Dear PCP, post visit summary

Dr. Brown,

First of all, thanks for getting me in early today for my check-up. Much appreciated. I promise I’ll try not to be so high maintenance in the future.

When your nurse roomed me, she asked if I had any specific issues I wanted to talk to you about. I told her ‘no’ and then did my best not to bust out laughing uncontrollably. Then she went through the standard screening questions about home safety. I assured her that I do, in fact, feel safe at home, but I left out the time last night that I freaked out and thought I was going to die. Danny had gone out with friends, Annie was sleeping and the older kids were spending the night with grandparents. Anyhow, I was relaxing and tending to some self-care when the dogs started barking. Not just barking to go outside or to eat…barking like “someone is trying to break in and kill you!” barking. Of course I was in a perfectly heated bathtub with just the right amount of bubbles, finishing off a glass of Auspicion. Their urgent barks had me convinced that a masked suspect had successfully broken through the back door and was about to sneak through the house to come get me. So I ended my bath prematurely, finished my wine hastily and tiptoed downstairs in my bathrobe to investigate. On the way down, I was distracted by a phone notification and stopped to figure out how many triangles were actually in the picture on facebook. I then decided that if there was an intruder, he was going to have to wait until I finished reading Dan Rather’s latest post, dripping wet, half way down the stairs, before we tangled. When I finally got to the dogs’ room, they were half-sleeping and looked up at me like “what’s your problem?” Turns out there was no intruder. I have no idea what the dogs were barking at. They’re jerks. And I have no idea how this story is pertinent to my check-up.

I digress… if you need to describe me as “tangential” in your progress note, that’s cool…I get it.

So about my labs…thanks for reviewing them with me. And thanks for indulging me by looking over the labs I printed off and brought in from earlier this spring when my LDL was 78. I realize that those labs were from a life insurance physical and not “official,” but I’m kind of proud of them. Will you please make sure this is documented in my chart? Maybe I’ll hang the paper copy on my refrigerator.

Also, my transaminases and bilirubin are good…just sayin’.

Aren’t you excited that my hemoglobin is now WITHIN NORMAL LIMITS and my ferritin has quadrupled!?!? Outstanding! Can I be honest with you? I wasn’t even taking my iron…sorry. But I will if you want me to. Because I am a compliant patient.

Now…I have to admit, I was a little worried when I saw that my sodium came back a little low. Of course I busted out my Pocket Medicine book (which now looks to be from the dark ages of medicine) and refreshed myself on hyponatremia.

You, however, are so clinically astute, you hypothesized that I likely consumed more water than normal the day I had my labs drawn. Of course I did! I was trying to hydrate so my creatinine and GFR would look good. You know me too well!

But let it be known, I was ready to talk about a differential diagnosis and potential work up strategy for my hyponatremia.

Also, thanks for listening to me describe my random belly pains. When you asked if I had tried any over the counter medications, you could have laughed when I admitted to taking an expired zantac…but you didn’t. Well, at least you didn’t laugh hard. It actually felt like you were laughing with me and not at me. I appreciate that. And you didn’t roll your eyes. Getting through my entire check-up without rolling your eyes is a true testament to your professionalism.

I also appreciate the fact that you seemed so surprised when you realized that I would turn 40 next year. When you’re documenting my physical exam, will you include “appears younger than stated age”? Or maybe “well coiffed…with cute shoes.” That would offset the “tangential” description that is so unfortunately accurate.

So…thanks for being my PCP. Thanks for normalizing my crazy and for using data and facts to support your clinical suspicion that I’m not actually dying.

You can never retire.

Your friend and favorite patient,

Christi

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