MY VISIT WITH MY PCP YESTERDAY

[Guest guest]

Greetings Fellow Lupies,

Actually.....My appointment with my PCP went VERY WELL. I did exactly as I said I would......I told him that I knew he was busy, but would he spend some extra time with me as I had a lot of things I needed to cover with him.

He just smiled and said .....well, you didn't make an appointment for an extended visit.....but since I see that you spent last weekend in the Hospital, I think we need to do that also.....We'll see what we can get covered today !

So I proceeded to pull out my "journal" and started going over everything that had happened over the last couple of months,including my visit to the clinic with one of his associates about my rash, in which that doctor had taken me off of the Carb/Levo thinking that was the Medication that had caused my rash to get worse.

I told him that I thought it was the trazodone, since the rash had still gotten worse.....plus All about the falls I had taken which I thought also was due to the Trazodone, and that I had not been able to get in touch with my Psychiatrist, to see about how I should go about getting off it, since she was out of town at the same time that he was......so I had just gotten off it the same way that she had me start it ....taking half a tablet for a week, then stopping it.

And wanted to make sure that I would be able to get my prescription for Carb/Levo refilled since the other doctor had taken me off it......and that had been the only medication I had found that helped my 'Restless Leg Syndrome'. He said sure, no problem!" And to add Trazodone to my list of medications I am allergic to.

I also asked him that since the Clonidine was controlling my Blood Pressure so well ...my Blood Pressure was 124/70 yesterday, could I get off the Norvasc completely because We had suspected the Norvasc of being another of the Culprits in causing my allergic rash, and had already decreased my dose from 10 mg. to 5 mg.

He said sure, that Clonidine was one of the strongest Blood pressure meds. with the least amount of side effects. I told him that I had read the Monograph for the Conidine, and an allergic rash was NOT high on the list of side effects, but was listed as a 'possibility' , to which he replied that just about EVERY medication had a 'possibility' of causing a rash to someone, somewhere, so they have to put that in the monograph.

I asked for and got a copy of my last labs. That his Partner had me do while he was out of town....plus a copy of the labs from my stay at the hospital in Arlington last weekend. He said He wondered why I had gone to the Arlington Hospital, instead of the Hospital that He uses....then he realized when he checked, that I lived in Arlington, and that it was a 30 mile drive for me to and from his Clinic.

So then I asked for suggestions about how I could monitor my blood pressure and blood work once a month without having to make that drive.....So he wrote me a "Prescription" to the Lab Core here in Arlington for me to go in once a month and get lab work done

......in fact lets just get a full panel done there every month, so I can keep track of your BUN and CREATNINE.....as well as your Potassium and Sodium, and if your blood sugar or Thyroid, or blood counts start to get out of whack .....we can catch it early and avoid any more Hospital Stays, and the stress of your not knowing when something may take a nose dive!

He then asked me what I had decided about "The Jerk" who was my new Rheumatologist.....HIS WORDS !.....had I decided to keep him or not. I had told him how the New Rheumy had treated me.....not doing an exam or ordering his own Labs.....and how he had told me that he doubted that I had ever had Lupus..

So I took this opportunity to show him the hospital Records from the Osteopathic hospital that I had sent to me, where I been diagnosed .....I had already underlined every place where the records says, Subacute Cutaneous Lupus. And the doctors notes where they state....Lupus Active....or Lupus Very Active.....and each place where they describe the Subacute Cutaneous Lesions.

The Notes of the Punch Out Biopsies they had done, and the immuno-flourescent tests that they had performed on the biopsies.

He also noticed where my TSH was 35.4.....and said,"no wonder you were in a coma!!. He also saw Acute Renal Failure....(which I had not noticed).....and the decision to put me on Solumedrol I.V.s for the rash covering my whole body. .....etc.....etc....etc....

I told him that I had an appointment with the New Rheumy in September, and wanted to keep that appointment IF FOR NO OTHER REASON THAN TO WAVE THESE IN HIS FACE !!....and If he continues to talk down to me, and has such a Pissy attitude, I will start another search for yet another Rheumatologist ! At this Point he was cracking up laughing.....but reminded me that there are just not a lot of Rheumatologist out there.....

I took this opportunity to tell him that although I was always happy with HIM, and the way HE treated me......That I get very frustrated with their Voice Mail system, and how I could never get to talk to HIM. and that when they say, leave a message, I am always cut off, when the time limit runs out, and that I never can get across to his Nurse what I am calling about....and that I had thought about trying to find a PCP closer to me.....and one that uses a hospital in my area.

I told him that I liked the idea of the After Hours Clinic that they have, and have used it many times when I felt I was going to have to wait too long before I could get an appt. with him, but needed to see a Doctor.

He reminded me that they have Their Family Health Care Clinics all around with the same hours. But I told him that HE was the only PCP who was taking new patients when I found him......That was why I chose him. ....I told him I had asked for and been sent a list of Nework Providers, but I had just recieved it yesterday, and had not had a chance to make any calls yet.......He said He would be sorry to lose me as a patient if I find another PCP....but he completly understood......And if I do find one nearere.... and it may take awhile.....that he would continue to Care for me there.....and get me as "Healthy and Polished Up" as he could before sending me on to someone else.

I then asked him if we could discuss Pain Management....He said Certainly.....I told him that I had been on the same dose of Vicodin ever since I was diagnosed in 1997......and that I felt that I needed something a little stronger, and I was in a lot of pain most of the time, and the Vicodin just wasn't helping me that much anymore. .....Also that a lot of people in my Support Group say that they use a muscle relaxer to boost the effects of their Pain Meds.

He told me that Vicodin will give you a short burst of relief .....but it wears off really fast....and you are left counting the hours till you can take another one. I asked him if he had been watching me?.....I told him that I didn't want to get addicted.....he laughed and said , "if you have been taking it for this long, you are already addicted.....and you are addicted to something that is not helping you." I'm guessing that your Pain Management technique consists of "Gritting your Teeth" a lot till you can take another Vicodin!.......I said , "you HAVE been watching me!"

So he wrote me a prescription for Soma to be taken along with the Vicodin to boost the Pain relief. And he said that if that doesn't work.....we might need to talk about going to a more Potent Pain Medication.....something with a Morphine base. .....But he said lets try this first, and if it doesn't help, we will look further to see what we can do for you. We are talking Quality of Life Here !

I then showed him my rotting fingernails......I practically have no nails left on my 3 left fingers of my right hand , and asked if he could prescribe the Penlac Nail Varnish .....Even though I may never be able to afford it, It was the only thing that had helped, but I ran out too soon......He looked at them and said ,"first let's make sure that it is a fungus, it may be something else, so he took a sample of one of the nails to send off to be analyzed to see exactly what it is.

So then I asked for the labs from my Hospital Stay last year, and he said that I would have to go to the Medical Records Dept. at the hospital to get those.

So he wrote me a Script to have blood work done at the Labcore here in Arlington. once a month....and he said to go to the Parmacy, and use their monitoring Machine once a week to check my bp......and if it is consistantly 140/90 or below. I'm okay, but if it gets higher and stays higher.....call him and he will increase my Clonidine.

Then I went to the hospital to get my medical records.....I told the lady I didn't know exactly what I needed....when I heard her tell another person, that if they wanted their complete records. It would cost $.50 a page....so I said I guess I just needed the labs.......She looked up my record, and saw that I had had a complete work up on my heart except for a Heart Cath.

She said I will give you such and such and such......and I said at 50 cents a Page?....she said "I wont charge you anything, just don't tell any body !"

I said ,"YOU GOT IT"!

Then I went to get my script for the Soma filled, and ran into a snag......Remember when I was going NUTS from no sleep because of my Restless Legs. and Both my PCP and my Shrink were out of town, and my PCPs partner had taken me of the Carb/levo thinking that was what was causing the rash?

Well I had called My Nephrologist, who prescribed Flexoril for me.....which did absoluly nothing for my Legs, so I just put it up in the cabinet because it made me too drowsy to take it during the day, and try to drive or anything. ......Anyway It is a muscle relaxer, and Soma is a Muscle Relaxer......so my ins. Co. would not pay for it because I already had the Flexoril.....Plus they only would cover a one month supply which in their eyes is 30 tablets. And My Doctor had written the Script for 90 tablets.

I expained to the pharmacist why he had written for so many, and so she said she would call my Doctor this morning and let him know that he would have to get it preauthorized....and let them know that I Needed that many and Why.

Then when I got home and realized that I needed to get my Prednisone and Carb/Levo refilled I called the Pharmacist,and told her that I needed them, and I also told her that I had forgotten to tell Dr.Ohman, that I had had to call Dr. Epstein for some Flexoril and why.....So ......We will see whether or not the ins. co. will cover the Soma ......I went through the whole thing with her.....realizing that my Ins. Co.probably thought I was "Doctor Shopping for Drugs."

I know this is way more than you bargained for when you asked....How did your Doctors Visit go, So if you get as tired of reading it as I have typing it.....You know where the "Delete " button is.

[Guest guest]

I am so proud of you I wish I could do this to get my point across

to my Dr.'s Love bunches MISSY

> BlankGreetings Fellow Lupies,

> Actually.....My appointment with my PCP went VERY WELL. I did

exactly as I said I would......I told him that I knew he was busy,

but would he spend some extra time with me as I had a lot of things I

needed to cover with him.

>

> He just smiled and said .....well, you didn't make an appointment

for an extended visit.....but since I see that you spent last weekend

in the Hospital, I think we need to do that also.....We'll see what

we can get covered today !

> So I proceeded to pull out my " journal " and started going over

everything that had happened over the last couple of months,including

my visit to the clinic with one of his associates about my rash, in

which that doctor had taken me off of the Carb/Levo thinking that

was the Medication that had caused my rash to get worse.

> I told him that I thought it was the trazodone, since the rash

had still gotten worse.....plus All about the falls I had taken which

I thought also was due to the Trazodone, and that I had not been able

to get in touch with my Psychiatrist, to see about how I should go

about getting off it, since she was out of town at the same time that

he was......so I had just gotten off it the same way that she had me

start it ....taking half a tablet for a week, then stopping it.

> And wanted to make sure that I would be able to get my

prescription for Carb/Levo refilled since the other doctor had taken

me off it......and that had been the only medication I had found that

helped my 'Restless Leg Syndrome'. He said sure, no problem! " And to

add Trazodone to my list of medications I am allergic to.

> I also asked him that since the Clonidine was controlling my

Blood Pressure so well ...my Blood Pressure was 124/70 yesterday,

could I get off the Norvasc completely because We had suspected the

Norvasc of being another of the Culprits in causing my allergic rash,

and had already decreased my dose from 10 mg. to 5 mg.

> He said sure, that Clonidine was one of the strongest Blood

pressure meds. with the least amount of side effects. I told him that

I had read the Monograph for the Conidine, and an allergic rash was

NOT high on the list of side effects, but was listed as

a 'possibility' , to which he replied that just about EVERY

medication had a 'possibility' of causing a rash to someone,

somewhere, so they have to put that in the monograph.

> I asked for and got a copy of my last labs. That his Partner had

me do while he was out of town....plus a copy of the labs from my

stay at the hospital in Arlington last weekend. He said He wondered

why I had gone to the Arlington Hospital, instead of the Hospital

that He uses....then he realized when he checked, that I lived in

Arlington, and that it was a 30 mile drive for me to and from his

Clinic.

> So then I asked for suggestions about how I could monitor my

blood pressure and blood work once a month without having to make

that drive.....So he wrote me a " Prescription " to the Lab Core here

in Arlington for me to go in once a month and get lab work done

> .....in fact lets just get a full panel done there every month, so

I can keep track of your BUN and CREATNINE.....as well as your

Potassium and Sodium, and if your blood sugar or Thyroid, or blood

counts start to get out of whack .....we can catch it early and avoid

any more Hospital Stays, and the stress of your not knowing when

something may take a nose dive!

> He then asked me what I had decided about " The Jerk " who was my

new Rheumatologist.....HIS WORDS !.....had I decided to keep him or

not. I had told him how the New Rheumy had treated me.....not doing

an exam or ordering his own Labs.....and how he had told me that he

doubted that I had ever had Lupus..

> So I took this opportunity to show him the hospital Records from

the Osteopathic hospital that I had sent to me, where I been

diagnosed .....I had already underlined every place where the records

says, Subacute Cutaneous Lupus. And the doctors notes where they

state....Lupus Active....or Lupus Very Active.....and each place

where they describe the Subacute Cutaneous Lesions.

> The Notes of the Punch Out Biopsies they had done, and the immuno-

flourescent tests that they had performed on the biopsies.

> He also noticed where my TSH was 35.4.....and said, " no wonder you

were in a coma!!. He also saw Acute Renal Failure....(which I had not

noticed).....and the decision to put me on Solumedrol I.V.s for the

rash covering my whole body. .....etc.....etc....etc....

> I told him that I had an appointment with the New Rheumy in

September, and wanted to keep that appointment IF FOR NO OTHER REASON

THAN TO WAVE THESE IN HIS FACE !!....and If he continues to talk down

to me, and has such a Pissy attitude, I will start another search for

yet another Rheumatologist ! At this Point he was cracking up

laughing.....but reminded me that there are just not a lot of

Rheumatologist out there.....

>

> I took this opportunity to tell him that although I was always

happy with HIM, and the way HE treated me......That I get very

frustrated with their Voice Mail system, and how I could never get to

talk to HIM. and that when they say, leave a message, I am always cut

off, when the time limit runs out, and that I never can get across to

his Nurse what I am calling about....and that I had thought about

trying to find a PCP closer to me.....and one that uses a hospital in

my area.

> I told him that I liked the idea of the After Hours Clinic that

they have, and have used it many times when I felt I was going to

have to wait too long before I could get an appt. with him, but

needed to see a Doctor.

> He reminded me that they have Their Family Health Care Clinics

all around with the same hours. But I told him that HE was the only

PCP who was taking new patients when I found him......That was why I

chose him. ....I told him I had asked for and been sent a list of

Nework Providers, but I had just recieved it yesterday, and had not

had a chance to make any calls yet.......He said He would be sorry to

lose me as a patient if I find another PCP....but he completly

understood......And if I do find one nearere.... and it may take

awhile.....that he would continue to Care for me there.....and get me

as " Healthy and Polished Up " as he could before sending me on to

someone else.

>

> I then asked him if we could discuss Pain Management....He said

Certainly.....I told him that I had been on the same dose of Vicodin

ever since I was diagnosed in 1997......and that I felt that I needed

something a little stronger, and I was in a lot of pain most of the

time, and the Vicodin just wasn't helping me that much

anymore. .....Also that a lot of people in my Support Group say that

they use a muscle relaxer to boost the effects of their Pain Meds.

> He told me that Vicodin will give you a short burst of

relief .....but it wears off really fast....and you are left counting

the hours till you can take another one. I asked him if he had been

watching me?.....I told him that I didn't want to get addicted.....he

laughed and said , " if you have been taking it for this long, you are

already addicted.....and you are addicted to something that is not

helping you. " I'm guessing that your Pain Management technique

consists of " Gritting your Teeth " a lot till you can take another

Vicodin!.......I said , " you HAVE been watching me! "

> So he wrote me a prescription for Soma to be taken along with the

Vicodin to boost the Pain relief. And he said that if that doesn't

work.....we might need to talk about going to a more Potent Pain

Medication.....something with a Morphine base. .....But he said lets

try this first, and if it doesn't help, we will look further to see

what we can do for you. We are talking Quality of Life Here !

> I then showed him my rotting fingernails......I practically have

no nails left on my 3 left fingers of my right hand , and asked if he

could prescribe the Penlac Nail Varnish .....Even though I may never

be able to afford it, It was the only thing that had helped, but I

ran out too soon......He looked at them and said , " first let's make

sure that it is a fungus, it may be something else, so he took a

sample of one of the nails to send off to be analyzed to see exactly

what it is.

>

> So then I asked for the labs from my Hospital Stay last year, and

he said that I would have to go to the Medical Records Dept. at the

hospital to get those.

> So he wrote me a Script to have blood work done at the Labcore

here in Arlington. once a month....and he said to go to the Parmacy,

and use their monitoring Machine once a week to check my bp......and

if it is consistantly 140/90 or below. I'm okay, but if it gets

higher and stays higher.....call him and he will increase my

Clonidine.

>

> Then I went to the hospital to get my medical records.....I told

the lady I didn't know exactly what I needed....when I heard her tell

another person, that if they wanted their complete records. It would

cost $.50 a page....so I said I guess I just needed the

labs.......She looked up my record, and saw that I had had a complete

work up on my heart except for a Heart Cath.

> She said I will give you such and such and such......and I said

at 50 cents a Page?....she said " I wont charge you anything, just

don't tell any body ! "

> I said , " YOU GOT IT " !

> Then I went to get my script for the Soma filled, and ran into a

snag......Remember when I was going NUTS from no sleep because of my

Restless Legs. and Both my PCP and my Shrink were out of town, and my

PCPs partner had taken me of the Carb/levo thinking that was what was

causing the rash?

> Well I had called My Nephrologist, who prescribed Flexoril for

me.....which did absoluly nothing for my Legs, so I just put it up in

the cabinet because it made me too drowsy to take it during the day,

and try to drive or anything. ......Anyway It is a muscle relaxer,

and Soma is a Muscle Relaxer......so my ins. Co. would not pay for it

because I already had the Flexoril.....Plus they only would cover a

one month supply which in their eyes is 30 tablets. And My Doctor had

written the Script for 90 tablets.

> I expained to the pharmacist why he had written for so many, and

so she said she would call my Doctor this morning and let him know

that he would have to get it preauthorized....and let them know that

I Needed that many and Why.

> Then when I got home and realized that I needed to get my

Prednisone and Carb/Levo refilled I called the Pharmacist,and told

her that I needed them, and I also told her that I had forgotten to

tell Dr.Ohman, that I had had to call Dr. Epstein for some Flexoril

and why.....So ......We will see whether or not the ins. co. will

cover the Soma ......I went through the whole thing with

her.....realizing that my Ins. Co.probably thought I was " Doctor

Shopping for Drugs. "

>

> I know this is way more than you bargained for when you

asked....How did your Doctors Visit go, So if you get as tired of

reading it as I have typing it.....You know where the " Delete "

button is.