The Good Doctor

I know that’s the name of a TV show (that I’ve never watched), but I’m talking about a very good doctor I saw today, and that helps to balance the poor experience I had with the orthopedic surgeon last month.

A few years ago, I had a series of white flashes that warned of a retinal tear in my left eye. Fortunately I caught it early, so it wasn’t yet detached and therefore able to be repaired by a laser. https://enchantedseashells.com/2022/03/16/i-see-you-eye-health-seriously/

In a roundabout way, that’s how I ended up meeting Al Gore. https://enchantedseashells.com/2015/11/04/i-met-vice-president-al-gore-at-the-apple-store/

Every year, I return to the retinal specialist for a comprehensive check of both eyes.

This was a completely different situation to the ortho; night and day.

Usually I see a female specialist but she wasn’t available, so I was warmly welcomed by one of the senior doctors in the practice.

We exchanged pleasantries and courteous chitchat while he readied the tools to see behind my eyes.

Always gentle and respectful, with reassurances and explanations during the exam, including me in the process, to let me know what, if anything, had changed since my last visit.

There was no disdain, no eye-rolling, no rush to get me in and out. He kindly explained the details of the exam procedures, answered my questions, and eased my worries about any deterioration or new tears or leaky vitreal fluid.

After the exam, which revealed that everything appeared healthy, he shook my hand and told me not to worry and he’d see me next year.

That’s the way to do it. Thank you, Doctor R! Peace of mind is priceless.

Not the Bees Knees 🐝

Of course I had to research the origin of that term "bees knees". The phrase was originally an 18th century fanciful phrase which referred to something that didn't exist. It was used as the kind of spoof item apprentices would be sent to the stores to fetch - like tartan paint or a left-handed hammer. That meaning is no longer used. In the Roaring Twenties in America, bright young things invented nonsense language to refer to things that were 'the tops' - like 'the cat's pajamas', 'the snake's hips' and so on. They utilized the existing 'bee's knees' phrase to add to that list. The expression has since spread and is now used worldwide to mean 'excellent/the very best'.

🐝 🐝 🐝 🐝 🐝 🐝

My visit with an orthopedic specialist was unsatisfactory on many levels.

First of all, the referral happened to send me to the same office that I had been to in the past for other random fractures and torn ligaments, which I thought was a great coincidence.

However, there was a major difference.

Before, I had PPO health insurance, (Preferred Provider Organization), which offers more doctor flexibility and has a higher monthly premium.

Now I have an HMO (Health Maintenance Organization), a network of health care professionals and hospitals who agree to provide medical care at minimal costs.

See the difference?

With PPO insurance, the attitude of staff and doctors is markedly more welcoming when scheduling an appointment than when you call to see a doctor who has first been referred by one’s primary doctor in an HMO. In fact, you can only see a specialist IF it’s been approved and authorized by the primary physician (who’s usually an internist) with a letter of referral from the insurance company.

I had always been treated respectfully — not this time, however!

Initially, when I called to make the appointment and they looked up my previous visits, the communication was pleasant and professional UNTIL I told them I had different insurance, no longer a premium PPO, but an HMO.

She said “Oh”. Her voice changed; her attitude changed. I didn’t think too much of it, didn’t take it personally, maybe it was a busy day or the scheduler had other things on her mind.

When I arrived for my consultation, to be fair, the front desk employees were friendly and professional which bolstered my view that the slight rudeness was a one-off…

However…

I finally saw the doctor about thirty minutes after my appointment time. From the moment he entered the room, I sensed that he was annoyed. He never made eye contact with me. He sat on his stupid little round stool and said “What’s the problem?” and when I I started to explain how it all occurred, he interrupted me to say, “But why are you here TODAY?”

As I started to explain, I could tell he wasn’t listening. He had that faraway look in his eyes that some people get when you know they’re not paying attention. My appointment was in the morning so it wasn’t like he had endured a full day of complaining patients.

He abruptly said, “Sit on the table and let me do an exam”.

It was rushed and cursory. He turned my knee in a few different directions, one of which caused a REALLY sharp pain, and then he pulled my shoes off without warning.

Let’s back up.

I’ve mostly always had great relationships with medical professionals. I like to consider that I’m an informed team member in my own health issues. It’s my body and all that. Because I know a bit about medicine, I feel that I offer valuable insights and points of view that MOST doctors seem to appreciate. I can talk the talk, as it were.

But while I was on the exam table, HE PULLED MY SHOES OFF.

He didn’t ask if I was OK with it, he didn’t ask ME to unlace and take off my workout shoes, he roughly pulled them off my feet — still laced up — and tossed them on the floor.

To me, that was absolutely disrespectful. No one should touch any part of one’s body without permission. Dignity, respect, and civility is not too much to ask of anyone, right?

I was definitely receiving the budget office visit, that’s for sure.

I asked a bunch of questions like I always do and he was SO ANNOYED with me, he didn’t even try to hide it. I could sense the eye roll…

Can I repeat that he never once made eye contact?

While my shoes were still off and on the floor, he opened the door and walked out of the room, turning around to say, “I’ll explain your MRI and x-rays.”

I said, “Am I supposed to follow you?”

No answer.

“Do I have time to put my shoes on?”

No answer.

So…I took my sweet time jumping off the table, bending down to pick up my shoes, unlacing my shoes and then put them on, re-lacing each shoe with a beautifully arranged bow, mindfully, lol.

I wasn’t feeling very comfortable with him as a doctor I’d ever allow to treat my knee.

His assessment of the data was pretty much as the MRI report stated, only more bleak because part of my knee is bone on bone, that’s why it hurts to do squats or lunges.

Here’s what he said, “When it gets bad enough, you’ll want knee surgery.”

“In the meantime, don’t do squats or lunges.” The unspoken words were apparently, “don’t be STUPID” and do squats or lunges.” He didn’t have to say that because his pass-agg attitude was clear.

He also offered to give me a cortisone injection. When I said that I have a bad reaction to steroids, he used “air quotes” to repeat what I said as if he didn’t believe me (really a jerky misogynist move) and instead offered a plasma injection spun out of my own blood which MY insurance doesn’t pay for and is $700 per injection.

“So what do you want to do?” he asked.

I responded that I’d discuss his opinion with my primary physician before I could intelligently decide any course of action, but it’s not bloody likely that I’ll have surgery that includes a recovery time frame of up to twelve weeks OFF my feet. Not bloody likely.

As he was halfway up off his stupid little round stool with his hand already on the door, I said, “But what about physical therapy or some kind of brace to protect and stabilize my knee?”

“What about the torn meniscus or inflamed bursa? That’s actually why I’m here. That’s what hurts. Is there something to do about that?”

“No, nothing will help.”

Then he said, “If you won’t do those things I suggested, there’s nothing I can do for you.”

And he was gone.

I had most likely run over my allotted budget appointment time.

I’m not being melodramatic or overly sensitive.

This is why people bemoan America’s healthcare system, one of many reasons why it’s all messed up.

It was a new experience for me to endure disrespectful and abbreviated treatment like I’m “less than”, a second class citizen solely based on the hierarchy of my health insurance.

Will I tell my own doctor how this one made me feel? You bet I will, and I’m going to request a second opinion, too.

I believe this doc was scalpel happy for sure, but there’s no way I’d trust him to slice open any part of my little body, no matter how many pictures he had on his wall of satisfied customers.

What’s the prognosis for my poor knee? I’m not sure, but at least I know what’s going on in there.

Will I stop doing squats and lunges? NOPE.

Update: I went for a walk along our beach seawall and saw a physical therapist had set up a tent and table for free consultations on a little grassy area. What great timing! I stopped to chat with him and I’m so glad I did! He offered better information about the mechanics of a knee and how to obtain relief (including a brace recommendation) than I did from that orthopedic specialist who wanted to slice and dice. PLUS he was respectful and gentle as he moved my leg around.

Foot Fetish

Due to a communications mixup, I didn’t get to see the new podiatrist until today.

Lemme back up…about a month ago, my foot started to hurt after a long walk. At first I thought it was a stress fracture, but there was no bruising.

Pretend doc that I think I am, I decided it was a joint or tendon injury: extensor tendonitis and possibly capsulitis of the second metatarsal. I wore a boot in the house, iced it, soaked in epsom salts, taped it up with KT tape, and did a lot of stretching.

Refusing to give in to the pain, I forced my poor foot to go on long walks that were excruciatingly painful.

Finally, this morning, I got an xray and waited for the doc. Actually there were two of them that came in to see me, ‘cos I guess it was a slow Monday. They asked me what happened and I gave them both the benefit of my ZERO years of medical school.

I was pretty chatty and finally, one of them broke in and said, “How’d you like to look at the xray?”

I said, “Well, you could have shut me up about five minutes ago haha”, but he said he liked listening to my diagnosis, even though I was totally wrong.

The xray left no doubt as to what the problem is IT’S a COMPLETELY BROKEN stress fracture at the base of the toe and not healing because I kept re-injuring it.

My initial diagnosis was correct! I should have gone to medical school for real, oh well, too late now…

I hate my feet, I really do, they’re tiny but completely deformed from too many years of ballet and toe-crushing pointe shoes, in addition to breaking every toe multiple times because I’m CARELESS. I call them my fat little trotters.

I can’t walk anywhere for two weeks, I have to wear a hiking boot in the house, I can’t go barefoot at all, and I had to promise to actually and truly wear the boot so I wouldn’t be forced to have an aircast up to my knee. In other words, my foot needs to be completely immobilized.

On the plus side, they told me I had the softest feet they had ever seen, (which was only slightly weird) and they loved my high arches–from an anatomical perspective. The docs said I should see the rest of the feet THEY have to look at all day, and in that regard, my feet were a PLEASURE. LOL. AND that my sunny disposition cheered them both up because they were having a not-so-great Monday. We spent a lot of time laughing which made me happy, too.

There’s a SLIGHT chance I’ll have to have surgery in January, but only if it doesn’t finish healing correctly if I disregard their expert advice.

That’s my Monday, I hope yours is less fraught with injury!