Wednesday, July 16, 2014

writing 101 -- with papa hemingway

Running out of blog material?  Too busy to tread the exotic aisles of Walmart?

Do what I do.  Take a trip to an American hospital.  It is always an adventure.  And the experience is target-rich with tales.

That is what I did yesterday morning.  When I left the emergency room on the 4th of July, the doctor told me to incrementally increase my blood pressure medicine dosage over the week.  If the blood pressure did not come down, I should either go to the immediate care clinic or return to the emergency room.

For once, I followed doctor's orders.  Over the past ten days I increased my medicine by a factor of four -- to no effect.  My blood pressure stubbornly stayed at the same level as when I left the emergency room.

Having given the emergency portion of the staff a shot at being helpful, I decided to try the immediate care clinic.  I almost failed my first trial by combat.  The very nice receptionist was concerned that my papers were not in order.

Getting into a hospital is becoming almost as difficult as entering Germany in less pleasant times.  Apparently, I am supposed to have cards from both Medicare and Tricare.  I guess, to prove that I am the same person as the one described in my driver's license and my passport.  I am not certain I ever had either of those cards.  They certainly were not in my wallet. 

But, we Obamacare exiles are not accustomed to being so thoroughly documented in Mexico.  At least, not to receive medical treatment.

To my great surprise, as we stepped through the underlying logic, she relied on her well-developed sense of common sense, and threw wide the doors of the inner sanctum.  Especially, after the admitting nurse talked with me.

Everyone at the clinic was personable and professional.  I felt as if I were receiving treatment from people who cared more about me than process.

Especially, the doctor.  He had reviewed my emergency room charts before he talked with me.  But, he allowed me to walk through my medical history as if I were a partner in my own care.

When I showed him the medication I was taking, his eyebrow jumped when I held up the box containing my diuretic.  He pointed out it was not a diuretic; it was actually the antihistamine Dra. Rosa had prescribed for my mysterious insect bites.  The medication I stopped taking because it made me too drowsy.

So, for almost two months, I have been taking no diuretic while taking a double dose of antihistamine for no condition.  I call it Geriatric Prescription Syndrome.

No wonder my blood pressure was out of control.

He asked me if the emergency room staff had seen my medication.  I told him I took the boxes along with me -- thinking the evidence might be relevant.  I also told the emergency room nurse what each one was.  She merely glanced at them.

I connected the dots that he left open.  Had the emergency room staff looked at my medication and listened to what I said, I would not have spent a week being frustrated by the lack of change.

If I lived in Bend, I would want the doctor I saw yesterday to be my primary care physician.  He seems to belong to a completely different denomination in the Religion of Medicine.

When I told him about my high triglycerides, he offered his opinion that because we know almost nothing about the interaction of the triglycerides with the body, my 500 level was probably not good.  But damage does not appear to occur until levels reach 1000.

He was just as sanguine about my blood pressure.  He said I should feel comfortable if I could get the lower measurement under 100.  But he was concerned that the upper number seemed to be rather erratic over the past ten days.

Now, that is a doctor I can trust. 

The emergency room nurse was so busy nagging me about life style changes that she never did see the cause right in front of her eyes.  She was one of those boring people I dread being seated next to at dinner parties.  You know the type.  Their only conversation centers around their running regimen and their "numbers."

I hope this is the last installment of Mexpatriate Goes Emergency.  After all, this medical tittle-tattle is cutting into my sociological studies in Bend's emporia.


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