Tuesday, October 16, 2007

A little extra time, a lot of important information

I find it harder and harder to stay on schedule these days as I look beyond the 'chief complaint' to see what's really going on in my patients' lives.

Yesterday, a 38 year old woman finally came in for a blood pressure check. We'd been nagging her for months to come in for follow-up (she'd request med refills; we'd okay the refill but sent increasingly strong messages through the pharmacist that this was last, last last, or last last last refill without her personal appearance at office.

She showed up one week out of her meds, BP crazy high. I discovered that she'd been unemployed, out of insurance, and she is the sole caretaker for her fifty-something year old mother disabled from a stroke. A fate that my patient is heading straight for with her uncontrolled blood pressure. I hope her graveyard shift cleaning at the airport will provide income and insurance to ease her life, but oy those hours and that fast food at midnight, what's that going to do for the blood pressure?


Ruth said...

Oh my! We sure take our universal health care system for granted in Canada. While it is not perfect, no one has an excuse for not getting primary medical care. But we still have too many non-compliant, high risk people around waiting for a stroke.

Jean said...

You're a dear refilling by phone. My MD won't and good point taken - plus, it takes a lot of unpaid time doing those calls - I remember from work. My guy would sit there at 5pm doing his Rx calls.People don't always appreciate the extra hours.

Mauigirl said...

That's so sad that her lifestyle is so bad for her health. Meds alone aren't enough in some cases. And stress is a big factor in high blood pressure (mine was normal until 2005 when I got oral cancer, my dad died and then my dog died, all within 3 months). I hope her life improves soon. It must be frustrating to know that no matter what care you give her, her lifestyle continues to work against her.