Today I went to the cardiologist. I was supposed to see him July 9; he called a week prior and cancelled. “Why?” I asked the receptionist who was the deliverer of the bad news.
“Uh … he can’t meet with you.” Duh.
“Yes. I’m wondering whether his grandma died or whether he simply decided to go on vacation.”
“You’ll have to speak to [somebody else].” Yeah, right. Somebody, anybody else. She patched me through.
“Hello there! I’ve been told that Dr. Unavailable can’t meet with me at my previously scheduled appointment. Do you know his reason for canceling with only a week’s notice?”
“Oh, that’s right. Hang on a sec, I’ll get you rescheduled right away –”
“Well, first I’d like to find out why he can’t meet me on the ninth.” And so it went. It turns out … drumroll, please … he’s on vacation! Bastard!
Do you know how difficult it is to make an appointment in Denver that I can actually keep? I no longer drive to Denver; Ben needs to be around to take me. That means no phone calls, no meetings, and no travel on that date. That’s hard to guarantee! Of course, I need to be free as well, which normally isn’t a problem except that this week is Vacation Bible School, which I’ve gotten sucked in to. I needed to find replacement craft teachers — not as hard as making sure my husband’s around, but annoying nonetheless.
After several failed attempts — meaning, several “We’ve got an 8:45am on Thursdays”, which is not going to work when it takes me an hour and a half to get to his office — I finally got my appointment rescheduled. Then, I remembered that I needed an echo, too.
“Um … OK,” the receptionist sighed. “How’s 9am on Tuesday?” I sighed, re-explained that it takes me an hour and a half to reach the office and that I DON’T DRIVE and therefore CAN’T MAKE TWO TRIPS. We eventually got my appointments rescheduled for today.
Then, at the crack of dawn on July 8, I got an automated call from the doctor’s office reminding me of my echo scheduled for tomorrow. I called back and practically screamed at the poor lady on the phone. “Hello. I just got a phone call reminding me of an appointment that no longer exists. Dr. Unavailable is going on vacation and won’t meet me tomorrow, so I moved my appointments to later in the month.”
“Let me put you on hold.” Cue ten minutes of terrible elevator music, punctuated all too often by healthy eating class announcements.
“OK, I see that you do indeed have another echo scheduled. You’re all set. See you on the 28th!”
That was, thank goodness, the last of my scheduling problems. Bashing my head against the wall may leave a few marks, but …
**********
So today, we got up at 9am to get ready, got in the car at 10:15, and drove down the canyon.
Yes, I did say it takes an hour and a half to get there; Ben just didn’t want to leave quite so early. I wasn’t terribly concerned about arriving late. The problem was that we got a poker in front of us driving 30mph down the twists and turns. He didn’t pull over.
We arrived a couple of minutes late, which worked out fine because they weren’t ready for us yet.
I was escorted back to an exam room, told to take off all my clothes above my waist and put on a gown. I did. Then, before I had a chance to say anything, the lady doing the exam — let’s call her Janelle — slapped a [sticky pad with a metal snap on it -- I don't know what they're called] on me. “Wait!” I exclaimed. She paused, the next one in her hand.
“Yes?”
“Do you have any pediatric versions of those? I can’t ever seem to manage to get those off.” For some reason, the kids’ ones are MUCH less sticky.
“No, I’m afraid you’re stuck with these.”
“Shoot. Could you at least take these off before I leave?”
“Oh, sure. They get stickier the longer you leave them on, don’t they?”
“You betcha!” I laughed. Janelle should be promoted above the doctors on the scale of “Niceness to Patients,” I thought.
She had me slip my left arm out of my gown and lie down to begin the exam. Echocardiograms are a very noninvasive, painless, boring exams, but I was really uncomfortable. I couldn’t figure out why I was so nervous.
Then it hit me: it was during this exact same exam six months ago that I was alerted that Annie was sick. During pregnancy, they call it a “fetal echocardiogram”, but it’s the same equipment. And during Annie’s, the tech simply looked and looked and looked for her heart valves until Ben asked her what she was doing.
“I’m looking for her heart valves. I don’t see them,” was the tech’s response.
I was suddenly worried that Janelle would find my heart simply incompatible with life. “Is it normal?” I asked halfway through the exam.
“The results should be read this afternoon,” she told me.
“But you know what they are.” It was a statement, not a question.
“Yes, I do.” I frowned and considered telling her why I was asking, but decided against it. Ben was watching from the corner and I didn’t want to make him uncomfortable.
“Why can’t you tell me? Is it the lawyers?”
“Yes, it is. I’m not a doctor; I’m not allowed tell you anything that will impact your life. My job is just to look.” She looked at me and must have registered my concern, because she continued in a soft voice, “But I wouldn’t worry.”
The whole test took probably 20 minutes. When we were done and I was dressed again, Ben and I went to Taste of Philly for some delicious cheesesteak sandwiches; it was the highlight of my day!
We were due at Dr. Unavailable’s office at 1:30, and we arrived in time! I filled out the crappy paperwork (well, OK, Ben did) and then … I waited. At 1:50, a drug rep walked in. I am constantly amazed at how uniformly BEAUTIFUL those stupid cheerleaders are. She wore a tight-fitting skirt and three inch heels. She greeted the receptionist and walked right back to the exam rooms. I glared at her.
At 2:00, we were finally escorted back to our exam room. At 2:10, Ben got up on the exam table and began a nap. At 2:30, Dr. Unavailable finally knocked on the door.
Now, at home and relaxed, I can think of several ways to greet him. “How was your vacation?” is one of them. “Could I be a drug rep? I don’t like to wait around …” is the other. Unfortunately, in the moment, all I had the guts to say was, “Come in.”
We went through all the hand-shaking and polite stuff you’re supposed to do. Then, Dr. Unavailable asked me what was new.
“Well, I got pregnant in September and we lost the baby in February.” I said it completely devoid of emotion — it was a medical fact to be shared, not something I wanted to tell him.
“I’m sorry to hear that. What happened?”
“She had mosaic trisomy 6.”
“So nothing hypercoagulable?”
I shook my head.
“How are you doing otherwise?”
“OK, I guess.”
“Are you working?”
“No.” I HATE it when people ask me if I’ve gotten a job yet. No, I haven’t. Am I looking for a job? No. Is it because employment is difficult to come by these days? That’s part of it — but no, not really.
It’s because I’m exhausted. ALL THE TIME. All day, every day. Most employers look for someone who won’t poop out on them at the end of a four-hour shift. Who won’t go home and fall asleep watching reruns of Law and Order every day. Who will always have enough energy to greet customers — or students, or geologists — politely. Someone who doesn’t have to worry about driving home after the shift because she’s worn out.
It’s not a physical tiredness. Now, I would kill to be physically tired. There was one day, before my sophomore year at Tech, on the Y-Hike, when I hiked 26 miles up the summit of the highest peak in the lower 48. I came back to camp, ate dinner, and went to bed. It was fantastic! I was a little sore the following day, but overall? I loved it.
Now, I can’t get to that point. My mind gives out before my body does. Two hours of VBS kids yelling and screaming and throwing their craft materials around? I go home and am DONE for the day.
There are more reasons, like my handwriting, but the fatigue is sufficient.
I would LIKE to have a job. I’ve thought about being a doctor or a professor or a high school teacher. And then I remember that I’ve already been a high school teacher … and I was terrible at it. School — second period, that is — started too early. The kids were too noisy. I came home exhausted. My handwriting on the board was okay, but the kids whined about tiny my comments on their papers. Oh, and I had that nasty GI bleed, and after that? Well, the depression resulting from yet another wishy-washy diagnosis, this time of Crohn’s Disease, combined with the physical exhaustion from the blood loss, rendered me a couch potato.
So, when Dr. Unavailable asked me if I had a job, I wasn’t in the best mood to give a good answer. He followed up.
“Why not? Is it the job market? What’s stopping you?”
“It’s not the job market, though it is difficult to find a good fit for me. What’s stopping me is my fatigue. I’m exhausted.”
“But your echo showed that your heart is in excellent condition! There’s no reason I can see that you should be so tired.”
“Oh, I know. It’s mental fatigue. It’s my brain.”
“Oh.”
And the rest of the appointment was downhill from there.
“I see no reason, from a cardiac perspective, for you to be on any blood thinners anymore.”
“Uh … I feel much more comfortable with *something* besides the occluder preventing more strokes.”
“OK, but just in case anybody asks, I say you can get off of them.”
“I don’t want to get off of them.”
“I know, but there’s no reason for you to be on them from a cardiac perspective. Perhaps your neurologist wants you to be on them; I don’t know.”
“If I have another stroke, just let me die. I don’t want to go through that recovery ever again. As I see it, there are two potential reasons why I haven’t had any more strokes since 2006: the occluder has buttoned up my heart or the blood thinners have saved me. I don’t know which it is. I don’t think anybody ever can. I’m will continue to take the Plavix, thank you very much.”
Ben pointed out later that, though this is an important conversation to have with my neurologist, it’s probably kind of pointless to have with my cardiologist, because I’ll never see him in the ER if I have another stroke. I concede that.
Then, to top it all off, he started telling me that my risk of recurrence was very low. “It’s in the 1% range.”
“I don’t consider that to be low.”
“Oh, I do. Imagine you had a hundred pennies and put put an “X” on one of them. Then, imagine you poured them into a big container. You’d never pull out the penny with the “X” on it the first time.” What the heck does he think I think “1%” means?!?! 1:10? 1:20? I’m not stupid!
“My chances of having a stroke at the age of 24 were 1:10,000. My chances of recurrence — twice — were probably one in a million. So while it’s good that you consider my chances of having another stroke to be slim, I’m not holding my breath.”
**********
July 28, 2010
Dear Annie,
Today is one of those days when my grief got the better of me, I think. I was tired and grumpy all day. I had a terrible doctor’s visit.
I miss you. I’m frustrated that I can’t walk into to my echocardiogram appointment and tell the tech that YOU had one of these and it didn’t go very well and I’m freaked out about it. I’m frustrated that I can’t lift you up and tell everybody and their brother how wonderful you were. I’m especially frustrated that I never got to see with my own eyes and ears how super you were — how kind, how loving, how special.
But I know that you were. I can’t wait to meet you, one day, up in Heaven.
Love,
Mommy
