Tuesday, April 12, 2022
I don’t ordinarily schedule medical appointments on Tuesday because of that being grocery shopping. This appointment was originally scheduled for Monday but Francis emailed me and said he needed to reschedule. Since I only have to go to Safeway today, I agreed on the 11:30 a.m. appointment on Tuesday for Pain Physical Therapy.
Linda had me put her walker in the van so she could get out and walk while I was in my appointment. But it was way too windy to do that! So I went inside 10 minutes before my appointment time to check in and wait for Francis. I wore my pink breathable “Unmask” since I knew I would need to keep it on for an hour.
When we got back to his office, he asked me if I wanted to weigh in. I hesitated only a moment then said, “Sure, why not?” I put my backpack down on a chair and took off my jacket. The scale registered at 133.6 lbs. Francis remarked that at my weigh in on January 17 I had weighed 141 lbs. That made me feel very good! It also told me that I had better keep working on losing weight (since my goal weight is 130 lbs.).
When we got to his office, he checked my medical record and saw that I had lab tests scheduled, including the A1C and a TSH for thyroid. I told him that my PCP’s office used to email me when they ordered tests but I had not heard from them. He wondered if I wanted to get the A1C done today and I told him I wanted to contact Dr. Prabaharan directly and ask for a c-peptide test. I told him I had the first shingles test and could get the second one after April 15. But I told him I wanted to get the permanent crown done first.
When I got home tonight, I logged on to my Kaiser account to see for myself what lab tests had been ordered. He did not order a lipid panel even though it’s been a year since the last one. Then I went to my Medical Record and saw the Summary that Francis had recorded.
Office Visit on 4/12/22
PROMPT Pt declines going to lab for A1c test – pt prefers to have Dr. P order peptide test first then she will get A1c test done.
Pt has already gotten first dose of Zoster vaccine – OK to get next dose after 4/15
1. Chief complaint: R cervical pain – resolving. Good relief with acupressure and acupuncture.
2. Pt continues to manage diabetes well with low carb diet and intermittent fasting
3. Pt hasn’t been walking outside lately due to windy weather, however, she has been much better about taking her dog for a daily 30 min walk which I endorse.
4. Pt was asking about online Pain Mg’t classes and will consider joining the Self-Care workshops.
Plan: pt would like to see me 1-2 more times before I retire later in the year. She will send me a message when she is ready for her next appt.
I’m okay with that.
We talked about other things. I told him I had been eating carnivore for Lent. He told me he was doing intermittent fasting with OMAD (one meal a day). He said he had lost 25 lbs. on that regimen.
We talked about kids. His two boys are out of the house but his father-in-law is living with them.
I asked him when he was actually going to retire and he said September or October. That means I could have 2 more visits with him.
He asked how much time I spent at the computer. I told him “all day.” Then I told him that I’m on Facebook primarily for keeping up with my kids but also to provide admin support for two diabetes groups I’m in, one of which I started on my own in 2013. He said that there had been some talk about having a Facebook support group for Pain Management patients and asked if I would be interested in a role as admin. I said, “Yes,” but someone else would have to create the group then invite me to be one of the admins. He said he would let me know.
I went back to my Medical Record online and read further:
Office Visit on 1/17/22
S: Chief complaints – chronic neck pain (improving), hand pain (worse with computer work), knee pain and ankle pain. Pt states that she has been able to establish a good routine for walking – 30 min 5x/wk around mobile home park and another 30 min on Tuesday at the Farmer’s Market (except on days when it is raining). Pt continues to see Sophie Tu LAc for acupuncture therapy and reports that it helps.
O: most recent A1c is 6.3
today’s wt is 140lbs (goal wt is 130 lbs)
A: Overall, pt is doing a good job with self care. Using low carb/keto diet to manage diabetes with good results. Using acupressure and exercise to manage neck pain. Patient would benefit from more frequent breaks from computer work to lessen hand pain/strain.
Plan: f/u office visit in Mar or Apr 2022.
Total time spent with patient today: 60 min (mostly counseling)
Interesting. Yes, my appointments since 2019 have been “mostly counseling” since I did not have a good experience with the individual “counselor” I was assigned after I took the 10-week depression group class that began in January 2019. I found out that the goal of such individual “counselors” is to get the patient to a satisfactory place by 6 months and then drop them. There is no such thing as an ongoing therapist in the Kaiser system, apparently. My last appointment with her was January 2020 and it was an “email appointment.” Just as well. I did not want to go back to her since her only suggested treatment was antidepressant drugs, which I told her I was not going to take because they raise blood sugar.
But I kept going to “see” Francis, my Pain Physical Therapist, every 3 to 4 months. Francis, by default, has become my “therapist,” not just for pain physical therapy but for emotional support. My last appointment with him was January 2020, just before the pandemic hit. I was very fortunate to be able to “attend” weekly Pain Management Group online for 17 months (from June 2020 to October 2021) with Dr. Julie Whitehead for the meditation and discussion part and Francis for the “gentle movement” part. I made sure I let him know how valuable that was for me.
