Dr. Hughes and Tahoe
I went to a Denver neurologist two weeks ago whom I actually LIKED!!! This is a big deal. I was sick and tired of seeing Dr. Smith, the guy who asks how I’m doing and then acts surprised when I say I’m exhausted. “A lot of my patients complain of tiredness,” he said, “but I can’t figure out why.” Umm … yeah. It’s these darn STROKES I’ve been having. Imagine that! Sigh.
I went to Dr. Hughes at the recommendation of Dr. Ning, my doctor at Mass General, and my ob-gyns at the University of Colorado Hospital. (Dr. Hughes is also at UCH, which makes visits much easier and coordinating medicine a comparative breeze.)
I saw a resident first — they do all the grunt work. She gave me a neurological exam. “Geez louise,” Ben groaned when she finally left, “they do that EVERY time and never find any problems. Doesn’t that bother you?”
“Not the first time I see a doctor. It’s when they do it every time I see them and seem to gain confidence in ‘how much I’m improving’ that it gets to me. Dr. Smith did that a lot. Besides, I don’t know what my super-strong reflexes mean; I could still be beat up in that arena.” I forgot to ask about that, but it was pretty dramatic. The doctor would poke me real quick with her hammer and I’d practically kick her.
Dr. Hughes came in shortly after the resident left. He *smiled* and introduced himself. (He smiled! Two more brownie points right there.) “I’ve got a few questions for you.” I forgot what those questions WERE, but they were fairly insightful.
He was fairly disorganized / his conversation was disjoint. That’s the only negative I can come up with. For example, I asked, “If I have another stroke, is clot retrieval an option? Should I come to UCH instead of BCH?”
“Well, that depends. Now, you said you’re tired?” Hmm, I thought, that doesn’t sound like a related question. I gave him the benefit of the doubt and we talked about my exhaustion for a while. Finally, I asked again: “Um, I was wondering about this clot retrieval stuff. Is that an option for me or can you not do clot retrieval after someone’s already had a stroke?”
I got my answer. “Clot retrieval is a good option, but not all hospitals are set up for it. A general rule is that it’s good to get somewhere FAST instead of somewhere where they can do a specific procedure. Heparin administered right away is just as good as clot retrieval done later. Now, BCH is a stroke center, right? They set up a great program about ten years ago. There was a nurse named Dr. [X] who headed that program.” We said that we knew her; she’d introduced herself to me after my first stroke.
“Now, do you have your MRIs? I’d like to take a look at them to see what’s going on inside that head of yours.” Oopsie. I’d thought about it but was too tired to collect the stuff that the doctor would want to see.
He thinks that my stroke was caused by my PFO. “But it was small!” I protested, playing devil’s advocate.
“That’s how I like them. The small ones are hypothesized to allow clots to form around the edges; they release the clot and cause the stroke. A lot of older neurologists would tell you that you’ll be on lifelong anticoagulation; I think we can wean you off, if you’d like.” That stopped me for a minute. I’d prefer to stay on Plavix, I think. After being on JUST aspirin for five and a half months after my first stroke and then having another, I feel much more comfortable on a REAL blood thinner. However, getting off the Plavix would significantly reduce my risk of another GI bleed, so I see his point: if you don’t have to take Plavix/Aggrenox/Coumadin, don’t. But I really don’t want another stroke! He punted that conversation to another day, thank goodness.
Anyway, that’s my doctor. Overall, a great visit!
_______________
Last weekend, Ben and I headed to Tahoe to join our college buds for a mini-reunion. I was pretty nervous about the whole weekend in general: What if we went skiing and I couldn’t keep up? (Come on, Ben pleaded, that was always the case and nobody held it against you!) What about nighttime activities? I can’t do any of those anymore! I just need to go to bed! (Nobody’s going to care, he assured me. Which made me wonder, in my already compromised mood, if anybody cared that I was there at all …) What if Matt forgets that we need our own bedroom? (I’ve already talked to him, Ben promised; for the last time, chill out! We’ll have our own bedroom!) Finally, I told him the truth: I was worried that I was going to be upset with *myself* for not keeping up with the crowd.
“That’s a struggle you’re going to have to deal with,” he informed me. “It’s never going away. This is your disability; it is what it is. Why don’t you just come along, do what you can, and try to enjoy yourself?” I thought about it for a minute and then agreed.
Ten minutes later, of course, I asked him to email Matt about the bedroom. “NO!!!” he screamed. I turned back to my compter, pouting. Ten minutes later, I came back over to Ben’s computer and asked for a hug.
“I don’t know why I’m so nervous,” I whispered.
“It’s OK,” Ben said quietly, grasping me in a big bear hug. “It’ll work out. Some of our friends are doctors; they should understand.” They SHOULD, I thought, but that’s no guarantee that they will. Dr. Smith sure didn’t. “Besides, when have you known our group of friends to be judgemental?” Never, I admitted. Thus concluded my nervousness session.
Our flight was uneventful. When we arrived at Reno/Tahoe Internation Airport we stopped at In ‘N Out to get our fill of extraneous calories, then drove the 90 or so minutes to South Lake Tahoe. We turned left onto “our” street and got a view of the slopes … Oh.My.Goodness. There was a mogul field in view — and nothing else! — that went from the horizon up to infinity. Nearly vertically. It was terrifying!
Anyway, the GPS navigated us right to the door of our place and we went inside and greeted our friends. Matt is the Head Honcho; he got the place and arranged the food. He’s now a doctor of emergency pediatrics in Houston. Martin works for Pixar; he’s quiet but really nice. Arjun was in my class at Tech; he’s really cool. He’s in grad school in biology at UCSF. (I think that’s where he is, at least.) He brought his girlfriend, Elisabeth. Brian is a supersmart work-a-holic; he’s holding down a full-time job at Lockheed Martin AND attending grad school to get his PhD full-time. There were some other people, too: [Jon] Palma, Matt’s colleage at the hospital at Stanford, where they both performed their residencies, and Architect 1 and Architect 2. I can’t remember the architects’ real names, unfortunately, but they were Jason’s friends from architecture school. (And yes, I got permission to call them Architect 1 and Architect 2.) Jason couldn’t make it this year.
And then, after the “Hello!”s and introductions, Matt said, “Let me show you guys your room!” I could’ve kissed him. He remembered! It made such a difference to have a place that was quiet and OURS to retreat to. (Not that folks were noisy or anything …)
I went to bed fairly soon after that; I was going skiing in the morning! I had a good sleep. I woke up fairly early the next morning and got up to make breakfast: eggs and bacon! (More cheers to the Food Master, Matt!) Soon after, I got dressed and headed to the slopes with the group. We rode a gondola over the Terrible Mogulfield and headed off for a morning of skiing.
Now, if you’ll recall, I do ski in Nederland — just not very much at one time. 1 1/2 – 2 hours is my limit; after that, I’m pooped. I wasn’t expecting anything to change on this trip, and for the most part, it didn’t. However, I kept up with the group — that’s pretty cool! — for THREE HOURS. I even followed them down moguls. (That was not so cool.) Finally, we stopped for lunch.
If I were a doctor, I would LOVE talking about my work; Palma, not so much. I didn’t want to make him uncomfortable, but I really wanted to know more about how they assign the terrible hours I’ve heard about. “I don’t see why not!” he answered. Oh geez. Ben had said that he explained why I went to sleep so early last night.
“I have an invisible disability; I get tired very easily. If I haven’t slept well, if I’ve been doing “brain stuff” all morning, or sometimes for no reason AT ALL, I get exhausted. I don’t want to do a surgery rotation that starts at five in the morning; I’d probably literally kill somebody. For similar reasons, five hours is probably my limit … I couldn’t be ‘on’ longer than that.”
“Well … I think medical schools should be sensitive to students’ medical restrictions. What speciality would you want to go into? There are some specialties that don’t require ER work or surgery, which might be better.” He’s getting it, I thought!
“Neurology, I think. I’ve seen quite a few neurologists, and the majority of them have been complete and utter numbnuts. To the point of acknowleding my tiredness and saying that they don’t know what caused it. It’s very frustrating!” (Can you tell that telling me my tiredness is an enigma bothers me?) “Neurology requires an ER component, though,” I remembered.
“Yeah, I’d say that you could do it. I only work 36 hours/week now,” he said, as if that was an incredibly light load. I declined to tell him that I teach one class a day, four days a week, it can leave me exhausted, and I could MAYBE do a twenty-hour week. MAYBE.
“What courses do you have to take to get into med school?” I pressed.
“Hmm … organic chemistry, biochemistry, physics, and some math,” he answered. All I’d need to take is a little O-Chem and BioChem? I can do that!
From a tiredness perspective, I was barely holding on, so I stopped my questions there. I kissed Ben goodbye and headed back down the mountain to the security of our room, but getting there was a challenge. I can’t remember if I mentioned the “lost”-ness I experienced in San Fransisco after my first stroke, when I travelled there to attend GSA (the Geological Society of America’s annual meeting) so allow me to describe it to you: I couldn’t find ANYTHING. My hotel? Nope. I arrived at night and spent an HOUR looking for it. The pizza place? Similiar experience. I had just arrived, it was about eight o’clock at night, I was starving and trying desperately to find dinner. I ended up ordering in. The Moscone Center, where the conference was held? Same deal. It got so bad that when I took the bus back from the Golden Gate Bridge, I rode it all the way to the Moscone Center instead of getting off at the stop near my hotel so that I could retrace the route I knew that I knew. I was lost.
Now, if you will, picture the sparkling white slopes at Heavenly, and little Kathy standing in the middle of them. I knew I had to take at least two lifts to get back, so I got on the first one, right near our picnic spot. Up we went! Get off that lift and “ski down to the next one,” as Ben so helpfully put it. So I skied and skied and looked at my map and skied some more and finally stopped near a little terrain park, took out my map and almost started to cry. Several people almost ran into me, then cursed me for standing in their way. I finally managed to navigate my way down to the gondola that would lift me over the Terrible Mogulfield– there was no WAY I was skiing down that thing!
Haf an hour later, I wuz in da shuwer, using up yer hot watur.
Which brings to mind the plaque hanging in the bathroom, which I thought was the BOMB:
Ten rolled around; no Ben. Ten fifteen; no Ben. Ten thirty; no Ben. I decided to call him. No answer. Finally, at 10:45, he called me. “You called?” he said innocently.
“Yes, I did. Where are you? You said you’d be home at ten!”
“Oh. Sorry about that. I’m two blocks away. I’ll be in in just a minute.” I read him the riot act when he finally entered the room. In my defense, he WAS indeed late, and “Ten was a guesstimate!” doesn’t seem like much of an excuse, but in his, I was being pretty irrational. He left. I looked at my watch: eleven o’clock. Eleven fifteen. I got up and went down to the kitchen table, where he was playing a very involved game of Asshole.
“Can you please come back to the bedroom?” I pleaded.
“No! I can’t. I’d lose the game!” Screw the game, I thought. “Did you take a sleeping pill?”
“Please. It’s important.” He looked around at his friends, ignored their friendly but mean comments … and put his hand down.
“OK, I’ll come tuck you in again. For the last time!” I slunk away from the table and back into bed. Then, something amazing happened.
I cried.
I can’t remember the last time I cried. It’s been a while. The antidepressant I’m on surpresses my ability to cry — one of the many reasons I’d like to get off of it. I SO needed to have a good, self-indulgent, self-pitying cry.
“They think I’m a freak!” I bawled. “I can’t even go to the casino with them! They didn’t even ask me if I wanted to come! Maybe I shouldn’t blame them for not inviting me … I wouldn’t have invited me! I can’t keep up with them on the mountain, either! I feel so LAME.” I buried my tear-stained eyes in the pillow.
“Can you do me a favor?” Ben asked. “I’d like you to take deep breaths. Slow, deep breaths. That’s it … slow … good!” I picked my head up off the pillow and turned to look at him. My crying returned in a frenzy and I buried my face again. “Slow, deep breaths. Slow … slower … excellent!” He waited a few minutes for me to calm down.
“You are NOT a freak,” he assured me. “They didn’t ask you to the casino because I told them that you couldn’t come; I’m sorry if I said that in error.” It would’ve been nice to have been asked, I thought, though you knew what my answer would’ve been. No thanks. “As for skiing … how long do you normally ski for? 1 1/2 hours? And you did three today? I think that’s FANTASTIC! You really made an effort, and it paid off.” Oh yeah? Can I tell you about my adventures getting off the mountain? How I had no idea which direction our house was in? Or how to get there? “I didn’t know about all of that. However, you made it back safely, and I’m very proud of you.”
“Really?” I asked, picking my head up.
“Mmm-hmm,” he said in affirmation.
“Sometime I can’t tell. Tonight, for instance, you dropped me off in bed and then went to the casino and you didn’t come home until almost eleven. I felt kind of abandoned.”
“I’m sorry, sweetie. I was giving rides to a couple of people, and they were all playing [that stupid game's name I can't remember!] and didn’t want to leave. I wasn’t abandoning you … I just couldn’t abandon *them*.” Fair enough. “Do you think you could fall asleep now?” I nodded. “I LOVE you.”
“I love you too.” He closed the door behind him and I was out within ten minutes.
I didn’t tell you, Ben, how much it meant to me that you stayed with me. It was a stupid temper tantrum, for God’s sake, but it meant the world to me — both the crying and having you there to tell me that you were proud of me. Thank you.
The next day, I stayed home with Martin, victim of a busted knee. The forecast was calling for winds of up to ninety miles an hour at the top of the mountain, and I can’t stand wind. I sat in bed and watched more bad movies on the internet while drifting in and out of sleep. I made dinner when folks returned. Our Mexican menu consisted of rice, enchiladas, ground beef with onions in it, lettuce, tomatoes, avacados, and a loaf of bread that Don gave me at the last Lenten class I went to before the trip. (Which was a success, Don! Everybody loved it! Despite the fact that I’d transported it by stuffing it in my ski boot!) We watched “Harold and Kumar Go To White Castle” — a funny movie, but please don’t judge our intelligence by it — and then Ben and I went to bed.
We got up early to head to the airport. The Reno/Tahoe airport is like a miniature version of Vegas’s — slot machine galore all over. And guess who wanted to play! That’s right, ladies and gentlemen, Jake did. I handed him the quarter I received in exchange for turning in my luggage cart at DIA. “It only takes dollar bills,” Jake said plainly. “Can you please give me your wallet?”
“No, but I’ll give you a dollar.” I handed it to him. He pulled the lever and won three dollars! Way to go, Jake! Here he is, sitting proudly with his stash:
Back in Denver, Ben hopped on another flight — he spent the week in Wisconsin — and I waited for our luggage and lugged it back to the car.
I was happily reunited with my pups, and completely zonked. I went to bed and slept until 6:30 the next morning, at which time Zamba, the Princess of Getting Up Early, jumped up on the bed and rudely roused me from my slumber. I took them out, but my stomach really hurt. I couldn’t stand up straight. It looked like I was pregnant, the way my stomach stuck out like that. I went back to bed. When I woke again at 9:30, my stomach felt fine! I called in sick to work and spent the rest of the day doing Very Productive Things (VPT) like watching TV.
Thanks to you all for a wonderful ski trip! See you next year!
