This first-person account of a new patient experience at the UPMC Simmons Center may not be representative of all similar cases.
I entered the small, comfortable waiting room and checked in with the receptionist. She handed me an insurance/consent form to sign and then asked me to wait until the nurse was free.
The nurse called me into the interview room and began the examination. She took my vital signs, including my blood pressure, pulse, and oxygen saturation (using a non-invasive unit with a finger clip). She then asked me a series of questions regarding my symptoms and medical history, including:
- Do I have allergies?
- What is my past medical history, including any operations and major tests?
- Did I ever smoke cigarettes? If so, how many and for how long?
- What medications do I take, and in what dosages?
- Do I get short of breath? When and how much? Does it only occur at when I move about (exercise) or also at rest?
- Do I cough on a daily basis? Frequency? Do I make sputum when I cough?
- Do I wake up coughing at night?
- What kind of work do I do (as well as prior work history)?
- What are my hobbies? Am I still able to engage in my hobbies?
- Do I have any pets?
She collected this information to gauge the severity of my symptoms, as well as to explore any possible substances I may have been exposed to at work or play that could cause lung scarring. She also told me that it is a good idea to bring a family member or friend who is familiar with my medical history to such visits because that person can help fill in information I might have omitted, as well as provide support.
The nurse entered my medical history information into a database for future reference. Following this preliminary interview, I was led into the doctor's examination room.
The doctor came in and introduced himself. He explained his specialty (pulmonary medicine) and said that he wanted to talk to me prior to reviewing my medical records. Some of the questions he asked include:
- When was the first time I had symptoms?
- When did I first seek medical attention?
- Were there any potential occupational exposures I could think of?
- Was/am I an active person?
- How long did I wait to seek medical treatment after experiencing symptoms?
We also talked at length about the outcome of my past treatments.
The doctor then performed a physical examination. He listened to my lungs, listening for telltale sounds ("kind of like Velcro or crackling," he explained) in the lower lobes that could indicate interstitial lung disease (ILD). He checked my hands and feet for swelling, as well as clubbing (a domed swelling) of my fingertips.
The doctor explained treatment options, which ranged from a course of steroids to being listed for a lung transplant (depending on final diagnosis).
He then ordered a series of tests to be performed at my next visit. These included a computerized tomography (CT) scan and a pulmonary function test (PFT). Both of these tests are relatively simple and non-invasive (no needles, dyes, etc.). If I had completed these tests prior to visiting the clinic, I would have been instructed to bring the x-rays and results with me when I scheduled this appointment.
At the end of my visit, the doctor and the nurse reviewed my plan of care. They gave me a written list of the medicines I should take. They also wrote down the additional testing I might need, other health care providers I should see, and a follow-up visit date.
My experience assured me that the doctors and nurses are there to ensure you go away with a complete understanding of your condition, and your treatment options. They are kind and patient, and will spend the time necessary to answer all of your questions.