Art's dad had his first heart attack in his late 40's and then he died of a heart attack at 70. For this reason Art has watched his diet and kept up a jogging regimen for as long as I've known him.
Our nurse practitioner at Tripler Army Hospital was concerned when Art said he wanted to train for a marathon. She scheduled a stress test for Art. We were told that the stress test showed his blood pressure being too high for strenuous exercise. He was immediately put on the lowest dose of blood pressure medication. The medication had a nasty side effect of making him constantly cough. I'm sure there were people who thought he had swine flu. His blood pressure was also terribly low a few minutes after a jog.
His medication was changed. The coughing was lessened but still not great.
His medication was changed again. The coughing stopped but he still had post nasal drip.
The possibility that he had actually developed an allergy gave him another medication to take.
Now that he has turned 65, he can no longer go to Tripler and needed to find an outside doctor. That is waaaay more easily said than done. Many doctors don't want to take two government insurance plans (Medicare + military). After calling numerous places he found a doctor who was supposed to be a cardiologist and internist according to the receptionist.
We went in to see him. Dr. T said Art's family history and blood pressure showed he had two of the five risk factors that meant he needed to really watch it. Dr.T also recommended he take cholesterol medicine since his cholesterol was a little elevated even though his HDL (I call this the Happy lipids.) was quite high. Then Dr. T said he wasn't an internist because he didn't want to deal with telling patients to go get a colonoscopy or whatnot. I detected a little disdain for regular internists and I was not impressed. I almost said, "You mean you have to know more to be an Internist?" I didn't but I wanted to. He recommended we go to Dr. S who he said was just an internist.
We went to see Dr. S today. OK. I don't believe I've met a doctor quite like Dr. S. before. For one thing, when we met him, there was no greeting. No "Nice to meet you. Welcome to my office. What can I do for you?" He reminded me a bit of Dr. House without the absolute rudeness.
Anyway, Dr. S. checked Art's records and said he didn't think Art should be on the blood pressure medication since it made his blood pressure too low after he exercised. He said there's no reason to believe that Art's heart is enlarged from the kinds of tests that were done in Illinois. He also didn't agree with Dr. T in many of his assessments. The key thing here was he took time to explain why. He made the assumption that we would understand what he was saying which impressed me, and when we asked for clarification, he gave it. From Art's meticulous charts of blood pressure readings and his questions, Dr. S asked if he was an engineer. When we confirmed his impression, Dr. S geared his explanations to an engineering standpoint.
Interestingly, although Dr. S did not have as many of the social niceties and bedside manner that I love, he had a lot of precise and extensive knowledge that he was willing to impart without checking his watch. He's scheduled Art for a couple of tests and says we can make a more educated decision later about what we should do.
He then reached behind, opened the door to indicate we were to leave and said, "I'll see you in 3 three weeks" without looking up from his computer. We left. The funny thing is we rather liked him.
Our nurse practitioner at Tripler Army Hospital was concerned when Art said he wanted to train for a marathon. She scheduled a stress test for Art. We were told that the stress test showed his blood pressure being too high for strenuous exercise. He was immediately put on the lowest dose of blood pressure medication. The medication had a nasty side effect of making him constantly cough. I'm sure there were people who thought he had swine flu. His blood pressure was also terribly low a few minutes after a jog.
His medication was changed. The coughing was lessened but still not great.
His medication was changed again. The coughing stopped but he still had post nasal drip.
The possibility that he had actually developed an allergy gave him another medication to take.
Now that he has turned 65, he can no longer go to Tripler and needed to find an outside doctor. That is waaaay more easily said than done. Many doctors don't want to take two government insurance plans (Medicare + military). After calling numerous places he found a doctor who was supposed to be a cardiologist and internist according to the receptionist.
We went in to see him. Dr. T said Art's family history and blood pressure showed he had two of the five risk factors that meant he needed to really watch it. Dr.T also recommended he take cholesterol medicine since his cholesterol was a little elevated even though his HDL (I call this the Happy lipids.) was quite high. Then Dr. T said he wasn't an internist because he didn't want to deal with telling patients to go get a colonoscopy or whatnot. I detected a little disdain for regular internists and I was not impressed. I almost said, "You mean you have to know more to be an Internist?" I didn't but I wanted to. He recommended we go to Dr. S who he said was just an internist.
We went to see Dr. S today. OK. I don't believe I've met a doctor quite like Dr. S. before. For one thing, when we met him, there was no greeting. No "Nice to meet you. Welcome to my office. What can I do for you?" He reminded me a bit of Dr. House without the absolute rudeness.
Anyway, Dr. S. checked Art's records and said he didn't think Art should be on the blood pressure medication since it made his blood pressure too low after he exercised. He said there's no reason to believe that Art's heart is enlarged from the kinds of tests that were done in Illinois. He also didn't agree with Dr. T in many of his assessments. The key thing here was he took time to explain why. He made the assumption that we would understand what he was saying which impressed me, and when we asked for clarification, he gave it. From Art's meticulous charts of blood pressure readings and his questions, Dr. S asked if he was an engineer. When we confirmed his impression, Dr. S geared his explanations to an engineering standpoint.
Interestingly, although Dr. S did not have as many of the social niceties and bedside manner that I love, he had a lot of precise and extensive knowledge that he was willing to impart without checking his watch. He's scheduled Art for a couple of tests and says we can make a more educated decision later about what we should do.
He then reached behind, opened the door to indicate we were to leave and said, "I'll see you in 3 three weeks" without looking up from his computer. We left. The funny thing is we rather liked him.
