Yearly Physical with My Primary Doctor
A detailed review of what happened at my yearly physical with my primary doctor.
This morning, I had my yearly physical with my primary doctor during a March snowstorm. My spouse drives me to all of my appointments, and starting last year, he attends my physical with me, per my request. Not only is he there for moral support, but my doctor treats me differently when she knows someone is willing to attend with me. I’m sure the fact that he’s a white man also helps. Today, she even made a comment about how nice it was that he was there with me.
Because I have had so many other medical appointments lately, it didn’t feel like there was as much to cover during my yearly review. Even so, I was at the clinic for two hours. Since I had already been to the OBGYN recently, I didn’t need to do a pap smear or re-up my birth control with my primary doctor. She still did a physical exam of me including a breast exam, and we talked about how I’m getting a diagnostic mammogram tomorrow. Her take on the lump in my armpit is that it feels like a swollen lymph node, and it is good to get it checked since it hasn’t dissipated since Halloween.
I talked to her about how I stopped taking ibuprofen & acetaminophen constantly, and the ultrasound confirmed that my ovarian cyst is gone. But I am still having abdominal pain. It is accompanied by disproportionate feelings of hunger pains, nausea, and like someone shoved their hand into my guts and clenched into a fist. Almost all of the pains are on my right side, and they are most prevalent near my ribs. (“upper right quadrant”) Since I’ve already had my gallbladder removed, my recent scans have shown my kidney stones are still inside my kidneys along with some cysts, and nothing else in the area has given them any concern (beyond the follow-up MRI in the Fall to check something on my liver) they’re running out of obvious reasons for my pain.
Sometimes eating will help my symptoms lessen, but sometimes eating makes things worse. The pain definitely increases when I have a second cup of coffee or eat acidic things like salsa and citrus. I asked my doctor if it was possible that I gave myself an ulcer from all the meds I took this year. She said that was a good question. Ulcers are caused by a bacteria called H. pylori. Apparently, they no longer do the blood test to check for H. pylori because there were too many false positives. So, the first step in determining if I have an ulcer is to do a stool test. I went home today with a kit for how to obtain my sample and instructions on how to drop it off for testing.
I am unclear on what the next step will be if my stool sample tests positive for H. pylori. If it is negative, my doctor suggested I go back to a GI doctor. (I stopped going to my last one because he wore a cologne that gave me migraines.) It is possible I will need an upper GI endoscopy to confirm I have an ulcer or rule out other options as well. I am definitely not looking forward to that, but hopefully I will be sedated if that happens. I am starting to be concerned that they will ultimately tell me that the pains I’m having are attributed to my IBS. (It is always IBS, fibro, and/or anxiety when they can’t pinpoint another reason. And when they land on one of those for the reason, the solution is basically, “Just deal with the pain.”)
My doctor also suggested I potentially see someone else in their clinic. It has only been a few hours, but I have already forgotten what my doc said their specialty was or what their name was. (I’m trying to write this all out before I forget everything because we went over a lot!) It boiled down to someone who would help me do physical therapy for my abdomen. I mentioned that I did not think the pains I was having were muscular, but my doctor said sometimes it is hard to tell, especially in the abdomen. Fair enough.
In my chart, my doctor saw that I am due for my Hepatitis A and Hepatitis B vaccines. She asked me if I wanted to do them today. I didn’t realize they each had more than one shot in their series, spread out over multiple visits, when I said yes. Today, I got the first shot for both the Hep A and Hep B vaccines. Next month, I go back for my second Hep B, and in October I get my second Hep A and third Hep B shots. As far as I know, these vaccines will make me up to date on my immunizations.
When the nurse came in to give me my shots, they were extremely helpful. Not only did they go over the shot schedule, but they also told me to check out https://www.immunize.org/ as a useful source for information on all immunizations. Also, this nurse taught me how to relax my deltoid muscles prior to getting shots. First, you put your arm with the hand palm up on your knee. Then, you slide your elbow back, and finally, you drop your shoulder down while you let your body get loose. In theory, this will not only help your arm to be more relaxed while you are getting your shots, but it will also lessen the soreness afterwards. (As someone who is perpetually tense, I will try to remember this trick for future shots.)
I did the motions as advised on both sides when I got my Hep B in my left deltoid and my Hep A in my right. The Hep B shot was referred to as a “stinger” which I can confirm is accurate. The Hep A afterwards was like nothing, comparatively. As with other vaccines, I was advised to hydrate today, move my arms & don’t “baby them,” and not to put ice directly on the shot spots. I specifically asked my doctor if getting these vaccines today would impact my mammogram tomorrow, but she said no, they shouldn’t. These Hep vaccines shouldn’t impact my lymph nodes like the COVID one could. And there isn’t usually a reaction where you feel unwell like with flu shots.
After my physical exam and my vaccines, I was sent down to the lab to get some blood drawn. My doctor decided not to retest my cholesterol because even though it was slightly elevated last time and my dad has high cholesterol, the score compiled from my risk factors showed that I was low risk. I did, however, get blood work done to get some info about my kidneys, liver, and glucose levels. At the lab, the person helping me drew one vial of blood and provided me with my stool sample kit to take home.
Before leaving, I was back at the front desk to schedule my other vaccine appointments, and they advised that I should call ahead with my stool sample. My instructions do not mention this, but it seems like a courtesy thing to let the front desk know before I just show up and try to drop off some poop in a bottle. Regardless of the results of my tests, I don’t believe I will see my primary doctor for another year as the nurse will handle my upcoming vaccines, and my prescription refills and referrals to other doctors should be able to be managed through the online messaging system in my chart.
I realize that reading about all of the medical appointments I’ve had recently can make it seem very overwhelming, like you shouldn’t start going to the doctor because once you do you just have more and more appointments to deal with everything. As much as I would prefer to not have to leave my house and deal with people, I still firmly believe that making appointments to keep up with your health stuff is necessary.
I’m once again gently recommending that you start the process by setting up whatever appointment you’ve been putting off. Avoiding them isn’t going to prevent/resolve any issues you’re having, and the sooner you can figure out what you have going on, the quicker you can figure out how to deal with it. (Says the person still trying to figure out what the root cause of my pain is without any real solutions, so far. 😇)
~The Overstimulated
I hope you get some answers soon. Great tip about how to relax for vaccines, I’m going to use that in the future thank you!