Saturday, December 17, 2011

Chores

I've been doing some garden chores. I think I mentioned last spring that one of my two Tamarack trees had died, and the other had half died (the top half). Well, I cut down the dead tree today, and bundled up the smaller stuff into kindling. I have a friend with an outdoor fireplace thing they use during summer, and I'm hoping they'd like some kindling and small wood pieces. (The tamarack had maybe a three inch diameter bole at the biggest part.)

One of my neighbors stopped by to welcome me back, so I asked him about one of my pine trees. A couple of years ago, the top leader died, and two branchings were vying to become the new top, with no clear winner. So it's either cut one of them off so the other will take over, or have a tree that splits. I chose to cut one of them off (not only for aesthetic reasons, either, but because I want more height and less chance of one part getting weak and coming down on top of my or my neighbor's house). And my neighbor handily had a pole saw. I had my doubts, but it was super easy, and about five minutes from walking into the yard with it to walking out to return it, having cut off the less straight leader.

I figure I have a couple hours of yard cleanup, cutting back dead iris stuff and other stuff, and then I need to get some mulch to put on the strawberries and such, I think.

At least I'm grateful for almost no snow in the yard for gardening sake, even if I'm impatient for skiing sake.

I mentioned back a waysthat one of my feet was hurting. Being back, I went to see the doctor about it, and I'm mildly (and probably irrationally) frustrated.

It starts with the weighing thing. Now I know I'm badly overweight. It's not a secret to anyone who looks at me. But I also know that weighing me means that the clinic gets to tick off extra stuff to make my visit more complex and more expensive, even though the nurse laughingly says that I'm getting more for my money. Yeah, not so much.

And then the blood pressure (also adding complexity to the visit), which was way high, higher than it's ever been. And then the doctor is working with a student nurse practitioner, so the SNP saw me first. That's fine for foot stuff, but I'm guessing this is a student at my school, and that means there's some chance that I've had any given NP student in some class at some point (writing or GE sorts of classes). And that seems weird. But for foot stuff, fine.

So she asks me about the pain compared with the worse pain I've ever had. I'll admit it here, I've never had a lot of pain (and said as much). I'm grateful for that lack of past pain, by the way. So then she asked about the worst pain I could imagine. So I'm thinking flaying alive, burned at the stake, broken on the wheel. I have a pretty good imagination, and given that, I told her that my pain was about a point one (same as I'd told the nurse before). I think that was a mistake.

The SNP pokes the foot a bit, and asks me to walk, so I do. And the foot doesn't hurt that day, though it did the night before a little in a soreness way.

Then the doctor comes in, and starts talking about my blood pressure, which as I mentioned is way high. The thing is, it's always way high at a doctor's office. So she measures it again, and it's down by like 30 points on the top part, but still high. I hand her the card that I've been using to keep track, as I was supposed to do (the nurse at the Abbey was kind enough to measure it for me every couple of weeks), and there it's a little higher than ideal, but not nearly this high.

The doctor says she's more worried about the blood pressure than my foot, and I say that I'm more worried about my foot because it's been hurting. It's not that I don't recognize that high blood pressure is a problem, but the foot hurts, and that's why I'm there. Then we talk about the cold medicine I've been on (which I'd also mentioned to the nurse when she asked about medications).

And she does look at the foot, poke it a bit, and have me walk.

The upshot is: (1) I'm not supposed to take cold medications anymore. She gave me a prescription for an inhaled steroid to use for sinus stuff if I get another cold.

(2) I have another card to do the blood pressure thing every couple weeks.

(3) She gave me a choice between trying some physical therapy for the foot or going to a podiatrist, and recommended the physical therapy, so she gave me a referral to the physical therapy department.


I guess I'm frustrated because what I want is to know what's wrong with my foot, and I don't. And I'm frustrated that I shouldn't take cold medications any more, and worried that the inhaled stuff won't help me and will mess up my nose and make it bleed, and then (if I get a cold), I'll be teaching with a nose that's running and bleeding, because I never feel like I can call in sick with a cold and have three classes of 20-35 people fall behind and get messed up.

And I know it's not really reasonable to be frustrated, because if the physical therapy works, then it won't matter what was wrong with my foot. And I don't usually get more than one cold a year when I'm not running around on busses, subways, and trains in a foreign country, so the cold thing isn't that big a deal, and I do know that having high blood pressure is really bad. But I didn't go for that, I went for my foot. I feel like being honest about the pain (and after all, I'm not disabled by it or writhing on the floor) means that she didn't really take the foot thing very seriously. But then, remembering Elaine Scarry reminds me that another person's pain is really hard to comprehend or really worry about.

The final kicker: I can't see the physical therapist she recommended until January 10th, which is after my new insurance kicks in, complete with a percentage co-pay (I think it's like 10%, but I can't remember for sure), so I guess I will need to call the insurance company at the beginning of the year and ask about if I need pre-approval. And then I'll have to call and ask the clinic how much a physical therapy appointment is likely to run, so that I can try to budget for my 10% (or whatever it is, I'll have to ask the insurance company). Then I'll have to try to get estimates for any other visits, which I gather isn't easy.

I think I need to go cut up some weeds or something to destress some more.

12 comments:

  1. Nasal steroids are fabulous. Don't worry about them. The other stuff, yeah, frsutrating as all get out, especially new insurance, but the steroids will help a lot.

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  2. I think decongestants are the biggest issue for high blood pressure - my doctor told me to stay off them too. There's one OTC brand that's designed for people with HBP, Coracidin, so you could try that if you're not thrilled about the steroids.

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  3. I find that whole "compare this pain to the worst pain you've ever experienced" thing difficult and weird, because how do they know what your worst pain is, so how does the number you give them really mean anything? Like you, I've never experienced significant pain, for which I'm very grateful; D., on the other hand, has experienced what most of us would find unimaginable pain. So my pain numbers would be a lot higher than hers in comparing the current pain to the worst experienced; how does that tell the medical professionals anything useful?

    Anyway, the medical stuff sounds frustrating (and my mom can no longer take decongestants because of her high blood pressure, so I guess this is a normal precaution). I hope that the physical therapy will help, come January.

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  4. *patpatpat*

    I hope the physical therapy works! There are a lot of really fantastic physical therapists out there, and I know people who have been "fixed" by physical therapists after being failed by medical specialists and/or chiropractors, so I'm hopeful for you.

    My sister was an athlete in college and picked up a lot of really awesome p/t tricks. Whenever I have a weird pain I'll call her and she'll tell me some kind of stretch to do and it will work.

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  5. So then she asked about the worst pain I could imagine. So I'm thinking flaying alive, burned at the stake, broken on the wheel. I have a pretty good imagination, and given that, I told her that my pain was about a point one (same as I'd told the nurse before). I think that was a mistake.

    This is exactly why I don't understand those pain questions. Didn't those medical professionals read any history before they concocted these tests?

    Feel better!

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  6. Thanks for the kind and encouraging words, friends. I'm especially glad to hear that the steroid things have worked well for someone else. And I've had good luck with physical therapy in the past, so I'm hopeful. :)

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  7. Anonymous10:50 AM

    (Message from a regular reader who has never posted before)

    You just took a long airplane trip, yes? Before you turn your foot pain over to a physical therapist, consider asking your doctor to check for deep vein thrombosis. Foot and leg pain (often accompanied by swelling) are common symptoms of a condition quite easy to treat if it's caught early. Note that I'm not a medical doctor (nor do I play one on TV), but I have a friend who developed DVT after a lengthy car trip once, so I'm inclined to think of it as a possibility.

    Insurance difficulties or no, take good care of yourself. I always look forward to reading your postings.

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  8. Nasal steroids rock. Have seriously changed my life -- and never a nosebleed.

    I totally get you on the pain scale thing. When I was miscarrying and getting prepped for the D&C the nurse asked how much pain I could tolerate post-surgery on a scale of 1-10. I told her I had no idea how to answer that question, and that I didn't want to be all loopy, I don't mind minor pain, but didn't want to be screaming in agony either. In the end, they either gave me a lot of non-loopy-makin painkillers in the IV or I just didn't have any pain, but the pain scale? Silliness!

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  9. http://xkcd.com/883/

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  10. Thanks, Anonymous, and welcome :) I had the foot thing while I was in London, after I was walking a lot as a tourist, but thinking about dvt stuff and plane rides is always important (I made sure to get up and do stand on my toe things in the back a couple times).

    Profgrrrl, I'm glad the nasal steroids work well for you. And sorry about the miscarriage.

    J. Harker, Perfection! Thank you!

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  11. Ditto on the dumb pain questions! I have a high pain threshold (speaking of foot pain, I once spent several weeks walking through France on a foot that turned out to be fractured--yeah, that hurt a lot!). Being able to tolerate pain doesn't mean I WANT to have to tolerate a lot of pain.

    I don't know if you've gotten checked for plantar fascitis, but that's a pretty common cause of foot pain, especially for people who are somewhat heavier and who do a lot of walking or standing (or in people of whatever weight who do lots of running). There are splints you can wear on your foot at night that really help many people. It might be worth having your doctor or therapist evaluate you for plantar fascititis if that hasn't already been done.

    Note--I'm not a medical professional at all, so take this for what it's worth, which might be nothing--just a long time runner who has had foot issues, including plantar fascitis at one point.

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  12. I HATE the pain scale. Everyone does. We just HAVE to do it because it's a "quality measure" that we aren't ignoring pain, and to be able to audit that, we need an "objective" scale. It's like a national requirement or something now. But the better question is really, "How is this pain impacting your life? What do you not do?" But then they can't bill it.

    And the billing, don't get me started. All that complexity stuff...it's awful.

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