Pain Physical Therapy #11

Friday, May 17, 2019, 3:00 p.m.

I had a lot of ambivalent feelings prior to today’s appointment. Major feeling was guilt in extending my pain physical therapy treatment this long! Wasting Francis’ time with me when I can’t get motivated to walk. And being a pain for Linda to have to drive me. But not brave enough to end things. It was different with Paul Simon and the individual acupuncture. I knew from the beginning that I would be limited to 10 sessions. And then I’d have to go back to group acupuncture for 6 months before getting individual acupuncture again.

But at 2:40 I found myself in the very familiar Building C. I took a picture of the nearly empty waiting area, and then I put my phone away and waited for Francis. As anticipated, he came down the hallway and called my name. He reached out his hand, and I thought how this seemed now to be the standard greeting for a patient (to shake their hand) and also a standard exit practice (to shake their hand). I responded with my left hand, though, instead of my right hand, and so it ended up being a quick squeeze rather than a handshake. And it was a warm feeling of friendship.

The walk through the corridors, where he unlocked a series of doors until we got to his office, is usually spent in small talk about the weather. This time we were both marveling at how there is so much rain now–in May!

I sat down in the chair across from his chair while he accessed my medical records. I told him I had completed the 9-week Depression Group in Building A, and he said, “Yes, I see that you have.” I told him that I thought it was an interesting experience, but more like a class than a therapy experience. And that I felt, more than ever now, that I should have an individual therapist. And that I saw on the Kaiser “Doctors Online” website that there were 9 such therapists in the San Leandro facility, and that all said “Accepting new patients by referral only.” And that I had tried to reach Dr. Prabaharan but he is out of the office until after June 3.

“How can I help you facilitate this?” he asked. “Would you like for me to contact Julie for you?”

“Oh, I can email her,” I said. I feel comfortable enough with Dr. Whitehead that I can do that. But I knew I would have to at least first call the number (for the Department of Psychiatry at San Leandro) that Dr. Prabaharan’s fill-in PCP gave me.

He nodded. “Well, what’s going on with you now?”

That was cue enough for me to tell him all about the stolen wallet saga! I tried so hard to keep it brief (and I did, I really did).

“And without my driver’s license, I couldn’t go to Harborside until I got it replaced!” (Now Francis and Paul Simon are the only two Kaiser practitioners that I would ever say that to!)

So I got through that as quickly as I could, and then I asked him if he could spend some time checking me on the basic set of pain physical exercises that I’ve been doing for the past year. I commented that I did spend some time with the “lighthouse” routine (video) that he had given me two months ago, and I was finally starting to get it but I needed more practice with the opposite side. His response was that the “lighthouse” was not essential, but just a fun thing to do. I agreed.

I went to the treatment table and positioned myself to go through the exercise set. His comments were mostly that I was still doing all the movements correctly. He did give me a couple of tweaks to add a gentle amount of challenge to the movements. He also was more insistent about the mindful breathing with all the exercises. He suggested that I increase the number of reps in a set, also to add more challenge and develop stamina.

When I sat up on the treatment table, I noticed that he no longer had the one Harborside brochure in his rack of flyers and booklets. I could only conclude that Kaiser management had told all the doctors and practitioners to not have anything about medical cannabis in their offices.

It felt really good–and helped to assuage some of the guilt–to actually do some in-office physical therapy instead of just talking about it. Francis made my next appointment, at my request, for the last Friday in July, so for sure it would be after our planned trip to Portland.

After he escorted me out of his office, it seemed like suddenly I was no longer confused as to which way to go. I looked straight ahead and saw the exit corridor, and pointed toward it, so there was no need for him to continue to escort me down the hall.

Linda and Emily were both sleeping when I got to the car, but Emily woke up with a start and seemed surprised to see me! Linda, however, looked like she felt better after her nap.

Update: Monday, May 20, 2019

One of the to-do’s on my list was to call the phone number that Dr. Prabaharan’s fill-in PCP had told me to call. Turns out, that number was to the Department of Mental Health in Union City! I apparently reached a medical assistant whom I told that I am a Kaiser Medicare Advantage patient and I just wanted some information about the process to get a therapist. I told her about finding the search results for the Kaiser Doctors Online site and that it gave a list of 9 therapists who were taking new patients by referral only. For San Leandro. Well, it turns out that there are NO therapists on the San Leandro campus and the only “Department of Psychiatry” is on the Union City campus! Then she said that maybe there were some counselors in the Behavior Modification Department in San Leandro but she would need to let me talk to one of the practitioners. She took my cell number and said someone would call me later this afternoon.

I spent some time doing my pain physical therapy exercises in the bedroom, petting Emily, and talking to Linda, mostly about my frustration with my OMAD (one meal a day) fast and my horrendous blood glucose numbers. She asked uncomfortable questions that I was forced to answer. She didn’t really understand why I just didn’t inject some insulin to get the blood sugar down, but she did understand that I wasn’t going to! Then she said, in her very-familiar way:

“May I make a suggestion?”

She knows I will never tell her she can’t make a suggestion. So my usual response is: “Yes, you can make a suggestion. But I may or may not follow it!”

“What is the next step?” And I knew what she was going to say: “Go for walk!”

So, as if to challenge her suggestion, to prove that it wasn’t going to work, I jumped up from the bed, put on my flip-flops, put Emily’s harness on her, and grabbed my water bottle. I grabbed my phone, in its case, from my desk and put it around my neck, then I put the water bottle and Emily in the dog stroller and opened the front doors.

When I was halfway down the front steps with Emily in the stroller, my cell phone rang. I heard it in my right hearing aid and I now knew how to answer a call by a quick push on the end of the microscopic tab on my right hearing aid. I knew it would take one full second to actually “pick up” the call.

“Hello?” I said into the air.

The woman on the other end identified herself as the promised practitioner from the Union City Department of Mental Health. I repeated my story to her, including telling her that I needed to have a therapist on the San Leandro campus. She verified that San Leandro did, indeed, have a Behavior Modification Department with therapists who deal with “mild cases.”

I breathed a silent sigh of relief. “I consider myself a ‘mild case’,” I said. “I’m just an old lady of 72 years, and have been having depression for about 3 years, and…” I went on and on, assuring her I was not suicidal nor homicidal. Just sad. And fearful.

She said she could do a preliminary screening on the phone, right now, and was this a good time for me? I told her I was out for a walk with my dog and this was a perfect time for a call. In reality, I was struggling with Emily, trying to get her to pee (which she never did), and fighting with her to keep her from chewing her feet. I alternated between picking her up and carrying her and putting her down to walk (which she wouldn’t do) and then putting her back into the stroller and trying to keep her from looking like she was going to jump out. All while I managed to get through the screening on the phone.

When the practitioner was convinced that I really am not suicidal or homicidal, that I have never been hospitalized for mental illness, that I am not addicted to alcohol or drugs, and that there are no guns in my house, she asked if I could wait another month for an appointment. (What was I going to say, or what would she say, if I said I couldn’t wait?) So I said, “Yes.”

She ended up giving me an appointment for a Thursday (perfect day) in June at 1:30 p.m. (perfect time). So I went home and put it in my Google calendar.