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Aug. 24, 2020

Routine Doctors Visits... UGH!

Routine Doctors Visits... UGH!

Routine does not mean regular when it comes to doctors office visits for Zetty. Much to J Smiles dismay, these common appointments are quite eventful.

Ever the observant comedic advocate, J Smiles gives the listener a first ear-view of several actual annual exams Zetty was forced to endure. You will never prepare a urine sample the same again. J offers a sprinkling of solutions to doctors and medical equipment manufacturers.

Toilet Hat (collect urine while seated)

Extra Wide Scale

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J Smiles:

It was a routine doctor's visit, Zetty was not in any medical distress. She needed to give a urine sample, no big deal. They gave us a cup, this was like a double Xl shotglass. I laughed, only inside, it's inappropriate to laugh in the doctor's office. So we go into the bathroom. It felt like a double wide version of an airplane toilet, which is a little squishy. Anyway, I'm up for the task. We go in there are no handlebars anywhere to be found. And I'm like, Well, what? How do we do this? I tell "Zetty, hold on a second." I go outside. I asked the lady "Ma'am. Do you have the little thing that you put up under the toilet seat so it can collect my mom's urine?" She said "Oh, Oh, you mean a hat? Like the urine had to collect what your mom eliminates? No, we don't have that. She just needs to squat." I'm sorry you want my Alzheimer's mama to squat and pee in this shotglass, first of all what she's supposed to hold on to the squat, ain't no rails. And how are we going to direct this stream, but I gave it a shot because the urine sample is important. We need to know about these UTIs. Y'all 27 minutes later, after I have washed my hands 16 times and after the tips of my shoes have become soggy. We exit the restroom with no urine sample I'm disgusted, Zetty's none the wiser. And the nurse lady is looking at me like where's the sample? And I'm like "uh ma'am, we don't have a sample and we have to proceed without it." She looks at me and says "Well, we're gonna have to see if the doctor will be willing to proceed with the appointment considering there is no sample." Houston we have a problem. Parenting Up- caregiving adventures with comedian J Smiles is the intense journey of unexpectedly being fully responsible for the well being of my mama. For almost a decade, I've been chipping away at the unknown, advocating for her, and pushing Alzheimer's awareness on anyone and anything with a heartbeat. Spoiler alert- I started comedy because this stuff is heavy, be ready for the jokes. Caregiver newbies, OGs, village members trying to just prop up a caregiver, you are in the right place.


Hi, this is Zetty. I hope you enjoy my daughter's podcast. Is that okay?

J Smiles:

Today's episode, routine doctor's visits. I hate taking Zetty to a regular doctor's checkup. I gotta admit it, because in those instances, nothing's wrong with her. So I'm not like rushing to the ER, oh my goodness, I gotta say my mom is like, Oh my god, actually, do we even have to go because it's a schlep, they're never really prepared for her. I don't feel like the office, the equipment or the staff, they're never really ready. I'm not saying that they didn't go to school, and that they're not trained. I'm saying the building, the infrastructure doesn't ever seen quite right. I mean, I take Zetty to a geriatric doctor, but to get there and the check in process, the counter is too tall for any old person. Even if you used to be tall, you know, y'all know, old people shrink, okay. Over a natural lifespan, the average person shrinks somewhere between three and four inches, okay, and these countertops are very tall, the pins are skinny, and they don't write very well. And then the lines where you're supposed to write your name is all real narrow. And because of HIPAA, what you write on is like slick paper. Or sometimes you're writing on a digital pad. They can't do all of that. Uh, anyway, so that process isn't cool. And then you're waiting, and then they call your name. My mother has Alzheimer's. They call her name as if she's alert. And then they look at me like, Where are you going? We didn't call you. We call the Yvette Smileyy Smith. And I say that's us. And they look down at the sheet. Pretty much looking like they're checking, saying, you know, you, young lady, you don't meet these age demographic qualifications. And I'm like, I'm her daughter, you know, I have to be with her, I'm her caregiver, power of attorney. "Oh, well, it's a little tight back here, we may not have room for you. I'll have to see." First of all, why don't you have room for me? This is a geriatric doctor's office. You should expect more times than not that there is somebody, a family member or hired person or maybe just a nice neighbor, caregiver, somebody from the church that's gone come along with the senior person. Even if they don't have Alzheimer's, they maybe they can't drive. Maybe they don't see well, they just need help remembering what they're going to hear from the doctor. Uh, anyway, so we go through that y'all then we get through the door why is the door, I know that the door is probably heavy for fire code, but I'm gonna need them to stand by the door and open it and keep it open until my mama comes through. Those doors are like 85 tons. They open it, and then they walk through it, it starts closing on my mama. I'm like, are you freaking kidding me? Then they want to say, Oh, please step up here. They want to take her weight, the scale is narrow. My mother has balance issues. She has Alzheimer's. The scale isn't that tall, but it's kind of narrow is maybe a foot wide. So if my mom rocks a little bit left or right, she's about to fall off. So she's unsteady, which means what, she's uncomfortable. She's trying to hold on to the side of the wall or hold on to me. And then the nurse or the staff is "Ma'am, you can't do that. Ma'am. You have to let go. Ma'am, you can't do that. Zetty starts to get unnerved and she's like JG JG JG. "Ma'am, you can't hold on to anything. Ma'am we have ma'am well maybe we won't be able to get her weight." First, first ma'am, okay, nurse, first of all, check your tone, check your tone, you work at a geriatric office and if you looked at the chart, she has Alzheimer's. First of all, why don't y'all have the wide people scale that they have either for very tall and the very heavy people, or they have at the rehab centers where people are learning to walk again. Just go ahead, pay a little extra money and have like the XL triple X, why not do that? My mom is a pleaser. She's always been that way. By this time she's looking at me- am I doing right JG? Is it okay? She's starting to feel like she's messing up and I want to pop this lady in the mouth. I'm not gonna do that well because that's wrong. But I'm like, you all have the wrong equipment. If you're gonna be dealing with old people, you take Medicare, right? I mean, okay, I'm sorry, which means, you know, you got a population of people over 65, which likely means there's a good chance that there are some people with cognitive impairment, even if they don't have full blown Alzheimer's, there's going to be some slowdown of cognition, hand eye coordination, stuff like that. Why y'all got the same scale, and doors and all of that, that my primary care physician is using for people in their 30s and 40s that have all their physical faculties, get out of here? Oh, let me back up a little bit about the urine specimen. So with that doctor, the doctor did try to tell me that without a urine specimen, they really couldn't continue with the appointment because it was supposed to be an annual examination. That particular doctor was a primary care physician and not a geriatric doctor. Obviously, I since left that practice, I certainly let them have one or two or three pieces of my mind. I don't even know how much mind I have left, y'all. Okay, no, so many pages of my mind in that office, because I said, "Well, why don't y'all have a hat? Why not? Why do you assume that everybody can even control their stream to get in this itty bitty little thing over here? What if anybody came this week with a with a back ache or a bad knee or somebody just had a cast on a foot, there's a lot of people that would have had problems getting in this little cup." Anywho I had to let y'all know how that had to go ahead and close that loop. So at Zetty's geriatric doctor, we're going through all this just trying to get her weight, we finally get that now it's time to get her blood pressure. And they're asking Zetty to roll up her sleeve and then they're saying, please give me your right arm and I'm furious, furious. In Episode 11, I talked about how much it really gets under my skin. It's a serious pet peeve, when medical people talk to my mom about left and right, as if she could really remember her left and her right. Anyway, the lady is trying to take my mom's pressure and my mother's asking her "What is it? What is it going to do'" and the lady is actually trying to explain the mechanics around the blood pressure cuff. And I'm trying to give her, I'm waving my hands and flailing my arms like I'm trying to stop a transfer truck as if I'm trying to get a hitchhiker. You know, to say hold on don't go through all that, that's giving up too much information. Anyway, we finally get her blood pressure. Zetty is very uncomfortable because it's getting too tight, but the lady has to take it several times because my mom keeps moving because the blood pressure cuff is too tight. The lady keeps telling her in increasingly frustrated tone- "Ma'am, you must stop moving. If you keep moving. I'm gonna have to do it again. You don't want me to do that, do you?" And she's saying it in a very derogatory and dictatorial tone, like she's chastising my mother, like a kid. Like to say, well, the more you keep moving, the more I'm gonna have to do it, like as if it's punishment. And I'm like, ma'am, she doesn't realize what you're saying she is not moving because she's trying to make your job more difficult. She's moving as a very visceral response to the pain and discomfort that she feels from the blood pressure cuff. Do you have any other way of getting her blood pressure or if there's someone else on your staff that can do it a tad more gently. We get into the examination room, these rooms really, really send me over the edge. They are definitely not prepared for adults over 65 and they have zero design for someone with dementia or Alzheimer's. I'm a product designer and engineer, it infuriates me when the products and the equipment does not at all meet the needs of the customer that is supposed to serve. The exam tables are tall enough for Shaq. You know what I'm saying? My mama needs a step stool to get to the step that's supposed to help her get on to the exam tape. Like I really have to go over and help her step onto a step, that's supposed to help her boost up to the exam table. It takes like 10 minutes of scooching and squirming it's like my mama doing a Tootsie Roll butterfly uh oh, let's go just to get up to there as crazy. You know, like a hospital bed can actually lower down to the ground so that a patient can easily just kind of walk up to it and sit down. Why don't they have those as standard examination tables everywhere where there geriatric patients. I think they should have that. And there's really no place for her to put her things. Y'all know old people travel with bags. Bag lady you gonna miss your bus shout out to Erykah Badu. Even though my mom has Alzheimer's, and there is nothing in her purse, y'all literally nothing. There's a wallet, and there's nothing in the wallet, okay, in Episode 16, I talked about that big old hundred, after she gave me that for the Coca Cola. She don't have no more money, like there's nothing in the purse, but we still have to take the purse. And then we have the bag that has all of the supplies that are necessary should we need to have personal cleaning. And then we have an umbrella and medicine should we need that, about three or four bags where are we supposed to put that, there's one chair in there that's for the doctor. The nurses say oh Ma'am, you can't sit there that's for the doctor. And there's really no expectation for someone like me, a caregiver or a family member to come. What in the world? And remember, this is an appointment with Zetty's not sick. So I'm already like,we aint really got to be here, y'all making this so uncomfortable. That thin paper that's supposed to be the hygenic clean paper that's lining the axamination table, OMG paper towels are thicker than that stuff. My mama gets up there and by the time we are scooching and twisting and spinning to get her up there, we have ripped that thing and so many places. My mama's bare butt almost is just sitting on the exam table. We need some version of teflon something for the elderly, because they scooting around and moving around like a toddler, you know what I'm saying? Anyway, it needs to be three ply, like like the healthy bag, or the extra heavy duty bag that you use for your gardening, not the little play play bag to just put paper towels in, but like the stuff that you use, when you are doing that heavy duty yard work and you like moving shoes and stuff to give to Goodwill. That's the kind of, that's the kind of paper that they need to put in the geriatric spot. The things on the walls are confusing and scary. It is dissections of the human body, so you see the inside of the brain, the inside of your guts, saw these charts and graphs and then it's erectile dysfunction and breast cancer, that stuff is scary. Who wants to see that? Why would someone that's a senior need to be reminded of any of that kind of mortality and definitely not someone with dementia or Alzheimer's. OMG! In Episode 14, I talked about commercials affecting my mom's mood. Well, this art, this medical art does the same thing in the doctor examination room. I know the doctor's could come up with something that's a little more entertaining, and a little more fun. Like pediatricians know, they have toys, and candy or fruit or things to play with things that is going to keep their attention. What's the version of that for my mom? Can we have charts and stuff, at least that have larger writing, because then the writing is so small, my mom is constantly wanting to get off the examination table, that we just spent 20 minutes to get on, to walk over to the wall to read it because it's so small. She is constantly cold while waiting in the examination room, that super thin cellophane paper that's supposed to cover up her private area while waiting on the doctor, she might as well be wearing newspaper. I understand that a blanket might not be the most hygienic thing, but either let it be a tad warmer, or give us 17 of these super thin pieces of loin cloth. I mean, she walks into the doctor's office healthy and she leaves with a cold. And you might be thinking well J Smiles, but that's a geriatric doctor and maybe they're not really prepared for Alheimer's, they're prepared for elderly patients who have all their mental faculties. Aha, aha, I was kind of leaning in that direction to but at her neurologist, same same. The same check in process, the same level of counter height, the same kind of pins, like why not have big old jumbo pins and pencils for the writing sign in process, the same size chairs and same height chairs in the lobby, the same setup in the bathroom, they also don't have hats....uuhhh, for the toilet to take the urine sample, it's a mess. They do have a slightly better scale, it's a little bit wider, but they have a huge, like three inch cushion on it because they want to see what her stability is. I tell them okay, that's cool, do know, my mama is just not gonna get up there. Is it possible that you can take her weight and then do this stability test somewhere else because you're going to sit up here for 10 minutes and you're gonna end up not getting either accomplished? But in terms of the examination table, and the examination room, even at the neurologists, the same set of issues, it appears to me that the doctors are not communicating to the medical equipment people the needs of their patients and I find that to be a trocious. One of the craziest that I just had to laugh, it was so crazy, it turned into total comedy was mom at the eye doctor. The check in process was the same level of confusion and chaos. Now when we go to check in, I sit my mom down far away from the chicken window, hoping that she will not try to communicate or get involved with the staff, that's my best hope. Anyway, we get to the back, everything is going pretty good until it's time for her to actually sit in the chair. I don't know if you all have been to the eye doctor in a while, but that chair is pretty hard and is pretty intimidating. So my mom sits down, she's saying JG you come over here because the chair for me is literally way across the room. I talk her into why it's okay for me to be on the other side of the room and that works. Then they turn off the light and she's like JG JG so I'm talking, I'm steady talking back and forth. "Hey, hey mom. I'm right here its JG. I'm right here." She said o"kay baby. Okay, okay. Okay." And then pure hilarity starts, this feels like this is some Oh, Red Skelton Carol Burnett, Flip Wilson SNL, everything rolled into one. They are asking my mother, take your right hand cover your left eye. I'm sorry. It is dark. And you're asking her to criss cross Simon says what her eyeballs and fingers sir, sir, seriously, sir? Is this a joke? And then they're asking her to keep one eye close, but look out the other eye and try to see the letters, read the letters, but not, but don't say the numerical digits. My mama, what she did was she just stopped talking. She was like, Uh huh, uh huh. Okay. Uh huh. Uh huh. And finally, they cut the light on and looked at me. And I was like, yeah, shit I tried to then told y'all. You cannot give her multiple commands through verbal cues. If you want her to cover her left eye with her right hand, you need to take her right hand and put it over her left eye and then say, tell me what you see. You cannot tell her read the letters, but don't say the numbers. You need to just say, tell me what you see and listen, make your notes and then write your prescription as best you can, sir. I'm not going to sue you just make sure she doesn't walk into walls. She's not driving, she's pretty much just reading Oprah magazines and watching the Game Show Network, that's all we trying to do? Yep, yep, yep, yep, yep. I have a bee in my bonnet because elderly patients and people would Alzheimer's are paying for these services. They have health insurance, they're going to the doctor. They're paying the CO pays. They're having the surgeries. They're buying the prescriptions. They're buying deodorant, they're buying the beds, they're paying for the food. They're paying for health care services, they're paying for caregivers, but because they don't have vocal advocates, or because they are not able to take up for themselves, I believe they are oftentimes being taking advantage of financially and that's not right. The experiences that I've watched my mom have, in doctor's offices, it's almost like they selling my mama a pair of shoes that are two sizes too small. She shouldn't have to go through all that trouble to get up on to a doctor's examination table that'ss crap. Why? Why? I bet you, you don't go to a pediatricians office and they don't have to climb up on to an adult table. Same same that's whatI think, I think same same. When Zetty's health is more stable, and these doctor's visits are more common and perfunctory, i can get more irritated by these small things because they're so easy to fix. These are like this is low hanging fruit, not asking you to cure the disease, I'm not asking you raise any money, and I asking you to change a law and saying make the table two inches shorter. I'm saying get a scale like the people have at the rehab center. These things already exist, I'm saying just go ahead and put them in your office. Make it a make it commonplace. Yeah, we could do that's easy. The snuggle up- number one, if there is a small modification that your ellos doctor, hairstylist, caregiving agency could make that would improve their way of life, ask. You never know, maybe they're willing to purchase a different scale. Or maybe the hair salon is willing to purchase a different shampoo bowl or rehab facility, maybe they're willing to purchase a different set of stretch bands or dumbbells. You never know until you ask. Number two check with your local Alzheimer's Association chapter to see if there is a committee of legislative efforts or community activism efforts that you can join or maybe even make phone calls or write emails that can assist in creating a critical mass to change the way our loved ones receive funding or receive treatment in the community at large. Number three, if you want to join the community, and be interviewed on the podcast, let me know. Or if you want to anonymously, give me your story, and I can weave it into the podcast, let me know that too. Loook into the show notes or how to get in touch with me. You know you You can join the community through the getvokal on Monday evenings and or by joining podcast email link. Can't wait to connect. That's it for now. Thank you for listening. Please subscribe for continuous caregiving tips, tricks, trends, and truth Pretty Pretty please with sugar on top share and review it too. I'm a comedian, Alzheimer's is heavy, but we ain't got to be