Tuesday, December 27, 2011

Holy crap Batman!

I am fortunate to have good health insurance and make the effort to do all those routine screenings that doctors advise. Well most of those screenings.

So early in January I had my annual physical scheduled with my general practitioner. I had been keeping a list of my nagging little complaints, mainly a chronic low grade headache that I mentioned each year, but also an interesting chest pain that occurred during intense physical activity. I also needed to complain about how long it took to actually schedule this appointment - seven months! For a long established patient!

I expected this physical to be pretty routine just as all my exams have fortunately been. After *nicely* expressing my frustration over the scheduling of the appointment, my doctor decides to re-take my blood pressure. 190/95. Wow! I had noticed a trend over the past few months in exam rooms, my blood pressure was routinely about 150/85. None of the doctors mentioned any concern, I am sure they attributed it to 'white coat syndrome'. However I never felt anxious at routine medical exams. So I began tracking it at home. There it was typically 140/80. Certainly not normal. But 190/95??? Ever Mr. Cool, my doctor simply says, 'that's too high' and writes me a prescription for a blood pressure medication and tells me I can expect to be on this for the rest of my life.

He then tells me he wants me to have a cardiac stress test - the tread mill test - and a cardiac ultra sound. He hands me a lab slip for a complete blood workup and says his nurse will be right in to do an EKG and that I should come back in a month to review the test results.

The cardiac tests were both scheduled at the hospital conveniently on the same day. I even had the blood work completed that day too.

Back at my doctor's office - the cardiac tests are reviewed, treadmill test and echo cardiogram, both normal, just as I expected. However, the next conversation was a bit of a surprise.

Doctor - I want you to see a hematologist. Do you have anyone you prefer?
Me - Why?
Doctor - Your platelets are high and have been for a while.
Me - What??? Remind me please what platelets do.
Doctor - Your bone marrow makes red cells, white cells and platelets. Platelets clot the blood.

Next stop hematology.

Welcome to my life!

2011 is quickly drawing to a close and I am struck by the changes that have occurred in my life during the past year. I had been a happy boring patient with just a handful of routine medical visits per year. Now I am an exotic patient with a rare hematological malignancy and a bevy of specialists. Where do I begin?

September 2010
My summer vacation has ended and I resumed my work as a middle school counselor. Middle school - grades 6, 7 and 8. Roughly ages 11 to 15. I have a caseload of 300 students. I like to live dangerously. One day I heard an announcement over the building PA system, the school nurse was conducting annual vision and hearing screenings. Teachers were to bring their classes to the health room for each student to be screened.

I noticed recently a persistent ringing in both ears known as tinnitus and that more and more of my students seemed to mumble. Teachers too, especially women, loved to speak to me by simply moving their mouth. I guess I was suppose to read lips. I was growing weary asking people to repeat what they just said. I decided to pop into the health room and ask the nurse if she would do a hearing screening for me.

Nurse Kelly was very eager to accommodate my request. She brought me into her back room and had me put on a headset, then she fiddled with some nobs and told me to raise my hand when I heard a tone. In just a few minutes she had the results plotted out on a graph. There was a noticeable loss of hearing in a specific frequency in both ears. She recommended that I have it checked out further with an audiologist.

Fast forward through the next few months. I was seen by an ENT - ear, nose and throat specialist - who ruled out any physical problems and ordered a complete hearing test by his audiologist. These results were remarkably similar to the quick screening the school nurse completed. The ENT told me I had a sensori-neuro hearing loss usually seen in patients who have been endured chemotherapy or loud gun shots. I had experienced neither. He offered no thoughts on what could have caused the hearing loss but he assured me it was not the result of my daily exposure to hundreds of screaming middle school students in the gym or cafeteria.

So what did this all mean for me? The doctor said hearing aids would be too annoying. Only a very limited frequency was affected and the devices would amplify the sounds I can hear well. The doctor said I would have difficulty with soft voices, women and children, people with accents and conversations with background noise. He suggested I avoid those situations or try to minimize the distraction and come back next year for a follow up exam.

And so I began my journey on the MPN fast lane.