Tuesday, January 13, 2009

The best laid plans...

sometimes get picked up and moved to another location. Sometimes literally.

On Monday morning at about 8:15, as I was leaving to go to my physical, the phone rang and I could see from the caller ID that it was the imaging center. They informed me that due to the cold weather, the CT machine was down. It *might* come up later in the day, they weren't sure. I could call back later in the day, but since I have to be npo for four hours before the test, I might want to just schedule for another day. I told them I'd call them back and quickly emailed my oncologist's assistant, who makes the CT appts for me. I asked her if she could get me an appt at the CT that is near to me office, which is the one I am used to going to anyhow. By the time I got to work, there was an email from her telling me that I was scheduled for 3PM today (Tuesday). Then, the CT tech was able to find a vein for the IV contrast on the first try! This is a record - I can't remember the last time I had a CT and they got in the first time. (The record is six pokes.) Maybe the weight loss helped?

My physical went fine. The fasting time wasn't completely wasted, as the nurse practitioner I saw ordered standard bloodwork and I was able to get that done while I was there. The NP was okay - she is new, hired to work with my doctor (Dr. K)'s patients as he is the medical director of his facility now so doesn't have much time for patients. While the medical assistant was taking my vitals, she told me how I would really like the NP, she is so great, etc. When the NP walked in, I felt a distinct chill in the air, and not the temperature kind. She was thorough but kind of curt or brisk. I wondered why. Was it because I was late? (Not my fault based on paragraph 1 above, though she didn't know that until later.) Was it because I am fat? She did not mention my weight per se, also did not notice the weight loss in my chart; I told her about it in answer to the standard question "have you gained or lost weight recently". She asked me what I was doing and I told her about working with R, trying to identify my emotional eating triggers, etc. She seemed rather unimpressed, asking me about the triggers but didn't offer me any encouragement. She stressed that I need to be exercising. She is completely right but man, I am having a hard time figuring out how to fit that in. I explained about my long commute, and she could relate because she's been to my building so that seemed to soften her a bit. "what about lunchtime?" she asked. Good question, but bad me usually works through. It's an issue I need to figure out and I will figure out this year. Anyhow, I was supposed to have my Pap test too but it looked like my period was starting so I have to go back for that. Now my period has disappeared again... I asked her if she thought that I should persue treating my PCOS or if my age indicated that I am just heading toward menopause. We discussed it a bit but never did come to a resolution. I have been thinking for a while that once I see where things are headed cancer-wise, I would contact the GYN/RE that helped me get pregnant with the girls, who diagnosed the PCOS, and get her thoughts. So anyhow, maybe I am projecting onto this NP my fears about medical professionals and how they treat fat people. Hard to say. It did occur to me later that I have a letter in my file, that I wrote to the doctor that I had chosen to be my PCP prior to seeing the one I have now (NP's boss). It was based on a template I had gotten from a fat-acceptance group I belong to, explaining my weight situation and that while I know about my weight being a risk factor, etc. that I did not want it to be brought up by me medical professionals in a shame-inducing way, or used as a scapegoat for any medical issues I might have. The doctor who was the recipient of this letter didn't even read it until our first appointment, and basically blew it off. So after Jim started seeing Dr. K and liked him, I blew her off in favor of him. It's really difficult in the space of an appointment to convey all that I know, feel, understand about my health. I know that it's the nature of the system that NP can't really get to know me right off the bat at the first appointment. I just didn't get the warm fuzzies I was hoping for, even when discussing my current cancer situation. Oh well, she'll get another chance when I go back for my Pap. She did also order my annual mammogram for me too, so I need to also schedule that bit of fun. :-)

So now I wait for Thursday and what news it will bring.

1 comment:

Sherry said...

Your instincts about the NP are probably correct, especially since the medical assistant was singing her praises right before you met her. I'd say, give her one more chance --- if she continues to treat you differently than the really nice doctors you see, give her the boot!

Good luck Thursday. I'm sending hugs and good thoughts for good results. :-)