Wellington · Living

But I digress. This is my personal journal of medicine, not JAMA, my own primary-care-physician visit edition. It went pretty well, but there's some bits worth noting for the future. Like, how I was asked five times if I wanted a flu shot. Apparently, this year the flu vaccine is in. No rationing for the young and elderly this time, no, as I walked into the waiting room, a nurse asked me if I wanted a flue shot. I told her I was just here for an appointment, and sat down. She asked me if she could give it to me while I was waiting. I thought, hey, here's my chance to sneak one in, so I took it. But no, it wasn't sneaking one over on the oldsters. My check-your-vitals nurse offered me one, and then my PCP offered me one, and then I got offered one when I went into the specimen collection office to get blood taken. Woo hoo, flu shots for everybody!

Another note for the future: the manual taking of your blood pressure is still very subjective, so take the Important! Warning! Live-Change-Now! instructions with a grain of salt. Oh wait: never go near salt again. That was my PCP's assessment. I came to her several pounds of fat lighter, more muscular, with a better resting heart rate (65, woo hoo!), and despite all that she decided we needed to focus on my "high end of normal" blood pressure. Apparently, out of all the stuff I'm already working on, I need to cut salt out of my diet, so much that it was 50% of what we talked about (read: she lectured me about.) I apparently need to cook for myself even more, since I can't trust restaurants not to put salt in stuff. Oh-kay. But, please note: the nurse that came in to take my vitals took my blood pressure, then took it again to be sure. She put me down at 118/78. My PCP took my blood pressure, decided she still wasn't sure, and took it again, for an official score of 138/78. First time she took it: 122/78. What was wrong with that? Last time, when I had 5% more body fat, my blood pressure was 120/80: I could see it on her screen. OK, she's a the doctor, with all the training, so I'll listen. But uh, next time, if my blood pressure again reads around the low 120's over 78 or 80, for even one of the times they take it, I'm not gonna have a zOMG! High! Blood! Pressure! reaction.

And, as a real funny: she told me I should probably maintain my current weight, and not gain too much more (her scale said 213.) When I gave her a really blank stare, she didn't get it. So I had to remind her of the whole happy point that I'm not dropping five pounds every two weeks, like I was back in August. Remember, when I finally met you in person? Gaining weight: it's a GREAT thing. I'm not going to stop. And if it's all muscle, and I'm losing fat, hi, you don't get to complain. OK, if I get stupidly huge and endanger my life with too low a body fat percentage, fine, but we aren't even close to that. Pul-lease. Don't gain too much more: ha! Having seen me dig my heels in on this, she told me to check with my endocrinologist about this when I see him in a month or so: fine. I know what he'll say: AWESUM, DUDE! HI-FIVE! (Well, I hope he will.)

Maybe all this was overcompensation for a lack of having anything else to tell me. The blood tests I'd had to take again finally came back, and they were all negative for increased clotting risk. So we have no idea what brought on the clots: I don't match any normal profile for clotters under 50. Honestly, I take it as good news that I'm not likely to get them again, or at least that there's nothing in my system that makes me more likely than the general healthy population to get them. But still, it worries a little. Which brings me to my final notable moment. So, she's looking back over my history in the computer, and she sees I've been over to the Pulmonary clinic, and asks, "Oh, you *did* see a lung specialist, good. What did Dr. Little say?" Whowhatnow? Um, Dr. Little is my allergist: yeah, I know he's over in the Pulmonary Clinic, but he's just been fixing my allergies. Oh, no, wacky, it turns out he's the BMC go-to lung man, knows a lot about pulmonary embolisms, and now she wants me to see him, in the hopes his second opinion might help find a smoking gun. And, weirdly enough, I already have a scheduled appointment with him for January (for an allergy follow up in the winter, when I usually have none, so he can do some more sensitive tests.)

OK, remember when I couldn't get in to see my PCP: I was still waiting for an appointment with her? And I had that ear infection? I instead ended up seeing my allergist first, 'cause I could get an appointment with him, and he took care of making sure it was OK. At the time, he found it funny, because he'd just re-certified his GP boards, and here he had the opportunity to be my PCP for an appointment. Now he's going to be my lung specialist as well as my allergist. Hell, I wish he really *was* a GP, 'cause then I'd ask him to be my PCP. I saw him on July 2nd, but didn't have the embolism until July 22nd, and haven't seen him since. If I'd known, I would have gone to see him right then, instead of waiting to see my PCP in August, waiting until November for her to think of him, and so seeing him in January, six months after the event.

C'est la vie. I'm healthy, I'm getting stronger, and I think my second and third opinions set up for December and January are going to confirm that.