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Adventures in Health Care and Snow
Jan. 18th, 2022 09:07 amOn Friday (Jan. 14), in anticipation of the Big Snow due to hit us on Monday, I made a point of returning my library book, which was also due on Monday. The plan was to stay home and cocoon for the day on Monday. But then, around 5:30 on Friday afternoon, I got a phonecall from the office of my new rheumatologist. Could I come in on Monday morning at 10:30 for my first visit? I mentioned the impending snowstorm and the receptionist agreed that it could be a problem but said the office would still be open. I consulted briefly with Dianora who was agreeable to driving me there, snow or no, and told the receptionist I'd try to make the appointment.
A brief bit of background here. I'd been seeing the last rheumatologist for about 15 years and I really liked her. Her office is conveniently located at Centrepointe but since March 2020, all our consultations have been by phone. Then in August 2021, she informed me that she would be retiring in the spring and would be passing my file on to a different rheumatologist located on Greenbank Road in Craig Henry. I looked up the new one on RateMyMD and the evaluations were really all over the map.
By Sunday evening, it had already been announced that all public libraries would be closed on Monday and there would be no garbage or recycling pickup. By Monday morning, school closures and bus cancellations were announced throughout the region. There would be no mail delivery either. We did have a newspaper (it usually arrives around 2AM, which was probably before the snowfall began in earnest; we still don't have our paper today)
I phoned the rheumatologist's office shortly after 8AM and the receptionist was already there on site. She suggested I aim to arrive around 10:45. Even if the doctor wasn't ready for me by then, she said I'd be able to visit the lab (located in the same building) for bloodwork.
So we headed off just after 10AM, with the snow already rapidly accumulating, keeping to the main roads as much as possible. Thank goodness for winter tires! We got there around 10:30. The parking lot wasn't very well plowed although to be fair, keeping it clear would have necessitated having a plow circle it in a continuous loop in order to keep up. The parking machine was broken and a sign in the lobby of the building indicated that we would not be charged for parking. I guess you get what you pay for! After masking up and ensuring I had all the necessary documentation with me, I was in the office by 10:40. It was nearly 12:30 by the time I left. But the thing is, there was practically no wasted time in the nearly two hours I was there; in one way or another, almost all of that time was devoted to serving my rheumatological needs.
I was the only patient in the waiting room (several others had cancelled or were being treated by phone). After taking down or verifying my particulars, the receptionist handed me a questionnaire, clipboard and pen. I had to indicate the degree of difficulty I had with various daily tasks (which were quite specific - opening a milk carton and a jar, raising a glass to my mouth, walking up 5 steps), the extent to which I needed asistance and any aids or devices I used. I had to mark on a scale the amount of pain I experienced at various times of day. Many of the questions were multiple choice but there was also space for free-form comments.
Not long after I returned the questionnaire, I was shown into one of the offices. I don't know if there was a nurse on duty yesterday at all, but I was introduced to a medical resident who had been completing placements in various rheumatology practices (including the office of my old rheumatologist). He did some typical nurse-type activities with the stethoscope and blood pressure cuff and also some things my previous rheumatologist used
to do when we were still having in-person visits, like squeezing joints to test for swelling and/or pain. He reviewed all my medications and bloodwork with me. In short, he was VERY thorough. He asked a lot of questions and actually seemed interested in my answers; he gave me plenty of opportunity to ask him questions too. He offered some initial ideas about the directions he thought my treatment might go in terms of medications, required diagnostic procedures or other therapies. Then he went to fetch the rheumatologist and we had a three-way interaction. It was quite encouraging; I really felt included as part of the treatment team. If it hadn't been a major snow day, I doubt very much that I would have had the undivided attention of these two specialists for so long. While I wouldn't have chosen to go out in that weather, there were some unexpected advantages to the situation!
My new rheumatologist seems very knowledgeable and up on the latest research. He also seems like the kind of person willing to tweak his approach according to what works best for the individual patient. I had hoped initially that I'd be referred to another woman, especially as rheumatoid arthritis (RA) afflicts far more women than men and I gather diseases of all kinds often manifest themselves differently in men and women. But I'm getting pretty good vibes from him so far.
Some highlights: as my condition is stable right now, I'll probably only need bloodwork done every three months instead of every two. For the medications, there could obviously be a concern about dampening my immune response to treat my RA but thereby increasing my vulnerability to Covid and other infections. My previous rheumatologist advised me to go off two of my DMARDs for two weeks following my Covid and flu shots and I had only recently resumed taking them. I had found with the methotrexate in particular that the side effects were magnified this time. It's one of those drugs where I have to take 8 pills all at once, once a week and I suppose my body was simply not used to it any more. So we're looking at gradually tapering off the methotrexate and sulfasalazine. Also at increasing my folic acid dosage, something one of the pharmacists had also suggested to me a while ago. It will be cheaper now too, since I'll no longer be buying them over-the-counter, and won't involve taking so many pills since the entire dosage will be complete in a single pill. My next appointment will be in 4 months' time, by phone (although I have to get x-rays and bloodwork done in the meantime).
I emerged from the building just before 12:30 to find Dianora assisting a woman who had gotten stuck in the snowy parking lot (the second one that morning, apparently). It was her first Canadian winter and her car was not equipped with winter tires. She did have a snow shovel in her trunk (as did we) and someone else who had just arrived came to lend a hand as well.
After brushing off our own car, we made our way home, although instead of backing into the driveway and garage as she usually does, Dianora had to dive in nose-first after a bit of shovelling and help from a neighbour with a snowblower, and a push from another neighbour.
I had some panicked moments later that afternoon when I realized my credit card and Optimum card were not in my purse where I usually put them. The thing is, I had pulled them out when I got back to the car after my appointment. I was about to mark down my next appointment in my little pocket planner when I suddenly realized we were leaving the parking lot and hastily thrust the cards aside to fasten my seatbelt.
To make a long story shorter: after thoroughly ransacking my purse and checking the car twice without success, I waded out to the garage a third time and located them on the floor of the car under the passenger seat.
Enough excitement for one day, we decided as we sat down to watch the news, Coronation Street and Murdoch Mysteries.
A brief bit of background here. I'd been seeing the last rheumatologist for about 15 years and I really liked her. Her office is conveniently located at Centrepointe but since March 2020, all our consultations have been by phone. Then in August 2021, she informed me that she would be retiring in the spring and would be passing my file on to a different rheumatologist located on Greenbank Road in Craig Henry. I looked up the new one on RateMyMD and the evaluations were really all over the map.
By Sunday evening, it had already been announced that all public libraries would be closed on Monday and there would be no garbage or recycling pickup. By Monday morning, school closures and bus cancellations were announced throughout the region. There would be no mail delivery either. We did have a newspaper (it usually arrives around 2AM, which was probably before the snowfall began in earnest; we still don't have our paper today)
I phoned the rheumatologist's office shortly after 8AM and the receptionist was already there on site. She suggested I aim to arrive around 10:45. Even if the doctor wasn't ready for me by then, she said I'd be able to visit the lab (located in the same building) for bloodwork.
So we headed off just after 10AM, with the snow already rapidly accumulating, keeping to the main roads as much as possible. Thank goodness for winter tires! We got there around 10:30. The parking lot wasn't very well plowed although to be fair, keeping it clear would have necessitated having a plow circle it in a continuous loop in order to keep up. The parking machine was broken and a sign in the lobby of the building indicated that we would not be charged for parking. I guess you get what you pay for! After masking up and ensuring I had all the necessary documentation with me, I was in the office by 10:40. It was nearly 12:30 by the time I left. But the thing is, there was practically no wasted time in the nearly two hours I was there; in one way or another, almost all of that time was devoted to serving my rheumatological needs.
I was the only patient in the waiting room (several others had cancelled or were being treated by phone). After taking down or verifying my particulars, the receptionist handed me a questionnaire, clipboard and pen. I had to indicate the degree of difficulty I had with various daily tasks (which were quite specific - opening a milk carton and a jar, raising a glass to my mouth, walking up 5 steps), the extent to which I needed asistance and any aids or devices I used. I had to mark on a scale the amount of pain I experienced at various times of day. Many of the questions were multiple choice but there was also space for free-form comments.
Not long after I returned the questionnaire, I was shown into one of the offices. I don't know if there was a nurse on duty yesterday at all, but I was introduced to a medical resident who had been completing placements in various rheumatology practices (including the office of my old rheumatologist). He did some typical nurse-type activities with the stethoscope and blood pressure cuff and also some things my previous rheumatologist used
to do when we were still having in-person visits, like squeezing joints to test for swelling and/or pain. He reviewed all my medications and bloodwork with me. In short, he was VERY thorough. He asked a lot of questions and actually seemed interested in my answers; he gave me plenty of opportunity to ask him questions too. He offered some initial ideas about the directions he thought my treatment might go in terms of medications, required diagnostic procedures or other therapies. Then he went to fetch the rheumatologist and we had a three-way interaction. It was quite encouraging; I really felt included as part of the treatment team. If it hadn't been a major snow day, I doubt very much that I would have had the undivided attention of these two specialists for so long. While I wouldn't have chosen to go out in that weather, there were some unexpected advantages to the situation!
My new rheumatologist seems very knowledgeable and up on the latest research. He also seems like the kind of person willing to tweak his approach according to what works best for the individual patient. I had hoped initially that I'd be referred to another woman, especially as rheumatoid arthritis (RA) afflicts far more women than men and I gather diseases of all kinds often manifest themselves differently in men and women. But I'm getting pretty good vibes from him so far.
Some highlights: as my condition is stable right now, I'll probably only need bloodwork done every three months instead of every two. For the medications, there could obviously be a concern about dampening my immune response to treat my RA but thereby increasing my vulnerability to Covid and other infections. My previous rheumatologist advised me to go off two of my DMARDs for two weeks following my Covid and flu shots and I had only recently resumed taking them. I had found with the methotrexate in particular that the side effects were magnified this time. It's one of those drugs where I have to take 8 pills all at once, once a week and I suppose my body was simply not used to it any more. So we're looking at gradually tapering off the methotrexate and sulfasalazine. Also at increasing my folic acid dosage, something one of the pharmacists had also suggested to me a while ago. It will be cheaper now too, since I'll no longer be buying them over-the-counter, and won't involve taking so many pills since the entire dosage will be complete in a single pill. My next appointment will be in 4 months' time, by phone (although I have to get x-rays and bloodwork done in the meantime).
I emerged from the building just before 12:30 to find Dianora assisting a woman who had gotten stuck in the snowy parking lot (the second one that morning, apparently). It was her first Canadian winter and her car was not equipped with winter tires. She did have a snow shovel in her trunk (as did we) and someone else who had just arrived came to lend a hand as well.
After brushing off our own car, we made our way home, although instead of backing into the driveway and garage as she usually does, Dianora had to dive in nose-first after a bit of shovelling and help from a neighbour with a snowblower, and a push from another neighbour.
I had some panicked moments later that afternoon when I realized my credit card and Optimum card were not in my purse where I usually put them. The thing is, I had pulled them out when I got back to the car after my appointment. I was about to mark down my next appointment in my little pocket planner when I suddenly realized we were leaving the parking lot and hastily thrust the cards aside to fasten my seatbelt.
To make a long story shorter: after thoroughly ransacking my purse and checking the car twice without success, I waded out to the garage a third time and located them on the floor of the car under the passenger seat.
Enough excitement for one day, we decided as we sat down to watch the news, Coronation Street and Murdoch Mysteries.
