The dreaded pre-op visit with my GP.

Yo Mom!

This just in:

PRIMARY CARE PHYSICIAN ANNOYS PINSKI, BUT PINSKI (eventually) "RISES ABOVE".

Details at 11! ....or now!!

Okay, for starters let me say that for the most part, I really like my primary care physician, Dr. S. Well spoken, nice guy, very well educated, never tough to get an appointment, etc.....but when it comes to issues of sleep apnea, I'm not so sure.
As I mentioned before, I had to go to him to get orders for the EKG and bloodwork that I need for my MMA surgery (coming up in a little less than 4 weeks). The appointment was yesterday and I promised my friend Toni that I wouldn't "engage" with him when he started giving his professional opinion about sleep apnea (again). Lets just say, our opinions differ. You see, when he previously saw my sleep study from 05', and it said "moderate sleep apnea", he commented that my oxygen saturation "wasn't *that* bad" and not to worry about it. Okay, fine. Whatever.
So, this time he comes in, was very professional, asks me when I'm having surgery, and who the doctor is (not even asking what I was having done) Then he takes my blood pressure, listens to my heart and lungs, and illudes to asking what kind of surgeon Dr. KL is and where it's being done. I tell him Dr. KL is an oral-maxilfacial surgeon in Palo Alto and the surgery is going to be at Stanford. He says okay, and asks me if Dr. KL was going to do the Pre-op "write up" himself , explaining that there has to be a formal write-up to let the hospital and anesthesiologist know you are in good enough shape to have the surgery.
I tell him that the only thing that might be questionable is actually the whole reason *why* I'm having the surgery, my sleep apnea, and that I'm having a Maxillomandibular Advancement and a Genioglossus Advancement B-z-z-z-T! Shouldn't have even gone there, but really: How can you pass up a chance to say Genioglossus Advancement??
Without much expression except for a slight rise in his eyebrow, he looks at my sleep study and says (and I am para-phrasing) "Dr's are making too big of a deal out of sleep apnea."
I tell him "It says my sleep apnea is 'moderately severe' now, so that can't be good for my heart, long-term, right? Also, I wake myself up gasping, my partner worries I'm not going to start breathing again and die some day and I haven't been allowed to sleep on my back for the past 6 years because of all the snoring and gasping I do"
Then he says "It's not so much about your heart...what we should *really* worry about is if the oxygen saturation too low it can cause brain damage, but with your levels, it's still not that bad". Uh, WHAT???
I mention to him about my 25 RDI, and how I stop breathing for as long as 49 seconds some time and he tells me that he's a diver and he can hold his breath for over 3 minutes, "so if you're in good cardio shape, 49 seconds isn't that much".....and adds that If my RDI was in the 60's, he'd be a lot more worried. Hello??? So would I, but still.....
...and *then* he says "..but I guess you're having this done for 'the other reasons' (i.e. the noise, and trying to make my partner more 'at ease')". WTF??? So, I guess I need to have 60 episodes an hour and oxygen saturation levels low enough to cause BRAIN DAMAGE before gets onboard? Sorry Dr. S. The apnea train is a-leavin' without you!! Toot-toot!

At first, I started second-guessing myself, but soon realized that between my initial gut feeling about my apnea being a real problem and confirmation from *4* oral maxilfacial surgeons who specialize in sleep disorders, I just clammed up after that (a little late, but still not bad) "rose above", and let him say what he was going to say. He wished me good luck (which seemed patronizing, but I don't know...I guess it could have been genuine) and then got out of there.
I stopped at the desk to pay my deductable and he tells me "Come back either before the surgery or after you've healed so we can discuss your bloodwork". After I've healed??
I'm thinkin' "Okay, then I'll see you next year"
WhatEVERRRR Missy!!

So, even after all that, I'm still confident I'm doing the right thing.

Then, it was downhill from there. The EKG was a breeze, and getting my blood taken was easy, and Dr. KL will have the results FAXed to him early next week, in plenty of time for my 6/22 pre-op appt. with him.

Oh! and I'm making progress on the "list-front".
Paul suggested I centralize all my surgery-related stuff, so we bought a nice, sparkley (...okay what do you expect?) folder at Walgreens and it's got everything in it now: The lists. The disability paperwork, receipts, my sleep study. A pretty good idea, P.Smitty!

BTW, thanks for the pics of the new and improved window that got installed in your office.
It looks great, and now you won't have to get up on your tip-toes to see what the (crappy) weather is like outside!

On Saturday, Paul and I are flying to "L.A. - L.A. - L.A." to spend Mothers Day with Rose Marie and the crew. I hear it's going to be a full house, so it should be fun. Probably the last time I'll be going there for a few months. I think I'll bring shorts to wear so I can get some sun on my pale hairy legs and everyone can make fun of them! Oh boy!

much love;
Pinski xoxox