Saturday, September 29, 2012

Mass confusion.



It a little bit sound like the Charlie Brown-cartoon-grown-up voice. All wobbled up and hard for somebody to understand. I keep looking at her and she looking at me. I'm smiling so she won't think I'm confused.

But I am.

Okay. I ain't stupid. I know I ain't. But this? It's so much so fast. Something 'bout how at first there was one medicine but that one did something and now she want to try another one. Big words for no reason keep throwing me off. She seem like she in a hurry, too. At some point, I just said bump it. I'll just see if the man at the WalMart pharmacy can help me.

Keep smiling. Smiling while she looking over all my pill bottles.

"This one is renal protective. Since you have diabetes that's a medicine you need to be on but your potassium has been creeping up. We'd thought about holding that one but there's also the added benefit of ventricular remodeling with your heart failure. In other words, how the heart is shaped and how it responds to all that's going on with you."

She set that bottle down after she said that part. It felt like a door slamming on me. Right in my face.

"Uh huh."

Still smiling.

"You with me, Mr. Allen?"

I just nod 'cause I don't want her to start over.

Now. What the hell do RENOPROTECTIVE mean anyway? I don't know. But she been talking  so much and for so long that I don't even want to ask. She seem like she care so much, too. But she talk so fast and with all these fancy ways to say stuff. RENOPROTECTIVE? What? And the remodel part don't mean nothing to me. I hope it mean something to the man at the WalMart pharmacy.

Smiling. Head nodding.

"There's a lot of compelling data to support us keeping an eye on the the K since the benefits far outweigh the risks of you being on an ACE."

K? What the hell is that?

"Oh. I almost forgot. K is just our abbreviated name for potassium. It's a salt in your body."

"Oh, okay."

"So, we'll keep the ACE on board and the thiazide, too. I also think it's a good idea to switch this atenolol to Coreg. I have no idea what you were doing on that atenolol when you have known systolic dysfunction."

Because y'all prescribed it when I was in the hospital, that's why. "Okay, then."

"Carvedilol is the superior beta blocker for patients with heart failure. There's plenty of good data to support that. It's more potent, too, so I think we'll get the most bang for our buck there."

I thought you just said a different name. Now I'm confused.

"Question, sir?"

"Uhhh. . . what is Coreg?"

"Carvedilol. That's just the trade name for it."

"Oh, okay."

Trade name? Whatever that is. So why the hell are you going between two names for it anyway? I don't even know what it is. But something about it being superior or whatever the hell she keep saying sounds okay, I guess. I guess.

Smiling. Nodding my head some more.

Here's the thing. I don't get ninety percent of what she say to me. But it seem like she care and like she smart. So even if it sound crazy, I just go with what she say.

Now she studying all my pill bottles like somebody gon' test her on 'em later. I kind of have to pee but hopefully we almost finished.

"Hey! What's this?"

Now she's looking at another bottle and her face is all twisted. Shit, I don't know. I just brought in my bag with all my bottles like you said to do. They changed some medicines when I was in the hospital last month and I thought all this was in that computer. Why then, she got to act all surprised like nobody is talking to nobody?

"How long have you been on this clonidine?"

Cloni-who?

I take the bottle and look at it. "That's from when I was in the hospital. I started it after I left."

"Uggh. I hate clonidine. What the heck were these guys thinking? Clonidine? Atenolol? Are you kidding me?"

I don't think them questions was for me. It was for the air, the situation and for herself. Words that woulda probably been spoken even if I wasn't there. Here's what I just decided. It make me kinda uneasy when one doctor make it seem like another doctor ain't doing right by you. Seem to me like everybody need to get on one page.

But the cloni-whatever wasn't my favorite. I stopped it like a week ago since it didn't agree with me. Why not tell her?

"That pill make me feel a little bit drowsy so I don't always take it."

Damn. What did I say that for? Now she shaking her head and mumbling some more stuff about the other doctor who gave me that medicine. But I was just being honest.

"Clonidine isn't always best for everyone. Yes, it can make you drowsy and it also causes rebound hypertension."

Whatever that is.

"When was the last time you took it, sir?"

"Ummm, I think yesterday." And by yesterday, I mean last week.

"Yesterday? Ugggh. Okay."

Now she typing all fast into that computer. I kind of like that they put the notes in the computer. But  look to me like they'd have some better idea of what's happening if they looked at what each other was doing.

"Maybe I took the clonidine last week. Not yesterday."

"Okay. Well we're stopping that anyway. The Coreg should do the trick, I think." She paused for a moment like she was about to say something else. "You still smoking?"

Shit.

"Uuuuhhhh. . . "

"I can smell cigarettes on you, sir. It's okay, you can tell me."

I smell onions on your breath from your lunch break but I didn't just call your ass out on it. Damn.

"I cut back a lot, though."

"What's that mean?"

"A pack last me three days now. That's a lot less."

Now that part was true. Last time she was pushing me to make a 'quit date' and to get her off my back I just went on and said I'd quit on my birthday. That day came and went.

"Hmm, okay. I know we'd set that quit date before. How are you feeling about quitting?"

"I want to quit."

That's true, too. Eventually I want to quit. But as far as being real, real ready to quit right this second, no. I drive trucks. I ain't really in no position to not smoke. What truck driver don't smoke? Well. There's Jimmy who quit. I think Big Marsha quit, too and she was a chain smoker. They went cold turkeys and I ain't so sure about that.

"Okay. We can set another quit date and this time use some nicotine replacement. How's that sound?"

It sound good for somebody ready to quit. I said I want to not I'm ready to. And I heard them nicotine patches make your skin break out and make you feel all jittery. She looking all up in my face so I better not say nothing, though.

"I guess that's okay."

"Okay, great." She starts squinting at this calendar on the wall. "What do you think about Thanksgiving?"

"What do I think about it?"

"Yes. As a quit date?"

"For the cigarettes?"

"Yes, Mr. Allen. That would be a great way to celebrate your Thanksgiving. What do you think about Thanksgiving?"

Here's what I think about Thanksgiving. I think I'm gon' have me some pie and loosen up my belt buckle after a big plate of food. Maybe two plates. I think I'm gon' play some bid whist, spades and dominoes with my sister and my brothers and my sons and we gon' talk shit and drink Jim Beam. And we also gon' smoke. That's what I think about Thanksgiving.

"That might be a little soon."

"Okay. How about Christmas?"

How about changing the subject? How 'bout you recognizing that we do the same thing on Christmas as we do on Thanksgiving?

"What do you say, Mr. Allen?"

This time she winked at me.

"Um, yeah, okay."

"Great, sir. That's great!"

More typing.

"We have flu shots in. So we'll give you one of those today, okay?"

Today? Damn. I'm not so keen on those. Last time my arm hurt for two whole weeks. But if I say no she gon' say what she said last year about me having sugar and how if I get the flu I could die. I don't know anybody who got the flu and died. Not a one person.

"Can I wait on that?"

"I wouldn't recommend it. You know you have diabetes and heart failure and if you were to get influenza it could be life threatening."

Told you. Now it's heart failure, too that will kill me with the flu? I just don't have it in me to fight. Plus my bladder feels very, very full and I want to just pee and then leave. See? That's why I don't like taking my water pill on the day I see the doctor.

"Okay."

"Okay for the flu shot?"

"I guess."

She holds a thumbs up. I smile. Again.

The last part involve something about this colon test I have coming up in a month. How it's very, very important for me to get this, especially since I'm Afro-American. I don't even remember saying I wanted that test. Or us talking about it. I do remember when my brother Charles Edward got that test. He said that stuff they give him the day before had his bowels running off so bad he thought he had the choler-y.

"It's only every ten years. Unless they find a mass or something."

A mass? What the?

"You know, like a polyp or something."

Charles Edward didn't say nothing about that.

"What happen if you don't get that test?"

She already revved up. "Well, if you had a colonic mass and it went undetected you could have colon cancer spread all through your body. The most aggressive forms affect African-Americans."

Here we go with that again. When did we switch from being black? Are we still black? I don't even know. I know we ain't colored. But NAACP still got the word 'colored' in it. I wonder why? Hmm. Hell if I know. I'm just ready to go.

"So that's on the twenty-second, okay, sir?"

"That's fine, ma'am. Are we just about finished up? I want to get to this pharmacy, you know." And to this bathroom. "Plus my son waiting on me, you know, and he got to get on to work."

"Absolutely."

Typed some more. Said a few more things, this time even faster than all the other stuff. Then when she was done with all of that she reached out and touched my hand.

"I love taking care of you, Mr. Allen. I hope you know that."

I smiled because that was kind. "I like you, too, doctor."

"Let me know if there's ever anything I can do to take better care of you, okay?"

She still got her hand on my hand and she looking all in my face like she really want to hear what I got to say. And man, I do got so much stuff to say.

Like:

You can slow down. You can use some smaller words. You can maybe draw it on a piece of paper for me. You can know that ACE and K and COREG and CARVEDILOL and COMPELLING DATA are words that sound like another language to me but how you say them in my direction seem like you think I speak it. I don't. So you could know that.

And:

You can not say nothing bad about the other doctor that saw me in the hospital. You can look inside the computer to see what they did. You can let me see how I feel about cigarettes. And flu shots. And not scare and confuse the shit out of me by saying something about a mass on my colon. You can just overall explain stuff to me different. Slower. Less fancy-like. You can know that even though I can read and write it don't mean I get all that you say. You can remember that when you talk to me. All that. That would make it better for me.

It would. It really, really would.

But that's a lot. And saying all that would make my son wait longer in that waiting area and my bladder almost explode. Plus it might hurt her feelings 'cause Lord knows it seem like she thinking hard and long about me. So I keep it simple.

"Okay, doc. I will."

"Alright, Mr. Allen. See you in three months?"

"Yes, ma'am. Three months."

***
Happy Saturday.


10 comments:

  1. When I first started reading your blog, I was thinking Oscar. Now imma' have to change that to Pulitzer. GREAT post!

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    1. Dang. That's a high compliment, my friend. Thank you so much.

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  2. So informative on so many levels...

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    1. Thank you for reading -- and commenting. 'Preciate you.

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  3. Exactly Kim. Exactly.

    Maria, fellow Meharrian

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    1. Hey there, Maria. Thanks for always reading.

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  4. You understand it Dr. Manning, even though I understand those big words and I've been on this merry-go-round long enough to just lay my feelings about what they want from me on the line. But, I know just how that man feels. And after my medical week this week, I'm tempted to add to his list. But I couldn't see through the tears to type it.

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  5. Another awesome post that cuts right to the heart of medicine...having seen it from a few different angles myself, I still say when I read posts like this that someday you ought to write a book (if you could ever find the time, between all the other stuff you write about doing). I could write one of my own but wouldn't know where to start.

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