The Doctor Will See You Now [Non-Fiction]

Chapter 131: General Medicine

OPD story.

A 60-year-old woman comes in for review of her kidney function. She has chronic kidney disease, which means her kidney function is suboptimal, but not yet bad enough to need dialysis. She will need continuous monitoring and adjustment of her medications to ensure she doesn't develop complications with electrolytes as chronic kidney conditions tend to.

Last visit, she said she had a gouty flare of her left ankle. Gout is common in older ages and also even more common in renal patients. I asked her about her gout; she said it was improving. Good news.

"Would I be able to do MRI scans?" she said out of the blue.

"Sure. As long as it's not involving contrast. You'll need to tell the doctor getting you the MRI scan that you have poor kidney functions. They might need to get a different type of contrast or forego contrast use altogether."

"Oh, OK."

I booked her follow-up and gave her the prescription. "OK, see you in three months."

"But what about my MRI?"

"What MRI?"

"You said I could get an MRI."

"Yeah, as long as IV contrast isn't involved."

"Aren't you booking it for me?"

I stared at her. Then it clicked. She wasn't asking me if she could safely undertake an MRI. She was telling me to book her an MRI.

"But you don't need an MRI," I said, confused.

"But my foot hurts."

"It's gout. You don't need an MRI for gout."

"My friend says I need an MRI."

I blinked. "Is your friend a doctor?"

"No."

"Well, I'm not going to book you an MRI you don't need." Nor am I going to follow the instructions from your friend-who-is-not-a-doctor.

I suppose her friend-who-is-not-a-doctor could read the images and write her the MRI report too?