The Appointment

The appointment actually wasn’t horrible.  I think my anxiety was the worst part of it, really.  My hands were shaking so badly it looked like a five-year-old filled out my paperwork.

I saw a nurse practitioner at this practice, and she was really good.  I don’t know what it is about them, but I very often have better results with NP’s than doctors.  They tend to have better people skills, in my experience.  She actually mentioned she’d read my chart the night before!  I think hell may have frozen over–I’ve never had a medical person read my chart prior to walking in the door.  She’d also done some research on UC because she wasn’t familiar with it.  So that won her big points right up front.

She was also respectful of my trauma issues.  She didn’t ask a bunch of questions about my abuse history, which I appreciated.  It’s hard enough to talk about it at all, but it would be even worse with someone I’d just met.  Once we’d established that I have no sex life, she stopped asking about that, too.  And I didn’t have to explain why I’ve never had an exam or pap smear.  You’d think that would be kind of self-explanatory once you know about my abuse history, but apparently it isn’t always.

C was actually a little overprotective, which was slightly annoying, and I told her I was okay with the questions.  I don’t want to be treated like I’m breakable.  If I’m clearly freaking out, okay, step in, but if I’m managing it okay, let me manage it.  There are times when I’m not quite an adult, but I want to be treated like one unless I’m clearly in a child state.

She didn’t insist on doing an exam.  She did say that it’s important for my health, especially given my abuse history, and that we’ll work toward me being able to do it, but she didn’t push it at all today.  Once we’d established that, my anxiety dropped a lot.

What we eventually settled on for progesterone was Nexplanon.  It’s an implant that goes in your arm and lasts for three years, so there’s one less pill I’d have to take.  And if I do have bad side effects, she can just take it out.  However, she’s going to be on vacation in August, so she didn’t want to put it in and then be away if I have problems.  So we’ll wait on that until late August/early September to put it in.  In the meantime, she wrote a prescription for Prometrium, which I’ve taken before.

But apparently my insurance no longer covers it at all.  That’s bizarre because they did a few months ago, and I thought they only change their formularies once a year.  So Monday I have to call back to the NP’s office and find out what we can switch me to.  I know there are a couple other progesterone-only birth control pills, and I’m pretty sure my insurance is legally required to cover those.  (I’m actually not sure why they’re not required to cover Prometrium.)  Gotta love it when your insurance pulls an asshole move on a Friday afternoon, right?  Luckily, my period just started, so I’ve got another three weeks to get started on something else before I go crazy.

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20 Comments

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20 responses to “The Appointment

  1. Sounds like this was an *almost* pleasant trip to the doctor? I mean, she read your chart, she researched UC, she didn’t make you do an exam, she prescribed something right away (damn insurance!) and you have a longer-term option in a little bit. How wonderful for you!

  2. Glad you met a provider that you like and will continue to see. Consistency is good all around. Darn the insurance complications. PMS probably added to your pre appointment anxiety, no?

  3. mandy

    I’m glad you got that over with! And its usually anxiety and lead up to appts that turns out to be the worst! Can’t believe she read your chart the night before–the doctors I’ve been seeing for years, I’m pretty sure STILL haven’t read my chart, lol. Proud of you 😉

    • I know, right? I thought there was something in the Hippocratic Oath: “First, read no charts.” I’ve had doctors make me fill out tons of paperwork, then just ask me everything I’d just written. I’m not sure how I managed to get someone who actually reads the chart.

  4. Happy the appointment went well and you had such a compassionate NP, sucks about the insurance coverage. I’d make a joke about working for Hobby Lobby but that’s probably be inappropriate. Anyways, glad it’s mostly over with and there is a plan in place.

    • Oh, I made snarky comments about Hobby Lobby, and she laughed. I just wish I could be as snarkily awesome as Ruth Bader Ginsburg! I also made snarky comments about UC–she was telling me I could have very unpredictable bleeding with the Nexplanon, and I said, “Unpredictable bleeding is not a big deal when you’re used to unpredictable crapping your pants.” I have zero TMI filter these days.

      • TMI is one thing there should be none of when you’re talking with your medical practitioner. In my book, all information is good information, when you’re working with someone to try to help them heal. Glad this turned out to be a relatively good experience. A good NP is worth her weight in gold (twice, if she’s skinny LOL).

      • I was never particularly squeamish, but post-UC, I have no TMI filter whatsoever. I’ve talked to more people about my poop in more detail than I ever would’ve imagined before this. Sometimes I feel sorry for my SO because he gets grossed out easily–like, he even has trouble getting blood drawn–and I frequently forget and start talking about medical stuff with him.

        I’ve tended to have really good experiences with NP’s. My old neurologist, who was a complete asshole with zero people skills, had this awesome NP. After he told me I had an AVM and then walked out of the room (I was 17 and all alone!), I thought I was going to die because he hadn’t even explained to me what it was. I was having a meltdown, but his NP calmed me down and spent nearly an hour explaining everything to me. Luckily, the neurosurgeon he sent me to actually had people skills!

      • Holy mackerel, my dear lady, you did get the luck of the draw, didn’t you?! Did you have to have the AVM surgically worked on?

      • Yeah, I apparently won several congenital lotteries. I had gamma knife surgery right after I turned 18. I was working at a science museum at the time, and my boss was very disappointed when I didn’t turn into the Hulk afterward.

      • What! Is that what the Hulk had done also? That must have been terrifying. I’ve had one neurosurgical procedure, which is more than enough, but I was considerably older than 18 and it was still terrifying to go into surgery not knowing what I was going to wake up as. You must have been petrified!

      • The Hulk got his powers when he was exposed to gamma radiation. That’s what happens when you work at a science museum with a bunch of nerds. I’d bring my brain scans in because everyone thought they were awesome. (To be fair, 3-D CT’s ARE awesome, and how many people can actually prove their brains exist?)

        I was awake for the gamma knife, but they gave me enough of the good drugs that I didn’t care. Was really fun when I went back to work with huge bruises where they’d screwed the frame to my skull, and a kid poked me. I passed out in the floor and scared the crap out of him (and my coworkers). Honestly, the angiogram was scarier–someone cutting into my femoral artery is not my idea of a good time. All I could think was, “What if he sneezes?”

      • Yow. The screw frame bruises sound frightful. I’ve just had a steroid injection into my neck and believe me I prayed a lot for the anesthesiologist’s brain while he was doing it. People poking about on the insides of one’s nervous system makes me, well, nervous. I also had an angio at one point, and since I was dissociated the whole time it was happening all I remember is the intense heat flooding through my body, which I guess was the dye.

      • Yeah, I’m not big on the “trusting people who are doing things to my body that could go very, very wrong with one little slip” thing. I’m actually not great with the trusting people thing in general, and multiply that by at least ten if they’re touching me.

        I’ve always hated dye-contrast scans because it makes me feel like I’ve just peed all over myself. The first 10 or 12 times I had them, nobody told me that was normal and that I wasn’t actually peeing. Well, I figured out I hadn’t actually peed once I got out of the CT, but I had no idea that was a normal feeling. So it always creeped me out because I could never make sure I hadn’t peed all over their CT machine until afterward. The first time, I was honestly afraid my pee was going to short out the machine and make it electrocute me. (In my defense, I was 17 and didn’t know much about anything then.)

  5. I have definitely had better experiences all around with NPs… My PCP is an N P and so is my orthopod, so to speak…much much prefer them. Good for you for going thru w your appt! You shd know that if you are not sexua lly active pap smears really are not necessary. I have had one or two in my entire 62 years and neither was called for…have never had what i considered really desired consensual sex myself, so i know what you mean…and i do not plan to ever see an OB-GYN ever again if i can l avoid it. Pam

  6. Insurance companies are just…awful.

  7. I’m glad things went well for you. It sucks that your insurance is giving you a hard time.

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