Well This Is Just Swell
Chapter 12: An Appointment with the Good Doctor
Hilery sighed as she glanced at the clock in the waiting room of Doc Appleby’s clinic. She had arrived early for her same-day appointment, which she was really starting to regret.
Renée Appleby looked up from her reception desk when Hilery sighed. The two were good friends, and the young receptionist and nurse-in-training understood how the young Davenport woman felt. Waiting typically drove them both insane.
“You can turn on the TV if you want.” Renée suggested.
“That’s okay,” was the reply. “Do y’all ever get any magazines in besides these medical journals?”
“You know we don’t.”
“Hilery?” Nurse Joy Appleby poked her head into the waiting room. Joy was the good doctor’s wife. They had met at the hospital where he’d done his residency before settling in Hazzard. “Come on back sweetheart.”
Hilery looked at the kind, matronly nurse and stood up. She grabbed her purse and walked back. She was still swollen, but not quite as bad as the day before.
Joy showed Hilery into one of the three exam rooms before having her take a seat on the table. “How have you been sweetheart?” she asked the younger woman as she placed the blood pressure cuff on her arm.
“Miserable.”
“I’m sorry to hear that dear.” Joy was quiet for a moment, the stethoscope in her ears as she listened. “Your blood pressure is a little high, but nothing severe.” She put the stethoscope back around her neck as she spoke.
“It was high the other night too.”
“Yes, you said you had an episode of anaphylaxis when you made your appointment. I am so sorry you had to go through that.” She pulled a thermometer out of the pocket on the wall after putting the blood pressure cuff back, and put a protective sleeve over the probe. Hilery opened her mouth and Joy stuck it under her tongue. She timed it before pulling it back out and nodded. “You also have a low fever. Did you have one the other night as well?”
“Yes.” She nodded and made a few notes in Hilery’s chart before washing her hands and exiting the room to fetch her husband.
A few minutes later, the kind, elderly doctor knocked on the door before entering. He seemed troubled when he saw her.
“How are you today, Hilery,” he asked.
“Miserable, swollen, tired.”
He nodded and took a seat on the stool before opening her chart to look it over, although he knew it by memory. He did note her blood pressure and fever though.
“No cough? No sore throat? No runny nose or congestion?”
“No, no, and no.”
He nodded again. “Just this anaphylaxis problem the other night…” he stopped short when he came to something odd in her file. “It says here the nurse practitioner prescribed you some birth control pills, to treat irregularity in your cycles and to treat acne?”
“Yes, and I have been having swelling problems ever since.”
“I want you to stop taking them.” He was rather gruff with his quick response. He made a few notes in her chart before looking back at her. He was very concerned with the swelling. She wasn’t the first patient he’d had with that problem. It had been earlier in his career, but he remembered the case well, and the result. As he studied her and her chart, he also noted that she had gained about twenty pounds between the time of her physical and the time she had seen the nurse practitioner. It was of mild concern to him, although her weight had always fluctuated. Fortunately, part of the point of his vacation had been to learn about some of the other diseases out there, so he could better treat his patients.
“I would like to draw some blood, Hilery,” he told her. “I want to check your insulin levels, and I want to test your testosterone levels. Yes, women produce low amounts of testosterone.” She shut her mouth. He had answered the question before she’d been able to ask it. “Joy will draw the blood, and it’ll be sent off to the lab today… and I am referring you to an allergist. I know you saw one as a child, but I think you need to be retested. Allergies change as we age. Some we outgrow, and some we develop as we get older.” And he hoped an allergist, or an immunologist as they were also known, could get to the bottom of why the young woman was swelling like she was.
“Alright,” Hilery agreed. After making a few more notes in her file the doctor stood up and put on a pair of gloves. He touched her face gently and noted just how swollen it was, then checked the glands of her throat. He checked inside her mouth too and didn’t like what he saw.
“I want you to take two tablets of Benadryl every six hours so long as you are swollen,” he told her. He paused, remembering something from a past case. “Have you had any belly pain with this?”
“A little, why?”
“Just wondering. Can you lie down so I can examine your abdomen?” She complied. Sure enough, when he pressed on her belly he could feel the swelling. He didn’t like the way she winced when she had laid down, nor the face she made when he pressed against her. He helped her sit up. “How bad is your pain, Hilery?”
“Tolerable.” She believed he would prescribe Ibuprofen or Tylenol which wouldn’t do anything anyway… and if he did prescribe something stronger, it would probably be something she wouldn’t take. She hated strong narcotics.
“Are you lying to me?” he asked. He noticed her cheeks redden more than they already were, so he sighed. “Hilery, I need you to be honest.”
“Alright,” she said softly. “It hurts really bad when I stand up straight or lay down flat. I want to scream when I lay on my side, but when I’m sitting or stand hunched over a little bit, it’s tolerable… and I am nauseated as hell.”
The doctor nodded, relieved that she was finally being honest about how much pain she was in. “I am going to prescribe you some Vicodin.”
“Oh no, I won’t take that.”
“Percocet,” he asked, offering something a little more mild.
“That’s still awfully strong Doc.” She hated how strong medications knocked her out.
“Well, I could prescribe you Tylenol with codeine,” he mused. “It’s not as strong as the other two, and won’t take the pain away quite as much, but it should at least take the edge off. I also want to prescribe Phenergan for nausea.” After mulling it over for a moment she nodded in agreement. “If the pain isn’t gone within three days, I want you to come back to see me.”
“Yes sir.”
“And I want you to see Dr. Meyers in Atlanta. He’s an excellent allergist. I went to medical school with him.”
“Is there anyone closer?” she asked.
“Well, he does tend to go to other counties where he’s needed. He is scheduled to be at a clinic in Chickasaw County one day later this month, and Choctaw County the day after. His patient loads in those two counties are light, so, I can see if he’ll squeeze you in. If not, I’m sure an associate can come see you.”
“Thanks Doc.” She watched him scribble on his prescription pad before tearing off a few sheets and handing them to her.
“I’ll let you know when your appointment is.”
“Again, thank you.”
“And Hilery, if your tongue or throat swell again, use the Epipen I just prescribed and get to the Emergency Room as quickly as you can.”
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