I pay them to say that” was the response when I told him he’d gotten wonderful patient reviews online), smart, ungodly thorough, twice printed out stuff for me to read from Mayo clinic’s site on a couple of conditions he wants to look into, and he has a good nurse.  Front desk gal ain’t bad either, not yet at least.   I like him as a person, and I have hope for him as a doctor.  I also have orders for quite a bit bloodwork including a glucose tolerance test (it’s about god damned time someone rule that out or in – I’m sick of passing out in restaurants), a tilt table test, and a sleep study.  Yes, the new primary care physician (nPCP) also gave me shit for not doing the “last test I can think of and if it’s not this then it’s nothing” 24 hour urine collection study some GI doc ordered back in 2004 when I pooped away just a touch over 30 lbs in just a touch under 5 months.  But nPCP didn’t do it dickishly.

The bad.

Hey, I got a follow up appointment with the GI doctor for today!  yay!  And I already had the day off!  Double Yay!  What’s that you say front desk lady?  Because my primary changed (literally last week), my referral to see the GI doctor has evaporated and now I need a new one in 5 minutes?  Fanfuckingtastic.  So 5 very irritating minutes of dealing with the front desk elf and 10 moderately less irritating minutes in her supervisor’s office later, there was indication of a referral from my nPCP.  And then they had me sign a thing saying I’d pay the fee for the visit “just in case”.  “Uh, in case what?”  “In case it doesn’t go through” “Approximately how much would this cost for me if I had to pay it out of pocket?” “Oh I don’t know that.  You’ll have to ask upstairs.”  (upstairs, the front desk lady is at her wits’ end with someone one the phone whose doctor submitted a routine and not urgent referral, which meant next appointment in September)  “Hi, sorry.  So they told me downstairs they submitted the referral but that I might have to pay for this out of pocket…do you know about how much that would run?”  Nope.  Estimate?  Nope.  High and low?  Nope.  Ah christ.  A medical assistant chimes in “It’s just something they do, the waiver.  They put in the referral, it’ll be fine.”  Ok, so I go in back and find the doctor in the hall saying with mock outrage: “Am I seeing a patient now or what?!”

Yes, this was exactly how I wanted to start off this appointment with her.  BP 120/80, which for me is high – often, 80 is my systolic.  We talked.  I apologized for being cranky with the staff (I was only moderately cranky – I thank the shrink for this), blamed the insurance company.  She apologized, blame the insurance company.  Offered me a drug that you can only take if you sign a letter promising not to sue if you get an ischemic bowel.  Nope.  I brought up the capsule endoscopy, held my breath, and YES!  Ok.  Well, maybe.  Depending on the insurance.  “I’ll write ‘rule out crohn’s’ in the referral” she said conspiratorially to me.  “?” Rule out crohn’s isn’t like a made up thing here, this is why you’d be doing it.  To rule out crohn’s.  “Would it help to know I have a positive ANA?”  “Mmm, probably not.  I can put ‘rule out vasculitis‘ too”.

Alright.  Well, that’s that.  So it’s capsule endoscopy if the insurance approves it.  I can live without it, of course that’s easy to say since I haven’t been pooping myself inside out this week.  One nice aspect of my period.  It really tends to seize everything up.

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1 Comment

  1. R. G. Maines

     /  June 11, 2010

    Don’t you just love the bureaucratic run around? Shuffling paperwork, passing the buck, bouncing the patient around like a ping pong ball.

    I’m glad that you had some ‘good news’, though you had to deal with bad stuff too… hopefully the good negated some of the bad.



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