Tuesday, May 29, 2012

Appointment with Dr. B (GP)

This appointment actually happened on May 24th but I am just getting around to typing it up now as my shoulder is still causing problems and haven't had much time that I could sit down and concentrate and remember all about the appointment. Originally this appointment was made to discuss my shoulder issues, go over my report from Dr. M (the crappy OS mentioned in this post) and to get my medications refilled.  But of course that isn't really how it turned out.

I had a mid-afternoon appointment and knew that I would end up being there a while as there were a handful of people already in the waiting room when I arrived.  I finally got called and went into the nurse's room (we will call the nurse "P") where she does the pre-appointment part where she asks why you are there, gets any paperwork ready and does all your vitals.  Thankfully I had made a list of all the things that I needed to get addressed during the appointment.  P did my vitals then I started on my list of issues.  I gave her all the paperwork for my dental surgery (Going to be on June 18th for those who are interested - just fillings though), asked about getting my vitamin D levels checked, gave her a list of the medications that I needed refilled and mentioned about the xrays I had done (both knees, right hip and right shoulder before seeing Dr. M; right shoulder a couple of weeks ago when I injured it).  P filled out all the paperwork for the dental surgery, wrote up a blood work sheet so I can get my Vit. D levels checked, printed off the latest shoulder xray (normal of course) and printed out the medications that I needed to refill.  Then it was just waiting for my doctor to become available (a drug rep and the building owner stopped by just before my appointment so they got in first :( ).  I was quite nervous about seeing Dr. B based solely on the issue with Dr. M and the fact that my mom was not at this appointment with me (Dad was out of town and mom had to be at home for when K got home from school).  I am going to put all of what happened in little sections so I don't forget anything and it doesn't get too confusing!

Pre-Op Paperwork - He read through the diagnosis's that I have (Mitral Valve Prolapse is on there so my old cardiologist must have diagnosed me with it, he just put a question mark beside it), basically MVP, EDS, Sinus Tachycardia and Syncope are listed.  All my medications and doses are also on the form.  Dr. B then pulls out a report he got from the anesthesiologist and was quite impressed by it.  It went over the no locals aspect and said that they had to be very very careful when moving me (this is something that I did NOT tell him), everything should be routine but that I may need to have emergency intubation and resuscitation which sounded a little scary to me but my doctor seemed pleased by it and said that it was one of the longest reports that he has ever seen from an anesthetist.

Testing - Dr. B agreed completely with the suggestion of getting my vitamin D levels rechecked to see where they are and what we need to do in regards to dosing the vitamins that I do take on a daily basis.  I then asked if / when I should get another DEXA scan as it's been slightly more than two years since I had my last one and I have been on an osteoporosis medications for 20 months now and would like to know if we are making progress or if we should be changing things up or what ever.  At the very least a new baseline should be established.  Dr. B fully agreed with me but does not want to do ANYTHING until after the surgery. He then checked my chart and saw the medication that I am on for the osteoporosis and says that there is a new formula of the medication that you take weekly instead of monthly that he thinks will be a better fit for me.  You don't have to follow any of those stupid don't drink for x minutes, don't lie down for y hours, don't eat for z minutes.  Then the fact that it has to be the first thing in your stomach when you wake up and taken with an entire bottle of water which makes it tricky as I take my morning meds right when I wake up also.  Apparently this new formula of the drug does not have all the restrictions that the old one has and is supposed to be easier on the stomach which is definitely important especially after discussing gastroparesis and medication absorption.  He also says that it should most likely stop at least part of the heartburn issues that I get after taking it.   The only down side to this medication is that I have to take it weekly instead of monthly but that's not a big deal as I do up a weekly pill organizer every week anyways to throw it in.

Medications Refilled - Figured this would just be a quick signature on the already printed off script but was surprised when he went to hand me the paper and then quickly pulled it back saying "Wait a minute, what do we have you on now?" (This is because we switch between two different long acting and two different breakthrough meds to keep down tolerance).  He looked at what I was on and said that there is a new medication either just out or coming out soon that is a narcotic but it also has neuropathic pain reducing qualities too it as well.  I asked him if that meant I might be able to combine my pain medication as well as the medication that I use for nerve pain but he wasn't sure but that we would look into it more after I have the surgery.  He didn't give me the name of it as he wanted to do some more research on it himself and isn't even sure if it is out on the market yet.

Shoulder Issues - The final issue was my shoulder.  He asked how the appointment with the OS went and I told him all that happened.  He very quickly skimmed the report and at the end it said that I had not decided if I wanted a new MRI ordered or not (huh??).  Anyways I told him that he wanted me to do physio but would not set limits, when Dr. B asked why I said I didn't know but that I wanted a time limit to try it or something and Dr. B says that's totally reasonable and asked why he wouldn't so when I told Dr. B that he said physio doesn't work like that he was confused.  He seemed disappointed because this doctor is so young and Dr. B thought that he would be the best chance because he might be more open minded.  He then told me that he wanted me to call the OS's office to get a new MRI ordered and if the OS won't order it then to just go right back to Dr. B because he feels it is definitely needed.  I then asked him if I could have a copy of the report for my files and he said of course and printed it out for me.  I told him that I just like to keep everything together just in case I need it down the line and he said that with the number of doctors and problems I have going on that that is a smart idea :)

So I left the appointment with a stack of papers - report of the shoulder xray I had just after injuring it, prescription for my pain medications, a requisition to get bloodwork done again, a copy of the forms that had been filled out for the surgery, the report from the OS and a card to go back two days after my dental surgery. 

However, by the time I had read through the report from the OS (Dr. M) I was furious!!!  So many inaccuracies and plain out lies!  I gave in and called the office on tuesday (May 29th) and as of today (June 1st) I have not heard anything from the office.  I am going to give it another week and contact my GP again about it.  After reading the report I don't really care to ever see this OS again.  There is enough contradictions, lies and things completely omitted that it is going to end up being an entire other post that I will get up this weekend (hopefully!).

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