Wednesday, February 25, 2015

Say Hello to Kim

In February I had annual checkups with my primary care physician and my neurologist, two doctors I’ve seen for almost fifteen years now. Both are wonderful individuals who I enjoy spending time with. It’s a good thing I do, because there’s very little to discuss on the medical front these days. I'm not finding fault with them. Such is the state of affairs with primary progressive multiple sclerosis, a disease that has no treatments.

For example, my primary care physician exam went something like this:
“How is your MS doing? Everything fairly stable?”
“I wouldn’t say that. I’m still getting worse, but at about the same rate as always.”
“Have you and your neurologist come up with anything new to try?”
“No. Just treating the symptoms.”
“Do you have any other health issues you’d like to discuss?”
“Not really.”
“Well, your bloodwork and your vitals all look good. I’ll go ahead and refill your prescriptions for another year. How is the family?”
I filled her in on my family, asked about hers, and she updated me. She then gave me a brief physical exam (take some deep breaths, stick out your tongue and say “ah”, etc.).
“Is there anything else, Mitch?”
“Oh yeah, I almost forgot. I now have my medical marijuana card. I’m experimenting mostly with insomnia at this point, but I haven’t had much luck.”
“I understand they have lots of different strains, so maybe you can go back and find something that does work for you.”
“That’s the plan.”
“When should I schedule you in next? We did nine months this time.”
“Let's schedule me out for one year from now?”
“A year? Really?”
“Yeah, I’ll be in to see you before that if anything comes up. Plus, I have an entire team at my disposal – a neurologist, a urologist, an occupational therapist, and a physical therapist,” I explained, and we both laughed.
“Okay. It was great catching up with you. Say hello to Kim.”

A couple of weeks later I had a routine checkup with my neurologist. It went something like this:
“So how is everything going?”
“Still getting worse, but at about the same pace. I really notice the deterioration at mealtime. It’s becoming harder and harder to get food from my plate to my mouth.”
“Mitch, I know you do as much or more research as I do on MS treatments. Anything out there look promising to you?”
“Not in the short term. Lots of activity on the stem cell front, but it seems to be focused on patients with active lesions, which I don’t have. Do you seen anything interesting?”
“Afraid not. Only for relapsing remitting MS. How is your spasticity?” (This term refers to stiffness and spasms, mostly in my legs.)
“Well, I’m up to 80 milligrams a day of baclofen.”
“At some point, down the road, you may need a baclofen pump to get enough medicine into your system.”
“Yup. I see one in my future.”
“Okay, anything else to discuss?”
“One more thing. I am now a licensed medical marijuana user. I’m trying it out for insomnia first, but without much luck. I’m still toying with it though.”
“Good for you. As you know, I’m not a big fan of the pharmaceutical sleep aids. So, how’s the family?”
I filled him in on my family, asked about his, and he updated me.
“How about I schedule you in again in nine months?”
“Sounds good.”
“Say hello to Kim.”

5 comments:

  1. Firstly Hello Kim is in order. Love to read your blog....thanks.

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  2. your medical appointments sound a lot like mine. sometimes i don't know why i bother. and i might suggest you contact compassionate caregivers of maine (http://mainemedmarijuana.com) to learn more about marijuana. they are my supplier, and we worked to find the right strain. works like a charm on insomnia, night-time leg cramps and spastic bladder. i use a tincture so i'm not sucking smoke into my lungs.

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  3. That is exactly how it goes. And I always find it interesting that even the docs I really, really like, seem to want to believe that I'm stable. Perhaps it is because they like me too, and just want the best for me?

    In any event, I usually find the fact that my MS is stable in the notes I get to take home, even though I have carefully corrected the error in our conversation.

    Hilarious post. I always love a good laugh in the morning!

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  4. With one exception that's how mine go too. My wife comes along with me to appointments to help with taking notes and supplant my memory.

    Fun times.

    Lately I just want the doctors to be pill dispensers and leave me be otherwise.

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  5. Karen, Kim says "right back at you."

    Stephen, I'm definitely not feeling the love from my local dispensary, but they are walking distance so it's hard to give up on them.

    Daphne, I think you are right. These doctors are human beings and they are susceptible to wishful thinking. It's our job to be as clear as we can, but we can't write their notes for them.

    Darren, I basically agree with your last sentence. I wish there was more they could do, but essentially they have become pill dispensers.

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