My Father’s Trip to the Doctor

 

 

 

 

 

 

 

 

 

 

 

 

Today, I had quite a busy day. My father had a doctor’s appointment with a new physician that was referred by his primary care physician. To tell you the truth, I really do not like his PCP. She is lazy, slow, her team is incompetent, and she gives you the vibe that she is just interested in making money. Whenever either of my parents need blood work, her nurse can never seem to find the appropriate vein to withdraw blood. Thus, she sends us to another off-site facility to have a true specialist withdraw blood samples. Dr. Wali’s office is never kind enough to give us a call in the days that follow to inform us that everything is well from the blood work, x-rays, MRIs, etc. We are the ones that need to call the doctor’s office to ask if the studies came out well. Come to think of it, as I am writing, I am asking myself why I have not helped my parents find a better primary doctor.

                Both my parents have long lists of illnesses that require frequent trips to all kinds of physicians. My mother is a breast cancer survivor and I am forever grateful at the work of oncologist, Philip Cimo, and surgeon, Dimitrios Boulafendis, great physicians that saved mommy’s life here in Houston. On the other hand, my dad suffers from congestive heart failure, this being from ischemic heart disease and angina pectoris. My dad has battled with hypertension over half of his life; his cardiologist of over 20 years has never been able to successfully bring his blood pressure down. Dr. El Hafi, Salah E. has nonetheless, saved my father’s life on more than one occasion. He has done six cardiac catheterizations to perform angioplasty, widening blood vessels in the heart that had become clogged or obstructed due to atherosclerosis. I, personally, have much faith in this cardiologist, his whole team is top notches.

           I accompanied my dad to this new physician early in the morning. He had been complaining of cough, flu-like symptoms, and frequency of urination (he currently gets up about 5-7 times to urinate at night). I helped him fill out the new patient forms. As I was filling them out, I saw that some of the forms were copies of copies of copies and they looked very unprofessional. I quickly filled out his illnesses, the reason (s) for his visit and the meds he was on: Clonidine .2 Mg (alpha 2 adrenergic agonist), Diovan 320 Mg (angiotensin II receptor blocker), Norvasc 10 Mg (calcium channel blocker), Tekturna 300 Mg (renin inhibitor), Plavix 75 Mg (antiplatelet agent for his two heart stents). The way these meds work, we actually covered in Dr. Brenda Whaley’s Drug Action class at HBU, a fun and interesting class… not to mention easy. The waiting area was empty, so they allowed us in fairly quickly.

            Inside, they informed us that the doctor was not present but that his nurse practitioner would gladly attend us. As usual, one nurse first weighed my father; he was within the 173 lbs I was accustomed to see.  The same nurse also took his blood pressure and said it was very high (as usual). We were then led to a small room and my father sat in the inspection chair while I sat on a stool. About 5 minutes later, a young African woman comes into the room wearing a surgical mask! With the entire buzz going around about A H1N1, they were taking special precautions. She introduced herself as Linda Knighten, a certified Family Nurse Practitioner. I took a liking to her because she seemed to actually care about my father’s symptoms. She also gave off a vibe of being extremely intelligent; I picked it up on my “intelli-radar” as soon as she stepped in the room. She took my dad’s plastic bag, and began inspecting all the medication and writing it down on her report sheet. Her biggest concern was my father’s high blood pressure, 184/120.

           

            “His blood pressure is always high, it has been for decades,” I tried to explain.

            “But he is not supposed to have it this high, not if he is taking all these strong medications,” she said. “They aren’t helping. They don’t seem to work then.”

            My father told me that he had only taken two of the meds, Norvasc and Diovan, that he would take the rest throughout the day, this info I passed on to the nurse practitioner.

            “Okay. The Clonidine, he needs to take three times a day. I want him to take one at 9 am, one at 2 pm, and another at 9 pm. Also, suspend the Tekturna and the Diovan, since they are not helping at all. I will give him a fluid pill, Benicar HCT, part diuretic, to take instead and write him a prescription,” she said.

            “Well… his cardiologist just recently put him on Tekturna two weeks ago, and wanted to see how it worked by checking him on the 27^th of this month, is it ok to just stop taking it?”

            “Oh. His cardiologist is trying it on him?” she asked. She seemed to pause and rethink her thoughts. “I will tell you what, tell your father to stop taking it for a couple of days and I want to see him this Friday afternoon.”

                “Ok, that sounds good. We can make it here on Friday,” I replied.

                She then said, “As for the other reasons for his visit, I will collect a cotton swab from his nose to check for the flu. As you can see, I am wearing a face mask for precaution. Also, the other nurse will withdraw blood from him to do blood work and check how he is doing. We can check his prostate after we get the blood pressure under control; afterwards, I can put him on a medication that will help him get rid of fluids during the day, so he can rest at night.”

               

                We were led out of the room and sure enough, they asked for a urine sample and they withdrew blood on the spot. I was impressed. The nurse practitioner told us she would call our pharmacy and order the Benicar HCT. In the meantime she gave us some samples. The laboratory that made the medication was Daiichi Sankyo in Japan, I read the label. For some reason I trust medication made in the UK, Germany, France, USA, and Japan the most! Moreover, the young nurse told us that she would also order a prescription of Tamiflu just to be safe. She wrote down the number of our Walgreens pharmacy and promised to place an order to be picked up. I was really pleased with the service we received, but it could have been due to them not being busy, also I still did not like the fact that the doctor was not there. As we headed for the parking lot, I started thinking if bypassing my father’s cardiologist was the way to go. Smart as she seemed, would it be wise to change my dad’s antihypertensive meds to what she suggested?

Tags: Diseases