Monday, April 23, 2007

Wonderful drs

I absolutely love our pcp. You see I always hated drs. You couldn't get me to see a dr to save my life. I grew up in the military healthcare system. I was born in a military hospital. I had never seen a civilian dr till I was pregnant with K. Then that dr was Belgian and I totally lost my trust and faith in her. She didn't do what she should have done. She didn't run the tests for pe. She told me I was ok. That the military drs were wrong. Then the crap hit the fan. Had she have run all of the tests and watching me like a hawk, would I have gotten as sick as I did? Not one blood test. Not one 24 hr urine. Not one NST. Not one doppler blood flow study. All of these tests are tests that are REQUIRED for pe, pih and hellp syndrome. I had none of them till she dumped me in the hospital for "observation". Only to find out I was delivering soon and I was a very very sick momma. So you can understand the mistrust that I have had for drs over the years. I never saw the same military dr twice (except when pregnant with K). A military dr diagnosed me with indigestion when it was really hellp syndrome with K.

It took me 5 years to take the plunge for S. I just dove in. I had a pcp that was ok. But I didn't really click with her. I am sure she is great for some people, but we didn't have that thing. I changed drs shortly before getting pregnant with K. It went from bad to worse. This place was awful. Lots of charity care, the office was dingy and dirty, staff was cold, and the dr was arrogant. However, I saw my ob's office most of the time when pregnant. I did get lucky, they sent me to my obgyn that I think is fabulous.

My obgyn was awesome when I was pregnant. He had very little to work with. Just a discharge sheet in French that said severe pe at 35 weeks. Delivery at 36 weeks. 5lbs 1oz. That's it. He took my word that I got very ill and watched me like a hawk. He sent me to a fabulous peri, Dr. W. Even though she graduated from Clemson University (die hard University of SC fan here), I forgave him for it. She was fabulous. She was my advocate. She was the one that called it quits when it came time for delivery. She knew that I was not done with having babies yet before I did. She was one that told me it was ok. My ob, is really great. He cares about his patients, he still gets a thrill when your baby kicks at the doppler. Did you feel that, that's really neat. He includes your children in your visit. He tells you it's ok to feel the way that you do after having a baby (major anxiety and ppd issues here when S was born). He had the nurses call me at home to check my bp numbers (and sometimes to make sure I was in bed!). He was kind. I went through a lot with him. A high risk pregnancy. A severe uterine and ecoli infection the week after S was born. An emergency d&c to remove an infected amniotic bag that stuck to my uterine wall. PPD. He saw me for 4 months after S was born for my bp. He told me it was ok to want another baby after everything we had gone through. He also let me know how scared he was that something could go wrong. Let's face it, I was running a bp of 160/120 while on strict bedrest with 2000 mg of Aldomet and 60mg of Procardia a day. He delivered at just the right moment. He ran interference with the nurses and tried to do the worrying for me. I also went through endometriosis with him. he let me know that I could call anytime from whatever state I was traveling in if there was a problem. I had a lap with him and he took down adhesions. He has been working with me on getting things taken care of before ttc the next baby. Which most of his nurses think I am crazy for ever considering. He has a great sense of humor to top it all off with. I know that I want him to take care of me the next time too.

Then there is my pcp that I have now. I switched to Dr. L after S was born and the nurse for my obgyn said that my pcp would be following my bp. I didn't like my previous pcp. He was arrogant. Showed off and everything. I just hated going there. I immediately liked Dr. L when I met her. Her offices were clean, new, well decorated. Her staff extremely friendly. Dr L came in and took her time with appts. She makes you a partner in your healthcare. If I ask questions from things that I have researched. She knows I have researched them well in advance of me asking them. She doesn't belittle the oh you got that off the internet. She says I am sensible about such things. While she doesn't agree with me trying again. She has figured if you can't beat them, join them. So she is working with Dr. E this fall to help me. She will be working on changing the bp meds and monitoring them. Then when I get a positive test, Dr E will take care of all that. Dr. L takes her time with you. She thoroughly explains stuff to you. She also will explain why you need this test, etc. I liked her so much that my dh switched to her. I thought with my girls, I really wanted her to take care of them because she was the one I trusted. Dr L is a family practice dr. She knows I know how to manage my daughters asthma meds. She doesn't take over that, she guides it. She knows if I call and say K needs prednisone, K really does need it. She precepts med school students and I like that she gives back to the community. The best part is that my girls LOVE Dr L. She is the first dr to give them shots where they don't cry. None of the peds in the city use that freezy stuff like her. When D gives the shots, she cries and asks if they still will be her best buds. M is a nurse trying for a baby too. S has 4 children of her own. I really enjoy our talks when we come in. She thinks it is really cool that I can go and negotiate things. I think it is cool that she is such a special dr.

I was in a car accident where a 17 year old kid hit me and totaled my car and his. My knee went into the dashboard and was bruised and cut. I saw Dr L the next day due to my husband's urging. I thought I was just a little sore. Hah, she said you are going to be hurting bad by the end of the week. She was right. I ended up having to do PT and robaxin for my shoulder and neck. It got somewhat better but still hurt. My knee progressively got worse. When it started giving out and I started to fall down. I went and saw her. She immediately said I had a torn meniscus and sent me for a MRI. The MRI place messed up (so much so that my ortho now sends MRIs to be read out of town). It was read as normal. Dr. l said I believe you have this pain that you are saying. PT made it worse. So she tried a nerve blocker which helped. When no fault started denying claims, she went to bat for me. Finally I requested as a last ditch effort to see an ortho. He immediately did an arthoscopy and my knee was totally torn up. Plica was irritated and inflamed and removed. Meniscus was torn and partially removed. The cartlidge underneath my kneecap was shredded. It had to be debrided and removed. Last my knee cap was totally offcenter and not in the groove. So I had about a 5 inch incision made arthroscopically in the inside of my knee to cut through the tendons to free my kneecap. Dr. L was right and believed me when I said something was not right. Had the MRI been read right we would have been on the right track. I don't blame Dr. L for that at all. I have just completed over 4 months of PT for my knee.

Which gets me to what I love about Dr. L. She knows me well. She knows I am a mother bear to my girls. She knows that I am stubborn and active and have a hard time taking it easy. She knows that I negotiate for a living so she tries to work with that (she has been working hard on me to try and do work from home at work). She knows I will research whatever is going on. Last Sat night while turning off the lights to the house, I tripped. I didn't fall on my butt. I honestly I don't remember how I landed. I just know that the outside of my foot (where the first metatarsal is) hurt. It was more of an annoyance than anything else. I was off work for Monday because it was my birthday (I don't work birthdays). I ended up being off work cause S was sick from daycare. Weds - Fri I worked but was firmly planted at my desk. Sat I worked all day and was planted on the couch on my laptop for work. Sunday was a beautiful day and I decided to take S for a stroller ride (she thoroughly enjoyed it). I however started having pain in that foot. I thought I might have overdid it. I am still recovering that knee you know. It got worse and worse throughout the day. By nighttime it was excruciating and I was near tears. My foot hurt so bad. I ended up at 130am this morning taking a 7.5mg Lortab from my knee and 800 mg of motrin. I elevated it. I iced it. But still bad pain. I went to work. I couldn't wear my shoe so I walked in my sock foot. I called the office and made an appt to be seen this evening (mondays are evening hours). When I called S asked so why do you need to be seen. I broke my foot. Seriously. Yes. Tell her patient was stupid, tripped over S's toy, and broke her foot. S laughed and said see you tonight. I get there tonight near tears because the pain was so bad. I tried to elevate and ice it at work. But it still hurt really bad. D&M come out to look at my foot. I threaten them with death if they tough it (jokingly of course). Dr L comes in and immediately says yes I think you are right, it is probably fractured. I even had the bone and everything nailed too (confirmed by xray). Dr L was fabulous. She sent me immediately to the hospital to get an xray. The xray tech when I asked if it was fractured said I am not a radiologist but yes it appears that way. Come here and see. There it was. A dark line on my first metatarsal. She called Dr. L because Dr L had called ahead and said she wanted the results asap. Dr L had told me what my options were probably going to be if it was fractured. Phalanges get taped together. Metatarsals get a soft cast with boot or a hard cast walking cast. She knows I loathe crutches. So She said I could probably get away without them. So the tech calls her and they send me home. The plan was if it was fractured to see if my ortho was on call. She wanted to talk with him only because she was concerned that now that my foot was fractured that I would be putting all my weight on my bad knee. Seeing that I had been walking on it all week, a little sleep on it was not going to hurt it. I get home, and D calls and asks how late can Dr L call. I said she can call anytime. She says Dr L is going to the hospital to review your films!!! How many pcps go and review a patients xray. Sure enough she sees clear as day, the fracture. She made some calls. One to the radiologist. The next to see if my ortho was on call (he wasn't). She made arrangements for tomorrow. My ortho does surgery on Tuesdays. So she is calling him first thing to see what needs to be done (cast or boot). He will call her back and review my films between surgeries. In the meantime, ice and elevate it. Yes I can go to work if I do those things. Good thing I have a desk job. She asks if I have enough Lortab. Um yeah I have 15. Enough to get me through a week at least. She said it was ok to take for my foot. She went above and beyond. She spent about 20 minutes on the phone answering different questions I had about options. If I get a hard walking cast can I bear weight on it? How long for it to heal? Will it need surgery (it was a clean break, YEAH). She has listened to my hopes (healthy girls, baby, and family). She has listened to my fears (can we get meningitis from mil, what if I die from HBP, what about stroke). I changed my girls to her cause I trust her. If something were to go wrong, I want her to be the one to tell me. If I have another baby, I want her to be checking my baby out. She is fabulous. She is a wonderful dr. I appreciate how much she took care of me tonight. I mean how many pcps run out to the hospital from their office to personally look at xrays???? I can 't think of one that I have had yet (except Dr E who wanted to know about the US when I had the emergency d&c and talked with the radiologist). How do you thank someone that takes care of you. That tells you when your child gets a mysterious illness right after your mil gets deathly ill and tells you you have every right to be concerned. She has never poo pooed me.

I am sure she gets her crazy patients. I always thought I was one of them. But she says no. I really appreciate my pcp, my obgyn, my ortho (although it took me a while to warm up to him), and my peri. You guys are the best. You have sucky hours, deal with difficult patients, get sucky reimbursements from insurance companies. But yet you soldier on and provide loving, nurturing care. It is one of the reasons that I even though I am a southern girl, probably won't move. I have never had drs that have cared for us like this before. To find 4 drs in different specialties is a rare and beautiful thing. So my hat off to you.

And Dr L, thank you for jumping into action today and making things happen. I was worried that I was overreacting a bit, but I also knew it was broken. You never once said nope, not broken. You sent me in for an xray, called to let people know you wanted results. I really do appreciate it. I am glad that I and my family are your patients.

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