I saw my pulmonologist yesterday. I have been SUPER GOOD AND COMPLIANT with my airway clearance, but I'm still not feeling great. The pulmo thus decided that it is time for me to have a bronchoscopy. I'm not thrilled with the prospect, but it makes sense given my situation. We want to see what's in there and what the best approach will be going forward.
I go in on Thursday morning to have my lungs scoped and basically washed out. I've taken to calling the lavage portion a spa appointment for my lungs. Friends tell me this can be pretty miserable feeling, but that it can help you on the road to recovery and to feeling better in the long run. I am hopeful it is that way with me, so my lungs can get rid of the gunk in them and the airway clearance can help keep them clear.
Not that I really want to have a bronchoscopy or lavage or any of this. Sometimes, we just don't get a choice. Sometimes, we just keep moving down the path because we're supposed to and because, in the end, it's what is best for us. Still, though. This stinks. Another thing to add to my list of surgical procedures. ARGH.
I am quite thankful to have a treatment team that I trust. This is one of those times that I have to remind myself of that. I would rather not need them, but I'm so glad I have them when I do.
Showing posts with label treatment plans. Show all posts
Showing posts with label treatment plans. Show all posts
Tuesday, April 30, 2013
Tuesday, July 17, 2012
Alea Iacta Est
I signed up with the One Medical Group. So far, it seems like it is extremely straightforward and their online system is great. I have booked an appointment with my preferred PCP for next week. We shall see how it goes, but right now, I'm excited.
One of my most hated of all activities is appointment scheduling for my doctors. This online option is the bomb diggity, at least as far as I am concerned. I can just go in, pull up the appointment calendar, select my chosen doctor and time I want and BAM! Done. All set. No calling and haggling over what is available or trying to figure out if they have an appointment around a certain time. No more trying to explain to the medically illiterate receptionist about what the problem is and why it is urgent. I can just write all of that in the notes field. My appointments are guaranteed to start on time and I'm only asked to arrive 5 minutes early, instead of the usual 30 minutes for first appointments.
I gladly welcome the medical profession into the 20th Century. I certainly hope this is the beginning of a long, beneficial relationship with this practice.
PS - I understand how privileged I am to have access to such a service. I am incredibly grateful.
One of my most hated of all activities is appointment scheduling for my doctors. This online option is the bomb diggity, at least as far as I am concerned. I can just go in, pull up the appointment calendar, select my chosen doctor and time I want and BAM! Done. All set. No calling and haggling over what is available or trying to figure out if they have an appointment around a certain time. No more trying to explain to the medically illiterate receptionist about what the problem is and why it is urgent. I can just write all of that in the notes field. My appointments are guaranteed to start on time and I'm only asked to arrive 5 minutes early, instead of the usual 30 minutes for first appointments.
I gladly welcome the medical profession into the 20th Century. I certainly hope this is the beginning of a long, beneficial relationship with this practice.
PS - I understand how privileged I am to have access to such a service. I am incredibly grateful.
Wednesday, July 11, 2012
To Concierge or not to Concierge
I have been thinking for a little bit now about getting a new primary care physician. I LOVE my current PCP, but her office isn't terribly convenient to my work and it can be very difficult to get the appointment time I need. She's completely focused on me when I'm there, though, and she knows me and deals with things... but I sometimes feel something lacking. I really enjoy talking with her, but she's not necessarily proactive in helping me with things and I am not entirely sure she's still a good fit for me.
In comes an offer for an affordable concierge physician service. They have a snappy website. They offer online scheduling for same-day appointments. They have specialists in women's health and complex conditions... and an office that is a 5 minute walk from work. It seems like a good idea, but what if they aren't as good as the current PCP? What if I want to go back? Will she feel betrayed?
I understand this is certainly a first world problem that I am fortunate to have.... and that many people even in the US don't get this kind of choice. But with choice is coming confusion.... What to do?
In comes an offer for an affordable concierge physician service. They have a snappy website. They offer online scheduling for same-day appointments. They have specialists in women's health and complex conditions... and an office that is a 5 minute walk from work. It seems like a good idea, but what if they aren't as good as the current PCP? What if I want to go back? Will she feel betrayed?
I understand this is certainly a first world problem that I am fortunate to have.... and that many people even in the US don't get this kind of choice. But with choice is coming confusion.... What to do?
Wednesday, April 4, 2012
Choosing Wisely
Today is the day. Choosing Wisely is releasing the lists from physician organizations regarding the "Five Things Physicians and Patients Should Question." As a patient, I question a lot more than these things, especially when it comes to procedures and testing. At some point, you have to be aware enough to realize that there has to be a line drawn somewhere.
One thing I find very interesting is that two of the lists invoke the recent study about sinusitis and antibiotics. I really hope the general public can and will seize on to this idea of waiting to get antibiotics. It will improve outcomes in the long run and help prevent secondary problems like antibiotic resistant strains of bacteria and gastrointestinal infections that can come from antibiotic exposure.
It's also interesting about the timing of difference high tech scans. I think that people are given far too many of these tests because they insist on them. They raise Cain until someone gives in to them and gives them unnecessary testing. I'm all for being thorough, but I believe that people in this country are far too quick to demand more and more intervention for silly things, like the common cold. Even with healthy immune systems, good musculature, solid bones, you won't be healthy all the time. Sometimes, things need to run their course. Obviously, this is different for people with chronic conditions, but I think even in our community we need to consider what is going on.
One thing I find very interesting is that two of the lists invoke the recent study about sinusitis and antibiotics. I really hope the general public can and will seize on to this idea of waiting to get antibiotics. It will improve outcomes in the long run and help prevent secondary problems like antibiotic resistant strains of bacteria and gastrointestinal infections that can come from antibiotic exposure.
It's also interesting about the timing of difference high tech scans. I think that people are given far too many of these tests because they insist on them. They raise Cain until someone gives in to them and gives them unnecessary testing. I'm all for being thorough, but I believe that people in this country are far too quick to demand more and more intervention for silly things, like the common cold. Even with healthy immune systems, good musculature, solid bones, you won't be healthy all the time. Sometimes, things need to run their course. Obviously, this is different for people with chronic conditions, but I think even in our community we need to consider what is going on.
Wednesday, February 15, 2012
Antibiotics and Sinusitis
Today, the American Academy of Allergy, Asthma, and Immunology linked to a study recently published by physicians at the Washington University School of Medicine. I'm sure the study will cause a lot of hubbub among doctors and patients because it essentially recommends just symptomatic treatment for most sinusitis, siding with a recent CDC panel's recommendations.
I, for one, am glad to see that serious work is being done to discuss what works and what doesn't for the average patient with sinusitis. Overusing antibiotics puts patients with chronic problems at higher risk for complications from antibiotic resistant bugs. Further, I think that most people go running to the primary care doctor for antibiotics at the first signs of discomfort. I think physicians should be much quicker to recommend symptom relief and much slower to dispense antibiotics. It would be better for people in the long run. People should also realize that it takes time for their immune response to fully kick in and remove the pathogens. In this study, patients treated with amoxicillin and patients treated with placebo had the same results 10 days out.
The study's authors were careful to exclude those with chronic sinusitis, ear infections, chest infections, and other complications to get a better picture of what the average person with a normal immune system and normal sinus presentations would experience. I am hopeful that the next stages of the investigators' work will yield some positive outcomes and treatment procedures for those with sinus infections... hopefully, they'll be antibiotic free.
I, for one, am glad to see that serious work is being done to discuss what works and what doesn't for the average patient with sinusitis. Overusing antibiotics puts patients with chronic problems at higher risk for complications from antibiotic resistant bugs. Further, I think that most people go running to the primary care doctor for antibiotics at the first signs of discomfort. I think physicians should be much quicker to recommend symptom relief and much slower to dispense antibiotics. It would be better for people in the long run. People should also realize that it takes time for their immune response to fully kick in and remove the pathogens. In this study, patients treated with amoxicillin and patients treated with placebo had the same results 10 days out.
The study's authors were careful to exclude those with chronic sinusitis, ear infections, chest infections, and other complications to get a better picture of what the average person with a normal immune system and normal sinus presentations would experience. I am hopeful that the next stages of the investigators' work will yield some positive outcomes and treatment procedures for those with sinus infections... hopefully, they'll be antibiotic free.
Monday, January 9, 2012
Sinus Complications
Today I had IVIG. I also have another sinus infection. At least that's what seems to be happening. I have a prescription for Cipro that I am to fill and start taking on Wednesday if I'm not feeling better.
The doctor and I discussed the increased infections I've been having, and we've come to the conclusion that there is more testing in my future. Basically, we'll treat this infection then see how long it takes for me to get another one. When I get the next one, especially if it is soon after stopping antibiotics, I will go in for an x-ray of my sinuses so we can see if there's anything structural that could be causing my issues. If there is that possibility, we'll go from there as to what happens next. I'm over all this and wish I could just fix it. Quickly and permanently. I'm tired of being sick.
The doctor and I discussed the increased infections I've been having, and we've come to the conclusion that there is more testing in my future. Basically, we'll treat this infection then see how long it takes for me to get another one. When I get the next one, especially if it is soon after stopping antibiotics, I will go in for an x-ray of my sinuses so we can see if there's anything structural that could be causing my issues. If there is that possibility, we'll go from there as to what happens next. I'm over all this and wish I could just fix it. Quickly and permanently. I'm tired of being sick.
Thursday, September 15, 2011
Confessions: Follow Up
One of the reasons I think I'm finding it difficult to blog lately is that I'm wrestling with a lot of things that I just don't know how to express effectively. The medical stuff I've been dealing with has been a little distracting and disheartening, but I think that will pass.
Earlier, I confessed how difficult it has been for me to be medically compliant and deal with things as they are happening. I was putting things off and being bad about things instead of acknowledging the problem and addressing it head on. So now I have done just that. I went to see the eye doctor. My eyes are apparently just fine. She was not concerned by the degradation of my vision, as it seems to be within normal bounds of what people experience year over year. So that's a relief. She said some of the other problems could be dryness in my eyes and that an OTC eye drop may help. That is a major load off.
The other thing is the matter of the plaquenil in general. I have established through my own, though admittedly non-scientific, methods that it was making me gain weight and lose hair. I'm having my immunologist run some thyrod tests along with the compliment testing we decided to do. He thinks the compliment testing will be negative, was curious about the TSH tests, and decided to add some vitamin D testing to the mix. Now we wait to see if there's anything going on or whether it is the plaquenil, which I've started taking again. Aren't you just so proud? You should be.
I am trying to frame things in a different manner. I am starting to feel like I am finally coming into my own as a person, and I am determined to treat myself better. If the plaquenil is going to make me gain weight, then I had better get my buns to the gym. I was discussing alternative treatments with my immuno and we agreed that the weight gain is a lesser of evils compared to what may happen on other drugs. We'll ride this out until December (if possible) and see where we are when I return to the rheumatologist.
Earlier, I confessed how difficult it has been for me to be medically compliant and deal with things as they are happening. I was putting things off and being bad about things instead of acknowledging the problem and addressing it head on. So now I have done just that. I went to see the eye doctor. My eyes are apparently just fine. She was not concerned by the degradation of my vision, as it seems to be within normal bounds of what people experience year over year. So that's a relief. She said some of the other problems could be dryness in my eyes and that an OTC eye drop may help. That is a major load off.
The other thing is the matter of the plaquenil in general. I have established through my own, though admittedly non-scientific, methods that it was making me gain weight and lose hair. I'm having my immunologist run some thyrod tests along with the compliment testing we decided to do. He thinks the compliment testing will be negative, was curious about the TSH tests, and decided to add some vitamin D testing to the mix. Now we wait to see if there's anything going on or whether it is the plaquenil, which I've started taking again. Aren't you just so proud? You should be.
I am trying to frame things in a different manner. I am starting to feel like I am finally coming into my own as a person, and I am determined to treat myself better. If the plaquenil is going to make me gain weight, then I had better get my buns to the gym. I was discussing alternative treatments with my immuno and we agreed that the weight gain is a lesser of evils compared to what may happen on other drugs. We'll ride this out until December (if possible) and see where we are when I return to the rheumatologist.
Monday, August 8, 2011
Doctor Patient Relationships
My medical team is awesome. We've discussed this before. I'm starting to form my own methods and opinions for how I've developed rapport with doctors. It's something that has taken a significant investment on my part, and some willingness to listen on theirs.
I think the difference for me has been becoming insistent. I had some of the same symptoms for a long time before I started trying to address them with my doctors. Sometimes, they were dismissive or wanted me to wait. It was when I decided to take more ownership and drive my own care that things began to change for me and I began to feel better about my level of care.
I didn't change doctors to accomplish this. I started doing research and asking better questions. I started connecting my symptoms and being more willing to discuss them in detail, making notes to ensure I didn't leave things out. I really wanted to understand what was going on with my care and wanted my doctors to understand how these things were making me feel physically. It has gotten to the point where my doctors now even ask about my emotional health. This is a major change for me.
I won't pretend that any of this was easy. It has taken years to get to this point, but now I go in to my appointments with more confidence. I discuss with my doctors the treatment plan, look at various options, and make sure we're all on the same page. It feels wonderful to be able to do that. My caveat would be that you must approach them in a professional, collegial manner. That's been the big key for me. I have utmost respect for my physicians, but I no longer fear them or just sit quietly while they dictate the treatment plan. Not every doctor will engage like this, but I think a lot more of them will than you might first think.
I know a lot of people struggle with this balance of asking questions but not seeming to be too aggressive. It takes time to learn and I think it's important to try. Small steps at first, like discussing all the available medications for a specific symptom, or even figuring out what OTC cold medications are right for you. These little things can begin to change the way you see your doctors and vice versa. You may also learn that things you've "always done" aren't necessarily the best or most advantageous for your body. Don't be afraid. Odds are your doctor wants you to be as healthy as possible, just like you do.
I think the difference for me has been becoming insistent. I had some of the same symptoms for a long time before I started trying to address them with my doctors. Sometimes, they were dismissive or wanted me to wait. It was when I decided to take more ownership and drive my own care that things began to change for me and I began to feel better about my level of care.
I didn't change doctors to accomplish this. I started doing research and asking better questions. I started connecting my symptoms and being more willing to discuss them in detail, making notes to ensure I didn't leave things out. I really wanted to understand what was going on with my care and wanted my doctors to understand how these things were making me feel physically. It has gotten to the point where my doctors now even ask about my emotional health. This is a major change for me.
I won't pretend that any of this was easy. It has taken years to get to this point, but now I go in to my appointments with more confidence. I discuss with my doctors the treatment plan, look at various options, and make sure we're all on the same page. It feels wonderful to be able to do that. My caveat would be that you must approach them in a professional, collegial manner. That's been the big key for me. I have utmost respect for my physicians, but I no longer fear them or just sit quietly while they dictate the treatment plan. Not every doctor will engage like this, but I think a lot more of them will than you might first think.
I know a lot of people struggle with this balance of asking questions but not seeming to be too aggressive. It takes time to learn and I think it's important to try. Small steps at first, like discussing all the available medications for a specific symptom, or even figuring out what OTC cold medications are right for you. These little things can begin to change the way you see your doctors and vice versa. You may also learn that things you've "always done" aren't necessarily the best or most advantageous for your body. Don't be afraid. Odds are your doctor wants you to be as healthy as possible, just like you do.
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