Friday, 14 February 2014
Crabby Old Lady and the Medical Establishment
Throughout her life, Crabby Old Lady's relationship with the world of medicine has been sporadic and she is only half kidding when she says that's what has kept her remarkably healthy through her life because doctors always find something wrong.
It's similar to the world looking like a nail if you are a hammer; if you are a physician, every patient needs treatment.
Since she moved to Oregon in 2010, Crabby's closest connection to the professional health community has been an annual flu shot from a pharmacist. Oh, and her yearly eye exam.
Now and then she reminded herself that she was getting on in years and ought to find a primary care physician so to have a baseline of medical records for comparison if something goes wrong in the future.
Good idea but not as easy as you would think.
Only a few medical schools in the U.S. require short courses – about six weeks – in geriatrics for non-specialists so ideally, Crabby wanted a geriatrician, someone with a lot of education and practical knowledge about old people's health.
That idea did not work out well. When, in her online research, she located a few and called their offices, Crabby was told they were not taking new patients. More than once, she was given that information after being asked what kind of insurance she has – Medicare, of course.
(Crabby is not saying there is a connection between insurance and physician availability but it does leave her wondering what kind of insurance a geriatrician's office would expect most people who need a geriatrician to have.)
After a few such discouraging telephone conversations, Crabby would set aside her search for a future day and did not often return to it.
In January, eight years after the initial diagnosis of cataracts, Crabby's doctor said she was ready for surgery and before she could say howdydoo, she was being evaluated in an eye surgeon's office.
But wait. No surgery without a recent physical examination. Uh-oh. No primary care physician in Crabby's life.
Armed with a recommendation from the surgeon's office, Crabby got lucky that day and within an hour was undergoing a general examination, blood and heart tests, etc. with an internist in the building next door.
So in a period of about three hours, in addition to her established eye doctor, Crabby had acquired an eye surgeon and a primary care physician – a collection that, in 21st century business jargon (it IS business these days), could be referred to as her personal healthcare management team.
Oh, but she was not nearly finished yet.
Crabby Old Lady doesn't remember much about her bout of flu in January. She lost about 10 days of her life and when she awoke clear-headed again, her right foot didn't work properly.
Before she goes any further, let Crabby explain something that won't be a surprise to anyone who has read this far: Crabby's theory of healthcare is that if it is not a broken bone or an artery gushing blood, give whatever is wrong some time and it will probably take care of itself.
Although Crabby does not recommend this conduct for others, her personal experience is that most of the time it works. It did not with her foot.
Step. Flop. Step. Flop. Step. Flop. Crabby could not lower the sole of her foot to the ground in a normal way; it just dropped to the ground (flop) on its own after her heel touched down.
A virtual walk around the web revealed that it was probably something called peroneal neuropathy and after a visit to Crabby's new primary care physician, she was in the office of a neurologist who was sticking electrified needles into her foot and leg.
Yup. Peroneal neuropathy caused, in Crabby's case, probably by crossing her legs - “don't ever do that again in your whole life,” said the neurologist. It's a common condition, he continued, and in Crabby's case treatment will return the foot to normal or near normal function but it will take months of physical therapy.
So Crabby Old Lady, who began 2014 with only an eye doctor, now has a personal healthcare management team consisting of that eye doctor, an eye surgeon (temporary), a primary, a neurologist and a physical therapist. She can't wait to see what's next.
Although there is some comfort now in having a primary care physician – someone to call when something goes wrong in the future - perhaps you can see Crabby's point: get involved with the medical establishment and they multiply like bunnies.
At The Elder Storytelling Place today, Chlele Gummer: My Dandy Brandy