Thursday, February 12, 2009

Doctor Office Observed: An Introspective

So I have NOT been running.

I am sick AGAIN as of Wednesday.

This time a soul sucking sinus infection is to blame. Its drippings make me cough like an oxygen tank toting octogenarian with a 3 pack a day habit. But my lungs are clear. Small favors for sure.

Antibiotics are kicking the sinus infection to the curb and I could probably run but I am looped out on cough syrup and some other drug that makes me feel all floaty. The cough drugs are preventing me from coughing which in turn keep my airways from spasming and allow me breathe A OK. Again, small favor since I can't run. All this breathing is just for waste if not spent running (or swimming or cycling), right?

So I may be breathing better but other than that I am a complete waste of flesh. Is this why the lives of people who are addicted to pain killers and other drugs go to pot? Cause I'm kinda in a whatever, that's cool state and I can tell you that I am NEVER like that. I am never chill. But I don't even think I could have an angry thought right now if I tried and it is freaking me out a little. I am almost comfortable just sitting here doing nothing, staring out the window, letting the kids have at their bags of Valentine goodies . . .

I have been questioning this line of treatment the doctor I saw prescribed: Azithromycin 3 day pack, Robitussin DM 2 TABLESPOONS every 4 hrs (triple dose), Tessalon, and Albuterol inhaler. He also prescribed a steroid inhaler but I passed on it since it cost $100. Figured if I really needed it I would go back and get it.

Sinus infections and I have been well acquainted since I was in high school and my allergies took a nasty turn. Of course the severity of infections have varied and sometimes require stronger medication but there is always the usual arsenal (usually antibiotics for 10-14 days, Flonase) and this treatment is decidedly a little different.

I saw a new doctor.

But that really isn't unusual.

I don't have a regular doctor. And that is because as small business owners we pay for our insurance out of pocket. Those of you that work for companies who pay for your insurance should count yourselves extremely lucky. Our monthly premium for insurance rivals (and sometimes has exceeded) our monthly mortgage payment. Never mind co-pays and stuff not covered. And because we own our business and pay out of pocket for insurance the insurance company, after the first year with them, can raise our premiums every 6 months. I continually have to shop other insurance companies for the best rate-- which often means whatever doctor I have been seeing is not covered. Generally speaking we swap about every other year between being covered by Kaiser Permanente and some other insurance company like Coventry (who we currently have). I have regular doctors for myself and the kids at Kaiser that I see when our insurance is under Kaiser. And my stipulation when having to choose an alternative insurance company is that they cover the pediatrician we see when we do not have Kaiser insurance. If they cover other doctors I have seen outside of Kaiser? Great. If not? Doesn't matter. I will find a new doctor. So at the very least I only have to swap medical records between two different sets of doctors for the kids. I have had to do this three times so far since Carmella was born. That is 3 times with Kaiser and 3 times with different insurance companies in 8 years.

(But Obama is going to save me from all this hassle, right?)

For this reason, I have been privy to the insides of many doctor's waiting rooms and offices. Certainly they all have some similar characteristics: reception area, examine rooms, nurses' station, triage/lab area, the doctor's office etc. What differs is the decor. For the most part I think doctor offices strive to have decor that you do not notice. At least that is what I have to think because most of it begs: Do not look at or remember me. I am bland and the same as the next doctor office. Completely uninspiring.


That part is not true of offices that cater to children or of psychiatrist offices (not that I know anything about that). Those are usually fairly well decorated and at the very least not bland. Generally they have better art. Sometimes original instead of framed prints of floral arrangements bought probably by the receptionist at one of the side of the road art sales. Oh, and I suppose I will concede that in-town doctor offices do tend to have better decor but really it is all, for the most part, pretty uninspiring, completely forgettable.

And that is what I figured about this last doctor I saw. At first. Ryan had warned me that it was "weird"there but I just kind of ignored him. Ryan is the one who gave me this cold. He has been sick with it for 2 weeks and I finally insisted he go to the doctor. He had seen this doctor over the summer when he had a tick bite and was convinced he had Lyme disease. (He didn't.)

As I mentioned before I was sick a few weeks ago with a nasty chest infection. I had found a doctor I really liked. Now if there was ever an uninspiring waiting room theirs was it. The chairs? The worst. I had to push them together and lay across several when my fever was spiking. I did fall asleep so they weren't totally uncomfortable but then again, I was in no position to be picky that day. It was actually pretty funny. You could have drawn a line down the room. Me on one half and all the other people in the waiting room on the other half. No one wanted to be near me.

They also had a tile floor and a flat screen TV that showed some repeating clip about flu precautions. All that money on a fancy mounted flat screen and you aren't going to put CNN on? Their magazines were crap also. I think they spent all their money on the TV and had nothing left for furniture or decor. BUT the office was new and clean. Huge pluses in my book.

And I would have gone back but I knew they didn't have an x-ray machine and I wanted to get a chest x-ray. Otherwise, what would have happened is that I would have spent $20 to see them and then they would have sent me somewhere to get a chest x-ray for which I would have paid $60 dollars to get and then I would have to bring the films back and pay another $20 copay to have them read the films to me.

I may not be be fabulous at math but after how much I pay per month for insurance I like to try to get the most bang for my $20 copay. When Ryan returned home from his doctor visit he told me that they had taken an x-ray of his sinuses. Prefect, I thought. So I tried to get in Wednesday with his doctor after spending all night coughing but they couldn't fit me in until Thursday. Boo.

Going to the doctor on Thursday was the main event of my day. And it did not disappoint.

Truth told I like to go to the doctor. Exhibit A-- for those that may have missed this from a previous post-- at 23, having not been sick for several years I went to the doctor and demanded a series of tests because I was convinced I had a disease that was killing all the other diseases. Really, I think I just missed seeing a doctor.

I like the attention and usually they say nice things to me since I tend to take fairly good care of myself. Also, when I am sick I tend to illicit lots of sympathy from strangers. They feel really sorry for me and are extra kind to me. This is absolutely not true of people who know me. People who know me are slightly annoyed by a sick Nat. That's okay because I am annoyed by sick people too.

So of course, on Thursday, I arrive early for my appointment prepared to fill out lots of paper work. This is one of my favorite parts of visiting a new doctor-- besides getting to see their office decor. I love that I am given pages that ask questions about ME! In a test like form no less! The only thing that would make this experience even more fabulous for me would be getting to fill out a bubble sheet with a number 2 pencil and write a 4 page essay about my health.

I checked in with the receptionist and handed over my driver's license, insurance card and credit card before she even asked for them and anxiously awaited to be handed the paperwork. All the while I am doing my cough that Carmella says sounds like a car that won't start. The receptionist, who hands me my clip board says "You poor baby. We are going to fix you right up!" A man and his wife who are waiting to be seen echo additional sympathies and further that their grandchildren have similar coughs. It is going around they all chorus. The nurse pops in the waiting room and tells me she will be with as soon as possible. Everyone is so nice! So happy to be at the doctors!

As I go to sit down and fill out my paperwork the receptionist tells me the silver lining to being sick is that my husband will cook dinner tonight. I tell her, between hacks, that isn't going to happen. Audible draws of breath and if they all had feathers they would have certainly be ruffled by this admission.

The receptionist says "Chinese food then. He will pick up Chinese food."

Nothing could sound more terrible to me at the moment, well except eggs and fish which always sound vile. The mention of Chinese food begins a lengthy conversation about where the best Chinese food in Atlanta can be found. Buford Highway. And ends being punctuated that Dim Sum? Is to die for. I participate in this conversation with hacks and failed engine coughs and occasionally by blowing my nose to make my point.

Generally, if I am lucky, there is usually another person filling out new patient paperwork and I can race them. I am a very fast test taker and I think it is pretty clear from this blog that I treat all of life's tiny endeavors as a competition if I can at all make it one. Sadly though I was the only new patient and as a result I was able to be a bit more thoughtful in my answers. And by thoughtful I mean excessively long winded.

The new patient paperwork was rather run of the mill until I got to these questions:

Do you like to have a good time?
What do you do for fun?
When was the last time you had fun and what did you do?

I started to rattle off my responses and then paused.

Perhaps this was a trick question? One designed to trip me up and contradict a previous answer I had made--you know like in those personality tests that will ask the same question phrased six different ways.

At that moment the music that had been playing stopped. I can't say what the music was exactly only that I noticed once it was gone. And I sat there another minute trying to remember what had been playing a second before. Funny how I don't notice the noise but rather the absence of noise.

So I answer my questions:
Of course, always.
Run, ride my bike, be outside, go to parties.
Saturday, had a party. Sunday, rode my bike. Tuesday, ran 12 miles.

Happy with my answers I turn in my paperwork and the receptionist asks me if she can get me some water and I tell her it won't matter. The gentleman whose wife is now being seen tries to engage me in a conversation. I notice the music is back but I can't focus on it since the gentleman and I are talking. Something vague, uptempo and without lyrics. Like elevator techno music, maybe.

Finally I am called back and told to go to "The Big Room". I look around puzzled and the nurse, who is humming along to the music, points to the room she wants me to go to. On the door is a label. It says, "The Big Room."

I sit on the examining table which is of the newer type. I say newer type to differentiate between the older type. The older type examining tables are like what my children's pediatrician has in their office. The pediatrician office is the same office I went to as a child. Well, and as an adult until my pediatrician complimented me on my bra. I was 25. He was a great doctor! I loved him!

My pediatrician died a few years ago but the new pediatrician kept all of his decor: the examination tables-- which are just plain wood tables with a thin mattress and sheet and shelf beneath for books and magazines, paintings (Rockefeller prints), waiting room furniture (brown plaid couch, blue floral chair, wood backed uncomfortable chair), end tables (chests), monkey lamps (left over from when he had a circus theme, later a zoo theme.)

The nurse flits about the examine room getting my bp, asking me questions and humming along to the music. She looks over my paper work and says, "So you like to run." I confirm that is true and then she leaves. I am sad that I didn't get to tell her more about just how much I love to run. It was like she didn't really care.

I wait for the doctor and look at the room. Pretty boring and typical. Definitely not updated but nothing too out of the ordinary. After a few moments the doctor arrives and introduces himself. I tell him my litany of symptoms and remind him that he just saw my husband. I tell him about my chest infection a few weeks ago and I am worried it might be back and that most of all I just want the coughing to stop. So after a quick listen at my lungs and a check at my nose and ears he orders a sinus and chest x-ray. He seems thrilled about it. Which makes me happy that I am not the only one excited about x-rays. I love getting to see my bones!

He leaves and the nurse comes back and directs me to the x-ray room. I notice as I walk down the hallway that someone has had a good time with a label maker. I don't really notice what the labels say except that there seems to be quite a bit of labeling going on. I am also trying to note the other decor. Decidedly ugly; a bizarre mix of tschotsky and old lady taste. Instantly I wonder if maybe he had his grandmother decorate his office. Then I decide he must have inherited them from her when she died and she left him the contents of her West Palm condo. The tea set I noticed set out in his office just didn't seem like something a man would choose, gay or not.I am not saying this doctor was gay because I don't think he was I am just saying that I don't think even a gay man would want this particular tea set. It just wasn't fantastic; more Pier One than Tiffany's.

Once in the X ray room, which I failed to note what this room was actually labeled, I had to first do a breathing test. I have had to do many of these and I was familiar with the machine they had. Because it was the exact model that I used when first diagnosed with asthma at 18. So it was pretty old school. In fact, so was the x-ray machine. I imagined that he must have obtained the equipment in some sort of doctor office state liquidation auction. Either that or he also got them out of his grandma's West Palm condo. She must have willed breathing machine and x-ray equipment to him on the stipulation he could have them but he must also display her prized tea set.

The best part of the whole breathing test and x-ray was that the nurse cheered me on the whole time. Go go go go! Yes! Score! Okay one more time.Sweetie you can do it! Okay, third time's a charm! And when she wasn't cheering she was humming.

And then as she measured me she cheered at each and every measurement and then told me where to stand for my x-rays. I then noticed more of the label maker at work. Remove your Jewelry. Said one label above the x-ray machine. And then when I got in position-- right at eye level, an inch from my eyes-- another label: Did you remember to remove your jewelry?

After the x-rays I was told to go back to my room. Which she asked if I remembered which one it is. I think maybe she was being funny because I think it was the only one but she reminded me it was "The Big Room."

So I went back to The Big Room to wait and as I walked in I noticed another door in the room that I didn't see before. It said "The Chamber of Secrets".

Yes! I was very tempted to open the door and sat there contemplating it for several long minutes. I am certain this is exactly how Adam and Eve felt about that tree of knowledge in the garden of Eden. Okay kids, I imagine God having said; you can have anything you want in this here garden but you need to leave that fruit on that there tree alone.

The Chamber of Secrets was just begging for me to open it; just like the fruit on that tree was begging to be eaten.

But I guess unlike Eve I am obedient,  because I didn't open the door. Though I did think quite a bit about what was in The Chamber of Secrets. . .

And then the Doctor came back and told me my lungs were clear and that I had a soul sucking sinus infection that would last all the days of my life unless I took the medicine.

And as I left and I walked out of the office to my car I swear I saw Cherubim with a flaming sword guarding the door.


  1. maybe I should see this funny Dr. too. I would open the secret chamber right away though. I sure miss the monkey lamps! lala (out of bed today!)

  2. But what about the cool "Teen Room" we all longed to be in...

  3. They just call the rooms by numbers. Which is very confusing for me since I think they called them by their decor or other names and I never know where to go.

    But FWIW we go to the "Teen Room" when I have both kids with me.

  4. This is terrific - really enjoyed reading it. Hope you feel better!

  5. I really hope you get to feeling better, I went to the Doc on Thursday only to find out that I had the common cold. I totally understand about insurance companies, and I won't go into my political spill but it pains me to think that someone has to skip on a medicine because of the cost. If you really need it let me know Carin and I get flexdollars so we might be able to help. Anyway winter is almost gone and spring will be here soon, which brings less flus, colds, coughs. I always get sick this time of the year.... it stinks!

  6. Preston, that is so nice of you! But if I really thought I needed it I would go and get it, or if it had been prescribed for the kids I would get it. But I don't really like taking medication unless absolutely necessary and since I was already using one inhaler that was working I thought 2 was a little overkill. Even before I knew the price I wasn't sure I wanted it and when the pharmacist told me how much it was the decision was easily made.

    I think my insurance recently changed what it covers in prescriptions because a nasal spray I paid $10 for last year was $98 if I wanted to get my refill this year. $98 for nasal spray is insane. So some stuff just isn't included and if I can get by without it or with something else I do.

    At any rate I am much better and back to running as of Sunday.

  7. Brim over I agree but I about the list inform should secure more info then it has.

  8. I found your blog to be very entertaining reading. I am a doctor and was googling "doctor office decor" to get some ideas on how to liven up our medical office. Once I started reading, I couldn't stop. Your descriptions of typical doctor offices pretty much describe my office, including old family house decor. too funny!