The Buck (Naked) Stops Here

Well, it was time to head back to my doctor’s office today for that most favorite of pastimes, the annual physical examination. I know, I know, some folks say that this is one medical procedure that is not needed anymore, that every other year or less is okay as long as you are healthy. It still makes me feel good to go down there and get humiliated into paying attention to my own wellbeing once a year. Kind of a swift kick in the pants, you know. Doctors need to stay healthy too.

The initial procedures, of course, included getting weighed, having my temperature taken and getting the bejesus squeezed out of my right arm, (my prescription writing arm, damn it) by an automatic contraption akin to a boa constrictor with a streak of Velcro on his belly. My blood pressure was fine, but darn if I don’t miss the days of having the nursing assistant or tech personally squeeze my arm until it’s blue. Medicine is losing its personal touch, for sure.

You know what happened next. I got herded into my own special room, complete with exam table, unused computer monitor, assorted tongue depressors and hard chairs. It’s usually cold enough to hang meet in this room, but today there were no hams or sides of beef in sight. Yippee. Global examination room warming is real, my friends.

“Since this is an annual examination thing, I’m going to have to give you a gown, you know,” the cute thirty-eight week pregnant assistant told me, looking back almost apologetically.

“Oh, yeah, sure, I know,” I answered lamely.

“Everything off except for underwear, and you can keep your socks on if you like,” she said, deadpan. Something about this whole interaction was just, well, so wrong.

She left the room and I dutifully disrobed, donning the backless gown like so many before me, wondering if it made my butt look big. (Of course it does.) You know that if you tie the thing you’ll tie it too tight and never be able to get it untied without asking for help from the pregnant assistant, but if you don’t tie it the darn thing keeps sliding off your shoulders like dead skin off the back of a Walking Dead zombie. No win scenario here.

I went with the fashionable, confidant choice and left things untied. Then I sat on one of the hard chairs and waited, ridiculous gown, black socks on feet, reading an article on my iPhone until Dr. H walked in.

Shortly, he did just that, chart in hand. He shook my hand, welcomed me genuinely and asked how I was. He is a very good doctor, thorough and competent but compassionate as well. When you are a doctor, seeing your own doctor like this is sort of like looking into a mirror.

You’re a doctor. He’s a doctor.

You know what he’s going to do. He knows what he’s going to do.

You’re basically naked and cold. He’s wearing khakis and a warm fleece sweater vest with the practice logo on it.

You have no tools of your trade at hand. He has rubber gloves and KY.

Somehow, no matter how kind the practitioner, you sort of feel that you are at a huge disadvantage here.

Now, once upon a time, way back when I was a fledging physician, routine annual histories and physical examinations might take from sixty to ninety minutes. The doc would sit and chat, scribble and write, take more notes, go back and ask more questions, then take another twenty to thirty minutes or so to do a complete physical exam checking cranial nerves, doing tests of reflexes, checking you for vibratory sensation, and watching to see if you could walk and chew gum at the same time. Not to mention the usual checking of heart, lungs, ears, mouth, teeth, belly, extremities and pulses.

My physical exam time with the doctor today was probably less than fifteen minutes total. Time with ancillary staff added another fifteen to thirty minutes to that of course. He does not have time to mince words in this fast-paced medical environment that we all labor in.

A side note: when updated information is obtained at my doctor’s office, such as my weight, height, medication history and the like, it is now entered into a patient portal, which I have access to on my iPhone via a secure app. By the time I got back to the exam room today and was undressed and seated waiting for the doctor, my most recent info was already entered and I was getting an email alerting me to check it out. I have to admit, that’s pretty impressive.

Now, speaking of info and numbers and data, they do not lie. No matter how many leather oxfords I slip out of or how many keys or phones I take out of my pockets before I step on the scale, my weight is going to be what it is. In my case, my weight is too high for my height. My BMI, which is a calculated number that speaks to that weight per height ratio, is also too high according to actuarial tables that speak to such things. Not terribly so. Not dangerously so. But it could be better. I know that. My doctor knows that. We discussed weight set points and aging and activity level and sedentary time and other issues that are real influencers of this height/weight/BMI thing.

I realize that it is not my doctor’s obligation or job to make me feel better about being unhealthy, but he is also responsible for helping me to interpret the numbers and other data including my labs (results of these pending at this writing) to help me be the healthiest, most active, happiest person I can be.

What does this all mean?

Well, if I was 7′ 6″ tall, my current weight would be absolutely at the lowest end of the “normal” weight range for that height, according to those tables I mentioned. Put another way, I could be at a perfect weight for my height and could 1) be cast as an extra in the next Avatar movie, or 2) be the starting center for any NBA team I chose. I have not lost heart or resolve. I could hit a major growth spurt in my sixties. It could happen. You don’t know.

The last part of any red-blooded American male’s annual physical is that most wonderful of experiences, the DRE. Now, I won’t offend those of you with weak constitutions by telling you exactly what that means, but suffice it to say that it is to check to make sure you 1) don’t have an easily identifiable (and hopefully highly treatable) rectal cancer, and 2) that your prostate is still behaving itself as you age gracefully in your backless gowns.

It is not a fun experience for either doctor or patient, but in all honesty it is one of those brief screening exams that can literally save your life. It’s worth doing. If you are a guy getting a physical, don’t skip this one. There is only one thing that makes this brief little exam even more awkward than it already is by default.

Trying to answer your doctor’s questions about bowel habits or urination flows or similar stuff while “assuming the position” is like trying to explain your theory of global exam room warming to your dentist with a suction hose, four metal instruments and two sets of hands in your completely numb mouth.

And that’s all I’m going to say about that.

I am happy to say that my blood pressure was good, my exam was normal and I left my doctor’s office reasonably healthy and happy for another year.

It was almost lunchtime when I headed back towards my own office for the afternoon’s work. I decided that I would stop for lunch before driving back.

There is nothing in the world like getting naked in front of your doctor for a physical examination to make you really think hard about what you are going to order for lunch immediately afterward. You’re thinking about weight, blood pressure, blood sugar, cholesterol, sleep, food, exercise and all the rest as you stand in line to place your order.

For me today? A market salad with fat-free Italian dressing and a large black coffee. Did I want to reward myself for my good results with a cookie or brownie or something else? Damn straight. Did I ? Not a chance. Not today.

My resolve should last until the next time I open the pantry and spy the last of the Christmas white chocolate bark with crushed almonds, dried cranberries and a touch of orange. Will I eat it?

Nah.

I’ll save it for my lovely wife, who has much more resolve and will power in her pinky than I have in my whole 7′ 6″ frame.

Did I mention that I seem to have had a recent growth spurt?

 

 

 

 

 

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