Thursday, August 1, 2013

Into the System

I'm half-way between visits with Dr. Francis about my RA. It's been nice not to have to plan life around her visits. I do have minor flare-ups but I take it easy and, after a couple of days, it goes away. I sometimes get achy for, what I can determine, is no discernible reason but this is still new territory and will be for a couple more years.

What I have not counted on is the peripheral amount of time spent in various doctor offices having a variety of tests done under the guise of "maintenance". I remember having a friend who lives with a chronic illness complain about seeing yet another doctor. Today, I am saying I should be shamed for thinking to myself, "Just go. Why are you complaining?" I didn't know. I hadn't walked even so much as 15 feet in her shoes. I know now what it is like and I am not amused.

I understand the need to make sure you are in the best health you can be as you progress from one life stage to another. In my case, RA elevates your risk of heart attack. They do not know why, at this point, they just know it does. So, it does make sense to have a blood work panel done. And I guess it does make sense to see your general practitioner, the one who started this all, after not seeing him for 18 months. Yet, I'm really disliking all the people who are suddenly involved in my care.

My glucose and triglyceride levels are high. There is another doctor's appointment scheduled to address those. I believe it's because, at the time of the blood draw, I wasn't eating well. I'm eating much better and had the blood been drawn this week, I firmly believe the results would have been completely different. I'm going to push back on adding new drugs to the line-up I keep on the microwave. A drug is not always the answer. I think diet modification is the key here to lowering both of those numbers.

The nodules on the thyroid necessitated a trip to a specialist. "And why are you here to see me?" he asked. "I have nodules on my thyroid," I replied. He chuckled and said, "Who doesn't?", which made me feel that getting up at 5:45 to get to a 7:40 appointment with him only to be faced with filling out 8 pages of medical history, information that is available in my online profile to which he has access, worthless. I came really close to saying, "Why am I here then?" But he quickly added that, in my case, the nodules were at or over 2 centimeter in diameter which is grounds for doing a biopsy just to be sure. "95% of these are benign and of the 5% that aren't, the cure rate on thyroid cancer is 97%," he said. "I'm willing to bet your nodules are benign but we should look at them." Again, the word, "Why?" entered my mind. I realize, partially, that it is probably in my best interest to have this done but he only takes appointments from 8:30 to 1:30 and I refuse to miss work for this. I'll get it done on the end of my vacation, not an ideal time, either, but one that is better able to accommodate something like this.

I was asked if I have sleep apnea. Then I was told that my neck interior is a bit on the small side and my tonsils, which swell a little with age, were throttling my airway, probably making it tough to breathe. "I'm going to prescribe a sleep study for you. I think you should see about this."

Now, here's where I part company with the medical establishment. I have lost count the number of friends who have come back from a doctor's visit with the comment, "...and he wants me to have a sleep study." I remember, back in 2011, when I was being treated by an orthopedic surgeon for pain in my knees. He told me, "If any doctor tells you that you need your knees replaced, you come talk to me and you get two more opinions. I'm telling you right now, knee replacements are lucrative for doctors. I refuse to do it until there is absolutely no cartilage left in your knee and the joint is starting to deteriorate. Before then, it's just a money maker for a doctor. The rehabilitation for run of the mill replacement like that is excruciating and you are NOT a candidate for it." It was refreshing to hear such honesty and I wish this would come into play in the area of sleep.

Not all my friends have sleep apnea. I have friends who sleep deeply, friends who sleep lightly. I have friends who must have a completely pitch black room to sleep and some who can fall asleep anywhere at any time including broad daylight, and not because they are exhausted. They just have the capability to sleep wherever they are. I can't sleep well the first night I'm in a hotel room. It takes the second night for me to get comfortable with the noise and the feel of a different mattress. I can sleep like a rock or I can't get to sleep to save my soul. I'll have the weirdest dreams and the next night not remember anything. I have allergies and that contributes to snoring as does my weight gain. Sleep apnea, however...?

A friend who works in the medical field told me the usual treatment for sleep apnea, a C-Pap machine, is a lucrative money maker for a doctor or hospital. The sleep study is also a money maker requiring not a lot of personnel to watch the sleeper or to interpret the results. Therefore, I look at the sleep study in the same fashion as the orthopedist looked at knee replacements. If I really am having problems sleeping, waking up repeatedly in the night, feeling exhausted in the morning, then I may have a problem. Until that time comes, I am not interested in that kind of a study. Dr. Francis wants my eyes checked as that's where I first notice a flare-up; my eyes get very itchy and red. Dr. Burandt wants a colonoscipy. To me, these things are far more important than feeding the medical system for a sleep study. So, the next step is the thyroid biopsy. Then, when the results come back from that, I take the next step.

I guess, as one ages, more things simply start to wear out. Add a chronic or auto-immune disease to this and you find yourself in multiple doctors' offices. I'm still not used to the fact that I went from seeing the doctor every other year to seeing the doctor every four months and adding names to my list of physicians. I'm working on convincing myself that I'm doing what I need to in order to stay healthy, even if it does mean getting up at 5:45 in the morning for a 7:40 appointment.

Beverage:  Raspberry Seltzer


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