Tag Archives: appointment

Diagnostic tests, doctor shopping, and medical snobbery…

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Since my original diagnosis of “probable SVT” way back in July took place under the umbrella of the ChristianaCare hospital system over in Delaware, my first appointment with cardiology was also made within their system. That was fine. Their main campus is reasonably well reviewed and I could get seen by a cardiology nurse practitioner in August, which I’ve found out through this process is a fast turnaround for a new cardiology patient who isn’t inactively laying in a hospital bed. 

In the intervening days and weeks, though, I had a follow up with my primary care doctor, who operates as part of the Johns Hopkins system. He was less enthused about my decision to use Christiana for my cardiology needs – explaining that their cardiology department, while fine, is “not ranked” whereas Hopkins cardiology is currently ranked 13th in the nation with the hospital consistently ranking very near the top of any list of “America’s best hospitals” that’s ever put together.

Yes, my primary care doctor is a medical snob.

Despite his cajoling, I kept my original appointment, which led through a series of tests and reports that I was going to need anyway. I also reached out to Hopkins Cardiology to get myself on their waiting list for new patients and ended up with an appointment scheduled deep into October. It wasn’t ideal, but since I was going through all the preliminary tests and could then hand over a pretty good sized file, the timing wasn’t a major issue for me. I was able to take advantage of their wait list option to get my first appointment in the books last week – with a guy who has been practicing for 40+ years and has the look and feel of someone who has seen just about everything. In other words, he’s exactly the guy I want even if all we’re doing at the moment is preventative and exploratory. 

With all other things being equal, if being able to access some of the best cardiologists in the country means driving 45 minutes west instead of 25 minutes east, ultimately it feels like not much of a decision at all. 

It turns out, like my primary care doctor, I too am a medical snob.

So, I’m going all in. My optometrist recently retired. Instead of going over to the doctor that took over his practice, I’ll let Hopkins run the show for my eyes too. I’ve got my first appointment set up with the closest branch of the Wilmer Eye Institute later this year. That puts all but one doc under a single banner… and when the time comes sometime in 2024, I’ll bring that one into the fold too.

All of these new faces on my medical team are a little further away than I’d like, but I feel like what I’ll lose in adding a few minutes of extra travel time, will pay me back in the convenience of having them all working under the same organization. I was woefully unprepared for the level of coordination I’d need to do myself when my primary care doc and everyone else had electronic records systems that refused to communicate with each other. 

I’m in no way fool enough to believe that being “nationally ranked” is any guarantee of better outcomes. For now, it appears that most of my problems are fairly benign, but should something become more involved or I develop a novel condition over time, I’m going to put my faith in the big name going forward. Hopefully they’re not just riding their 135-year-old reputation. 

Some people would take this opportunity to rail against the American healthcare system. Undoubtedly, it has challenges – but I’ve been absolutely amazed by the level of services and the array of options that have been presented to me over the last three months. Don’t think for a moment I’ve failed to realize my great good fortune to have both the geographic proximity to one of America’s great medical centers and an insurance plan that makes walking through their doors possible. There hasn’t been a day go past recently when it hasn’t been at the forefront of my thoughts.

Firing my vet…

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To put the bottom line up front, I’m going to have to fire my current vet.

Given how often I find myself in need of veterinary services, I feel like that’s a statement that probably deserves some follow up. The fact is, I like my current vet. They’ve got a beautiful new facility. The docs and staff are consistently good to work with during appointments.

Unfortunately, it’s getting those appointments in the first palace that’s causing the trouble. I called yesterday afternoon, wanting to get an appointment for Jorah. He’s got a lot of the classic signs of an ear infection. It’s one of those things that’s not going to trigger a high speed run to the emergency vet, but that should get treated sooner rather than later. After I explained his symptoms, the receptionist offered me a choice of appointments on July 9th or 11th. I’m sorry. What? I’m sure some people will let their animals linger, in pain and possibly getting worse for the better part of three weeks for an appointment, but I’m not one of them.

They didn’t offer the option of a drop off appointment or even ask if I wanted to get on the cancellation list.

I’m not putting their name on blast here, because I know the veterinary industry is currently under a phenomenal amount of pressure and doing it while perennially understaffed. Although I understand the overall issue, that’s not going to get in the way of me using every resource I can bring to bear to get Jorah, Anya, Cordelia, or George the treatment they need in a timely manner.

In any case, I do want to voice my appreciation for Middletown Veterinary Hospital for getting Jorah scheduled for an appointment – as a new patient – in less than 48 hours from the time I called. They’re the place that did Cordy’s spay last week since my current vet of record was scheduling those out into August and September.

Based on the sum total of experiences getting this menagerie of mine vetted over the last few months, the only logical thing to do is start the process of getting the three furry ones transferred over to Middletown while I’m there tomorrow. Getting all their files transferred will be a hassle. It’s going to add 20 minutes to every trip to the vet. Unfortunately, it can’t be helped. The vet I’m firing was awfully promising, but all the promise in the world is wasted when it takes the better part of a month to get basic care.

Not what I signed up for…

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A few months ago, my doctor started hectoring me to schedule an appointment with a nutritionist. The guy cured some recurring foot pain I was having years ago with the power of positive thinking, so I’m usually game for anything he wants to try.

Let me start off by saying I could probably have gotten a cardiology appointment more quickly that I was able to get something scheduled with a local nutritionist. I made the appointment so long ago that I’d honestly forgotten about it. In fact, it wasn’t until my boss mentioned this morning that I was scheduled off this afternoon that I remembered it at all. That’s not the finest hour for my long-term memory, but I made it on time today so at least I have that going for me. 

I’m not sure what the doc expected me to learn. Eat less, exercise more, knock it off with the red meat and gin. I’m perfectly willing to admit intellectually that I should be exercising an hour a day or that I should be eating low-calorie, flavor-free foods. But the simple fact remains that a) That’s not how I want to allocate my limited free time and b) I like foods that don’t taste like someone smeared cottage cheese on cardboard. I’m well aware that I’m taking years off my life… but I’m not at all sure that the cost of adding years is worth what joys I’d be expected to give up.

This all would have been a fine use of an afternoon, except for the part where when I called requesting an appointment with a nutritionist, the nice people at Christiana instead made me an appointment with an endocrinologist. She was pleasant enough, I suppose, but far more interested in sending me off for a round of all the bloodwork than discussing how to make low-fat lasagna that doesn’t taste worse than the box in which the noodles arrive. I’m pretty sure that’s not what my doc or I really had in mind… but she said her office will be happy to refer me to a nutritionist, so I guess I’ll just go ahead and build a whole suite of medical professionals while I’m waiting on that to happen.

Sometimes it’s increasingly difficult to tell if I’m the sane one and the world has gone mad, or if the world is sane and I’ve lost my mind. Maybe it doesn’t make any difference.

What Annoys Jeff this Week?

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1. Forty minutes. I overslept by 40 minutes. I know that doesn’t sound like much – and it isn’t in this work from home environment where I regularly climb out of bed two hours before I need to sign on for the day. It is, however, just enough time shaved off the morning to make me feel like I’m running behind for the rest of the day. So, sure, I’m marginally more rested but carrying around loads of extra angst while spending the day trying to shave minutes and seconds off everything and get back to baseline so I don’t feel like I’ve squandered the day when it comes time to lay my head down again.

2. Reminders. I have an appointment with my doctor on Friday. I know I have this appointment because when I made it, I tapped it into my calendar and set a reminder. To the best of my knowledge, even in the time before electronic, handheld calendars when everything was written on paper, I never missed or even found myself late for an appointment with my doctor. I’d even be comfortable extending that to pretty much any appointment I’ve ever made as a grown adult. If I tell you I’m going to be there, I’ll be there. On the rare occasion where it hasn’t been possible to keep an appointment, I’ve cancelled as soon as I knew there was an unavoidable conflict. My doctor’s office, however, seems to think I’m the most ragingly incompetent adult who has every shuffled through life. So far in the last seven days I’ve received three text messages and an email imploring me to remember that I have this appointment. I’m trying to remember that this is probably just a reflection of the general public being barely able to dress and feed themselves without assistance. Honestly, I’m not sure if that makes me feel better or worse about the situation.

3. The Gas Rebate Act of 2022. Proposed before the U.S. House of Representatives is the Gas Rebate Act of 2022. As proposed, it would send $100 to every American (plus an additional $100 per dependent) each month that the price of gasoline exceeds $4.00 a gallon. Maybe I truly am just one of the olds now, but I distinctly remember a time in America where we expected to need to pay our own way in life. That seems to have gone out of fashion with the bailout of homeowners who over-mortgaged themselves in the early 2000s and has only accelerated in the Plague Era when rent and mortgage payments could be suspended completely while Uncle sent out round after round of cash money “just because.” I increasingly feel like a real sucker – over here paying my own bills and seeing the obscene amount of money being taxed away every year so I can pay for other people’s goddamned gasoline too. 

What I Did on My Furlough Day (Part 3 of 11)

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Someone furloughed shouldn’t be working as hard as I am. I got up at 6:30 this morning (Hush, that is sleeping in for people who normally wake up around 5:00), drank a pot of coffee, emailed my usual anti-furlough rant to the members of the Maryland Congressional delegation. I thought about calling them out on Facebook and Twitter, but thought better of it since I was on a schedule. I was on a schedule because I had my six month check up with the ol’ sawbones this morning. Ironically, I picked this doctor at least in part because his practice is not far from the office so it would be easy to slip out and back for appointments. Being Furlough Friday, of course, I believe I have discovered a flaw in what was an otherwise logical arrangement. And, please, don’t get me started on their rescheduling the appointment from yesterday to today with about 18 hours notice.

I could turn this into a long story, but I won’t. As usual the doc is annoyed that my blood pressure is good, blood sugar is well within tolerance, and the acid reflux has been gone now for well over a year without meds. They pulled blood in the hopes of finding something wrong, but I have no reason to expect it will come back as anything but “normal” as it always has in the past. So it was a typical visit – lose weight, less meat, nothing over 10g of sugar.

OK, look, doc. At some point we’re going to have to have a serious discussion about not just health, but also quality of life. Maybe if I eat nothing but tofu, almond milk, and salad with no dressing for the rest of my days I’ll live to be 106… but I’m not sure 71 years without steak, pizza, craft beer, or blue cheese dressing is a world I wish to inhabit. Sure, I’d be alive, but I’m not sure I’d really be living.