Thursday, December 07, 2006

Hypertension 20: The New Specialist

I'm not bored, I could write about me all day. But why are you still reading? Is it late? Have you been drinking? I will admit, at times it is difficult for me to understand the blogosphere. Maybe I should have a blogoscomy.

Be that as it may....

An earlier post mentioned the change in prescription medications in November, along with a change in specialists. Here is the whole story.

Specialist #1 was one swell fella. We got along fine, he was knowledgable about the Chinese herbal treatments and approved of them (as long as they continued to work), and he wore the most-in-need-of-a-wash labcoat I'd ever seen. He saw me on October 4, 2006, and felt I needed significantly more medication (sigh) and much more time off work (okay!). I saw him again three weeks later, at the end of October. At which time, we said good-bye because he was moving to Alberta.

Alberta is not a shampoo company, but another province in Canada.

I don't think he moved because of something I said. He was going up in the world, to a University position, and more power to him!

This meant proceeding to another specialist. My family doctor was fine, but I wanted a physician who lived, breathed, ate and was obsessed by Hypertension. Well, okay, also a specialist because my employer would not be all that interested in a family doctor's recommendations. Specialists carry more weight. I knew that from my work.

He recommended, at my request, another specialist, who was in the Adult Cardiac unit of a local hospital. It took several weeks for the appointment, in part because first my family doctor had to make the referral--that is how the system works. Civilians can not just phone up and make the appointment on their own.

The weeks went by. Down to the hospital I went, where I registered and actually was given a white plastic wrist band for while I was there. Then I went up to the unit, waited a relatively short time, and was called into a waiting room. Where, of course, I waited.

Not for long. A nurse came in, took my blood pressure, interviewed me, and then said the doctor would come in. A few minuts later, a quite nice student doctor came in. He explained he was a student, or intern, or resident, or at least "not quite" a full doctor. He was very efficient, to the point of being brusque: but very politely brusque. This is Canada, after all. He took my blood pressure again, examined me, asked more questions. Then he explained he would leave, review everything with the specialist, and they would both come back in.

I was absolutely wallowing in attention.

A short time later the student and the specialist came back in. The specialist asked some more questions. He reviewed the side effects which I had mentioned to the nurse and intern. He asked the intern what changes should be made. The intern suggested increasing the Tevetin. The specialist said no, that would increase the negative side effects. It went back and forth like that for a little while. I commented to them it was like being in an episode of "House", and we all had a rather jolly laugh.

Eventually the specialist changed the caduet I had been prescribed, giving me two new prescription drugs instead, adalat and lipitor (which I had heard on from the relentless tv ads). He said the new combination should help with the feelings of weakness. He recommended continuing exercising. Regarding dieting, he had no recommendation to my query about the circular nature of feeling weak so I ate more, except to note the new medications should leave me less weak, so that should certainly help.

He was quite done when I noted to him my last concern. In a couple of months, after continued exercise, dieting and adjusting to yet more new medications, I would return to work. My concern was that the stressful nature of my work would bop up my blood pressure again as soon as I returned. To my surprise--stress and high blood pressure are controversial, at least for employers and their human resource departments--he and the intern completely agreed, and said they would write a letter to my union, recommending I be given less stressful work on my return.

For the first time in a long long time: really good news!

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