Ever since my orthopedist told me to ditch the Xarelto, and I decided to ignore him, I've been meaning to schedule an actual follow-up appointment with my husband's PCP to, I don't know, discuss a plan? Although I informally consulted several other medical professionals regarding their thoughts on continuing Xarelto despite improvement in my DVT, and all agreed on a minimum of three months, I never got a formal opinion. I figured that at the very least, I would need my husband's doctor to write a script for my Xarelto, since I could hardly ask my orthopedist to renew it after he told me to stop taking it. I just hadn't gotten around to it yet, mostly because I'm not out of Xarelto yet. (Thank you, drug reps, for free samples. :))
However, I saw my husband's doctor this morning, because I have been hideously sick for 10 days now and finally realized that I was getting worse, not better. On Monday, after a week of constant nose blowing + the Xarelto, the blood vessels in my nose finally rebelled, causing The Mother Of All Nosebleeds, at least in my adult life. (I've had worse as a child; one time the bleeding required having all the blood sucked out of my nose and then having my nostril cauterized.) Anyway, my husband texted Dr. A last night to see if he was seeing patients today, and if so, if he could squeeze me in. Since my husband took the day off and the kids don't have school, we
slept in this morning (although, due to my coughing, I'm not sure either
one of us has actually slept for real in several days). We both 'woke
up' around 7:30, at which point my husband checked his phone and told me
Dr. A would see me 8:30. It turns out that Dr. A was not actually seeing patients today, but agreed to squeeze me in between paperwork. I only later found out that my husband's text was: My wife has a marriage-ending cough. Is there any way you can see her tomorrow? LOL.
Since Dr. A was doing me a huuuuuuge favor, I decided it would not be an appropriate time to bring up the blood clot. However, he brought it up on his own. (I used to see his PA, who has now moved, so he has all my records.) After diagnosing me with having 'The Crap,' he asked how my right leg was doing. I launched into an abridged version of the saga, and he reiterated that while he did not want to insult anyone, according to his training, I should be on Xarelto for six months, at which point we should do another ultrasound. He also thought that it might not be a bad idea to have a lab workup of my blood done, just to make sure I don't have any clotting disorders or anything funky, and we can also check cholesterol and all that fun stuff. Since I can't have that done while on Xarelto, we should schedule that for approximately two weeks after I stop taking it. That means sometime in February. He asked me if my orthopedist had told me why he thought it was a good idea for me to stop taking Xarelto and I told him I got the feeling my orthopedist just wanted me to go away already.
Finally, he asked me how my hip was, and I told him it felt pretty much the same as it did before the surgery, and added that I thought I might need a new orthopedist. He said labrums were notoriously finicky, then asked if I'd had an arthrogram of my hip, with contrast dye. I told him I hadn't, and he said in his experience, straight up MRIs weren't that useful for hips - and added, 'I don't mean any offense to anyone.' The funny thing is that it is his former PA, Sarah, who ordered the MRI, which I told him. I didn't say it in an obnoxious way, just an FYI way. He semi-frowned, then flipped through my records, and pulled up a page with a sticky note on it, and said, 'Yup, here it is.' Then he read the sticky note out loud to me - apparently a note he had written: Sarah - an MRI for a hip is of limited usefulness without contrast dye. LOL. OOPS. I do miss Sarah, though, even if she didn't order the dye.
At any rate, he was very prompt and very thorough, and spent about 20 minutes with me, which I really appreciate considering he was seeing me on a day when he wasn't even seeing patients, and I'm not even really his patient. I finally understood why my husband likes this guy so much. Yesterday, when I was at the pediatrician's with my daughter for her annual checkup, I was thinking how funny it is that almost all of our primary care providers are old-school doctors - as I've told my husband before, old white men. Ha. These are usually solo practitioners who still do things like give out their home phone numbers and do house calls. They don't have fancy patient portals, and when you pay them, you actually write a check out to them and send it to their physical address, and not some place in Phoenix or Chicago. I've calculated that our pediatrician must be almost the same age as my long-dead grandparents, and I dread the day when he retires (or dies), because he is just fabulous, and I love him. (The pediatrician we had before him was the same way, and he did retire.) I think part of why it's so hard for me to deal with orthopedists is because they are, like, the opposite of the old-school style I'm drawn to. It is the huge corporation versus the mom and pop corner store. Interestingly, our old pediatrician once saw me limping when I brought my daughter in and wanted to know what was wrong. At the time, I was having a lot knee pain, so he referred me to one of his orthopedist friends, a solo practitioner orthopedist. (You just don't see many of those anymore.) I remember being shocked when the orthopedist himself came out into the waiting room to get me - no nurse or MA, just him. He was fabulous, but unfortunately, like most other doctors of this type, he is retired. Now, don't get me wrong, I appreciate the modern techniques and know-how of the orthopedists in the Gigantic Orthopedic Conglomerates, and I understand that no one hopes for a long-term relationship with an orthopedist the way they might hope for a long-term relationship with a primary care provider. At the same time, I could not help but note the stark contrast between my time spent with Dr. A and the time spent with my orthopedist. While modern orthopedic techniques are indeed amazing, it seems like throwing in a little bit of old-fashioned medicine might go a long way.
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