QOD: Tele-medicine.

“Criminy Dad, are you going to need a hysterectomy after I get to residency??!”

~ Me, mentally exclaiming after hearing about my father’s latest medical misfortune.

My dad always seems to be afflicted with something since I started the clinical years of medical school. When I was following a pulmonologist it was bronchitis, on my internal med sub-i it was diverticulitis, then there was a nasty bout with gout, and a serious shingles scare. So, three days into general surgery, I was dismayed but not terribly surprised to get a text from him, “I’ve got a godd*mn hernia.”

See my initial reaction above. My second thought was, Dear Lord please let it be inguinal.  He had a major bowel surgery due to a perforation and peritonitis when I was in my teens, and has a foot long mid-line abdominal scar to show for it. I was hoping against hope that there were no dreaded incisional hernias in that beast, and maybe he just had some groin discomfort and perhaps a little bulge in the scrotum with heavy lifting.

I called him as soon as I got out of surgery for the day, and of course, it was the abdominal incision. Apparently, a “slight bulge” had just “popped out” about half way down the scar one day. He’d gone to his family doctor who referred him to a surgeon. But dad didn’t think he needed to go to any surgeon, he’d “just lose a little weight” and it would “all be fine.”

Deep breath. Count to ten.

My dad is always saying stuff like this. Like when he had a persistant sinus infection, and instead of going to the doctor for it, he said he would “just take some of those antibiotics left over” from when he had “diverticulitis.” Okay, A) What do you mean you had antibiotics Ieft over??? B) Antibiotics are not one-size-fits-all dad. Metronidazole will not treat your sinus infection!, and C) Gahhhhhhhh!!!

At work, with normal patients, I fully expect to hear stuff like this, and I (hopefully, I always try to anyway) respond in a calm, empathetic, professional manner to the excellent teaching opportunity such situations present. With my dad, it just makes me slightly insane. I don’t care that his only medical education is whatever he’s picked up from Grey’s Anatomy, I’ve been a nurse for almost a decade, I’ve almost completed four years of medical school, and he should d*mn well know better. Because…because…..we share DNA. Or something.

After he texted me a picture of the “slight bulge” I told him to forget the weight loss plan and schedule an appointment with the surgeon immediately. He hemmed and hawed until I explained that there was a thin piece of fat and skin holding his guts in and with one good weight routine they could be all over the floor. I know, that was mean and probably totally exaggerated, but he called the surgeon’s office as soon as we got off the phone.

He called me again after his appointment with the surgeon a few days later. He knows I like to hear about these things in minute detail with as much medical jargon as possible, so when he could only tell me that the doctor’s diagnostics consisted of “poking” at his hernia and telling him he needed surgery, he said I should probably just call the guy myself.

Thus, I was in a quandry. I live half a continent away from my dad so I can’t go to his appointments and really know what is going on, or what the doctors he sees are really like. Aside from vague descriptions like “he seems really nice,” or “he operated on my golf buddy and he’s okay.” But I don’t want to be some a-hole family member with a handful of medical education calling up to interrupt and interrogate some poor, unsuspecting, perfectly qualified, very busy physician.

I satisfied myself with asking collegues about this “poking” method of hernia evaluation (which is apparently a perfectly acceptable method for experienced surgeons), poring over the surgeon’s qualifications on the surgery center’s website, and doing a lit search on incisional hernia repair. From what I could tell, they seemed legit.

Dad had his surgery last week, and from my daily telephone updates he seems to be doing fine. Except for day 2 post-op when his girlfriend cum home health care aide called to tattle that he wasn’t going to take his pain meds. He’d told her he didn’t think he needed them because he “felt just fine.” I made her put him on the phone and told him that he felt just fine because he had been taking his pain meds regularly, that if he didn’t want his incision to develop complications (which I listed off in gruesome detail, I know, mean spirited exaggeration again), he had better take them regularly until his follow up visit, and I would be calling to make sure he did.

And I had better not hear about any golfing activities for the next several weeks. Oh, and, ah, at his follow up visit he needed to ask for a copy of the Op note. Which he needs to fax to me. You know, just…..because.

So, maybe I will be at least somewhat participating in male health care in my future. Just for one male though. Mostly by phone, er, consultation.

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