Foggy

My writing brain is sluggish tonight. Yesterday morning started early for me; I had to beat traffic going downtown to have some labs drawn. And even though I slept in today, I'm dragging now. Thank goodness for the end to Daylight Savings Time. The day we "fall back" is one of my most favorite in the year.

When I got to the doctor's office, things were pretty quiet, unlike Wednesday afternoon, when I was there for follow-up with the new internist. The lab techs were just getting started with their preparations for the day -- filling syringes with flu vaccine, restocking vials for blood -- and I didn't have to wait to be called in. The woman with my lab orders waved me over right away and started tying a tourniquet around my arm.

"You fasting?" she asked.

I nodded. I hadn't been sure if the tests required it, but it seemed better to err on the side of caution than to have to reschedule the draw -- one of the tests could only be done first thing in the morning.

I glanced at the labels the woman had printed out for each vial of blood and noticed the number was remarkably short for what I'd seen on the day of my follow-up appointment. (The tech who had originally printed them that afternoon had advised me to wait, given the morning-only test, and have all the blood taken at the same time to save me an extra needle stick.) So -- "We're doing cortisol, anti-TPO, vitamin B-12, and vitamin D today?" I asked, just to be sure.

"Hmm? No, no, I've just got lipids and a hemoglobin A1c," the woman said. "Wait, what's your name again?" She fumbled around with her order sheet for a moment as I gave her my information. "Oh yes, I remember! The other girl said you were going to come back today to get everything done and she taped your other labels to the fridge -- "

We both turned to look at the refrigerator, whose doors were bare.

"Shoot," the woman said, untying the tourniquet. "Wait right here."

I've learned not to be surprised when snafus like this occur. Even as recently as Wednesday, there were some near-mistakes that happened -- the physician ordered the wrong test and only realized it when I asked her why she'd chosen it over an alternative that was purportedly more accurate; then the lab tech handling a urine test gave me the wrong label for the specimen cup and only realized it when I pointed out that it was for the second of two urine tests my doctor had ordered, which could only be done while I was symptomatic (I wasn't that day).

Is it just me, or does it seem like I'm having to double-check what shouldn't be mine to check in the first place?

The woman taking my blood Friday morning eventually found the labels she needed -- in a garbage can. Lucky for me; apparently, once those labels are printed, the request records leave the lab computer and go to a completely different facility where specimens are received (that way, the folks handling that step in the process know exactly what to look for). I don't know whether we would have ended up having to call the receiving facility to figure out what testing needed to be done or if anyone was even at said facility at that time of day. Either way, it wasn't going to be a simple fix.

So. I'm grateful that everything worked out in the end. I just hope the incidence of error drops in future visits. For the next set of tests, scheduled for Wednesday of the coming week, I'll be sedated -- and there's no way I can look out for myself like that!

And then things got ugly

I've been waiting.

At first it was just waiting for an appointment with a new doctor -- an internist to start with; she comes highly recommended. She works within a well-reputed medical center I've been referred to in Seattle, one whose philosophy emphasizes continuity of care: a single system, linking all of its specialists. Everybody has access to your records, your history. No faxing things to separate people, no need to dig channels of communication. They're already in place. But you have to have a primary care physician within the organization -- he or she acts as your point person -- before you can arrange to see anyone else (like, say, an endocrinologist).

So my appointment, which I made the day before my last post, is this Wednesday.

The same day of my last post, within the hour I hit publish, my body threw a hissy fit. I'll spare you a list of the symptoms, but suffice it to say, they weren't something to ignore.

We weren't sure of the cause, but the first suspect was that kidney stone. Its initial presentation was odd, which I knew, but it turns out the urologist's report hems and haws about whether it was ever even a stone. If it was, it's up and done something unkind. If it wasn't, then something else is going on and we need to figure out what that is.

In the interim between the Friday I got sick and this Wednesday (not quite three weeks), we've done some stopgap investigating. As much as I didn't want to, we went to an ER on the first Saturday (on the advice of the nursing consult service D's company provides to its employees) to make sure nothing imminently life-threatening was happening. After that, we were advised to follow up with a urologist. Of course, the earliest appointment I could get was after the first appointment with the new internist (this is how new-patient scheduling sometimes goes). I was still feeling off, so my remaining option while waiting was to go back to my current doctors.

At some point in April, when the endocrine guy was beginning to run out of ideas, he referred me to a rheumatologist (suspecting something autoimmune). "He's a very good diagnostician," he told me. So I saw that person in June (see what I mean about new-patient scheduling?) but in the end received no new answers after one more round of tests.

Given the new symptoms from September, I figured it might be worth going back to him. Fortunately, he had an opening the Tuesday after I got sick; still no answers, but he repeated his tests.

The Thursday of that week, we left for D's brother's wedding weekend, during which my symptoms got worse. Tack on one more ER visit.

Then we came home. Symptoms even worse. Decided to forgo the ER visit against most natural instincts, sensing from our track record that we wouldn't get answers. The rheumatologist's tests came back a few days ago with nothing new either. And now, we're here.

I've got all my paperwork gathered and organized, all the records I could pull together from the last eighteen months. I've sat down and charted from scratch on a timeline all the weird things that have happened with my body since I got diagnosed with prediabetes, and then some from the time before. I've noted diet changes, weight changes, GI changes, urological changes, medicinal changes, mental changes, environmental changes. There's nothing more I can think of to add.

I wanted to wait to write about any of this, hoping I'd have better news. But here I am, waiting.

I just have to make it to Wednesday. We start fresh there.

For the record

Twenty minutes of my life I will never get back. May the following phone conversation at least provide entertainment (or something else?) here.


Monday morning. Contemporary Troubadour dials the number of her future doctor's office at Almost Dr. Sis's medical school and places the phone to her ear. After three or four rings, someone answers.

Female Receptionist: [Laughing loudly at something] "Hello? ThisisFemaleReceptionisthowmayIhelpyou?"

Contemporary Troubadour: "Hi. This is Contemporary Troubadour; I called --"

F. Receptionist: "Hold on." Click.

A slight hiss is just audible from the phone, indicating that the connection is still intact. Many minutes later ...

F. Receptionist: "Hello?"

C. Troubadour: "Hi. This is Contemporary Troubadour; I called just under two weeks ago to set up an appointment with Dr. Specialist. You and I spoke about having my records sent to him for a consult --"

F. Receptionist: "What's your name?"

C. Troubadour: "Contemporary Troubadour."

F. Receptionist: "Mm hold on." [Sounds of typing.] "How do you spell that?"

C. Troubadour: "First name Contemporary, last name T-R-O-U-B-A-D-O-U-R."

F. Receptionist: "Hold on." [Several more minutes pass.] "I'm not finding you in the system. What was it you had faxed?"

C. Troubadour: "Well, there were records from my GI doctor and my endocrinol--"

F. Receptionist: "Who's the referring doctor?"

C. Troubadour: "Er -- I don't have one; my sister is a student at Medical University who contacted Dr. Senior Specialist to ask whom I should see, and he e-mailed her Dr. Specialist's name."

F. Receptionist: "Oh, okay, Dr. Senior Specialist ... and what was your name?"

C. Troubadour: "Contemporary Troubadour."

F. Receptionist: "Could you spell that?"

Contemporary Troubadour takes a deep breath and obliges. Glances at clock. Ten minutes have passed since she first dialed the doctor's office.

F. Receptionist: "Yeah, we don't have anything for you. Well, wait, there are some lab results from Seattle Business --"

C. Troubadour: "Yes! My husband faxed those from his office."

F. Receptionist: "Oh, well then we've just got those two sheets! They don't have any patient information on them."

C. Troubadour: "But -- I'm sorry, what now?"

F. Receptionist: "We haven't got anything. No date of birth or social security number; these are just lab results. But while I've got you on the phone, let me ask you --" [Ruffles papers.] "Okay, okay, who is this D. Troubadour on the cover sheet?"

C. Troubadour: "That's my husband."

F. Receptionist: "Oh, see we thought that was the patient. Now how do you spell your name so I can put it in the computer?"

C. Troubadour: "Contemporary. T-R-O-U-B-A-D-O-U-R."

F. Receptionist: "Mmkay, now how about your address?"

C. Troubadour: "1234 555th Way --"

F. Receptionist: "Hang on, 1234 555?"

C. Troubadour: "House number 1234. Then the street is called 555th Way."

F. Receptionist: "Way? Like W-A-Y?"

C. Troubadour: "Yes."

F. Receptionist: "And 555 with a T-H?"

C. Troubadour: "Mm hm."

F. Receptionist: "Okay, 1234 555th Way. Man, you must not get a lot of mail with that address."

C. Troubadour: "?!?"

F. Receptionist: "All right. Got it in the system. You'll be contacted shortly by someone now that you're there."

C. Troubadour: "Okay, but --"

F. Receptionist: "Have a nice day." Click.

Thirty seconds later, the phone rings.

F. Receptionist: "Hi, could I speak with Contemporary?"

C. Troubadour: "This is Contemporary."

F. Receptionist: "Hi, this is Female Receptionist; we just spoke a minute ago. Could you give me your date of birth and social?"


Aaaaaaand scene.

Back!

As in flat on it, until the rest of today is over.

Oh no, you're thinking, this doesn't sound good. My apologies in advance. I hate, hate, hate to make the first post of 2010 a less than jolly one, but I didn't start this blog to create yet another place where I'd have to hide my real thoughts and feelings. I will throw in happy things at the end, so don't worry. Bumming in awaits! But if you're not up for (down with?) less than jolly, feel free to skip right to the photos. The happy starts there.

So. I feel moderately guilty that I've spent most of the afternoon in a travel-induced daze while D had to go straight to work from the airport, but I'm accepting my pathetic lack of vigor for now because I'm in a weird place. Limbo, I suppose, but it's a different limbo than the one I was in before the holidays.

Before we left town in December, I was doing my best not to get too worried about my not-so-great liver enzyme test results. There were presents to pack and people to look forward to seeing. And there was nothing to be done regarding the liver stuff until my seven weeks sans alcohol were up (more on that later). I did have some GI symptoms in the few days before we headed for D's parents' place, but I chalked it up to stress. (It's been known as early on as high school to cause me such problems.)

But the symptoms didn't go away. And they got more and more severe until on the morning of Christmas Eve, D and I decided I'd better give my GI doctor a call. One of his partners got back to me right away, advising me to double the dose of Pancrecarb I'd been taking before meals and call back after the weekend with an update on how it was working out. Simple enough -- and effective. By the end of the day, I was feeling tons better. I can't emphasize how nice it is to be able to eat without worrying how sick it might make me feel 30 minutes later.

I knew, though, that the previous ten days of ramped-up symptoms signified that things with my pancreas were getting worse. And once Troubadour Dad got news of the liver enzyme issues on top of the GI distress, he decided that something "wasn't right," particularly for someone my age, and suggested it was time to get a consult from a doctor at a more academic institution, i.e., a specialist with access to the most current research.

As it happens, Almost Dr. Sis has doctor-professors who are just those kinds of specialists. She very kindly contacted a senior doctor in the GI department to ask whom I should see, given my history, and he sent back a recommendation right away. So during the remainder of the week at my parents' house, I faxed off requests to all my doctors here in Seattle to get the pertinent parts of my medical records forwarded to said chosen specialist. The plan is to try to schedule a trip for me to get checked out by him in February. We're guessing it'll be a two-week visit, but we'll know better once this doctor has had the chance to review everything in my chart.

So, limbo. It's eating at me more than before -- probably because the whole flying-across-the-country-to-see-an-expert thing makes everything feel way more serious. Not sure what to do about that, so here I am, writing.

In the meantime, I have one more blood draw scheduled with my GI person here to look at those liver enzymes. I was a good girl and didn't even have a drink on New Year's Eve, even though Troubadour Dad was serving this:


But I was mildly naughty (from a blood sugar standpoint) and joined in the Spanish tradition of eating twelve grapes at midnight for good luck in the new year. One of Troubadour Dad's colleagues, who hails from Madrid, introduced us to the ritual that evening. Fun and hopeful! And excellent with really good cheeses afterward ...

Overall, my time with family was all right too. I have tons of photos to go through from the visit, which I might look at tomorrow when I need a break from thesis work (yep, it's time to get back to that before the semester starts up in two weeks). For now, here are a few shots of Troubadour Mom's bathroom residents. Proof that plants really can thrive by the tub!




I'm also thrilled to report that the rose we received back in October survived our absence marvelously. I wasn't sure it would, but these watering globes, which D picked up from Home Depot, actually worked. I'll take it as a good omen.

On that note, here's to a happy 2010, everyone. May it bring good things, surprising or otherwise, to you and the people you love.