"The Game is a Foot" by Troy H. Cheek on Apr 21, 2008
My primary care physician (PCP, though I can come up with better expansions for that abbreviation) just about had a heart attack of his own when he realized that I had gone 40 years without an eye exam or a foot exam. Everybody needs those regularly, even if you're not diabetic like me.
I tried to explain that I'd had an eye exam just the year before, but any eye doctor who works for an eyeglasses place isn't a real eye doctor. I described my visit to the "real" eye doctor last week.
I also tried to explain that my previous PCP examined my feet regularly, the last time being about a year ago, but a general medical doctor isn't a real foot doctor, apparently.
Prior to meeting my PCP, I met many other general medical doctors. In my experience, the average opinion held by general medical doctors towards any kind of specialist doctor is that specialists are pansies. Specialists weren't smart enough to pass their general anatomy courses. Specialists don't have the attention span to check the patient's whole body. Specialists focus on one tiny part of the body because that reduces the amount of actual medical knowledge they need to prevent wrongful death suits.
Of course, the specialists I know have exactly the opposite opinion. To quote a dentist of mine, specialists know everything that a general medical doctor knows, plus two more years of schooling about the speciality. A specialist is imminently qualified to act as a general practitioner if needed, but a GP can never act as a specialist. Your average medical doctor just wasn't doctor enough to take on a speciality.
Now, I can understand why my PCP couldn't examine my eyes for me. After all, that takes special equipment. However, examining feet requires nothing more than hands and eyes and maybe a sharp stick. Those were readily available in my PCP's office. Those had been done by my previous PCP. Yet, my current PCP insisted I see a specialist.
At this point, I'm torn. I can't decide if my PCP is simply very cautious and thorough, exactly the sort of doctor that my middle-aged ass needs, or if he's the product of a diploma mill with zero medical knowledge who's farming out my actual care to real doctors.
Anyway, going to the foot doctor required me to visit my third hospital campus in as many weeks. I work at one, my eye doctor has an office at a second, and my foot doctor has an office at the third. I hate hospitals and I'm not overly fond of doctors. Yes, I work at hospitals and around doctors all the time. After a while, I get comfortable with the idea. After all, it's just a job. But when I'm the patient, suddenly everything is scary again.
This doctor had a web presence and online driving instructions, so at least I knew where I was going. That facility had a parking garage. I hate those, too. The actual parking structure isn't too bad; it's the other idiots driving around that make it unpleasant. For example, I've noticed that the same people who have no problem parking in an open lot suddenly can't drive when confronted with an identical set of lines inside a parking garage.
"I'm afraid I'm going to hit that big concrete support over there!" they scream as they hit their brakes. This is the big concrete support which is, I must point out, clearly outside of the marked parking area they're supposed to be aiming for. If they were in a "real" parking lot, the concrete support would be an SUV in the adjacent parking spot.
"The parking spaces are just so small!" they claim. And, yet, still within the same Federal guidelines that define parking spaces in "real" parking lots.
"The rows are too close together! I don't have room to back out!" they whine when it comes time to leave. Again, same Federal guidelines. Plus, as the driver of a full-sized truck, let me assure you that the average parking garage has more ass room than the average lot when I'm backing out.
I bring this up because as soon as I entered the garage I was surrounded by people who were apparently overwhelmed by the experience. Also, as I was puttering through the garage trying to find a space in the general vicinity of an elevator, I was tailed very closely by two women in a small foreign car. As I was driving a large truck, I swung a bit wide on every turn to make sure my back end didn't snag a curb or a wall or something. Every time I would swing wide, the car would speed up and disappear from my rear view mirror, as if they were trying to pass me on the inside of my turn or something. Furthermore, when I finally gave up and turned into a space that was a bit off to one side but at least in view of the elevator, I heard tires squeal and looked to see that the front bumper was within arm's reach of my driver side door. They had apparently tried to either pass me or beat me into the parking space. Judging from the looks on their faces, they were mad at me for cutting them off. When I got out of the truck and revealed my police/military/SWAT-style uniform, they beat a hasty retreat. I heard them park about two levels up.
Okay, I know I'm not supposed to wear the uniform when I'm not on duty, but I had to drive straight from work to get to the appointment on time. Besides, it's so much fun.
I reached the foot doctor's office itself by following my printed out directions and reading the signs. Although I kept a steady pace, read signs in passing, checked my printed directions while walking, I still had people asking if they could help me find something. Either I looked completely lost in spite of my best efforts, or I looked suspicious. If you aren't lost but people are asking if they can help you, bet money that they think you're up to something and are just trying to slow you down until the police can arrive. It's what I do.
Foot doctors must make good money, because his office was the fanciest of the three I'd been to in as many weeks. Because of the web presence, I'd been able to print out and fill in almost all the necessary first time patient paperwork, so I actually got to wait in the waiting room. That' okay. I'd brought a paperback book with me. I settled into a very comfortable chair and started to read a story about killer tropical fish let loose in New York. Two sentences in, I realized that the story was actually about a gangster family whose nickname came from a killer tropical fish. Luckily, that was all the time I had before the doctor was ready to see me. I donated the paperback to his collection of reading materials.
The foot doctor came in, washed his hands, shook mine, washed his hands, examined my feet, washed his hands, trimmed a particularly tough toenail, washed his hands, spoke with me a while, washed his hands, shook my hand again, washed his hands, and then left. I heard water running in an adjoining room, so I'm pretty sure the first thing he did after he left was wash his hands again. Did I mention he washed his hands a lot? I guess if it was my job to handle other people's feet, I'd do the same.
Aside from trimming the nail for me, the foot doctor did nothing that my old PCP doctor hadn't done when examining my feet. He had me close my eyes and poked the bottom of my feet with a sharp stick. It was my job to say "ow!" when he hurt me. I apparently was hurting enough because he declared there was no sign of diabetic neuropathy. This translates to "nerves sick because of diabetes." In layman's terms, it means that the nerves in my feet still work, even though most diabetics lose feelings in their extremities. In spite of the fact that this is very good news, doctors always seem disappointed when they tell me. Likewise, my last PCP would poke and prod at my ankles hard enough to leave tender spots hours later while trying to detect any evidence of my feet swelling, that being one of the first signs of heart disease, and always seemed let down when he didn't find any.
The foot doctor trimmed the one nail because of a fungal infection which had caused the nail to thicken and separate from the nail bed. It turns out that the only reason this was a problem was that I hadn't recognized the separation and was still trimming it out at the end of my toe like the other nails. He did tell me to get a better pair of clippers (I had been using a set of small fingernail clippers and kind of whittling away at it) and possible employ outside help if I couldn't trim without myself.
The foot doctor gave me the standard diabetic foot advice, said that I had the feet of a 20 year old, made me promise to check my feet daily, and said there was no reason to come back to see him until I actually had a problem. He was unsure why I had come to see him in the first place as he'd done nothing a general practitioner couldn't have done. I explained about my PCP and his whole "specialists have superpowers" theory.
He even said that my shoes looked good, nice and wide with a good arch, even though they were $10 shoes from a discount store. However, seeing as I was on my feet all day, I needed to get a good set of diabetic shoes, so he wrote me a prescription. I explained that I wouldn't know where to fill such a prescription, but he pointed out the map printed on the back.
I dropped by the orthopedic and prosthetics place on my way home, figuring I'd just get the shoes and get out, but it turns out you need an appointment for a fitting first. I go back in a couple of weeks.
