O Tannenbaum

Ready for Christmas

My older brother helped decorate my Charlie Brown Christmas tree today. Last night in one of my sleepless tries at distraction I managed to drag it out of the garage, but I couldn't find any of my Christmas decorations. My younger brother helped us organize the garage last summer, and my malfunctioning noggin couldn't remember where we had put anything. I was lucky I had covered the tree with a big pink sheet last year so it at least was easy to find.

My mom was so pleased to have the tree up even in its sad kind of bedraggled state with no ornaments. My brother took pity and went and bought more lights and some ornaments in town and decorated it. It was transformed by the time I got home, and my mom was delighted. The biggest benefit of my procrastination is that he got all the ornaments 50% off! I guess it pays to buy your decorations close to Christmas.

I have two days off this week for Christmas Holiday. I have one day off next week for New Years, and a floating holiday I will save for later. I am sure I will end up having to use it for some sort of sick day. I haven't really had a vacation in the last six years because of my terrible luck with health issues - all my time off is used for illness. I have the best bosses in the world to have put up with me and my defective body for this long!!!  I just wish I was physically in better shape to do the job they need me to do.  Sigh.

I had a great day at work, got many things done. I have to say I'm a purdy darn good trouble shooter. Now as a fixer, I'm just not as talented so it takes a little more work for me to fix things. Some I won't even attempt - best left for the professional programmers.  The Legs are bad for an hour two each day after I get there, and the same way when I get home so I am paying a price in pain for every trip.  Being able to be productive in spite of The Legs is making me happy.

To make my day even better, I was visited by a good friend at work. I was able to talk with her a bit, and go out and visit for a minute with her husband. She has the most positive attitude of anyone I have ever met, and perseverance that surmounts any obstacle. I tell her we must be long lost cousins because her family is just about the same as mine!!! She had not seen me since I had started using my cane BLING, and somehow it hadn't really occurred to me that using a cane would be a difference that was noticeable. I guess BLING is rather shiny.  We have been friends for over 15 years but I am sure neither one of us looks a day older!

I am on a new diabetic medication, Januvia, along with metformin. I ended up going to Dr. Kid's office and seeing Dr. Kid's endocrinology physician assistant, Ms. Cheerful. We discussed my options because of my refusal to take Actos (cankle maker extraordinaire) and my chronic pancreatitis. Dr. Kid wanted me to take Byetta which has the added benefit of causing weight loss but because it works by holding food in your stomach longer this won't do for me. Ms. Cheerful agreed.

Your pancreas starts producing exocrine enzymes (lipase, protease, and amylase are three main ones) to digest things in your stomach the minute something hits your stomach and keeps on going I guess until the food gets down the digestive chain a little ways. Holding food there longer would just be an exercise in increased pain that I don't want to experience. Januvia has caused problems with pancreatitis also, so I guess I will just have to watch The Belly closely for a while and see how it goes.

I got a couple of letters from Dr. Kildare's office today.  One was rescheduling my March 2011 appointment.  Sooner?? I thought incredulously.  No way!  I was rescheduled from Thursday March 24th to Monday March 28th because Dr. Kildare is not going to be in the office on the 24th.  The other letter was from Nurse Goodguy telling me that one of my blood tests was normal (CPK).  No surprise there.  Time is ticking while I am sure Dr. Kildare and Nurse Goodguy are pondering over my extensive medical record trying to come up with a treatment plan for me and The Legs.  I give them two more weeks after this Friday.  Somehow I think they are going to miss that deadline. 

I think that time actually must flow differently at Dr. Kildare's practice.  A month for me must be like a day to them.  That's my theory of relativity for medical appointments - the closer you get to the speed of "more time to deal with you than I think my time is worth", the slower it gets to your next appointment.  From the doctor's point of view however, it is a blink of an eye and there you are again: older, grumpier, not any better, he still hasn't bothered to review your records, and he can't figure out why you aren't pleased when he can't even remember why you had an appointment and doesn't have an answer for any of your questions. At this point if the doctor is not careful you reach critical mass and explode right there in front of him.

Dr. Kildare's Crisis

Put My Cankly Foot Down

After a night of pain and cranky thoughts and almost no sleep due to driving yesterday, I woke up in a not so happy mood after my half hour of dozing.  I had found some of the records Dr. Kildare had me fill out requests for, so I called and left a voice mail for Nurse Goodguy saying that I had some copies of records that I would leave for him when I came in for my blood draw (the tests had to be fasting for Dr. Kildare).

Then I said (I hope in a nice voice but I wasn't feeling very nice) that I didn't want to say how they ran their practice or decided the frequency for visits, but if March 2011 was when I was going to get any follow up done then let's just cut to the chase and refer me to a bigger hospital in a major city. In this area, I said my preferences would be Barnes Jewish/Washington University in St. Louis (where Dr. Bellyfixer works) or KU Medical Center in Kansas City (where Doc Optimist works).  This seemed to hit a sore spot, as when I got home this evening (having worked around five hours  - trying to earn a paycheck even though I am in pain, and it is very difficult for me to sit or concentrate) there was a message from Dr. Kildare.

First off,  he tried to blame the March 2011 appointment on the computerized scheduler.  I work in health care, and I have trained schedulers, and even been a scheduler once upon a time about 20 years ago.  The doctor says what frequency you return in.  If they want you back in one day, and that day is completely overbooked, the scheduler STILL sticks you in that day somewhere.  Why?  Because a physician ordered it that way.  My return appointment was "the first Thursday appointment available".  The scheduler (person) using the scheduler (computer) put this in, the first Thursday appointment available was in mid March 2011.  I asked twice, "Are you sure that is correct?  Is this what was ordered?"  since I had just come from an exam room where they had said for me to "be patient" for just a little while longer.  I don't know what universe Dr. Kildare comes from, but in mine three months is not "just a little while longer" and is beyond what I am willing to patienty wait for.

Perhaps poor Dr. Kildare is having to serve penance in my mind because when Dr. Dense was my physician and I was in incredible mindboggling daily pain with The Headache unsucessfully medicated I had no way to get any care between appointments.  The practice paid lip service to "just call and we will take care of you" when in reality it was call, be ignored, call back, have the nurse get snippy, call back, be told you need to go somewhere else. 

I will call tomorrow and either talk to Dr. Kildare's nurse, Nurse Goodguy's nurse, Dr. Kildare, or Nurse Goodguy and reply to my message.  Dr. Kildare asked in his message that I give them a couple of weeks to read my records and come up with a game plan.  I don't mind giving them a couple of weeks or even a month if I have to, but I am NOT waiting another three months, just to find out in three months there is nothing that they will or can do and I am another three months in pain and another three months further disabled and another three months up the creek without a paddle.  This has been ongoing for about a month messing with this and that, and I have been messed with enough. 

He also said if I had a problem with my return visit, I should have said something at the time.  I did!  The nurse AND the scheduler told me they were not willing to question Dr. Kildare as he had distinctly scribbled "Next Avail Thurs" on my "superbill" in the followup section.  I wasn't going to sit there and argue with them, they knew Dr. Kildare better than I did.  Guess Dr. Kildare is more than a little defensive about this.

Hoping I get lucky and Dr. Kildare gets lucky and I have a nutritional deficiency.  Maybe that will fix everything and I can take a pill and everything will be perfect from then on!!!  Hoping my blood tests are back tomorrow then I can find out.

The Dr. Dense Backstory:

I was in excruciating pain so bad I was in tears the day I called it quits with Dr. Dense.  It was mid summer 2008.  Dr. Dense had tried different medications since I started seing her in January that year: none worked. She ignored the records I finally got transferred to her from St. Louis University Hospital where I had been diagnosed with an indomethacin responsive headache, although she was the one who referred me there. The last medication she tried had been lithium which definitely did not agree with me.  I refused to take it after the second week.  She refused to prescribe anything else.  This was the third time since I had seen her that she simply left me without any medication or adequate pain managment for a significant number of days/weeks.

The day before she said she wouldn't prescribe indomethacin (hemicrania continua is an indomethacin responsive headache disorder - nothing else really works well) but she would hospitalize me for a three day infusion with DHE, depakote, and steroids.  I agreed because something was better than nothing which is what Dr. Dense had me on at the time. The nurse got all the permissions/preauthorizations done, called me said she was waiting for the doctor to say when I should go in.  I waited and waited and waited when I should have been at an emergency room.  The nurse calls back at the end of the day saying Dr. Dense, although in the office, was not responding to her requests for an admission time. 

 I called back the next morning in full melt down, and the nurse said very apologetically that Dr. Dense wouldn't admit me until the middle of the next week, as she was on call then.  I asked why she wouldn't admit me this week, as I was getting to the place I would not be able to drive myself to the hospital, and Dr. Dense actually said because she didn't want to inconvenience the other doctor who was on call that day.  WHAT????  The last straw was when I got the office manager involved and asked if Dr. Dense would reconsider prescribing the indomethacin as it actually reduced the pain, and Dr. Dense told her she would do that ONLY if I came in and signed an agreement that I would not see her again and I would get another doctor.  WHAT??? 

Idiotic, egotistical, unprofessional, unethical, arrogant, rude and offensive all at once - she was giving me the complete Doctor God package.  I went to the ER got medicated by some miscellaneous ER doc and as soon as I could I went back to my PCP and got referred to sweet Doc Optimist in Kansas City.  I guess Dr. Dense got her way as I have not seen her again nor do I wish to.