Navigating the VA System when scheduling an AVS

January 27, 2012

I'll start by conceding to you Francis, you might be right - my glass is half

empty this morning!

Yesterday afternoon the IR's secretary called to schedule the AVS for February

22 (if you remember, The chief Endo told me they " couldn't schedule until early

Feb. " a couple weeks ago and I pushed him since I will be off spiro for 6weeks

Feb 3d. (Dr. B - Strike 1)

I asked her who was doing the procedure and she confirmed it is Dr. Lenz. I

asked her if he did all AVS's for the VA & DHMC. Her response, " Oh no, he only

works at the VA now " . (Dr. B - Strike 2)

Chief of Endo (Dr. told me they would provide me written instructions so I

asked her and she said all I needed is to show up! (Dr. L - strike 1) I said,

" surely they will want me fasting! " ! Her response " well of course " like

everybody knows that! I asked her about being off MCBs, ACEI and ARBs. Her

response was " ofcourse you should stay on your BP meds, what are MCBs " I told

her she should check with Dr. L. because that was contrary to what the

Hypertension Primer 4th edition says! " What about asprin? " " Probably " (Dr. L -

strike 2).

I then asked who would be doing the surgery if warrented and she said she had no

idea, she didn't schedule that which is appropriate for her but I asked Dr. B

for that and he said Dr. L would have all that info.

She decided she better have Dr. L call me and we finally agreed on something!

Honestly , I didn't abuse her! (JC - 1 attaboy!)

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

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