Get out the cheese and crackers because I am getting ready to whine. It was long, long ago, about 2005, that my primary care physician was an accomplished in Internal Medicine. I had switched to his practice when I was fifty years old, reasoning that as I aged I would need someone with a more systemic awareness. Like those words? Sounds great but Doctor Wackowitz proved to be a pain in my wazooo. And he was the guy in charge of updating my Medical Record.
The original health complaint is lost to history. I do remember that Dr. Wackowitz sent me in for an abdominal cat scan and some upper GI tests. The cat scan revealed noting of concern around GI – but apparently it showed a partial blockage of my abdominal aorta. I don’t know exactly what that is but I do understand words like ‘blockage’, ‘abdominal’, and ‘aorta’. Dr Wackowitz prescribed several, as in five, meds, I only remember Crestor. I took those drugs for two days and felt like I was ninety years old. My joints ached and I could barely walk. Goodby Dr. Wackowitz.
Ssomeone recommended a Family Nurse Practitioner, a young man who ran marathons on the weekends. He looked at my test results and asked if I minded doing some exercise. “Do you mean as opposed to doing those Wackowitz drugs? I don’t mind at all.”
I began a walking and wei9ghtlifting regimen. Short but brisk walks, like three miles. Light weights – more repetitions. Stretching before and after a workout. I became healthy again.
Fast forward to August of 2015. My significant other was working in Detroit (she is a contract RN doing specialized Medical Records audits, or something like that). When an ailment shows up on my radar I am reluctant to immediately call upon the vast and expensive health care network available to Americans. But I had a headache. A slight headache. Not worth mentioning. But it lasted for three days. I was sitting at home at about nine o’clock, talking to a friend on the phone. I mentioned my three day headache. She asked if I had a blood pressure kit. Yes. But I have never had high blood pressure, and I was an active walker (not like the kind in The Walking Dead, just a regular walker). To entertain her I found the kit and took did the test. Surprise: 200/95.
That was a kick in the pants – but again, I am not quick to pull the trigger on seeking health care. She suggested I go to the ER but I knew better; the machine was probably faulty. We hung up the phone and I tried the test again. And again it was 200/95. I pondered the situation and then retrieved my health insurance card from my wallet. I called the Nurse Hotline on the back of the card. That nurse’s job is to keep me out of the hospital and save money for her employer. She had me do the text again – this time it was 205/95.
I left immediately for the ER. Those ER folks get excited when an old man walks in and says ‘My blood pressure is too high”. I was on a cart with IV needles stuck in my arm and an ekg machine humming along in about a minute.
The ER Doc came in. “Yes, your blood pressure is high. Have you had any problems before with your blood pressure or other things of that nature?”
“Nope,” I answered honestly.
He scratched his chin, “Well we see you are on Crestor and four other drugs….”
“WHAT?,” I interrupted. “What are you talking about?” I had honestly forgotten Dr. Wackowitz.
He showed me my chart. I was fuming. It was OK because my blood pressure could not get any higher. The ER Doc thinks I am in denial. He thinks I am lying to him. Geez, there I was trying to explain Dr. Wackowitz. “Forget that nutcase,” I pleaded.
After a few hours they decided that I was not dying. They gave me a shot in the ass to bring my blood pressure down in the short term and recommended I see my regular physician soon.
I reflect back on that experience and I feel fortunate that I was coherent, as opposed to being knocked out from an accident or something. I was able to tell the ER Doc to ignore that goofball Doctor of recent history.
My electronic Medical Record is at best and incomplete history. Yes I took Crestor when I was 54 years old. It does not say that I took these drugs for only two days. It does not say I was pissed off at the doctor and found a new doc that I trusted more. It does not say that I walk three miles a day.
The problem with any electronic record goes to the simple saying: “Garbage in, Garbage out. ” The medical record never contains a note from the doctor that says, “We were wrong and have discontinued that medicine.” There are no notes that say, “I am sorry that I did not have time to sit and talk with you about your issue”. There are no notes that say, “The patient reports that I am a jackass and should have my license revoked”.
The problem is that this is serious stuff. They (medical professionals) argue that the electronic medical record is invaluable in the case of an emergency, such as when the patient is unable to talk. I argue the opposite.