I'll probably end up abbreviating these posts as PDD: Date but I figured it would make more sense to write it out at least once. Days when I see the pain doc can be days that fill me with purposeful rage in response to a perceived insult or new hope because of an idea that came up during the appointment. I plan on doing a narrative style post about the experience followed by later posts on specific topics. There isn't much of a narrative concerning today's appointment so I'll give you an overview of my history.
I have "worked my way" into the pain doc's new pain clinic. It's for stable patients who are at the maintenance level of treatment. From the patient's point of view, it's a lot like what skipping the security line at the airport and doing what little waiting you have to do in the first class lounge. I arrived a little earlier than usual for my appointment and Melissa noted that we left about three minutes after the appointment had been scheduled to start. Unfortunately, this is not the typical patient experience at the pain doc's office. It's a good news/bad news sort of thing. I've already told you the good news. The bad news is that I've been a patient at the practice for about ten years or so.
The typical patient experience from my point of view involves checking in at least 15 minutes before my appointment time in case of surprise paperwork. It also cushions me against bad luck in traffic or other resons for being late. I can't stand it when I'm late. If I may toot my own horn, I have a decent amount of patience and I pride myself in it. It might come from growing up around very impatient people but I am very rarely part of the problem when people get angry about delays.
Before the pain clinic idea went into effect, the over/under wait time for an appointment was three hours. In betting terms, that means you will wait more than three hours exactly as often as you will wait less. Three hours? How is it possible to have a three hour wait much less the eight hour waits I've experienced? There are a few main causes. The first is that there are not enough pain docs in the state of Delaware and there are too many patients. Insurance companies make the situation worse by forcing doctors to see two patients every 15 minutes. With pain management and all those knobs I've mentioned, this is physically impossible. Thus, the doctor starts "falling behind" in the first appointment. He can catch up a little with people like me who can deal with any issues below the doctor level. Then, he just has to show up, double check the underlings' work and sign off on it. (I use terms like underling, toady and peon for everyone below doctor level for the sake of humor and to help me disguise identities. I respect and actually like almost all of them.)
On some days, things go wrong. For insurance purposes, the slightest problem with a proceedure means a trip to the hospital by ambulance. When this happens, it's inevitable that someone will ask me if everyone must stop what they're doing and help. I don't remember why but the answer is yes. So, take the overscheduling required by the insurance company on a good day and throw in a full hour of nothing happening.
Thus, I joked to my fellow inmates that they should drop out of [needing pain management] and go to medical school along with all of the stuff you do afterward. The only other options are dropping dead or finding ways to cope and pass the time. How on Earth can you pass that much time? More specifically, how can you pass that much time when the environment triggers symptom spikes that make you want to die? As with home, music is a friend. There are tiny MP-3 players that can hold hours of music. With my MP-3 player and a paperback book that I could re-read, I was good for eight hours of entertainment.
The problems were symptom and crowd control. Symptom control was limited in the scope of what I could do so it was simpler. Noise makes me feel worse so I carry a supply of disposable ear plugs. Those are uncomfortable because my ears are also sensitive to the touch so I alternate methods. I wear the ear plugs for a while, use my MP-3 player with the less uncomfortable ear plug style earphones and I put up with the noise for a while. The same thing applies to seating where I go from an uncomfortable chair to needing to stretch out on the floor to feeling bruised on the floor to pacing off nervous tension.
One reason why I'm nervous is that I have a life long fear of getting caught up in a riot. People who are in pain have a natural tendency to feel angry. People who have to wait will fret even more in today's scheduled down to the second society. People who have people waiting on them usually at some expense have added stress. Then you have the people who work at the practice who do nothing but deal with angry people all day. They have to protect themselves against verbal abuse at the very least. This involves putting up a shell of polite assertiveness.
I use my experience of doing what I call "tiptoeing through the landmines" to help everyone that I can. There are times in life when a kind word or a smile can bring someone one important step back from the brink. Thus, I listen to people who want to talk and I hear the strangest rhings. My defenses include a healthy level of skepticism and the realization that I can afford to believe these people. I can't give them anything material so I am safe as long as I am careful to give out no protected information. As long as that riot doesn't start, I'm safe.
Finally, I managed to cope with the long waits by remembering the math class rule. Despite the fact that time appears to stop at the start of an unpleasant wait, it's an illusion. The struggle will end and things will get better. After all, one of the underlings came up with the idea of the pain clinic. After nearly a decade of these impossible waits, I get the pain clinic's royal treatment.
The rest of the day will have to wait for tomorrow.
No comments:
Post a Comment