Six month Follow Up Visits

My last patient today was Mrs P. She was supposed to be a very easy patient. She has restless legs which are well controlled. She was here for a six month follow up, which means she's in pretty good shape. Nothing is better than a six month follow up except a one year follow up. Actually, the best thing of all is the "I hope I don't see you again" never follow up. But then again, those patients aren't really "in the practice". Anyway, her restless legs aren't that great, really. They're bothering her more. But she is under some stress too. Her husband is very ill. He is very weak and has been falling. He has had many surgeries. The VA eliminated his pension after review of his case, and they don't really have enough money. They are investigating a reverse mortgage to make ends meet. Anyhow, she got ill in October with coughing. She had no fever, but was very short of breath. Her doctor thought she had pneumonia, but her X-Ray and her Cat scan were normal. Another doctor thought she had bronchitis. But she hasn't gotten any better, really. She still coughs. She feels weak. She is always short of breath, and it gets worse if she lays down. It's not worse, really. But it's certainly not any better. And her restless legs is somewhat worse. I don't really understand why, but neither of the other doctors got her an examination of her heart. I think she really needs that, because all of these complaints could also indicate a heart problem. That wouldn't surprise me. The medicine she's on, Lyrica, is also a concern. It could do some of these things as well. Well, it wasn't really a routine six months follow up after all. You never can know what to expect. You can't really predict anything at all, it turns out.