Check the Boxes

Some jobs have scripts that must be followed and it doesn't matter what the consumer/patient says, these questions must be asked and each box checked. I had a hysterectomy sometime in the 90's (more on that later) and after the surgery, I was not improving, in fact, each day I felt worse. I was anticipating the fun of telling my girlfriends that I no longer had to deal with periods but I was too sick to brag. Anyway, after talking to my doctor she said to check in through the ER and she would meet me there.

The employee checking me in was a young man probably in his 20's. I sat down and the questions began.

Why are you here today?

I had a hysterectomy last week and something isn't right so my doctor said to come to the ER.

When was your last menstrual cycle?

I don't know, but I can assure you it's not relevant to this particular problem and I'm about to pass out.

Are you on your period now?

No, I'm hemorrhaging and can feel my life blood slipping away but I'm not currently on my period nor will I ever be again. I'm gonna sit on the floor now so I don't get a concussion when I pass out.

Is there any chance that you're pregnant?

Oh honey, bless your heart.  I've got an idea, if you run across a question that you wouldn't ask a man skip it because for real I'm about to drop right here in this lobby. Get the stretcher and a crash cart ready.

For the record, I DID pass out but was fortunate to already be in a bed. When you're hooked up to a bunch of monitors and your heart rate plummets they RUSH to your bedside and you don't have to answer any more questions, THEN you can brag about no periods.

I have a great number of health issues and therefore have several doctors. This means that frequently I have to complete health information that I cannot possibly remember. It goes something like this.

Please list any previous surgeries and when they were performed.

Tonsillectomy - when I was a kid

Appendectomy - in the 80's

Hysterectomy - in the 90's

Some knee surgeries maybe in the 90's but most likely the 2000's.

My friend Beth helps me piece together the memories of my life from the 70's and 80's but even she can't keep up with all my health issues. So this is what happened yesterday when I went to the doctor. I was there to see the nurse practitioner and I have always had great luck with nurse practitioners. He was extremely nice, very personable but we had a few snags in our conversation. It went mostly like this.

How long have you had these particular symptoms?

I don't know, a few months maybe.

A few months!!! Why didn't you come in sooner?

I don't know, didn't feel like it I guess.

Well, that's terrible, you should come see us when you're sick, don't wait so long next time.

OK.

Looking at your chart I

What chart?

Your medical chart.

Oh, OK.

I see that you were hospitalized in 2007 with pancreatitis, are your current symptoms similar to those in 2007?

You're kidding me, right? I have a vague memory of pancreatitis, that was nasty stuff, but until you mentioned it I couldn't have told you within a couple of years either way when I had it. Beth might remember but I don't. I suffer from memory issues.

Who's Beth?

A very dear friend that I've known since I was 16.

Why would Beth know?

She helps keep track of my life, there was a gap of time when I moved to Richardson that I wasn't under her wing though so 2007 might have slipped through the cracks.
Ask me about 2006 though! I almost had a heart attack in 2006!

What? I don't see that in your chart!

What chart?

Your medical chart.

Why would it be in my medical chart?

Didn't you say you almost had a heart attack?

Yes. The Mavs were leading the series 2-0 and then inexplicably imploded and lost the next 4 to the Heat. I hate the Heat. I hated them before Lebron and that Velociraptor Bosch joined the team then once they joined up, yikes, my hate runs deep for the Heat.

Are you talking about basketball?

Yes. What did you think I was talking about?

Your health.

I was. That series really hurt my heart. I've never recovered but ask me about 2011! Go ahead, ask...I went stark raving crazy in 2011.

I don't see any mental health issues on the chart for 2011.

Chart?

Your medical chart.

Why would it be on my medical chart? Anyway, in June of 2011, we won it all. We beat the Heat! Wade, Lebron, and Bosch (he really does look like a velociraptor.) I went crazy! Alas, the Rangers lost to the Cardinals in the World Series, that kind of sucked, but Dirk and the Mavs! Whoo boy!

Basketball and Baseball?

Yes. Obviously.

Let's get back to your chart, your medical chart. What can you tell me about your hospital stay in 2007?

I've got nothing. Too late for Beth and too early for Tracy.

Who's Tracy?

She took over for Beth but I didn't know Tracy when I moved to Richardson that's why there are gaps in my history.

That doesn't bother you?

Hell yes it bothers me, I would have loved to have a seamless transition from Beth to Tracy but I didn't know Tracy yet.

Have you thought of keeping track of it yourself? You do seem to have a keen memory for sports, maybe you could parlay that into remembering your health issues.

Parlay? Argghh (that's pirate talk.) I made a notebook once with all of my doctors in it and lab results and stuff. I even had business card holders, tabs, it was cool.

That would be excellent, why didn't you bring it today?

I don't know where it is.

Perhaps your husband could accompany you during your visits so you have someone else with you that can remember important information regarding your health.

Not a bad idea, I will have to ask Tracy when Paul might be available.

The clinician in me is SCREAMING to stop asking questions but the rest of me realizes what a tremendous train wreck this is and can't stop myself. Why do you need to ask Tracy about your husband's schedule?

Well, he emails his schedule to me (and Tracy) but sometimes I go a day or 2 without checking my email and then I end up with hundreds of emails and it overwhelms me so I delete all of them and start over. Occasionally, one of his emails might get deleted and then I won't know he's out of town until I get hungry.

I'm sorry...did you say you don't notice he's not home until you get hungry?

Yes, he's the cook so when I get hungry at night and he's not home I know he's either running late or out of town. After I've been hungry for a while I call Tracy.

Why don't you call him?

Oh, he never answers his phone.

I see. Well, since you waited a while to come in to see us I don't suppose it would hurt to wait a few days more so why don't we go out and make an appointment with the doctor. I'll warn her, I mean I will tell her, I'll just make a note in your chart that you stopped in.

What chart?

Pharm to Market

In America it costs over a billion dollars to bring a new medication to market. Yes, I said over a BILLION $$$$$'s! This includes all the failures and this is one of the reasons that medication costs so much for the patient. Actually, that cost is usually passed on to private insurance companies and the government through medicare or medicaid.

In 2005 the drug industry spent almost 5 billion dollars on advertising. Yes, 5 billion dollars. Those ads are rather fun to hear when they are listing the side effects of the medication. It's hard to believe that after hearing a drug ad people actually request the drug from their doctor but almost 25% of the people do. The ads work!

If you watch much TV you will see  many of these ads. Sometimes in the same commercial break you will see a drug ad and then an ad from a law firm encouraging you to call if you have taken certain medications as you might be eligible for compensation. Most of the commercials list death as a side effect and listing the side effects takes up the majority of the commercial time. 

Have Low-T? How about trying axiron? There are just a few peskly little side effects. It is actually applied under the arms. Transfer of the medication may cause puberty in young children and acne and facial hair growth in women. If you expect another person to have direct skin-to-skin contact with your armpits, first wash the application area well with soap and water. Unless you are a wrestler when do you actually expect someone to come into contact with your armpits? But, on with the side effects: enlarged or painful breasts, problems breathing, blood clots, skin irritation, headache, diarrhea, vomiting, increased risk of prostate cancer etc...So, it's one thing to agree to these side effects if they only will affect you but if your son ends up with boobs and your wife has trouble shaving her beard because of all the acne then you're an ass and you're not going to get sex anyway. 

How about ED? Here's the commercial for that:
Adman: When the mood is right and your wife actually is in the mood for sex you better hurry man! First, find two clawfooted bath tubs and haul them to the top of a mountain. Then pop a pill. Grab your woman and run to the top of the mountain and get in the tubs and hold hands. 
Woman: What in the bloody hell are we doing in these bathtubs? This is what I get for saying I'm in the mood - you make me run to the top of a damn mountain and lay in a cold bathtub. Is this your idea of romance? I liked it better when your idea of romance was to poke me and say, "Hey, you asleep?" 
Adman:  There may be some side effects when taking Cialis (other than your woman hating you.) The most common side effects are: headache, indigestion, back pain, muscle aches (probably from hauling two heavy bathtubs up a mountain), flushing, and stuffy or runny nose. Uncommon but serious side effects include: an erection that won't go away, decrease or loss of vision, loss or decrease in hearing.

Seriously? How badly do you want it? I don't know, if it were me I think I'd just opt for a feisty game of parcheesi instead of the whole bathtub/pill experience but then I'm a woman. Judging from the sales of these drugs annually I don't think there is much parcheesi being played. I still don't understand the whole bathtub thing.

Some of the stuff is just gross, like if you had a vaginal mesh implant (ew!) there are many lawsuits you can join to get compensation for an implant gone wrong. A vaginal mesh implant just sounds wrong anyway. There are ads for pocket catheters. I realize catheters are needed but I don't want to hear about self lubricating catheters. You can actually order a catheter sampler pack that includes the handy self lubricating catheters.

How about over the counter medication? I can no longer read the labels on OTC meds. The print is so small because they have to list all the possible side effects. Some of these effects are really stupid. For example on a sleep aid - might cause drowsiness. Hmm.

Side note: I had a dog shampoo that listed on the bottle: Not tested on animals. Hmm. So, are my dogs the test subjects? Did you test it on humans? Did you test it at all?

I take a lot of medicine and I am very impressionable so I don't read the side effects. Sometimes my doctor forces me to read them. I find that if I read them that many times I feel those side effects. Next thing you know I'm telling my doctor that my testicles do in fact feel tender and swollen. She then assures me that I probably don't have that problem since I am a woman. I don't get on WebMD anymore. I put in a few symptoms and then it tells me I might have dengue fever, a flesh eating bacteria, prostate cancer, or I might have a cold. I will walk around for a few days thinking my flesh is slowly being eaten or that my prostate is enlarged (even though I don't actually have a prostate.)

So, even though the medications are expensive and the side effects can be horrible people still ask for these medicines A LOT. You might end up blind and deaf but hey - you can have sex! And, I guess if it kills you - you die happy.