Follow Up Visit

February 23, 2008

“139 over 96.” She said to me matter-of-factly, as she loosened the band around my left arm. “That’s pretty high.”

I thought for a second about what I would say.

“Well…” I started, “… I did just rush over here in commuter traffic, so I’m sure that knocked it up a few points.”

She twisted her lip a bit and I could see that she wasn’t buying it, and started to scribble down notes on my chart.

“I was here on Monday for a test. If you look at my last chart, you’ll see that it was only 100 over 80 then.”

She looked up form her paperwork and nodded lazily, pushing her bottom lip up into the top one in an equally obvious tone that not only did she not believe me, but she didn’t care. She was an older hispanic nurse, and looked remarkably a lot like a friend of mine’s wife might look in another 15 years, still attractive in way that was hard to figure out.

There were voices outside and then some laughing. The nurse started laughing as well.

“A dios mio… we’re playing a joke on Dr. Kumar.” She said. “We have him convinced that he ate one of the other nurse’s lunch today by accident.” And she started laughing again.

I laughed too but I didn’t know why. This was only my second time seeing the doctor and the first time I had ever had this nurse. It was a very friendly office as it was, because while I was in the waiting room an old man started talking to me about his case of “the gout” that he was often inflicted with.

What was “the gout”? I asked myself. Was is something only old people got? Was it painful? Annoying? Should there be a “the” in there and it was in reality just “gout”? I wanted to ask these questions, but the old man seemed angry and I didn’t want to provoke him. Why was this man telling me about his health problems anyway? I’m a stranger and horror movies start off like this.

Other people in the room were talking about there sicknesses as well. A middle-aged man had a blood clot in his leg. A younger woman was having chest pains from time to time. Another woman didn’t have any problems that she spoke of, but knew someone with a blood infection. I didn’t want to talk about these people’s diseases because I didn’t think it appropriate. This was in no was in no way bring us together closer as a community, and I would have no part of it. Luckily the nurse had called my name in before I had to tell everyone that I have a perfectly working heart and no real health issues and that I was just there for a follow up.

The nurse was laughing more as the conversation kept going outside. Nobody was letting the good doctor in on the joke.

“I’m so sorry!” She said in between laughs, “Dr. Kumar will be in to see you in a little bit.” And she shuffled out the door and joined in on the conversation.

I slid back on the examination table and made myself comfortable leaning against the wall. The door was incredibly thin, as I could hear everything that was going on outside. I chose to ignore it, and instead closed my eyes and relaxed. I thought that if anything I would be able to meditate myself into a lower blood pressure bracket, knowing from regular visits with my old doctor that if you just go loose and relax for ten minutes or so that your blood pressure could drop over 10 points on both levels.
I started letting my mind wander and after a few seconds became very aware of my heart beating. Blocking out the world around me it seemed like each beat echoed like a shotgun blast in the woods. I could hear and feel the blood moving through my veins with all the force that my heart could push it with and as I let go of my concentration it became more and more distant until I could barely hear it at all.

They should really take my blood pressure now. I thought to myself, and then a moment later the door opened up and the doctor entered into the room doling out pleasant hello’s the whole way.

“So I had a chance to look over your test results…” The doctor began, but I interrupted.

“Let me guess, I have a heart and it works?”

“Yes! Amazing isn’t it?” The doctor snickered.

“Truly a marvel of modern science!” I said and we both laughed. He continued to tell me that everything looked fine according to the findings from the stress echocardiogram I had done a few days earlier and spoke to the same old song about me eating better and exercising to lose some weight.

“Do you check your blood pressure at home?” He asked.


“Do you have a machine at home to check your blood pressure with?”


“Do you have a cuff?”

“… what kind of cuff are you talking about Doc?”

“… um… not sure I want to know now.”

“No, I don’t.”

“Alright then. Well I want you to start exercising more and get your heartrate up to where it was for the stress test at least for 15-20 minutes DAILY. We’ve already got the hypertension to deal with so now we’re planning for 20 years down the road and you need to start working towards that. Deal?”

“Will do doc.” I said, as I had gotten into the habit of doing whenever a medical professional told me what I should do with my life. We shook hands and the doctor left the room and I got up to leave when I was met at the door by the nurse from before.

“Just a minute, Dr. Kumar wants to take some blood for testing liver enzymes.”

“Oh?” I must have missed that part. “I didn’t know there was anything wrong with my liver.”

“There probably isn’t and the offset may be due to cholesterol, but we want to be sure.” I moved reluctantly back to the examination table, and almost asked if she take my blood pressure again.

“How are you veins?” She asked.

I paused for a second again to come up with a quip.

“Well, they’ve been a little down lately since their wife left them. I’ve tried to console them but all they want to do is drink and hang out with their friends.”

She laughed. I was a pretty damn witty patient.

“I’m just foolin’…” I said, “They are real hard to find. Last time I had this done they took the blood out of the top of my hand and that didn’t feel real good.”

“Oh, I don’t like taking it out of the top of the hand either. I’ll just grab a butterfly.”

The butterfly was a small needle at the end of a tube that made it easier to get into veins inside the arm because there was no bottle connected directly to it to contend with. I’d grown used to this process, having blood taken and tests run on me more times than I’d liked to have remembered over the past couple years that I had been treated for my “Benign Hypertension”, as read on my chart. If it was really benign then why all the fuss?

When she was done she asked what I had for lunch that day. I informed her I had pizza, to which she said that they probably wouldn’t run a cholesterol test then because it would likely skew the results. I made a mental note of that and I had just learned a new trick. As I got up to leave I asked the nurse a question.

“Hey, just wondering… what is the gout?”

“Gout? It’s a build up of uric acid in the muscle that crystalize. It’s painful because as the muscles move they break the crystals up. It comes and goes at random.”

“Huh… and it’s painful you say?”

“Very. Why do you ask?”

“No reason… just curious. Have a good night” And I thought about that old guy from the waiting room and understood why he was so angry.

She smiled and said goodbye, then turned out the door and walked the opposite way from me down the hall. At least I had gotten that test out of the way finally, even if it was 2 months overdue in getting it done.


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