We arrived at 7:45AM to the Geriatric Center for the 8:00AM medical appointment dad had on Tuesday. This was the Memory Clinic - which turned out to not be much of anything. It was basically an interview or evaluation that repeated the same Q&A that we've had with every other medical professional over the last few months. The end result was basically nothing new, no treatment, just the usual advice about diet and exercise and activity - and the "We'll do a follow-up in 6 months" routine.
The doctor did have the records from the memory and cognitive tests that dad underwent in 2014. Those tests revealed concerning issues, but since dad has continued with his normal life all these years since then, it was a credit to his active routines and heavy reading. His mental decline since the beginning of the pandemic is due to the breaking of those routines and the change to a sedentary isolated lifestyle.
This has been a very common situation for older and elderly people during the pandemic and the new society structure that we are moving into. I understand that, and know there is no real treatment, no magic pill, that will fix my father. I am just venting because it seems to me to be a waste of time to have him come in and sit around for hours, be poked and prodded by (to him) strangers and be spoken to like he was a small child.
The memory clinic doctor (who is, I assume, in her 40's or 50's) wore a light-colored billowing short summer dress. I have no idea what those are called (or how to tell exactly how old a woman is either). It was like the one in the photo below, but pale or white with a very slight floral design. The dress length shown in the photo is correct, as well as the wide billowing nature of it. It is a dress I'd expect to see worn at the beach, or on a boardwalk, but not by a doctor in a medical office.
After coming into the room and greeting us, the doctor moved a chair directly in front of us and then sat down casually. I saw the upper part of her bare thighs before I forced my eyes up to lock my view onto her nose. I don't believe that my father has that kind of eye control. She then crossed her legs and we proceeded on with the interview. My eyes stayed resolutely locked onto her face. When she ushered me away by myself to another room to talk with me privately while dad was being talked to by another person, she did the same thing with the chair. My eyes didn't stray from her face. Not once.
Perhaps she was wearing a bodysuit under that dress. Perhaps she was wearing regular panties, or lace panties, crotchless, or no panties at all. I don't know. Dad probably did know, but he has since completely forgotten that we went to those appointments yesterday. Perhaps that is best.
**
After the Memory Clinic appointment was over at 9:30AM, we had to wait around in the reception area for the "Falls" Clinic Evaluation at 10:30AM. There was not a coffee shop, or vending machine area in the building. Not a single one. They gave us some bottled water, thankfully. We didn't have enough time to go out to the car, leave, go get coffee, and come back. We'd have lost the close-to-the-front-door parking space, plus it was raining, so we sat there for that hour and 20 minutes.
Dad repeatedly asked me why we were there and what we were waiting on. They finally got us back to the examination room at 10:50AM.
When I say that my father's short-term memory is short, I do mean... short.
We were taken back to a large examination room where 3 female medical professionals began to talk to us, and not to us, but between themselves, and back and forth. One of the three was his new Primary Care Physician (P.C.P.), who is a Nurse Practitioner (N.P.). The room had bad acoustics, everyone was wearing masks, one was wearing a plastic visor too, so both dad and I had a lot of difficulty hearing anything they said. They also sat too far away in the beginning.
Wearing a plastic face visor and a mask together doesn't help prevent the spread of COVID in the least, and in fact probably increases the chances of catching it because the person keeps flipped the visor up with their unprotected fingers and pulling their mask up and down.
A MUCH better option is a Face Shield Helmet like shown in the photos below. They tuck in, seal, and some even have powered air circulation and filtration. I am sure there are models out there with voice amplification too. At least people could read lips if the medical professional wore something like this.
In the long run, the cost to outfit all medical professionals with these kinds of helmets would be less costly than buying all those temporary and discardable medical masks. It for sure would better help protect the medical professionals and would benefit the patients in many ways too. At the bare minimum, they should outfit people who work with special needs patients, and in geriatric clinics, with these helmets.
This all was especially aggravating and annoying to me because the place we were at is designated specifically as a Geriatric Clinic; Most of the patients are hearing impaired or deaf, and old and elderly.
Both of these appointments were aggravating to me, and it began to show. Too long sitting in the waiting room, too long waiting idly in examination rooms, too many people talking at once, crowding around, and the repetitive questioning, as well as the difficulty in hearing; That all began to take its toll. I finally had enough and said something about it.
I tensely said, "Neither of us can hear you. This room has very bad acoustics; You are wearing masks; You are sitting too far away from us; And sometimes we cannot tell if you are talking to us or to each other while looking at the computer screen at the same time."
Yes, I was at the end of my rope, or tether, or patience. All 3 of them were talking about things and asking the same questions that we had discussed at the earlier appointment, and we had talked about at the appointments the previous week with the very same Nurse Practitioner.
After that, they begin to finally get down to business, which turned out to be kind of useless. They put a belt on dad (I assume to help them if he began to fall or needed support getting up) and had him walk (with the rolling walker) back and forth a few times. Sit, get up, walk to this marker, and back, then sit. Repeat. They also gauged his strength by having him raise his knees, and arms, against them pressing down. The exact same Nurse Practitioner had dad do that the previous week too.
And after that, they took us into a smaller examination room (all 5 of us) and took dad's blood pressure several times with different devices, and also tested him while laying down and sitting up. The N.P. was concerned that dad's blood pressure was a little high. I know why it was high: He was aggravated, tired, and hungry. It didn't help that 3 people were talking about him, all while standing around him, and not to him, but like he was a study object.
The end result of the Falls Clinic Evaluation was... nothing. There is no follow-up appointment. I asked, and they said this was an evaluation to determine the likelihood that someone might be prone to falls.
Eh! What? Dad keeled over three times this year. I think that more or less answers that question. Pfffft.
***
We finally got home at 12:40PM - Just in time for my appointment with a dental service to assess a loose and painful front tooth. I got dad situated with coffee and lunch, then waited for my appointment.
I had issues earlier this year with my health coverage no longer being accepted by my previous dental office. I admit it has been years since my last dental visit, part of that time due to the COVID pandemic. Then it was delayed even more after I began to have the issue with the tooth because of my dad falling, his hospitalizations, and us being diagnosed with COVID.
I had a great deal of difficulty locating a dental office that accepts my Passport Health Plan (Medicaid). Passport Health Plan was once a local nonprofit community-based health plan administering Kentucky Medicaid benefits.
During the Matt Bevin (R) administration, Passport was derailed and their contracts for Medicaid were cut - this, despite Governor Matt Bevin highlighting Passport as an example and model of "how to do the Medicaid business" in previous years. During his last years in office suddenly Bevin began to favor for-profit competitors to take over the Medicaid services in Kentucky - even going so far as to claim that Passport was a poorly run operation. This, after 22 years in business, and being highly praised by both plan members and medical providers.
In the end, Passport had to sell to a for-profit company, Molina Health (or Healthcare). The transition had its issues for members, and apparently for providers too, because a great many medical providers who once accepted Passport stopped accepting it after Molina took over.
It is now Passport Health Plan by Molina Healthcare. I have not seen much change personally, but the sparse number of dental providers shown on the "find a provider" link on the website says a lot. The site mentions that members need to find a provider that accepts AVESIS, but if you go to the AVESIS main website site, it doesn't mention Dental, only Vision. It is very difficult to locate the dental part of the site, and when you do, it doesn't mention Molina at all.
****
I finally gave up and called Passport Member Services in hopes that they could find me a nearer dentist who would accept the health plan and for urgent care dental. My front tooth had gotten worse over the last week. It descended down but was not going to come out easily. It was painful at times, and it was becoming difficult for me to eat anything more than soup.
I discovered that using Garlic "juice" (I've read that garlic oil is good) stopped the swelling, infection, and the tooth pain. It worked wonderfully for me. I had a jar of minced garlic in water that I dipped a Q-Tip into and dabbed that on and around my bad tooth. Almost instant pain relief! If you ever have a tooth pain issue, try that in a pinch. It is an all-natural remedy.
The first suggestion the Passport associate gave me was not good. Mortenson Family Dental WAS my previous dental provider, and this is the provider that was suggested by the associate. The associate put me on hold and called Mortenson, who told her there were two locations remaining that accepted Passport. She relayed that to me.
Earlier this year, after declining the Passport Health Plan at my previous dental location, Mortenson's main office tried to find me one of their locations that accepted Passport (they told me that 2 still did) - and in fact set me up with an appointment at one of those other locations.
4 days later, the day before my appointment, they canceled and informed me that Passport was no longer accepted at that location. I was told we could try another location, but it would in Taylorville, not Louisville, some 42 country-road miles away.
The second suggestion was something I have never heard of before: A Mobile Dental Office. They come to you; you don't go to them. Amazing! And they accept Medicaid / Passport Health Plan!
The [Kare Mobile Dental] service was here on time. It was such a relief after the morning I had to be able to walk right out to the van, get in, and get on with appointment. No waiting around, no sitting in a waiting room, no battling to read someone's lips behind a mask, and no filling out forms (I already did all of the forms and signatures online). I was in the chair and dealt with immediately, professionally, and with care and consideration.
The dental hygienist (Stacy) did an exam and digital radiography of my teeth. She asked about my concerns, my issues with my teeth, and about that loose tooth. She also did a deep cleaning, which was outstanding! The best one I have ever had. The cleanest my teeth have been in the last 30 or more years. She was efficient, friendly, personable, and was respectful.
The fact that she also laughed at my jokes gives her even more praise from me. 😜
The next step in this process is for a dentist at the home office to evaluate the scans of my teeth. I have some issues beyond my "bad tooth". There is chipping and wear down, as well as a broken lower molar (All probably due to me grinding my teeth from anxiety and stress). I could also blame pizza, but I try never to cast blame on the pizza.
My next appointment will be to address the bad tooth and other issues. Then we will talk about a partial denture and a crown for my broken molar. That will not be inexpensive. My out-of-pocket expense will be significant because my dental coverage is only for the bare essentials. I accept that. It is a needful thing and is more important than many other things - even pizza.
If you read this far, I thank you. I know that I covered a lot of ground here - and I drank a lot of coffee while writing it. I am sure YOU needed coffee before, during, and probably after this lengthy "this happened to me today" blog post. It is a day in the life, and yet another day in my pants.
There is a lot of room in my pants, but not a lot of room in my shoes. Not enough to walk a mile.
Respectfully yours,
M.W. Van Dyke
Update: The Mobile Dentist story didn't turn out as expected. You can read what happened [Here].
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