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Patient Seeks New Prescription Before Upcoming Cruise

A 62-year-old man has a long-standing relationship with his primary care physician, having been a patient for two years and undergoing yearly wellness evaluations. With a cruise scheduled for the upcoming week, he submitted a request through the doctor's portal on Monday for Scopolamine patches to prevent seasickness. However, he did not receive any response for 48 hours and subsequently made multiple phone calls on Wednesday, Thursday, and Friday. During these calls, the staff informed him that the medical assistant had yet to confer with the doctor regarding his request. Finally, on Friday, just 15 minutes before closing time, the office contacted him to confirm that the prescription had been sent to the pharmacy. They also mentioned that moving forward, an in-person appointment would be necessary for all new prescriptions. Is it common for clinics to mandate an office visit for any new prescriptions? While I can understand that stricter measures might be needed for controlled substances or in situations where there are health risks associated with the medication, this seems excessive in my case. Is a five-day wait period for a prescription considered reasonable? Had they notified me on Wednesday that I needed to book an appointment, I would have had time to do so or to seek assistance at an urgent care facility. As an additional note, my wife contacted her primary care provider on the same Monday and had her prescription called into the pharmacy by Tuesday. For what it’s worth, I've enjoyed several cruises in the past without issues, but I’ve noticed some discussions online warning about the possibility of rough winds and turbulent seas in the upcoming travel area.

WellnessLifestyle ChangesFamily Medicine
Male25-34
2 minutes ago

Navigating Health Anxiety: Should I Seek Further Testing?

This explanation might be a bit lengthy, but I appreciate your consideration. I’m a 32-year-old individual with no major health issues in my history, however, my family has a medical background. My mother is a type 2 diabetic, and my father faced hypertension and underwent angioplasty approximately two decades ago. Recently, for the last three to four months, I've been experiencing episodes where I wake up suddenly at night with my heart pounding. The first few instances were quite alarming, as they were unfamiliar to me; there was even an occurrence during the daytime. These experiences have made me excessively attentive to any fluctuations in my heart rate. I began to habitually monitor my pulse, constantly trying to determine if my heart was beating too quickly or if everything was stable. Even the slightest twinge in my chest would provoke anxiety about my heart's well-being, resulting in heightened sensitivity towards any heart-related sensations. As time has passed, I’ve started to cope more effectively during these episodes. I remind myself that this feeling will eventually subside, take a few deep breaths while lying down, and gradually my heart rate stabilizes. To date, I haven’t experienced any additional symptoms during these episodes, such as breathlessness or dizziness. However, I have occasionally felt some discomfort in the area between my stomach and diaphragm, which leads me to ponder whether my symptoms might stem from some unhealthy lifestyle choices, particularly concerning my sleep routine and meal timing, potentially disrupting my circadian rhythm. Here’s my reasoning: I’ve been averaging around six hours of sleep each night for the past three years. I often find myself ruminating over various aspects of my life, contributing to mild anxiety (though it hasn't become severe). I usually eat dinner around 10 PM, head to bed by 1:30 or 2 AM, and tend to browse social media before I fall asleep. Sometimes I notice that I snore, which raises concerns that I could have some kind of breathing obstruction leading to my nocturnal episodes of waking up with an accelerated heart rate. However, I can’t definitively say whether I’ve always snored or if I’ve had similar experiences of waking up without being particularly aware of them. Additionally, I’ve noted that four out of ten times, I awaken with a racing heart while having some sort of dream, although I can’t classify them as nightmares. Earlier this year, I underwent blood tests three times, and the most recent results showed normal levels for hemoglobin, cholesterol, triglycerides, and other relevant markers. The sole area of concern was my high-sensitivity C-reactive protein level, which registered at 4.56, indicating an elevated state since anything over 3 is marked as high. I consulted with a cardiologist regarding my findings, yet I felt that my specific situation wasn’t fully appreciated. He prescribed beta blockers for anxiety and hypertension, but I suspect this recommendation stemmed more from my office blood pressure reading of 149/88 and a heart rate of 117. I believe these measurements were possibly skewed by my anxiety during the consultation, and don’t truly reflect my regular status. Additionally, the nurse who recorded my blood pressure didn’t seem to account for my posture, and she took the reading three distinct times. The cardiologist did comment that my circadian rhythm might be disrupted due to my irregular sleep and dinner patterns. I opted not to pursue the prescribed medication and instead reached out for a second viewpoint from a knowledgeable family member who specializes in pathology. He advised against starting blood pressure medication considering my blood pressure isn’t elevated. He suggested a very mild dose of amitriptyline if absolutely necessary, but strictly as a last resort. This entire ordeal has intensified my health anxiety, leading to a fear of being alone in public. Whenever I notice a twitch or an unexplained ache in my chest, my mind immediately jumps to worst-case scenarios related to my heart. I frequently hesitate to engage in brisk walks or home weight lifting, concerned that it might trigger a heart attack. Any insights or advice from those who have faced similar challenges would be greatly appreciated. Thank you to everyone who read this lengthy account and is willing to offer their support and recommendations.

PTSDAnxietyDepression
Male25-34
12 minutes ago