This is a far overdue posting, which is finally only making it because I want to add part 3 to the saga, which happened today. But much happened in between my trip to the doctor today and the one from the posting of May 2010. So some backfilling is in order....
Last summer, I seemed to be having a consistently high (for me) heart rate. I suspect it was primarily related to stress, but I finally decided to visit the doctor. Given that nothing ever came out of the failed attempt in May, I decided to look for a new doctor. The firm has an arrangement with International SOS which, in addition to being able to find medical care for me when I am in the middle of nowhere and may need to be airlifted out, also can find local healthcare professionals in other countries. So I called them up and asked for a local doctor who was bilingual and whose staff members were bilingual as well. And they delivered.
The new doctor's practice had a nice website that boasted of its "Integrated City Practice" approach, having a cardiologist on-site as well as internists and an accupuncturist, with other specialists within walking distance. The building is an old pre-war house (think brownstone) on Schweizer Straße about 100 meters from the river. You walk in through a big wooden door and follow some signs to the practice on the second floor.
Now, I thought perhaps there would be a sort of modern rehab inside the building, it being a medical practice and all. Not so much. The high ceilings with detailed wood crownwork are still visible with some fascinating lighting fixtures. The windows in the waiting room were tall French doors. Hardwood parquet floors throughout in beautiful patterns. I was taking all of this in, when I was called into the doctor's office. And I do mean the doctor's office. It was a big room with a large desk and two chairs in front of it, and a large couch/seating area in the other half. He invited me to take one of the seats in front of the desk, where I had a nice view of the courtyard out behind through the open windows sans window treatments. So with this in mind, you can imagine how I thought it a bit odd when he unceremoniously asked me to pull up my shirt. Uhhh.... But he was just going to listen to my lungs, my heart and then take my blood pressure. This was when I began to realize how prudish we may have become in the US.
His initial comments were that the heartrate/blood pressure readings I had brought with me were not particularly high, he thought it might make sense to do a few tests just to be sure. First step was to outfit me with a low-tech version of what the May doctor tried - 24-blood pressure monitoring. The lower tech version was a device the size of about two walkie talkies worn in a bag slung across me and with a rubber hose snaking down my sleeve to an arm cuff. Ever 20 minutes, the machine would power up and take my blood pressure. Including during sleep. Not so much fun. It was particularly awkward when I attended a dinner event and during the speech by a banker I started to "buzz" with the blood pressure taking event. Awkward.....
Step two was a full battery of tests, all performed at their office. The procedure rooms, if you will, are really just separate compartments created out of somewhat temporary partitions and some curtains. Not exactly noiseproof, but I guess if the doctor gives you the news that you are dying or have some awful disease while you are in his huge office, perhaps whatever goes on in the procedures room is not a big deal?
The tests were performed one at a time. You waited until you were called, went in for one of the tests, then were returned to the waiting room until your name was called again. The tests, though, were all performed by different people, so this perhaps made more sense. The tests included a breathing test, bloodwork, ultrasound of major organs and a separate ultrasound of the heart. All were directly connected to computers to capture and display the results. And what was perhaps most surprising is that the ultrasounds were performed by my primary care physician and the cardiologist themselves, whereas I would have expected some kind of technician to do those in the US. The prudish American in me was awakened many times, such as when, after he had performed the ultrasound of major organs, my doctor said I could get dressed. Apparently while he was still in the room. No big deal. But honestly, once I got used to it, it is so much smarter than dealing with the paper gowns that we have in the US that are more awkward than helpful most of the time.
The third step was a review of the results. Nutshell, I have a great heart that is responding well to stress. But the doctor's guidance was that I just needed to have less stress in my life and I should at a minimum take a three week vacation. At which point I literally laughed out loud. Which was followed by him making a remark about workaholic Americans.... He then noted that as someone trained in western medicine, he is trained to look for symptoms and causes, but not whole life health so he suggested I consider accupunture to reduce my stress levels and improve my overall health in a systemic manner. Uhh...? More reminders that I wasn't in the US anymore as you know that wouldn't be covered by most health insurance plans. All in all, though, a satisfactory experience. Anyone want to guess what all of these tests cost?
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