The Nurse's Pregnancy Miracle. Ann McIntosh
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four hours of sleep I get a night?”
While his pleasant expression hadn’t changed, there was a steely tone in his voice. He obviously wasn’t used to being lectured or opposed, but once more David didn’t back down.
“I see from the chart Nurse Cory tried to schedule you for some tests, but you told her not to set them up.”
“Yup.” Doug shifted on the table, lifting one beefy leg and then the other, obviously uncomfortable although his smile remained in place. “I’m heading to Taiwan in three days, so it doesn’t make sense for her to bother. I won’t make the appointments anyway.”
David glanced at Nychelle and she gave him a quick upward quirk of her eyebrows. A silent good luck. Then David gave Doug a thoughtful look. Normally by now he should be telling the patient to put on his clothes and come into the adjacent office, where they could sit and discuss the situation in comfort. Instead, perhaps to underscore the importance of what he had to say, David launched right in.
“Okay, Mr. Comstock. I know I should probably be more tactful, but I don’t think you’ll take me seriously. So I’m going to give this to you straight.”
Was that a slight wavering of the smile on their patient’s face? Nychelle couldn’t be sure, but she hoped so. It might mean the other man was really listening.
“You’re at least a hundred pounds over the optimal weight for your height and bone structure. I suspect, from the X-rays and MRI results, that you may have a herniated disc, which accounts for the leg pain, and the numbness and weakness you’re experiencing. While there are treatments that could help with the pain, those are best explored with a specialist like Dr. Napoli. Realistically, though, the treatment is probably going to be ineffective if you don’t address the root causes of the problem. And pain medication on its own will only mask the symptoms.”
“But—”
David gave the man a stern look and held up one hand. “Wait, please. Let me finish.”
Smile totally gone, Doug gave a little huff of clear annoyance, but subsided.
“Perhaps even more important, even at your age, your weight puts you at risk for so many other diseases. Ones that can halt you right in your busy tracks.”
He glanced down at the tablet in his hand, maybe to give his words a chance to sink in, then continued.
“Your blood pressure is elevated, and although you’re on the appropriate medication you say you haven’t been to a doctor in a few years, so I suspect your management of that hasn’t been tracked, nor your medication adjusted. Uncontrolled blood pressure can lead to a stroke.”
Doug’s eyes widened slightly, but David pressed on, relentless in a way she suspected he normally wouldn’t be. Seeing him like this was a little surreal.
And surprisingly attractive.
She shook that thought away, but not before a little tingle had tiptoed down her spine.
“You’re also at an elevated risk for diabetes—which, should you develop it, would definitely add new tasks to your daily routine, such as taking your blood sugar levels three times a day and giving yourself injections of insulin to ensure you don’t go into a diabetic coma.”
Doug Comstock paled. His lips parted, but then he looked down and closed them again. David waited and then, assured the other man wouldn’t interrupt, he continued.
“Nurse Cory has noted you’ve had some breathing issues, which could be something as simple as a reaction to air quality or as serious as imminent congestive heart failure. I’m also concerned about your cholesterol levels, considering your lifestyle, but there is no way to know whether you should be worried about either of those matters without further tests. Furthermore, your excess weight, as well as putting undue pressure on your back, is also putting immense pressure on your other joints, so you can expect to begin experiencing knee, hip and/or ankle problems. Also, with all the traveling you do, you are definitely at risk for deep vein thrombosis. Do you know what that is?”
A now somber Doug shook his head. David definitely had his attention now, thank goodness.
“That is when blood clots form in your legs, which can then travel through the veins and cause a pulmonary embolism—a blockage in your lungs. You have two of the major risk factors—you sit down a lot, and you’re overweight.”
Sensing the patient’s rising anxiety, Nychelle stepped closer, and said, “Mr. Comstock, I know it seems like a real inconvenience to try to lose weight, or to concentrate on your health when you have so much going on, and so many people depending on you, but we can help. Make it achievable without adding too much fuss to your day.”
She smiled, hoping to soften the words. It was like playing “good cop, bad cop,” and if it would help to get the patient on the right track, she was willing to go with it.
“I...” Doug Comstock frowned, then looked down again at his hands, where they lay on his thighs. “I guess I can at least try. I haven’t been feeling so good lately, and I’m not sleeping well, but I just put it down to the pain.”
David opened his mouth, and Nychelle hoped he wouldn’t bring up any of the other myriad conditions obesity might be causing the patient, like sleep apnea. There was no point in overloading Doug with what ifs and risk him shutting down. Not now, when he seemed amenable to letting them guide him to a healthier way of life.
But instead David said, “Why don’t you put on your clothes and come through to the office? We’ll get you scheduled for some blood tests—many of which we can do right now, before you leave—and Nurse Cory and I will set you up with a plan to get you on the right track.”
“Okay. Okay.” Doug heaved himself off the table. “I’ve only gotten this big in the last six years, since my management business took off, believe it or not.”
“That’s actually good,” David said. “It’s not the habits of a lifetime you’re trying to break, just those you’ve developed over a short space of time. I think, for a man of your drive and character, this will be a breeze.”
And Doug, thankfully, was smiling again as David and Nychelle left the room.
* * *
David was hard pressed to remember when last he’d been so annoyed with a patient and, given the thoughtful look Nychelle sent him as they entered her office, he guessed he hadn’t hidden it very well.
“Whew,” Nychelle said quietly, after making sure the door to the examination room was firmly closed. David was already on the defensive, even before she said, “I’m glad you got through to Mr. Comstock, but you were pretty hard on him.”
“He needed me to be.”
He realized how much of a growl that had been when Nychelle glanced at him again, her eyebrows raised.
But all she said was, “Apparently. I said a lot of the same things to him and all he did was brush me off. I was a little worried he was prescription shopping, when he kept insisting all he needed were painkillers.”
As she crossed to the credenza where she kept various informational brochures, David went to sit at her desk and blew out a long breath.
“At least we cleared up that misapprehension, but I honestly have no idea whether he’ll actually listen to us and try to make the changes we suggest.” He pulled the laptop closer to bring up the necessary records. “Sometimes I wonder why we bother.”
Pausing in the midst of pulling pamphlets from a drawer, Nychelle sent him a steady look over her shoulder. “It can frustrating at times, I know.” Turning back to her chore, she asked, quietly, “Everything okay?”
“Yes.” Yet, he could hear the lie in his voice—feel it in the jagged ache that fired through his chest. “I’m fine.”
Thankfully she didn’t reply immediately, allowing him to continue selecting the tests he wanted the