Angst

Nice relapse yesterday. Felt amazingly terrible all day. Damn it, this (whatever this is) couldn’t happen at a worse time. We have two projects in house and yesterday a potential new client called to inquire if we could work on his business’s entire opus. Since he’s been around for a while, there’s a lot of it.

This is exactly the kind of customer we’ve been praying for: a business whose needs can occupy us for a long time, and that’s likely to bring in enough revenue to contribute significantly toward our goal of having The Copyeditor’s Desk generate an income that both of us can actually live on.

Yesterday I called Young Dr. Kildare’s office and described the continuing onslaught of symptoms, which are not really helped significantly by large doses of meds. The only thing that helps is not eating, the result of which has been that I’ve lost seven pounds in seven days. That’s nice, since I’ve never been so fat in my life. But I’d kind of like to have more control over the process… He immediately had his underlings refer me to a gastroenterologist for the dreaded endoscopy. So obviously I’m not going to get out of that, and since they have to knock you out for the light-show, it will consume an entire day of my work schedule. And if they find anything significant, of course, it will consume the rest of my (not very lengthy) life.

YDK called last night after working hours, obviously concerned. I observed that one of my complaints is consistently listed as a symptom of gastric cancer and never as either of the two other possible ailments. He asked me to stop reading Internet sites and said indeed that particular part of the bellyache also can manifest itself with GERD and with peptic ulcer. Or a hiatal hernia.

My mother had a hernia. The resulting surgery was not minor. Had her in the hospital the better part of a week (true—that was in the day when we actually took care of surgery patients, which we don’t anymore), and it took about three months for her to recover. She never did fully recover, come to think of it. From that point on, it was pretty much a long, slow, downhill slide.

To complicate matters, the urchins turned in a raft of in-class diagnostic essays that I have to turn around before Monday, and another client sent a wad of copy to read. I don’t even know which one to try to move first. Guess I need to write a to-do list to keep this sh!t under control. As best as anything can be brought under control. Which isn’t very “best.”

Why do we labor under the illusion that life ever is under control?

Hm. I suppose it’s a survival adaptation. If we fully appreciated how random and pointless it all is, we’d go mad. What creature would put out the amount of energy and work required to stay alive if it thought food and mates and shelter came its way more by chance than by its own efforts?

I wonder if an amoeba believes it has some control over the environment it swims through. Probably does.

Well, it’s already after 5:00 a.m. Since I’ve got to arrive at an office halfway to Casa Grande by 9:30, I’d probably better try to work on at least one of those projects before any more time passes.

So a fine flare-up of a chronic bellyache sends me to the Mayo’s ER with chest pains. Six hours of idling around that place in some discomfort yields the discovery that I have not ever had and am not now having a heart attack. The ER doc diagnoses GERD and a probable ulcer, and urges me to make an appointment with a regular doctor.

Now, the problem is, the part of the Mayo that houses its doctors’ offices is halfway to Payson from my house: twenty miles one-way, an hour’s drive through thick traffic.

Anyway, concerned about the possibility of an ulcer, I present myself to yet another new-to-me doctor (you never see the same doctor twice out there). She decides that I need an endoscopy with biopsies for H. pylori and cancer. This unpleasant test entails knocking you out, stuffing a tube down your throat, and cutting a sample out of your stomach lining.  Obviously, since they drug you into oblivion, you can’t drive home.

So I start searching for someone to drive me out there. La Maya is in full crisis mode just now. KJG lives halfway to Yuma on the other side of the valley; asking her to drive to the Mayo would be like asking her to drive to Albuquerque. My son has a difficult time getting off work; besides, I’d just as soon he doesn’t find out about this until I learn what the hell we’re talking about. I call the church and at first am rebuffed, but then reach the head of the health-care ministry, who launches into a full-bore search for someone to make the 40-mile drive with me.

Time passes. Eventually, I calm down enough to think this through.

Item: The Mayo does not take Medicare assignment. This means that Medicare and Medigap will only reimburse—me, not the clinic—for the amounts they unilaterally decide services and procedures are worth. The Mayo will send the bills to Medicare but will not accept reimbursement. This means you have to pay the up front and then collect whatever Medicare and a Medigap insurer will disburse, which comes in little dribs and drabs of $30 or $40 over a period of several weeks, always long after the bill is due.

I figure an endoscopy and two biopsies are going to be bloody expensive. I also despair of finding someone to drive me out there, and I sure as hell can’t afford a taxi, which at best, with the senior citizen discount, would run over $80. A Mayo phone lady seriously suggests I rent a room at the Marriott next to the hospital, for a mere $100 a night, two-night minimum.

So it now occurs to me that really, if I need this procedure, there’s no reason to have it done at the Mayo. Why not find a provider who will accept Medicare assignment and then just have them send the results over to my doctors? Besides, wouldn’t it be better to have a doctor close to hand who can see me for routine issues, rather than having to drive all the way out to Taliesin West for every sniffle and bellyache?

At Angie’s List I find one, count it one, medical practice that’s universally lauded and is not in Scottsdale or way over on the far west side. Make an appointment. Get in forthwith to see a brand-new young doctor. He’s a DO, not an MD, but the old guys who do have MDs aren’t taking new patients, and since he’s the new kid in the practice I figure he’s probably consulting with the bosses, at least until they’re sure he’s not going to kill anyone.

Young Dr. Kildare, as it develops, is an absolute charmer about my son’s age. We discuss my various complaints.

He expresses surprise that the Mayo doc even brought up the prospect of cancer with me, much less went into detail about staging, surgery, and chemotherapy. Gastric cancer, he says, manifests several other symptoms that I don’t have, such as swollen lymph  nodes, bleeding, and weight loss. He says he’s certain that it’s GERD, about which he knows quite a lot because he suffers with it, too. It is possible, he thinks, that an ulcer is forming and suggests doubling up on the omeprazole, which he says needs to be used for three or four months to get the situation fully under control. At this time, he says, an endoscopy is unnecessary. Instead, he thinks it would be better to continue the drug treatment for a few weeks, especially since the ailment is starting to settle down. If, however, break-through symptoms persist, he will want to do an upper GI series or an endoscopy. But not now. Come back in six weeks.

Meanwhile, he suggests I stay off the sauce, refrain from eating large meals, never eat late in the evening, lose weight, and get some exercise.

Huh. Whaddaya make of that?

Sure sounds like I was about to be subjected to some serious medical overkill, doesn’t it? Anyway, the tests are off until we find out whether the omeprazole (which is generic Prilosec) kicks in and and gets this thing under control. There may yet be a tube down the throat in the future, but at least now I should be able to keep the cost of it under control.

And so to the pool, for some of the prescribed exercise…

Image: Flexible endoscope. de:Benutzer:Kalumet. Creative Commons Attribution-Share Alike 3.0 Unported license.

Who was young Dr. Kildare?

So it was off to a specialist this morning, a pulmonologist recommended by a friend on the choir, who herself is an RN. He, I discovered when I got there, managed to get himself on Phoenix Magazine’s “Top Docs” list in 2011, for whatever that’s worth.

At any rate, his office proved to be very professional and efficient. They got me in to see him today when I called yesterday morning, which has to be some sort of all-time speed record for an American doctor’s office. At the Mayo, I couldn’t even get past the gate-keepers the last time I called–their phone answering lady just left me hanging, to suffer over the weekend and beyond.

He did some breathing tests and asked a wide variety of questions. Tentatively his theory is that it’s either a chronic bronchitis that began with a viral infection six weeks ago or is Valley fever. He’s redoing the Valley fever test, on the theory that antibodies often don’t show up until a month or more after the infection; however, when I said I’d tested positive in my 20s, he remarked that probably, then, this is not Valley fever. That notwithstanding, as long as he’s bleeding me anyway, he ordered the test.

He also is testing for a variety of other ailments and signs of asthma and allergies; next week he wants to do allergy tests.

Let’s hope he doesn’t decide I’m allergic to Cassie!

Never have had a problem with dogs before, though long-term exposure to cats gives me a chronic stuffy head. I had no idea it wasn’t normal for one’s nose to be plugged up until I left my husband and his houseful of cats. After I’d been away for a while, one day it dawned on me…hey! my head isn’t stuffy all the time. Since then I’ve avoided puddy tats.

At any rate, the new doc came forth with a packet of Prednisone pills considerably less powerful than the ones the Mayo’s ER doc gave me, and he said that yes, they would disarm my immune system, but not enough to cause a clinical immunocompromise. He felt that no matter what I might be infected with, the stuff would be safe to take in the short term.

He also thought I should start the antibiotic she gave me, but was puzzled when I told him she said I should do the Prednisone first and then if that didn’t work I should take the antibiotic. He said for acute bronchitis you’re supposed to take them together. And also swallow some Prilosec to try to control the bellyache these drugs will cause.

So in the course of two hours, I’ve gone from no drugs to three drugs a day

He said that even though the antibiotic is in the same family with erythromycin, which has caused some untoward effects in my body, 80 percent of people who have a bad reaction to erythromycin can tolerate this stuff. I pointed out that if a drug has a weird side effect, any weird side effect, I inevitably am gonna get it. He said if anything uncomfortable arises, just quit taking the stuff.

Meanwhile last night when I dragged out to the mailbox, what should I find but a jury summons.

Damn.

Actually, I don’t mind serving on a jury—or wouldn’t, if I ever got past the stage of wasting eight hours in the court’s waiting room. But the problem right now is that if I miss a day of class, my pay is docked, no ifs ands or buts. I’m trying to get the District to come forth with a written statement of that policy, but the woman in the District office the college told me to call can’t be bothered to return my call.

Ideally, I would like to get myself excused from this recurring hassle. But if I can’t get her off the dime, it is at least possible to ask for a postponement, and apparently you can even go online and ask for a specific date. So if I can, I’ll just push it forward to this summer, which at least would give a week or two on which to serve, in the unlikely event that I’m called.

People with PhD’s by and large are not regarded by lawyers as any client’s “peers,” so in all these years I’ve never made it on to a jury.

A friend of mine did, though. The judge told the jury to expect the trial to last a couple of days. Two weeks later it was still dragging on!

She was teaching, too, but at GDU no one pays much attention to whether you’re there or not, and so she at least didn’t get the financial shaft. And she taught poli sci, not writing courses, making it possible for her to send her friends to the classroom bearing videos to keep the kiddies busy.

I, on the other hand, will simply lose my paycheck if I’m forced to serve on a jury.

The other concern is that experience shows the various courts are using the same rotating call-up list. You get called for Superior Court, then City Court, then Federal Court, then the Grand Jury. A summons to the Grand Jury is really bad news, because you’re shanghaied not for a week or two but for many, many  months, during which you’re on call and have to show up at the drop of a proverbial hat to proceedings that can last for lengthy periods. So I can expect at least two and possibly three more of these little headaches to show up in the mail within the next few weeks. Goodie!

Well, a ton of copy awaits. And so, to work…