Monday, December 9, 2013

Battle of the Blood Pressure

So, a new clinic opened in Louisville a few months ago. They specialize in back & knee pain and non-invasive therapies for both. Free consultations were offered, so I decided to give it a go. After reviewing my history, they said I was a good candidate for their services. The bonus was that they'd contact the insurance company and find out how many treatments they'd pay for and what type. Then I got a free aqua massage which left me feeling better than I had in months.

Well, when I went in for my second consultation, they took my blood pressure as part of the pre-treatment procedures. Backing up for a minute, I was stressed to hell when I got there that day. My appointment was for 9 a.m, but traffic was horrible with numersous wrecks along the routes, and I didn't get there until 9:30, despite the fact that I'd left home at 8 just to be on the safe side. As I've mentioned before, I'm a high stress driver, so you can imagine my state of mind by the time I got there.

Anyway, the guy took my BP. And freaked. So he tried it again. Still freaked. Got a new cuff from another tech, tried that, and freaked some more. Then he went and got the staff doctor. She took my BP and her eyes were huge. At this point I began to suspect something might be wrong. (LOL) They asked me if I had any idea why my blood pressure might be excessively high. I explained about stress and the drive, and told them that if they'd give me 30 minutes to calm down, it would probably drop. "Not that much- you should be dropping dead from a stroke right now." (they phrased it a bit more diplomatically) I told them that it was also higher than normal due to the insurance company having priced my old medication out of reach & that I'd been off it for several months. Dr B had given me a new one to replace it, but I'd only been taking it a week. They were still insistent that something was WRONG, and called his office. My luck- it was his day off and the covering doctor didn't want to be bothered with me. They were told to send me to the an immediate care center.

So, back in my car I go. The clinic wanted to call an ambulance, but being the stubborn person that I am, I knew I was ok and there was an ICC a couple of miles down the road. Headed there over their protests. Got to the clinic and explained to the desk clerk what I was there for. The intake nurse took my BP and shrieked "OH MY GOD!" Ok, so maybe it's a little higher than I thought. They threw me into an exam room and told me to lie down and try to relax while they got the doctor. She came in, I went through the whole story with her, and she took my BP again, with a similar reaction.

Dr X gave me a dose of some medication and said they'd come check me again in 30 minutes. They also checked my sugar, expecting it to be out of control too. (it wasn't)Less than 15 minutes later, they took my BP again and it had barely changed. "Well," I was told. "You're going to have to go to the ER becasue we're not prepared for this. We'll call an ambulance for you." Um, no. They made it clear that they weren't going to let me drive and threatened to call the police if I tried to. That was the last thing I wanted/needed, although I was tempted to tell them to go ahead because it would probably be a friend of mine. I told them that my parents lived less than 5 minutes away, so I'd call them to come get me and would hand my keys over to the staff until they got there.

Called my parents. I had texted them about what was going on before I'd left the PT clinic, just to give them a heads up. It took 5 tries, calling both their phones alternately, before one of them FINALLY picked up. After talking Mom down from her freak-out, I told her to hurry up and get there before they panicked at the ICC and tried to stuff me into an ambulance that I really didn't want to have to pay for.

It took my parents 30 minutes to arrive. They live less than 5 minutes, literally, from the ICC. (one of the reasons I chose to go to that one) I was not amused. Mom babbled about taking a shower, etc. I wouldn't have cared if she was funkier than Miley Cyrus, as long as she got there quickly. The ICC asked me what hospital I wanted to go to as they were going to call and tell them I was coming. I told them where I wanted to go (Jewish East, where Dr B's office is and where they know our whole family pretty well after the last few years) and they said "Oh we don't send patients there. Why don't you go to THIS (a newly constructed Norton building) Hospital instead?"

Fine. Then I had to argue with my mother over the directions. We got there, went to the ER and was told that they didn't know anything about me coming, but to sit down and they'd call me when they were ready to see me. Good thing I wasn't really having a stroke or I wouldn't be here to type this post.

I finally got called back and they proceeded to repeat the taking of the BP & freaking out. The nurse practioner assigned to me asked what I'd been given & when I took it last. I gave her all the paperwork from the ICC and repeated what my daily meds were and when I'd taken my last doses of them. She told me that the meds I was given at the ICC had lowered my BP a little, but probably needed more time to work. She also agreed with my assessment that I probably could use a shot of Atenolol (a med I used to take but stopped per Dr B because we thought that was the one causing my dizzy spells)and ordered it. She was impressed that I was so conversant in my meds and my reactions to them. (and knew I wasn't having a stroke because I was able to converse rationally with her about everything)

So, I got hooked up to an IV (at least they didn't put it in my hand this time) and was given saline for dehydration and the Atenolol. By this point, I've called the office and told them I wouldn't be in that day, and possibly the next. I'd been told that if my BP didn't drop appreciably in the next 2 hours, I was going to be admitted. You can imagine the helpful responses I got to that.

2 hours later I was told that my BP was still high, but at an acceptable level to let me go home. 90 minutes later, I finally got to go home. Now, this all started at 9:30 a.m. It was 4:30 by the time we left the hospital. I'd had nothing to eat all day (the parents & I were supposed to go to Red Lobster for lunch between the clinic & work)and was freezing because the ER was cold. The hospital had a Starbuck$ in it, so Mom went and got me a hot chocolate while we waited for my release papers.

I was told to follow up with my doctor the next day. Duh. We went to an early dinner at Red Lobster before going back to collect my car at the ICC. I went home, went to bed, and slept until 9 a.m. Dr B's office had already called to get me on the schedule, so I called them back and went straight over. He went ballistic when he found out his covering partner had REFUSED to see me and was irate that I'd had to spend so much on co-pays. (he remembers my budget issues) My BP was still higher than he was happy about, but he agreed with me that it was lower than it had been when I first started seeing him 5 years ago (and it had not gotten that high the day before) and would probably come back down as long as I stayed on my new meds. But to make up for some of the drama I'd been put through, he called my office for me and told them I wouldn't be in that day either, walked me down to the ER in their building, and had me hooked up to an Atenolol drip again. He told the attending nurse to bill his practice for the treatment, NOT ME.

So, that was Wed/Thursday. I probably should have stayed home Friday, but there was nobody to cover me at work, so I went in. I had to go back on Monday for Dr B to check me again. BP was still high. Another ER session billed to his practice (he told me that he found out which partner was in the wrong and was making them pay for my subsequent treatments. Apparently I wasn't the only one this cluck refused to see when they were supposed to be covering for him)and I was treated to another day off from work.

I've been back several times since then. For some reason, my BP is no longer responding to most of the meds. Poor Dr B is at his wit's end. I'm not at stroke level for the time being, but nothing is working as well as the meds that I can no longer afford. To add insult to injury, a lot of the side effects that we thought were coming from the meds he had me stop taking turned out to be effects of the expensive meds instead. I've had considerably less dizziness, psoriasis, joint pain, etc since I stopped taking the Benicar.

The good thing is that Dr B isn't charging me to come in and have my BP checked every week. I call his assistant directly, she checks the schedule, and they whisk me in/out between patients. Since it IS slowly coming down & hasn't been bad enough to need further in-office medication, I'm only there about 5 minutes. He says he'd rather not charge me $25 for each of these 5 minute trips if it means that I'll keep coming and let him try to keep me alive for a few more years. (I think my morbid sense of humor has rubbed off on him)

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