Art's dad had his first heart attack in his late 40's and then he died of a heart attack at 70. For this reason Art has watched his diet and kept up a jogging regimen for as long as I've known him.
Our nurse practitioner at Tripler Army Hospital was concerned when Art said he wanted to train for a marathon. She scheduled a stress test for Art. We were told that the stress test showed his blood pressure being too high for strenuous exercise. He was immediately put on the lowest dose of blood pressure medication. The medication had a nasty side effect of making him constantly cough. I'm sure there were people who thought he had swine flu. His blood pressure was also terribly low a few minutes after a jog.
His medication was changed. The coughing was lessened but still not great.
His medication was changed again. The coughing stopped but he still had post nasal drip.
The possibility that he had actually developed an allergy gave him another medication to take.
Now that he has turned 65, he can no longer go to Tripler and needed to find an outside doctor. That is waaaay more easily said than done. Many doctors don't want to take two government insurance plans (Medicare + military). After calling numerous places he found a doctor who was supposed to be a cardiologist and internist according to the receptionist.
We went in to see him. Dr. T said Art's family history and blood pressure showed he had two of the five risk factors that meant he needed to really watch it. Dr.T also recommended he take cholesterol medicine since his cholesterol was a little elevated even though his HDL (I call this the Happy lipids.) was quite high. Then Dr. T said he wasn't an internist because he didn't want to deal with telling patients to go get a colonoscopy or whatnot. I detected a little disdain for regular internists and I was not impressed. I almost said, "You mean you have to know more to be an Internist?" I didn't but I wanted to. He recommended we go to Dr. S who he said was just an internist.
We went to see Dr. S today. OK. I don't believe I've met a doctor quite like Dr. S. before. For one thing, when we met him, there was no greeting. No "Nice to meet you. Welcome to my office. What can I do for you?" He reminded me a bit of Dr. House without the absolute rudeness.
Anyway, Dr. S. checked Art's records and said he didn't think Art should be on the blood pressure medication since it made his blood pressure too low after he exercised. He said there's no reason to believe that Art's heart is enlarged from the kinds of tests that were done in Illinois. He also didn't agree with Dr. T in many of his assessments. The key thing here was he took time to explain why. He made the assumption that we would understand what he was saying which impressed me, and when we asked for clarification, he gave it. From Art's meticulous charts of blood pressure readings and his questions, Dr. S asked if he was an engineer. When we confirmed his impression, Dr. S geared his explanations to an engineering standpoint.
Interestingly, although Dr. S did not have as many of the social niceties and bedside manner that I love, he had a lot of precise and extensive knowledge that he was willing to impart without checking his watch. He's scheduled Art for a couple of tests and says we can make a more educated decision later about what we should do.
He then reached behind, opened the door to indicate we were to leave and said, "I'll see you in 3 three weeks" without looking up from his computer. We left. The funny thing is we rather liked him.
Our nurse practitioner at Tripler Army Hospital was concerned when Art said he wanted to train for a marathon. She scheduled a stress test for Art. We were told that the stress test showed his blood pressure being too high for strenuous exercise. He was immediately put on the lowest dose of blood pressure medication. The medication had a nasty side effect of making him constantly cough. I'm sure there were people who thought he had swine flu. His blood pressure was also terribly low a few minutes after a jog.
His medication was changed. The coughing was lessened but still not great.
His medication was changed again. The coughing stopped but he still had post nasal drip.
The possibility that he had actually developed an allergy gave him another medication to take.
Now that he has turned 65, he can no longer go to Tripler and needed to find an outside doctor. That is waaaay more easily said than done. Many doctors don't want to take two government insurance plans (Medicare + military). After calling numerous places he found a doctor who was supposed to be a cardiologist and internist according to the receptionist.
We went in to see him. Dr. T said Art's family history and blood pressure showed he had two of the five risk factors that meant he needed to really watch it. Dr.T also recommended he take cholesterol medicine since his cholesterol was a little elevated even though his HDL (I call this the Happy lipids.) was quite high. Then Dr. T said he wasn't an internist because he didn't want to deal with telling patients to go get a colonoscopy or whatnot. I detected a little disdain for regular internists and I was not impressed. I almost said, "You mean you have to know more to be an Internist?" I didn't but I wanted to. He recommended we go to Dr. S who he said was just an internist.
We went to see Dr. S today. OK. I don't believe I've met a doctor quite like Dr. S. before. For one thing, when we met him, there was no greeting. No "Nice to meet you. Welcome to my office. What can I do for you?" He reminded me a bit of Dr. House without the absolute rudeness.
Anyway, Dr. S. checked Art's records and said he didn't think Art should be on the blood pressure medication since it made his blood pressure too low after he exercised. He said there's no reason to believe that Art's heart is enlarged from the kinds of tests that were done in Illinois. He also didn't agree with Dr. T in many of his assessments. The key thing here was he took time to explain why. He made the assumption that we would understand what he was saying which impressed me, and when we asked for clarification, he gave it. From Art's meticulous charts of blood pressure readings and his questions, Dr. S asked if he was an engineer. When we confirmed his impression, Dr. S geared his explanations to an engineering standpoint.
Interestingly, although Dr. S did not have as many of the social niceties and bedside manner that I love, he had a lot of precise and extensive knowledge that he was willing to impart without checking his watch. He's scheduled Art for a couple of tests and says we can make a more educated decision later about what we should do.
He then reached behind, opened the door to indicate we were to leave and said, "I'll see you in 3 three weeks" without looking up from his computer. We left. The funny thing is we rather liked him.
aren't doctors interesting and their assistants. there is so many different kinds of blood pressure meds-I'm on two and still need another. Some pills make you very tired, never heard of coughing though...interesting. well, he should do well with his jogging and watching his weight. diet too is so important and not stressing about it all which is easier said than done. too bad your choice of doctors is influenced by your health insurance coverage. good luck with it all.
ReplyDeleteIn our medical co-op, I have a primary care doctor, but I often see someone else when she has a full schedule. Often it's a physicains assistant. Then there are the referrals to specialists, some in the co-op, some contracted from outside. We have fully computerized records so everything should be there, but the docs are scheduled tightly so yes, there was clock watching the last time I saw my primary care physician. And my purpose was to pull all of my various findings and conditions together. She was completely unaware of my hand condition because my assigned doc has been changed four times in the last six years or so. Doctors leave the system and interims are appointed until a new hire is placed in the service.
ReplyDeleteThere is no question that we have to be our own advocates, and insist on clear information. I continue to learn this.
With Art you must be still sort of up in the air about who knows what. Hopefully after some tests you'll know who's right, or wrong.
I feel so sorry for Art. Did his mother have heart disease also?
ReplyDeleteI belong to HMSA-HMO at Straub Clinic & Hospital. Straub is supposed to be nationally well known for its excellent cardiac care. You might want to check it out if Dr. S proves to be unsatisfactory...
KAY....i hope this dr.'s expertise and knowledge works for Art.....we have a very dft. setup for these checkups......most of us are not covered by insurances..we pay one on one ,so choice of Dr. is not ruled by insurance...our govt. hospitals and medical colleges offer free services ....in these institutions minimal fees are charged for a surgery ...the problem is loooong waiting list.
ReplyDeleteMy experience with the medical profession has been nightmarish at best. Funny, because I am posting a piece later this morning about my experiences with doctors. Ah, Kay, great minds must think alike! Good luck to you and Art both!
ReplyDeleteWhat a strange bedside manner! But if he's extremely knowledgeable and thorough, I guess that's what really matters.
ReplyDeleteNo time for niceties. Here in my clinic they schedule patients ten minutes apart. You just have to hope the doc can type fast.
ReplyDeleteYour Dr. T sounds fine. Good luck.
Changing doctors is such a hassle, but it sounds like you've got a good one there (even without the bedside manner). It's nice to have a doctor who'll listen, and explain things! Good luck to Art getting his medication worked out. My husband has a bad family history of heart attacks too so we're careful.
ReplyDeleteI must have had that same blood pressure medicine that Art took. It made me cough so much to the point of gagging. I thought I was sick. Had no idea it was a side effect! Glad you found a knowledgeable doctor. I hope that the test results will reveal what meds Art needs to be on, if any. :)
ReplyDeleteSounds as if you've found a doctor who wastes no time, but gears it to his advantage and to yours. So long as he isn't actually rude, I think I'd like him.
ReplyDeleteI think today that doctors have to be so wary of malpractice lawsuits that they have to work twice as hard (and schedule too many patients in a day!)to pay for their insurance and unfortunately, the patients suffer. Dr. S sounds like one I would prefer, due to his careful explaining but its too bad his bedside manner isn't the best! I do hope all is well with Art though, he certainly sounds healthy with his exercise and diet.
ReplyDeleteHe sounds like a good doctor without the social niceties. Personally I would like a smile every now and again. I get very nervous in doctor's offices - I have the white coat syndrome - my blood pressure goes sky high as soon as I walk through the door.
ReplyDeleteI think the doctor sounds great! He was thorough and spent time with you.
ReplyDeleteBedside manner isn't everything. The best orthopedist I ever had had no bedside manner but he fixed me up perfectly. Nurses hid when he came on the floor. He was a perfectionist who expected that they take care of me perfectly.
After five years of doctors who don't listen, I'm looking for one who does.
I have a pretty jaundiced view of doctors. They always want to find something wrong that they can give you medication for, and then if you get side effects they want to give you another medication. They don't seem to want to take the time to find out what's causing the problem in the first place. If they can't give you a label or a medication they're just not really interested. Let's hope you've found a doctor that's an exception.
ReplyDeleteI was first put on a blood pressure med that made me cough. I'm now on something called Diovan (valsartan)angiotension II inhibitor.
ReplyDeleteGood luck with treatment.
Gosh, Kay. I'm sorry to hear about all the testing and worrying you and Art have to do until you get the results. I am glad though that you both ended up liking the doctor. When you said he reminded you of "House" I was ready to come over there and throw him under a us or something..."House" is a mess. He ruins a good show for me.
ReplyDeleteI hope you and Art get good news real soon about his results.
Sometimes I do hit it off with a new doctor and if I lose it and tell them what I think then I don't go back.
ReplyDeleteAll doctors have their certificate or diploma hanging on the wall but so far I have yet to see what that tells what their grades were in school. You know there are a lot of numbskulls who got out of school with more than one D and F on grade cards.
I just hate it when I get an F student Doctor.
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Hahah, geniuses are a little stuck up in their own way. Its good to know that Art is really keeping tabs on his health.
ReplyDeleteI think I rather like him, too. I'd rather have Dr. House take care of my husband's heart than anyone on scrubs... or the good old family Dr, Marcus Welby, MD.
ReplyDeleteMuch nicer to keep a good hubby than keep a friendly doctor.
I usually say what is on my mind, so I haven't always gotten along with docs so they are happy when I don't go back. LOL...I have the best neurologist and immunologist in the world..My primary care is OK. I hope you find the answers that you are looking for with hubby Art..
ReplyDeleteI'm guessing the first medication that they put him on was Lisinopril. I don't even know why Dr's try to start with that. Shawn, as well as many other people I've since talked to have had that VERY side effect of 'dry cough'. Though Shawn's dad is ok with it. Shawn also couldn't handle heat well, he would fell like fainting. He's now on Atenolol, which is doing him wonders. Good Luck with finding the right Dx for Uncle Art!
ReplyDeleteLike you, I prefer better 'bed-side' manners, but Shawn, on other hand, likes Drs that 'cut through the bull' and just 'get right through it'.
How nice to hear from you, Julie. I didn't know you were out there in blogland. This is great! You're right about the lisinopril. By the way, Jon and Tif will be coming to see Shawn perform in Waikiki when we get ourselves organized. Grandma wanted to go too but she's just caught a cold and I don't know if she'll be recovered in time. We'll see. Please send our love to Shawn.
ReplyDelete