ArnuMed Primary Care in Warren, PA

12/09/2025

With the temperature taking a nosedive in recent days, I thought I’d share this old post from Dr Tahara that may potentially save a foot amputation.

Initially under his tutelage via weekly shadowing, I learned about common mistakes P*Ps would make (admittedly myself among them), and has been able to help my patients on issues I didnt even recognize were issues previously.

I was recruited to help with procedures once to twice a month and learn first hand how endovascular procedures work. It was humbling to see the instantaneous improvement patients would have post-procedure.

I continue to work closely with Dr Tahara… usually seeking consult over the phone whenever I am stumped with a complex vascular case.

Not an expert by any means, I am more adept than the average P*P at recognizing vascular issues. If you think you have a vascular issue, come find to be evaluated and if warranted, I will run the case by Dr Tahara for his expert opinion.

Best regards,
-Dr Le

12/06/2025

Going for a drive around the neighborhood today became interesting. Tried to multi-task so I called a homebound patient to make sure he remembers his specialist appointment and also that he has a plan to get to and from there.

"A friend is driving me there, then my wife will pick me up."
"She's leaving work early to pick you up?"
"No, when she gets out."
"Isn't your appointment at 1?!"
"Yes."
"That's insane, there has to be a better way."

We discussed alternative options that would be more efficient for him.

“Sorry doctor, I think I hear a car honking."
"I know. That's me. Get your stuff together, I'm taking you."

It appeared my reputation precedes me; the secretary greeted me by name.
“Do you have his welcome packet?”
“Yep”
My white coat has EIGHT pockets, eight! I pulled out hard copies of some important records.

I parked my patient in a spacious corner of the waiting room, and went to get him coffee.

"You'll hold the cup OK with that tremor?"
"I'll be fine."
"Try not to spill it."
"I won't"
I sensed he may be uneasy for the amount of attention we were attracting.
"Don’t mind them..., it's not exactly everyday a doctor accompanies his patient to a visit, let alone pushes his wheelchair and serve him coffee.”
“I am very honored you’re here,” he remarked graciously.

-Dr Le

12/05/2025

Just thought I’d help spread the word in support of my neighbor across the street.

In the ~ 0.5% chance I get that gas money, a patient of mine will be very happy for a new set of compression stockings in his Xmas… uh, stocking… this year. Venous stasis ulcers… suck.

Merry Xmas,
-Dr Le

P.S. Those without a car can still get rides to medical visits (get those bus vouchers signed by yours truly). Call and ask me about it if you aren’t familiar😇.

Merry Christmas from Follett Run Bay Wash in Warren!! Tag a friend, like this page and share this post for a chance to WIN A 250.00 GAS ⛽️ CARD!!!! *winner will be drawn on Christmas Day!!

All 12.00 car washes will be discounted to 10.00 with code 1225 until Christmas Day!!!

12/03/2025

Clarification about free clinic…

So long as you don’t have insurance (or ones I don’t accept), you’re welcome anytime if you dont mind potentially having to wait. Please be mindful the nature of such visit should not be type that you should have with a P*P.

Anyone in need of my help gets it. As a healer, of course, I am thrilled you’re seeking medical care and should the person to deliver that be me, I am honored.

*see comment below about how the event unfolded.

-Dr Le

11/23/2025

https://www.darlingshomecare.com/

Fun fact: Despite being Asian and having gone to MIT, I suck at math.

Where 1+1 Becomes 3

I had submitted an order to initiate home care a few days prior. My patient expressed a preference for Darling’s. When I arrived at my patient’s home today, I discovered that a visiting nurse from Darling’s Home Care was already present.

While reconciling the patient’s medication list, she remarked that there were some that were… confusing. I gave a verbal order to stop several meds that would be redundant, even potentially unsafe.

The nurse stated the straight caths had been ordered but hadnt arrived yet. Not wanting our patient to go more than a full day of urinary retention, I had intended to go to the ER and get a straight cath kit. (🙏🙏🙏, Begging is not beneath me 😅, so long as it’s in a patient’s best interest.)

The nurse went out to her car and gathered some sterile medical supplies that would serve the intended purpose. We worked together to get our patient into his bed, in a comfortable position, and then swiftly emptied his bladder.

His wife remarked, “Done already? That was really quick.” When a task is well understood by all parties involved, the workflow can become remarkably synchronized—almost a hive-mind–like efficiency. It’s rare when this happens. This was one of those rare moments.

I yearn for the day when the medical community of Warren come together and act in unison to best serve our patients. Until then, I’ll take any bit of help I can get.

-Dr Le

11/19/2025

About a dozen checks I still havent gotten around to deposit and what worries me the most is the status of a patient who had just had open heart surgery.

My web portal pinged me in real time about new labs coming in. I reviewed it extensively: some drop in his blood count, but otherwise everything else seems… reassuring.

I called his wife to get an update on how he appears. Told her I had a crazy busy day but that I would come visit in the morning.

“He would appreciate that. The ICU’s visiting hours are…”

“You’re funny. As his doctor, I come see my patient at a time he needs me most whenever I damn please.”

-Dr Le

11/17/2025

One thing I love about rural medicine is the feasibility of home visits, which allows me to help patients who need it the most. My patients live just minutes from my home or office, which means I can deliver care to people who might otherwise get little—or none. It also allows me to step in personally for procedures that are simple for me but incredibly difficult for the patient.

Gone are the inpatient days of writing orders like, “Bladder scan q8h; if >500 mL, page MD for straight cath,” only for a nurse to carry it out. God forbid Dr. Le ever perform his own orders. 🤣😂 Today I did exactly that—swung by a patient’s home and performed a straight cath (thanks to WGH ER for the quick supply). We drained 600 mL. That’s a lot! 😮

This patient is homebound and had a severe UTI months ago that left him delirious and hospitalized for an extended period. He had another UTI a month ago, and based on symptoms he described yesterday, I suspect he developed yet another. I immediately started antibiotics empirically (update: urinalysis results confirms he does have a UTI.)

Most men will never experience a UTI, but he’s losing bladder control and developing urinary retention—major risk factors. Normally, about 200 mL triggers the urge to urinate; he feels nothing even at 600 mL. With no ability to void voluntarily, his only “escape valve” is leaking into a diaper, waking up each morning soaked. Intermittent self-catheterization would be the standard solution, but it requires dexterity and confidence he simply doesn’t have.

Since taking over his care two weeks ago, I stopped his bumex—a powerful diuretic appropriate for heart failure but not helpful for venous insufficiency (thank you, Dr. Tahara, for the pearl). After emptying his bladder today, I brought his urine to the hospital lab for culture.

Rural medicine may not have all the bells and whistles, but it offers something just as valuable: the ability to show up, literally, for the people who need it most.

-Dr Le

11/14/2025

Another awesome day working with veterans🫡. 🇺🇸

One veteran happens to be a local so it was ironic we both had to travel to Bradford. I’m not sure VES has approved sites in Warren at the moment, as I havent been assigned there or near there. Other than my branch office in Bradford, other locations I’ve been tentatively sent to are Erie and Seneca.

My former office in Russell would easily be approved with VES, but my current office in Warren doesnt meet all of ADA compliance.

Any ideas on a suitable location in Warren (or even Warren county) that would give permission for veteran evaluations?

🫡🇺🇸
-Dr Le

Veterans Evaluation Services, a Maximus company, supports the U.S. Department of Veterans Affairs in its mission to provide Veterans and transitioning service members with the benefits they’ve earned through their service to our country.

11/12/2025

As a P*P, it is not uncommon for patients to defer a decision until they have discussed with me. Recently, I had the honor and privilege of a share decision-making in real time.

The other week, a patient and his wife asked me to be at a specialist appointment. The office being only a hop and skip away from mine, I agreed, if for no other reason than to provide moral support. During the visit, he was given several management options. Lost in thought, he turned over to me, “What do you think, doctor?” I remarked that the decision is entirely up to him. Considering it was *his* decision to ask me (not his wife, not the specialist, not any of his grown children) I spoke up in his advocacy, “If you were my dad, I would advise …. for reasons….” Thankfully, it aligned with what his decision would have been.

I can’t imagine being in the hot seat and asked to choose between the lesser of evils, catastrophizing what if they made the “wrong one.” I did not expect that when given choice A, B, or C, he shrewdly went with choice D, “Phone a doctor”.

To be trusted enough to chime in on a life altering decision reminded me how telling a patient that you’ll act in their best interest is very different than them knowing that you’ll always act in their best interest. It’s a privilege I work hard to earn, not demand as a default.

-Dr Le

11/10/2025

“People sacrifice their health to make money, then money to recover their health, while being too anxious about the future to enjoy the present, and ultimately ‘dies having never really lived’”

~Dalai Lama

11/06/2025

Had a peculiar and surprisingly fulfilling day today. I was informed that home health care was unable to draw blood from a wheelchair bound patient, one whom i did a home visit the night prior.

He has a truck, I have a driver license; figured what could possibly go wrong 🤷‍♂️. Drove to his house and got him ready for an adventure. Getting clothed was easy, considering I used to work as a personal care assistant (PCA). Initially I used momentum to get the wheelchair over bumps, but then realized I could use the backwheels as a fulcrum to lift a 240 lbs, 6’1” person over these bumps (yah, finally put my MIT degree to use). He was quite a trooper and got himself into the truck without much assistance from me. Apologies to all those affected by me operating a truck and DWA*.

Got the labs drawn, he got himself back in the truck, I drove him home, and got him settled in his house. I had the honor to get lunch out of the fridge for him, something he would have not been able to reach. As I left to head back to my office, he asked, “Are you taking me on as a patient?” I felt privileged at the thought of how a quick, simple choice by me makes a difference in someone else’s life. I replied, “You already are.”

I’ve been a PCA, and on a good day, I behave like a proper doctor. I could never imagine how gratifying it would be to simultaneously function as both for someone.

*driving while Asian