Tuesday, January 26, 2010

LOFT LIFE: Winding up the medical stuff and re-visiting life

Only two days until I see Dr. G. and learn that, except for some continued chest pain (when I cough), and the feeling of fatigue if I run around doing things like shopping, I am mostly well. The CT scan came back with a radiologist’s report saying I have some small cysts in my lungs. They want another reading in six months, “just to be sure.” I am pretty sure what they want to be sure of is that I don’t sue them for missing something.

I have never sued a doctor, and believe me, I have had plenty of occasion to do so. It alarms and terrifies me how many doctor-mistakes cause thousands (250,000) of deaths every year. In fact, some statistics cite doctors as the third leading cause of death in the U.S. (Told you it was terrifying.)

But, to my thinking, doctors are humans, in spite of the myth circulating our society that they are deities. They just are not. And, frankly, I’d rather have the medical savings, health care cost reduction of NOT having outrageous malpractice suits, clearly causing doctors to up charges, than to have the human errors costing our health care system to skyrocket to the extent that some can be convinced government-run systems are a better answer. When a doctor has to literally pay millions for malpractice insurance, clearly there is some problem in the way we think. We do NOT need government to run things badly. We need people to stop thinking that a windfall of cash for an error is worth an overall costly health care system. Changing this one area, in my opinion, would make this whole health care cost thing cease to be a problem, and would correct most of what’s wrong: over-treatment and too many tests for instance. And, the other two areas would be for people to educate themselves and upgrade their healthful lifestyles. If they don't do that, they are going to get sick. As for me, I am positive that these cysts have been on my lung for years. And, yes, if there had been some malignancy, we would have caught it early, and I would be grateful. But, I knew it wasn’t that, and my usual intuitive self-diagnosis is dependable enough for me. I pray. God speaks. I will depend on that.

As for our society deifying doctors, it just has to change. Nurses may get close to deity, but not doctors. Most of my friends are nurses, or phlebotomists, or some other version of below-doctor status medical practitioner, and I can tell you, they are at least saints. (I always laugh when I call someone a saint, because, you do know that the Bible says every Christian is one.) But, I am using the Roman Catholic category of people who have performed at least three miracles, and who have been martyred--if not literally, at least in some fashion, like doctors yelling at them, when really they deserve medals.

OK. Back to me. :) Actually, I have some small cysts all over me. I am a cyst-maker! I know several people who are cyst-makers also. Now, I will have to devote my medical research to why some people make cysts and some don’t. My friend who is a doctor tells me no one knows, which, of course, makes me all the more sure I can discover this secret. In my next life I think I want to be a diagnostician. I have a knack for it. I could tell you stories of people I have helped with my intuitive ability to diagnose--unofficially, with disclaimers that I am not a doctor, and do not play one on television. Nonetheless, they were grateful, and they got well.

I especially am intrigued with Dr. Peter J. D’Adamo’s book on Eat Right 4 Your Type. Although I do not go with this 100 percent, I do think it is very interesting that the blood types I know seem to align with what he says, most of the time: O types get reactions of all kinds when they eat dairy; A types can’t have hot peppers or highly-acidic foods; B types eat most things with no problems, and seem to favor getting rare diseases rather than common ones. I don’t think I know any AB types, so I have no opinions on them. I will have to read the book again to brush up, and probably will have to find someone who represents that type, to round out my thoughts.

In any case, I am mostly back to normal and again heap on the thanksgiving for you all. It could have been worth losing two months of ambulatory life to have the followers and comments on my blog. It’s that important! So don’t make me get sick again to continue to have you all in my life--OK?

Wednesday, January 20, 2010

LOFT LIFE: Almost there

Saint Jay, on his lunch break, is driving my x-rays to the Jefferson Radiology radiologist as I write this. So, hopefully the report will soon be on its way to my pulmonary guy (notice I am trying not to call him a turnip anymore), so it will be there in time for my appointment on the 28th. And, hopefully the final diagnosis that I will survive will be unanimous. (I do think God makes that final decision.)

In the meantime, I am feeling stronger, and am appreciating you all so much. I am working a few hours a day, and doing my best to reserve strength, but not stay in bed all day.

Tonight is the Bigelow book club. Jay and I would rather have movie clubs, and I want an American Idol club--but that is mostly because we still don’t fork out the $150 a month for cable, and the community room has a big screen. :) For some reason, people assume that if you a writer, you like to talk about books. I do, sometimes, but feel a lot of pressure to read faster than I normally do when I have to report on a book. Also, most of the recommendations I give and receive on books in book clubs have little to do with what I actually read.

I have been addicted to Patricia Cornwell’s Scarpetta series, but what more is there to say than that I love them. If you tell anything, you ruin them for the reader. And, I just finished reading Lauren Bacall’s By Myself and Then Some, which frankly ruined what used to be admiration for her, and ended up giving me the feeling, from her own words, that she is a pretty self-absorbed actress. Actually Bogey said it to her: "All you actors are alike” meaning prima donnas. And they are!

Jay and I have become addicted to watching Dexter--a Showtime series about a serial killer. We have heated discussions on Dexter, namely about me saying he is sweet and only kills bad people, and Jay insisting that killing is killing if it is illegal, and that Dex has a big problem. I think Jay doesn’t really “get” people with detachment disorders--like me, and that Dex, except for this teeny problem, and the fact that he memorizes social behavior rather than “feeling” what to do, is a pretty decent guy.

I also seem to compulsively take my polls on Dexter with others: my hairdresser also thinks he is sweet; my pastor says Dex is “not a healthy person.” Okay, I might have to admit his M.O. isn’t “healthy” but still it is helpful to others. Think of all the innocents he has protected from the killers he has killed. I ask you, wouldn’t you want Dex as your neighbor and friend? I like him even more than Sling Blade.

So, you see I am back to my usual self. Thank God, and family and friends. Now I can continue with Loft Life without the self-absorption. Maybe I should consider acting.

Tuesday, January 19, 2010

LOFT LIFE: More waves

OK. You’re not going to believe this.

Did I mention that when I was having the CT scan, I happened to say this all started with a chest x-ray at the clinic? I left out of my saga that the technician said the radiologist at Jefferson was likely to want to see it. I asked her if I should get it for them--since I had hand carried it back to the clinic from the pulmonary specialist’s office, at his request.

No, she said they would have no problem getting it. No problem. That should have been my first clue.

Now a week later, after the CT scan, I am on prickly pins and needles trying not to worry that a whole week has gone by without a phone call. I am also imagining more turnip-behavior from a guy who probably knows what the lab said and isn’t telling me. But, I would be wrong. He doesn’t even know all this is happening! I look down at my ringing cell phone and it says the name of the clinic--which wouldn't be the people who should be calling. Evidently the radiologist is just getting around to requesting the x-ray, and the clinic needs me to pick them up since they don't mail them.

Remember that long drive to the radiologist, where I needed my husband to drive me in case...well, now my husband, who is rapidly reaching sainthood, is driving to the clinic at 6:00 p.m., missing praise band practice, and will have to take time from work tomorrow to deliver them to the radiologist. No problem! For whom?

I don’t blame the clinic for not mailing original pictures of people’s chests. (I think it’s safe to assume they don’t mail pictures of any body parts.) It has to be hand carried.

In our world of technology, you would think they could make a DVD or something--but then they did that at the Grand Canyon clinic when I broke my foot, and when I handed it to my IL doc, he said, “Nice technology, and very efficient, except it’s not your foot, it’s someone’s chest.” Oh dear. Where's the chest pic when you need it. :)

So after Jay delivers the x-ray, perhaps, within another week, I will have an answer. I’m telling you, this is never simple. And, dare I hint that this is when the government is not running the system. We all know how much more efficient it would be if they were, right?

LOFT LIFE: Navigating the medical system

My husband wants a GPS. I tell him I AM his GPS, and much more flexible, even accurate. But my road navigational skills are nothing compared to my ability to wend through the ocean of complication that is the health care system.

Starting with the clinic that diagnosed pneumonia, which was NOT pneumonia, a radiologist who agreed with the erroneous diagnosis (assuming infection is visible on x-rays as pneumonia), the radiologist did detect the “nodule,” which launched me to the next destination: pulmonary specialist.

NOTE: the office manager in my dentist office, dear, encouraging woman, told me her mother had a lung growth and was sent straight to an oncologist, not a pulmonary specialist, which she thought was encouraging in my case.

Now that I think about it, maybe x-ray infection just looks like infection, and Dr. G.’s sureness that it wasn’t pneumonia might have been from my 98% oxygen levels and not from the x-ray picture at all. That makes sense. Geesh. A person has to be a logician to get ahead of these guys.

Anyway, before I could move to the next port: CT Scan, Dr. G. said I needed a blood test before the scan, and that it was required for someone my age, just in case I had kidney problems. I told him I had great kidneys, He said, “How do you know?” I replied, “I would be yellow if I had problems.” He just shrugged. and his dear office manager argued that the lab he was sending me to did NOT require the blood test until a much older age than I. That meant I could go right to the CT port without having to do the time-consuming Q &A with Dr. G. about what this age-related blood test was about.

Tired yet?

So my CAT was scheduled for the next Friday. Of course, I had to know 1) how much would it cost? 2) do they discount self-pays like us? and 3) what is this contrast dye that is so gnarly that a blood test is needed, and maybe 4) what would happen if i do not want the dye?

After literally a dozen calls to the lab, with not one person who would answer my questions, no one knew anything about the cost of a CT scan of the chest with dye.

My friend Andi said to Google diagnostic labs in Connecticut until I found my answer, I did, and found Jefferson Radiology. They were not only friendly and willing to talk, they actually knew the answers. (I did tell you this ocean needs lots of skill to sail.)

The billing department priced me at $1090, said they DO discount self-pays, then transferred me to the lab for my other questions. Though they were nice, they suggested I Google contrast dye. (Seeing a pattern here?) They explained the kidneys have to have good creatinine levels to handle the dye without risk of side effects that could be serious.

So whatever it is, it is heavy-duty enough to have to measure creatinine levels in my kidneys, I thought. So I wanted to know. Google’s answer was gadolinium, which turns out not to be the dye my CAT used, but oh well.

After reading side effects of gadolinium, if creatinine levels aren’t right, I was horrified. Among possibilities are: thickening of the skin, compromised bones, blood vessels, yellowing of the eyes...rashes, hives, etc.

I called Dr. G’s office, explained to dear office manager that I was just wondering how important this dye was to diagnosis, that I should risk being a thick-skinned, crippled, yellow-eyed old woman just to find out that the “nodule” was nothing. I was feeling asea.

She assured me my questions were good ones, deserving of answers, and she would have Dr. G call me.

She must have given him a piece of her mind. Dr. G. sounded somewhat recalcitrant and almost personal--and did proceed to answer several of my questions, convincing me that “if it should be something like a malignant tumor” the dye would help him see that. Maybe we should do phone visits in the future.

I also asked them to cancel the first lab and go with Jefferson. (On my 13th call to the first lab, I got a range of $1000 to $2000.) We agreed the range was too broad and vague. So she booked me for Tuesday at Jefferson. Only problem was, Jefferson required the blood test for my age. Phew.

I warned you that once you are in the system, the waves can get choppy. All this pro-active stuff takes stamina. Really, if you need to go get a cup of coffee, or something stronger, I understand. Just relating the facts, so that should you ever need a CAT scan, you know the ropes.

I then booked a blood test back at the clinic. It turned out they do not do blood tests, but there were two possibilities in the same building. I chose Quest, a very positive experience. My phlebotomist was charming. I asked my test question: “Are you a vampire or a gentle soul?” She replied, “Depends on how I feel.” The twinkle and sense of humor let me know I was in good hands. I was. I will buy stock in Quest. Good outfit.

Then the waiting for the blood results. Dr. G sounded happy again, this time at my creatinine, so I was all set. So, glad to bring him some joy in life.

I had planned to drive myself to the scan, but my daughter, Melissa, leaned hard on me to get Jay to drive, if only for the emotional support--which I never believe I will need, but did.

The scan was a bit more traumatic than I expected. The dye felt heavy, I was dizzy and, though they said it would be in my system for 90 seconds, they really meant 90 seconds for the test part. The dye affected me a day and a half: headache, dizzy, nausea, and a heavy feeling. Thankfully my eyes did not yellow and my skin remains un-thick.

I do have to add that the front desk personnel at Jefferson in Bloomington are exceptional. At least these doctors--and that is at all of my providers--know how to hire the best. Thank you all for your compassion, competency and humanity. It makes a huge difference to a patient.

More waiting. I’ve been very tired, off and on--well enough to go on with stuff like writing, laundry, cooking, and getting the mail, but not good after four hours or so of being up and about. Haven’t felt well enough to do much else. Probably it isn’t the “nodule,” but the lingering effects of a serious bronchial infection.

All in all, I know a lot more about the world of CAT scans and dyes, and why they’re the best thing since sliced bread. Truth to tell, I’m hoping the test shows nothing. But, in case it isn’t nothing, and in case this whole ordeal of mold-induced chest infection turns out to be for finding some little lung lump early, I guess i am grateful. No, I AM grateful.

Most of all, I continue to count my blessings: a loving family, great, caring friends, and even a medical system that, if you keep a persistent eye on things, works pretty well.

Monday, January 18, 2010

LOFT LIFE: I Will Survie

I have made a decision. I will survive. Yes, I saw the pulmonary specialist--more about him in a minute. He said I did NOT have pneumonia, never did have it, that the mold probably kicked off a bronchial thing--definitely infection, but not pneumonia.

Also I did not have a mold infection, though my spraying mold cleaner and getting tons of mold droplets in my face (my words) probably did create the infection. His real concern, and I use that word clinically, not personally, was this “nodule” the radiologist at the clinic--that does’t know what pneumonia looks like--found.

My daughter accompanied me to Dr. G’s and she was not pleased at all with him. I’m kind of numb to this kind of non-personal medical type, but she isn’t. She expected a: “Hi, I’m Dr. G and how are you feeling.” In fact, he didn’t even look at me but sat down at his desk, while I sat on the end of the examination table, and as I talked about my symptoms, he typed.

Now, let me tell you I know about doctors. In California most of my PR clients were doctors and hospitals. In Illinois, my best friend is a marriage-family therapist. i know about the hours of transcription necessary after consults and all the paperwork burdens HIPAA and insurance create for time-consuming reporting. Privacy acts now even make it illegal to take the reports home to accomplish in the comfort of an easy chair, beer and soft music. Anyway, Dr. G. wasn’t going to waste any time being personal, looking up from his typing, or saying “Hi.” He got right to typing, and continued, only pausing, my daughter said, to smirk (laugh) at some of my questions, which by the way he did not bother to answer. His answer to everything was that he would tell me what was wrong when he knew. Finding out I didn't have pneumonia or a mold-infection weren't things he volunteered. I gleaned this during the back and forth--mostly back, conversation.

I explained I wasn’t asking for his diagnosis yet, merely input for my extremely analytical data-base of a brain. (OK, maybe that does deserve a chuckle, even though it is dead seriously true) and that I wanted to know what he was doing, why, what he was hoping or not hoping to see, and what logic-tree of possibilities there were for a “nodule” on the lung of the smallish size and shape of mine. Nada. No response at all. Instead, he continued typing, then examined me with no explanation whatsoever, except to say that the finger-impression oxygen machine showed I was at 98% which seemed to make him very happy. I got the feeling after that that he felt I was taking up time and space that could have belonged to his really sick (dying) patients, which should have made me feel better, but didn’t. His elation at my high oxygen level, felt more like an indictment than a relief.

He scheduled CAT scan in the same building for a few days later.

I have been saying that Dr. G. has the beside (ok, office) manner of a turnip. My husband says I am defaming Dr. G’s character with this statement, to which I reply that beside manner is hardly a statement of character. Even though my daughter was most upset at him, wanted me to leave, and said she didn’t trust him, I remained loyal, and didn’t leave, and gave him the benefit of the doubt. I defended that he kind of viewed me as a lung instead of a person, and perhaps he was an expert in lungs, if not in people. I hope that analysis is correct and that it isn’t that: 1) I remind him of his mother or 2) he has really sick patients and thinks I am wasting his time, or 3) that he just doesn’t care and is thinking about playing racquetball with the hour he saved typing instead of relating to me.

Upon taking my usual surveys of almost everyone i know and even some I don’t know well--my dentist, for instance, on whether being a turnip is a question of character, it is about 50-50. Some see it as a lack of kindness, others as simply that some specialists are just not people-persons, even with all the research about how much treating a patient as a whole person counts in the healing process.

Suffice to say that i will stop calling him a turnip, and try to evaluate whether I can continue with someone so non-verbal, so unwilling to answer questions. I did tell him to his face that I needed a doctor who talks. He just smiled. I also told him that most of my California doctor clients were like him, and that I translated them to the public so well that I made them lots of money, and therefore, he might want to call me. I made it quite clear to his office manager, that if it were not for her kind and caring personality, he probably wouldn’t have many patients.

Well, I will have to weigh the pros and cons of remaining with Dr. G until after the CAT scan.