It’s been such a long time since I’ve attended a doctor’s appointment that was anything better than neutral that, almost 24 hours later, I still don’t know how to react.
I don’t have cancer. We’re pretty sure, anyway. Sure enough not to schedule any follow-ups; that has to be a good sign (or a really, really bad one), right? My past year, medically, has meant that, for one fun fact, my insurance company – new since September 2010, so they didn’t even have to make the really big payoffs – has never denied a single request for a non-covered procedure, doctor or medication. And for another, it has meant that, as soon as I start showing symptoms of anything more exciting than the common cold or yet another (if I could keep track of numbers above five, I would offer a guess, but once I run out of fingers I lose track… all I know is, in the past ten months, I’ve had more than five nasty GI bugs), I get a direct pass to whatever specialist I want to see. No PCP, less than 24 hours for the right referral… how jealous are you?
So, a few weeks ago, I had yet another GI bug, and spent almost a week with no solids, few liquids, and no medications. Once I was starting to reenter the world of gastric consumption, I convinced my primary care physician – having been fired by my new pain clinic, because they couldn’t figure out any procedures to offer me and that looks bad on their statistics, right? – to restart me on the same opiates as before, but just over half the prior dosage. It just made sense to me: I had been at a certain level, and then post-March I had all of these abdominal scars and nastiness, and (surprise!) that hurt, so I would attend my monthly old pain clinic appointments and they would increase, and increase, and increase the dosage, until I was within spittin’ distance of the highest safest human consumption. So after a week off and reasonable confidence that I had done whatever withdrawing I was going to do, I decided that it was time to drop back to the pre-abdominal-surgeries dosage. I’m still not 100% healed, surgically, but close enough.
My doctor, whom I love even when she pisses me off, agreed. And within a week or so of the lower dosage, I realized, hmmmm… I never had pain in quite that spot before… not to mention, that’s awfully close to where the initial problems started, last March. I asked for a referral to the wound care guy I saw after MGH gave me MRSA (have I written all this out yet? I really probably should, at least to fill in the blanks… but, yes, last August, me and MRSA were like wicked BFFs for a while), and was granted an appointment.
I had a bad feeling about it, because any time you have a spot that causes both pain and numbness, that just doesn’t seem like a good thing. So I asked around, and Gretchen volunteered to take me to that appointment. I walked out with a diagnosis of a “1.5 by 0.7 solid cyst,” after the wound care guy – who, ohbytheway, also happens to be a vascular and oncological surgeon – gave the ultrasound technician a really effective ix-nay on the umor-tay look, when she mentioned, “Oh, look at that… there really is a tumor or something, right there where she said.” It was in a bad spot anyway – not like there’s a good spot for such a thing, but this was particularly delicate – and the only reason I caught her comment to the doctor was because I realized, within about 30 seconds of the start of it all, that I will never, ever have another fun, baby-peeking sort of ultrasound, and so I had stopped watching the screen and happened to be watching her face.
I had worked with this physician last year, from August to November, and so he already knew that my preference is to work as conservatively as is medically safe, rather than going in with a scalpel and a flamethrower. We agreed that he would prescribe a one-week dose of Keflex, a high-potency antibiotic in the warm-and-fuzzy cephalosporin family, just to see if maybe this was bacterial in nature. I went home, procrastinated for two days, and then started taking the medication on Sunday, January 16.
By January 18, the antibiotic had reached a fairly high blood level, and I had reached a fairly high delirium-level. (Did you know that antibiotics could cause that kind of side effect? And if so, how come you didn’t psychically let me know?? Because I had no idea, until I suddenly couldn’t name the day of the week, or figure out how to cook, or carry on an intelligent conversation, or any number of things that I can usually at least fake, if not fully pull off.) Happily, that delirium included not taking any more antibiotics – though I marked it off on my medication calendar, because my post-coma memory makes things like remembering four doses a day impossible, for that day plus two extra days into the future – and so by Wednesday the 19th I was as sane as I get, these days. Called that doctor’s nurse, because this was the only new medication I was playing with that particular week, and received exactly the feedback I expected: “For the love of God, woman, throw the rest out and don’t ever take that again!” And, lo and behold, it hasn’t happened again yet, though I’m not yet confident enough to use the word ever.
Anyway, I had already scheduled a follow-up appointment for January 28th, on the logic that this should give me the full course of antibiotics plus a few extra days for my body to adjust, and then we would figure out the next step. Full course or no, I kept that appointment – this time with my dad driving me, because I spent several days freaking out about it and I’m not a fabulous driver when freaking out – and he re-measured, and lo and behold… it shrunk. Not all-the-way, but down to half the prior size on its own, to the point that the doctor was willing to declare it a lymph node that had swollen on its own for no apparent reason. No more antibiotics, no need for a follow-up appointment as long as I continue to run a normal-range body temperature and no sign of acute inflammation.
I had been carrying that particular Big C around as a possibility for weeks, without fully acknowledging the anxiety and fear it caused… so I came home yesterday afternoon, spent some time with the kids and Willem, and went to bed early. I still haven’t fully wrapped my head around the non-scary (though vaguely irritating, because, as the doctor admitted, the coma and sepsis and such of last year has “screwed up” – an official medical term – my immune system, could be for another month, could be for the rest of my life, who knows?) just-a-lymph-node diagnosis. After all, as I asked Willem last night, “When is the last time I attended a doctor’s appointment and heard results that were better than mundane?” And I meant it: this was not a rhetorical question, I really cannot remember the last time I got news that was either same-old-same-old or worse-than-that.
So. Now what? I still can’t claim to have a whole week without appointments; just next week, I have one appointment with my therapist and two with different doctors. But all of those are routine sorts of things, nothing symptom-related or scary. And maybe, just maybe, I’ll be able to earmark a week in February without something new-and-different wrong with me.