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posted by [personal profile] eftychia at 04:42pm on 2007-09-19

There's got to be a better way. On Monday, after seeing the doctor for my physical exam and referrals, I got sent to a nurse for vaccinations and a TB test. He circled the injection site with a pen and said to come back in two days. I mentioned joking about just sending in a digital photo (though my joke was really a subtle probe to see whether that was possible). So, today, supposed to get there by 16:30 to have that circled spot on my arm (which currently contains a faint 3mm X 5mm bruise, not visibly swollen but identifiable as a bump by touch, so it's gotta be raised somewhat less than as quarter of a millimeter) looked at...

And I can barely walk. I've taken codeine, and it hasn't helped enough to make me able to walk a mile and a half or so[*], just made getting down the stairs to feed Perrine possible. I might be able to coax my lower back into cooperating with enough time with a hot pack and more meds, but it became obvious a while ago that if I got out of the house it would not be before the clinic closed for the day.

I phoned in to ask what to do. The answer (as, alas, expected): gotta start over, make a new appointment for another test, go back two days after that. The problem, of course, is that walking there for the test greatly reduces the odds of my being able to walk that far two days later. (And I might be overlooking one somewhere, but the nearest bus stop to the clinic seems to involve about the same walking distance as just walking straight from my house.) If I had a car, this would be trivial -- there are days when I'm too badly off to go anywhere, but the chances of my feeling well enough to drive a short distance twice in three days are much better than the probability of my feeling well enough to walk that far twice in that time. (And if, on the later day, I did feel well enough to walk, I could skip burning the gas that day.)

Their procedure makes perfect sense for most patients: most people either have the ability to walk that far most days, or have access to a car. The system isn't Completely Broken; it doesn't work for me because of how I'm broken. But it still sucks that there's no better workaround than "keep trying until I have two good walking days two days apart starting on a day they could schedule an appointment for me".

Maybe I'll get lucky and catch a ride there on Monday, if my housemate comes home for lunch at the right time or if I catch a neighbour on my way out. That'll improve my chances for next Wednesday. Or maybe, despite very much Not being a Trained Clinician, I should just take the size of the induration[**] (word I just learned today by searching the web for info on how the TB skin test works) as a sign that I shouldn't really worry about it, and not bother making sure the official result is in my chart?

At least I think I understand why a photo won't work though, now that I've looked it up and learned a new word. It sounds like the nurse will have to feel the spot, not look at it.


[*] Estimated round trip distance according to one measurment with an unreliable toy pedometer.

[**] According to emedtv, "[...] people in the following high-risk groups should be considered for treatment of latent tuberculosis if their TB skin test reading is greater than 10 mm of induration [...]", but I don't know whether they mean linear measurment at its widest, or area. Anyhow, the "bump" covers a smaller area than the visible bruise,and is less than 10mm2.

There are 12 comments on this entry. (Reply.)
 
posted by [identity profile] sjo.livejournal.com at 08:45pm on 2007-09-19
If you can give me a heads up for when you need to go to the doctor for the test and for followup, I could arrange to give you a ride...
 
posted by [identity profile] dglenn.livejournal.com at 09:08pm on 2007-09-19
I'd gotten the impression that you were too far away for that to be reasonable, but I'm happy to hear I was mistaken -- thanks!

I've got an appointment for 14:15 Monday and will need to go back for the followup any time Wednesday. It's difficult to predict ahead of time how I'll be feeling on any particular day, but my guess is that having a ride will matter more Wednesday.
 
posted by [identity profile] sjo.livejournal.com at 09:17pm on 2007-09-19
The thing is, yeah, I work in Silver Spring so that precludes casual dropping by, but for a friend in need I've been known to drive greater distances than Baltimore. If your appointment Monday is at 14:15, what time do you need to leave your house?
 
posted by [identity profile] dglenn.livejournal.com at 07:16am on 2007-09-20
By car, about 14:10. Maybe 14:05 to allow for signing in at the guard desk, etc. (It's only fifteen minutes on foot, when I'm well enough to walk it at all.)

Thanks.
 
posted by [identity profile] sjo.livejournal.com at 02:14pm on 2007-09-21
Would you send me your address in private e-mail (stephanie at vialarp dot org)? That way I have a clue where I'm going Monday afternoon. Thanks!
 
posted by [identity profile] starmalachite.livejournal.com at 03:59am on 2007-09-20
Next time it's that critical, try calling me too. I can't absolutely promise, but odds are good.
 
posted by [identity profile] dglenn.livejournal.com at 07:24am on 2007-09-20
At the time it seemed more Really Annoying than 'critical'; I'm pretty sure I know what the result is, but I have to Do Things In The Right Order it seems (by which I don't just mean the coming back two days after they stick me, which makes sense given how the test works, but rather that they seem to really want to do everything acording to their checklists instead of adapting to fit the patient, so I feel like I need to get this done all official-like to be seen as playing-by-the-rules and not being a 'noncompliant' patient).

By the time I figured out that the codeine wasn't going to be enough, it was kind of late for anyone to get up here in time; if I'd realized earlier on, that would've been different.

And: thank you. I'm not good at remembering, when I need it, that friends have previously offered to try to help; I'm trying to get better at that.
 
posted by [identity profile] sjo.livejournal.com at 03:22pm on 2007-09-21
What are the odds on Monday? I just found out about a meeting at work which I can't get out of... I can probably get to [livejournal.com profile] dglenn in time for his appointment if there's no other option, but damn it would be better if someone NOT stuck in a meeting could make it!
 
posted by [identity profile] starmalachite.livejournal.com at 05:54pm on 2007-09-21
What time? I can't in the morning, but afternoon should be doable.
 
posted by [identity profile] sjo.livejournal.com at 06:02pm on 2007-09-21
I think [livejournal.com profile] dglenn said his appointment is at 14:15? I can likely do Wednesday as needed, though... stupid staff meetings!
 
posted by [identity profile] dglenn.livejournal.com at 08:19pm on 2007-09-21
14:15 Monday, but Wednesday is more likely to matter (because ride or no ride on Monday, Monday is going to consume spoons that I may or may not get back by Wednesday), and Wednesday is any time before 16:30.

Rides will matter even more when I start getting appointments scheduled with specialists and a location three times as far away. I'll be sure to post a request for help once I get that orthopedics referral. I am grateful for the help.
 
posted by [identity profile] starmalachite.livejournal.com at 05:39am on 2007-09-22
I can do Monday or Wednesday as needed. Just let me know for sure..

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