September chitchat

[agate]

Doctors here seem to be micromanaged if they're part of some system or other. There aren't very many doctors left who are just in practice by themselves so far as I can figure out.

So we have doctors who have every minute of their day mapped out, often at 20-minute intervals, and you as the patient aren't supposed to bring up any problems that will take more than your 20-minute time slot allows. If the scheduler thinks your presenting problem might take longer than 20 minutes, you're given a longer time, but doctors seem to be under pressure about how their time is spent.

And they no longer write up their own chart notes on your office visits, or at least that's how it looks to me. My doctor uses a "scribe" who is a real person (somewhere), visible on her laptop, who takes notes on the visit and then someone writes up those notes. Or maybe the chart notes are done by AI.

It's all so high tech now that if you go into a hospital, you're looking at a vast world filled with lights and beeps and pings--as I discovered some years ago when visiting my son who was in for surgery. I was so bewildered by the place that I was genuinely afraid I couldn't find my way around in it.

[agate]

A couple of people who were regulars here until recently have been observed to have logged in recently. Maybe they will decide to say something. We'd love to know how things are going for them.

[Prot]

Little things can mean a lot. On Sunday my eldest granddaughter came round with a roast dinner for me to have. Also a chicken curry from the school cafeteria she works at( which I had last night)- ., and a lasagne that my daughter made which I'm having this evening.

[jingle]

Oh, Prot, that sounds wonderful! You are a very fortunate man. My dear cousin is being released from a two week stay with her brother after a very complicated hip replacement surgery. I've been taking care of her cat and now I'll be doing what I can to help her. Today I'm going shopping for her and preparing food. I think I will be doing the cooking for a couple weeks. Your "menu" sounds good.

[agate]

That's such good news, Tim! I do hope you've been able to eat the food in spite of the dental misery.

jingle, it's so kind of you to help your cousin in her hour of need. The world could use more people like you!

[Prot]

I hope your cousin can be as fit as possible as soon as possible. Your help and support, I have no doubt, will make that far more likely.

[Prot]

Things aren't too bad dental wise. I can't really complain.

[Virginia]

Tim, glad you are getting some good food to eat, and that you are able to eat it.

Jingle, your family is very lucky to have you to help out. It sounds as though the help is needed. What a treat for them.

Agate, from all that I can find out you are pretty much right about our health care system. For people on Medicare who do not have a private physician any longer, it can get very scary. I had always had a private physician, and it has been a rude awakening for me the last few years. Doctors now have such limited time to give their patients, that I think they like having more healthy patients. I used to hear about how bad medicine was in the U.K., but now I think we have about caught up with them.

Speaking of doctors. I am finally going tomorrow. I don't look for anything to come from it, but maybe I will at least find out if I have a UTI. I am thinking that I do. If they would do some blood work, I might could read some of it myself when it is posted. I don't look for that to happen. My appointment is not until 4:20 and unless they have changed it the lab closes about that time.

My family had a little good news this past Friday. One of my sister-in-law had been told she had spots on her liver which had tested positive. They think it has metastasized from another part of the body. They did a PET scan to see where it was located. It didn't show up on the PET scan. They are going to do an MRI every six months until it shows up, if it does. They say it is very slow growing. It is not curable, but it is treatable when it does show up. Under the circumstances, it was the best news they could get. It is so slow growing they said it might be many, many years. My brother who is married to her has Parkinsons and he relies on her to help him.

I told my youngest brother I had been putting myself off until things in the family settled down. It turns out he has some things going on and has been doing the same thing.

[agate]

Virginia, that does sound like good news about your sister-in-law. Anything involving the liver is a big concern, I've heard, and it's really nice to know that some things can develop with the liver that aren't bad news, or at least aren't likely to be bad news.

Do you have a home test kit for UTIs? I hope you won't turn out to have a UTI.

I was at the doctor's yesterday myself, for a routine medications review. It was scheduled for a 20-minute appointment but it took 40 minutes. They were really nice about going overtime, and I'm so glad that the doctor took so much interest in everything I'm taking. It's been many years since anyone was so thorough. I'm really encouraged that she's being careful.

While I was there, I also filled out an updated POLST form. Does everyone have a POLST form? After 10 years you need to redo it, I learned when I had a letter telling me that.

[Virginia]

Agate, what a stroke of luck to get a doctor who would give you that amount of time. I hope you were able to accomplish everything that needed doing.

I don't have very high hopes for my appointment this afternoon. My brother and his wife were over my way and stopped in last night. My brother insisted on coming back and taking my today. He didn't want me to drive there.

[agate]

Virginia, if you have a UTI, at least the doctor can prescribe something. Even if there has to be a wait for a urine culture to "grow" in the lab, doctors will often prescribe a broad-spectrum antibiotic to tide you over until the correct drug can be prescribed. But you knew that from past experience, I'm betting.

The doctor's appointment on Tuesday accomplished much though not everything. She updated the POLST form and carefully went over all of my rx and nonrx meds. I brought in all of the containers for the nonrx items, all 12 of them, using a backpack that hooks onto the wheelchair.

While I was there, I asked about COVID shots, just in case things had changed. No, the doctor's office still isn't giving COVID shots. I was told that the reason is that Medicare isn't covering COVID shots given at a doctor's office. This was news to me. Since my last COVID vaccine was in December 2023, I made an appointment to get an updated one in October at the nearest supermarket.

That supermarket is 1.6 miles away from here and may close soon. I'm hoping to get the vaccine there before it closes.

[Virginia]

Agate, I am not sure what a POLST is. Is it something like a power of attorney.

I do have a UTI. I started on antibiotics today. So, that will go on for 7 days.

The rain from Hurricane Helene has started here several hours ago. Later tonight and especially tomorrow is to be pretty bad according to an email I received from the power company. They expect power outages, strong winds and with our ground as saturated as it is I am concerned about falling trees. We have had so much rain the past couple of months that my yard just stands in water. That is not what a person wants when they have a lot of trees right out of their front door.

I hope the people of Florida will be safe.

[agate]

Virginia, I was just about to send out an APB on you after learning how severe Helene is and where it is going. I hope you'll manage to be out of the worst of it! How about your family?

POLST is a form you get at your doctor's office. You decide how you feel about life-sustaining measures that might or might not be used if you are in a situation where that is an issue. This tells about it:

Only registered and activated users can see links., Click Here To Register...

Ten years ago I filled out one of these. People in this building are asked to keep this form along with other papers (like power of attorney, advance directives) prominently displayed, usually on the refrigerator door.

I had a notice telling me that after 10 years I'd need to update the form. So I had to fill out a new form on Monday, with the doctor's signature.

I hope your power stays on and you can stay right where you are, Virginia! I also hope Jeanie Z will be OK where she is.

[Prot]

My daughter helped me set up lasting power of attorney. She will deal with financial and health matters should the need arise. If she is unable to do so my older granddaughter will deal with health issues,and the younger granddaughter financial issues.

[agate]

I made one change in the POLST form the other day when I did the 10-year update. There are 3 big choices on it after you decide whether you want to be DNR (Do Not Resuscitate) or not. On the oldl form, probably with the doctor's advice, I chose "Full Treatment." This time I asked again about that after choosing "DNR," and the doctor said I couldn't choose "Full Treatment" if I had opted for DNR. That made sense. So I chose "Limited Treatment." The third option was "Comfort Measures Only."

I don't really know what's involved in those 3 choices but from what little I know, it seemed like the best choice for me.