A Visit to the. . . (wtf). . . Physician's Assistant

Originally Posted Saturday, November 15, 2014

I went for my one week check up after knee surgery.  Not such good news.  The doctor was not there, so I had to see his P.A.  What is a P.A. anyway? How is it different from a nurse practitioner?  And why would I want to see one?  I understand why doctors want them as they relieve them from the tedium of daily healthcare while putting more money in their pockets.

The P.A. informed me that the doctor had trimmed the meniscus and had removed some arthritis growth.  He had also found scar tissue under the patella and had removed that as well.  That was going to slow down the recovery quite a bit.  That will take longer to heal.  I should "be careful" and not "overdo it" in my recovery. 

?!?!?!?!?!?!?!?!?!?!?!

The last thing the doctor told me was that I would not need any physical therapy and that I would be able to do whatever I wanted as long as it didn't hurt.  He'd had patients who were running again in a couple weeks, etc.  Do what you can, he said. 

I wasn't even given crutches. 

Instructions were to ice the knee for three days after surgery. 

So. . . why didn't anyone tell me this?

I was the last surgery on a Friday night, of course.  I'm sure the surgeon had left the building long before I came to. 

I began walking half an hour after surgery. 

"If you overdo it," said the P.A., "you can slow down the recovery. You don't want swelling.  Ice is your friend.  You should be icing your knee three times a day.  Don't try to do too much." 

He was leaning toward the door, one ass cheek on the seat, folder in hand. 

"Wait a minute you little twerp," I said.  Wanted to say.  It would have done me no good to insult the good P.A.  He was only trying to help me. . . .  No he wasn't.  Not really.  He was just reciting lines.  I tried to tell him about how I was walking and about the pain that occurred whenever I did a heal strike.  Was this normal? 

"Be careful," he said again.  "Just don't overdo it."

"What the FUCK does that mean?  I need metrics motherfucker!"

I didn't say that, either.  What does it mean, though, to "be careful"?  How do you do that?  Tell me not to ride my bike on the roof, and I get it.  Don't chew glass.  Those kind of specific things.  How do I know if I am "overdoing it"?  You expect this sort of vague advice from a distant relative, but from a. . . well, a P.A.? 

Maybe. 

At least I now know why I have pain in the top part of my knee cap.  There lies most of the surgical damage
. 

The nurse came in--I think she was a nurse, but who knows?  She was wearing scrubs like everyone else, but she could have been the cleaning lady.  I read her tag.  It said "Medical Assistant."  What is that?  Jesus Christ, they might just make badges up that say "Healthcare Professional" or "Medical Engineer." 

"Can I have one of those badges?"

"Sure, take one.  They don't mean anything, but people like wearing them.  It seems to give them confidence." 

Anyway, the woman in the smock was there to take out my stitches. 

"Will it hurt?"

"Sure.  What do you think?  How are your meds holding up." 

"I quit taking the Percocet.  They made me feel weird and constipated."

"Oh, you are allergic to them, then.  I'll put that on your record" 

"I am allergic to Oxycontin.  That is on the chart.  These have Oxycodone.  I asked if they would be O.K.  It is different from Codeine, right?  Do they still make Tylenol 4?"

"Tylenol with Codeine?  Yes."

"I do fine with that.  Can I trade mine in for those." 

"Maybe.  I'll ask the doctor."

"He's not in." 

"I know." 

Etc. 

This is considered to be the top orthopedic clinic in town.  My doctor is one of the top surgeons. 

I went to the gym yesterday, the first time since surgery.  I did some light leg exercises and rode the exercise bike for a bit.  Then I went out for drinks with a friend.  Floriditas for me, Gin and Jam for her.  Oh that bar.  She wore a red scarf and a black top and a black, felt hat.  Blonde.  Spectacular.  We ate a starter of fried rabbit and had a beet salad at the bar.  The night was cool, the crowd eclectic.  Cocktails on a Friday night in a small, good bar with friends is the reason for many things.  Fortunately, in a place like this, the money runs out quickly.  We split a blue cheese burger and fries and switched to craft beers on draft.  I would have gotten drunker if the drinks were cheaper, and switching to beer always slows me way the fuck down. 

Later, limping in the night's air, she asked me if I needed her to ice my knee.  Oh yes, I said.  I obviously needed icing. 

I woke this morning sore all over.  Not from the icing, of course, but from the workout.  I am beginning to look like Jack Nicholson.  I am going to have to drink only expensive cocktails in expensive cocktail bars.  I drink far too much at home.  Yes, that is my plan.  If I want a drink, I shall go to the bar.  I will keep the teas well stocked in the cupboards.  I will learn to make them all, sticky sweet Turkish teas and milky fat Tibetan chai.  I will grind my own cardamon. 

I don't think I'll lose weight, though.  It seems impossible.  I look like a gourd with swizzle sticks now.  All that is left is to do is drape myself in pretty clothing.