Progress

So today was the day! I sent an e-mail directly to the GI I was trying to get in to see last week, and on Monday I received a call from her nurse. She was incredibly nice and apologetic about the trouble I've been having trying to get established as a new patient, and helped me get in to see a different doctor than the one I was scheduled to see. We met this morning, and it went...okay.

Pros:

Everyone I've dealt with at the medical center so far has been really cordial and has had excellent bedside manner. This is not as easy to come by as you might hope.

Very timely appointment. I didn't have to wait long to be taken to the exam room, or to see the doctor.

The doctor himself was nice, and easy to talk to. I was able to speak frankly about my symptoms, things I sometimes do to self medicate (wink) and didn't come away feeling judged. He made it very clear that I am welcome to call if I have any pressing concerns between now and my follow-up.

Cons:

The physical part of the exam was the equivalent of kids playing make-believe. I'm used to giving several deep breaths while my GI listens to my heart and lungs, then having my abdomen palpated to check for tenderness. What I got this time around was a brief graze over my heart and gut with the stethoscope, without even lifting the heavy sweatshirt I was wearing. It honestly lasted two seconds. I guess better brief than overly-thorough (meaning I'm glad there was no rectal exam.)

I asked for prescriptions, expecting to be handed paper copies to bring to the pharmacy next time I need to re-up. The conversation went on after that, so I didn't realize I hadn't been handed them until I was halfway out the door. I did have a page with my exam notes on it, and saw that the scripts were listed there. I went back to the front desk to ask if I was supposed to hand this to the pharmacy (and only later noted they had the wrong pharmacy listed, even though I had specified my preferred pharmacy with the other front desk clerk when I arrived.) She told me I was meant to call them to have them call the pharmacy when I needed my meds. It was confusing, but I was not in "self-advocate" mode today and decided to walk away and deal with it later since I don't need any of my meds for another month.

My previous GI sent my records, but they failed to make it to the doctor's hands before my appointment. I overheard one of the nurses say it was her bad, and I appreciate that she admitted it. Not a big deal, really, but I suspect having them prior to meeting would have made the appointment more productive. One of the issues I have with this health center in general is that they seem to have too many people going at once - too many chefs spoiling the pot, as they say. Instead of making things more efficient and effective I find it mostly causes confusion and miscommunications.

 Conclusion:

The take-away from the appointment was that I may need a colonoscopy to determine if this is a flare-up and requires prednisone, or if we should try changing course to bio-therapy like remicaid (yikes!) I, of course, am hesitant to have another scope, since the last one is what sparked me up back in April. So we're kind of at a stale-mate. I understand why he wants the scope, he understands why I don't want it. We have a follow-up scheduled in a month and, as previously mentioned, I am welcome to call in the interim if things get worse. If anything from my records or blood work from today raise any eyebrows they will call me. Somewhat inconclusive overall, but at least it's a start.

Of All The Things...

When I left New York for Vermont I anticipated a certain amount of culture shock. I knew I would miss certain conveniences. Food delivery, late-night dining, the ability to walk everywhere... But never, NEVER did I think the #1 thing I would miss would be the ease of making a doctor's appointment.

Let's recap: In April I had a flare-up. Just as it was settling down, my apartment burned down. That was in June. I have had diarrhea ever since. Some bowel movements are slighly less watery than others, but I have basically not had a solid poop since June 3rd. That is four months of the runs. For the first two months I truly believed it was just stress sickness from what we went through. We tried to make it work for us in NY, but I couldn't handle it. Everywhere I looked was a painful memory, even the good ones. Both our cats died of smoke inhalation and, having already lost my first cat to stomach cancer in March, I wasn't taking the extra loss well.  We moved back to Vermont in August, and I tried to continue my day job from my parents' house. Emotional issues and constant post-diarrhea exhaustion made that damn near impossible, so I'm now on leave while I go to counseling for anxiety and PTSD. Being here has, for the most part, been far less stressful than life in NYC. I'm enjoying being with my family, and seeing a lot of friends that I haven't been geographically close to in over ten years. The air is fresh and delicious, the foliage is knocking my socks off, and I'm getting my kitty fix by volunteering at the local animal shelter. My main complaints are the terrible drivers (always on cell phones - for some reason there are no hands-free driving laws up here, which is upsetting) and, above all else, the length of time it takes to get in to see a doctor.

Which brings us back to the four-months of diarrhea. In August I called a local GI to make an appointment. First I was told I needed a referral from my general practitioner. I explained that I had already called my insurance company, and they had said a referral wasn't needed, but they insisted, saying it wasn't for the insurance, it was just an office policy. So I called my GP back in New York, asking for her to give her blessing to get me an appointment. Her nurse called back after speaking with the practice in VT, and was confused beyond belief. So I called the VT practice myself for clarification - what they actually needed were my records from my previous GI. Ah. Now that's something else entirely. So I called the records department, had the files sent over and was given an appointment for November 1st. I took the appointment, put myself on a wait list, and crossed my fingers.

Then the letter came. Not even the courtesy of a phone call - a letter, explaining that my appointment had been pushed back to November 21st at 8am. Well God help you if you want to meet me at 8 in the morning. And it's a damn good thing I don't have plans to travel for Thanksgiving. Thanks for making these decision for me, health center. When I called to see if there were earlier appointments or better times being offered on the 21st I got a negative. So I called around to some other practices, but they all have comparable wait-times and fed me the same "we need a referral" line and I decided to just keep the appointment I had.

Then I got a UTI. Thinking it would be a cinch to get in to see my GP from my younger years, I called her office and asked if there was time to fit me in that day. Turns out because I've been away for so long, I would be considered a new patient, which my old GP isn't accepting. (Except, as my  mom learned when she ran into my old GP socially, she would have gladly taken me if the receptionist had asked.) I could make an appointment to see another doctor at that practice, but they were booking ten-weeks out. Yeah, UTIs don't wait ten weeks. Luckily I caught it early enough that chugging water and downing cranberry pills for four days staved it off. I certainly wasn't looking to go on anti-biotics anyway, considering the whole unending diarrhea problem.

Now I was pissed. I still am pissed. Every practice seems to be involved with the main hospital around here, which makes sense - but being that this is a health-center-wide issue, it doesn't allow for much freedom for the patient. Every practice I called had a sickening wait-time for new patients. I contacted my pediatric GI for advice, and he suggested I get my former GI to call the new practice and try to get me bumped up. Still no appointment. Still having diarrhea, and now abdominal pains to boot, thanks, in part, to the ovarian cyst removal I had a few weeks ago. The surgery itself went swimmingly - however, despite the fact that my chart says I have an adverse reaction to generic medications, I was given generic percocet for my recovery. Great job, health center! Thanks for taking things from bad to worse! Yesterday it dawned on me that the GI I'm scheduled with would have an e-mail address on the hospital website, so I sent her a plea to get me in sooner, explaining that typically when a new patient calls it's not just to make chit-chat, it's because they're in need. I wait with bated breath for a response.

So that's where I'm at. My appetite is lacking, my gut hurts, and I'm tired all the time. Being on leave helps hugely because I can sleep when I need to, and socializing with shelter pets lifts my spirits. I get to hang out with my mom and grandparents and friends during the day, and I'm definitely not as sick as I could be. That being said, I'm nervous that waiting and waiting to deal with this will only make things worse and that I won't be seen by a doctor until I'm in an emergency situation. Which is - pun intended - shitty.


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