Tuesday, January 27, 2015

Appointment with the ENT.

January 27, 2015

I went to my room at around 10:30 last night intending to read The Penultimate Truth by Philip K. Dick and wound up instead falling asleep. I woke up around 7:00 this morning. Yesterday was a big day, the day of my appointment with an Ears, Nose, and Throat specialist to get a more in-depth reading of my results and discuss the next steps.

The office is located in Providence Medical Center in the Hollywood district of Portland, which happens to be my favourite neighbourhood in the city. It’s got my favouritest movie theatre ever (the Hollywood Theatre!!), a Trader Joe’s, a Whole Foods, a farmer’s market when the season’s in, my gym, a Things From Another World, and a major transit center with several buses and three trains that stop there. There are also two martial arts studios (hapkido and jujitsu), my favourite Starbucks, the hospital, and at least one urgent care center… It’s pretty much awesome. Of course, everyone wants to live there so rent is like holy moly guacamole high. Maybe some day!

Anyway, I hopped on the train and headed to the medical center a bit early. I’m usually early to whatever appointments I have simply because I use public transportation and I want to make sure to leave room for whatever might come up. I was early enough that the office was still out to lunch!


The view from the sixth floor of Providence Medical Center. If I were to zoom in, you'd see Mount Hood.

Eventually, they let us in and I filled out the new, establishing paperwork for the office - medical history, symptoms, etc. They got me in quickly and the doctor came in soon thereafter. 

Doctor's office selfie.

I’ll call him Dr. Green. He looked a bit like my pediatric physician from Ohio mixed with a relative of mine, except he's not as tall as either of those gentlemen. He took a seat and the first thing we talked about was how they didn’t take samples of the left side lump that feels a bit harder than the rest, but he said that it was okay, they didn’t have to. He said that the tumours are benign and the thyroid is functioning normally so I don’t need to take thyroid pills. Fantastic news!

He then said that the right side tumour is 2 cm or half a centimetre away from being an inch big. Since it’s benign, if it were three centimetres, or just over an inch, then he’d recommend surgery. If it gets bigger over the next year, changes shape, or changes make-up, then I go under the scalpel, but until then, it's all good. Also fantastic news!

He said, firmly, that the thyroid isn’t what’s causing my exhaustion, my throat and voice issues, or anything else and prescribed me a nasal spray for allergies / post nasal drip and recommended that I do a neti pot nasal cleanse. 

While, on the surface, this is great news, it feels anticlimactic. Here I was, thinking and hoping I was going to have potential answers for issues that don’t feel normal for me, and instead, it feels like they’re telling me it really IS all in my head, that I’m weak or lazy and to just get over it, all of the things I’ve been telling myself for years even though this just doesn’t feel right. It’s no wonder that people don’t really talk to their doctors, they don’t want their issues to be discounted or to be told, even if the wording is different, that everything really is all in their head.

I don’t have the numeric results from the biopsy, just the biopsy report, and after talking to a friend who has similar issues, I wonder if I’m on the verge of Hashimoto’s, but because I’m not off the chart yet, they’re not going to diagnose and treat. I understand that they don’t want to treat someone for something they don’t have, that would be ridiculous, but what if I’m close enough to the edge that for my body and my endocrine system, I might as well be diagnosed and treated before it gets worse because it’s not being treated. So, my plan is to get a blood test in a week or two to see what my thyroid levels are as a sort of second opinion. In the meanwhile, I’ll just keep pushing, like I always do and always have. I have too many stories trying to get out and movies that want to be made and too much coming up to just let it be and “wait and see”. 

When I was a kid, it took the doctors seven years before they formally diagnosed me as being an asthmatic. During those seven years, I was in and out of hospitals with adrenaline shots and steroid pills and breathing treatments and somophyllin, a medicine that they knew was toxic, particularly to kids, and which made my heart race and limbs shake. I was constantly sick, constantly missing school. That was my wait and see. Pardon my language here, but FUCK THAT NOISE. I don't want to go through that again. Let’s get this sorted and get to feeling better!!

A beautiful sunset in the Hollywood district. Why? Because it's purdy.

After the appointment, I went to Starbucks and wrote for a while. It felt good to move forward on creative stuff in spite of feeling a bit foggy... Then I came home, relaxed for a minute, and went to bed at 10:30, feeling like a lil ol' lady and feeling like I've gotta get ready for a battle.


Marguerite Barnett said...

Most doctors don't mean to make patients feel discounted but a good deal of what we deal with are symptoms for which we have no treatments. Fatigue for instance (once we have ruled out diseases we can treat such as cancers or vitamin deficiencies) is a real stumper. Certainly your thyroid cannot be called normal as it has lumps but its function as best as can be ascertained is within normal limits, so to treat it risks toxicity and side effects of medication. Too much thyroid medication can cause heart issues or strokes. Generalized aches and pains, brain fuzz and other such poorly understood symptoms are really problematic for doctors; we see them all the time and don't know what to do about it. We can embark on a mega-work up to try and find rare diseases but that's expensive and sometimes painful and frequently results in some red herring results which require further studies which in turn have their risks and so on and so forth. We wonder why health insurance costs so much in the USA! Meanwhile the powers that be have determined to cut costs by making me jump through increasingly complicated hoops to try and help my patients or just outright denying coverage for many of these tests/treatments to the point where i am just trying to focus on making sure that i don't let anyone die. It's a balancing act and i'm the first to admit that i don't do a good job at it, but who would under the circumstances? So here's what i've learned as a provider/patient: I have to take charge of my health- most doctors are not able to do anything but the worst of disease. It's simple but not easy- kinda like the stuff your mama preached-eat well, get plenty of sleep, exercise and keep clean of toxins. By eating well, i've come to realize that we are omnivores and many people have some extreme diets they think are healthy but are not best for their body's needs. The simplest rules are to eat whole foods as opposed to processed foods, mostly plants and to try and minimize sugars and additives. Most people cannot get the nutrients (especially vitamin B12) they need without some meat but we eat far too much in this country. EXERCISE! This is so hard for me because of time constraints but so important even if it's just walking. Sleep is greatly underdone in modern society because we are on our digital screens late into the night, working and the blue light affects our melatonin product in a negative way and if we don't sleep, we can't repair our bodies and it becomes a vicious cycle. We try to jump-start our systems with stimulants like caffeine and sugar and then we crash and again enter the cycles. And when i lived up north, i did not get enough sunlight (i still don't) so i was low on Vitamen D and that leads to some yechy symptoms. And finally, i had to learn how to keep in balance mentally, emotionally and spiritually because all of these aspects of the psyche are intertwined with the physical. Haven't had much luck with organized religion but some practices such as breathing/meditation have been useful and i've occasionally found that talk therapy has been helpful not because it's all in my head but sometimes it helps to see things from a different perspective. And lastly, i really find that body work, i.e. massage, has been a life-saver. i don't know if it relieves stress or what, but it really helps me recharge. And NONE of the above things were ever taught in medical school! Good luck in your journey to health!

Lori said...

Hi Marguerite!

Yeah, believe me, I know. I think we're all up against a rock and a hard place. One of the very few things I don't do that you listed is that I don't eat meat consistently, but I have a B12 sublingual supplement (that I also don't take consistently because Vitamin C lessens its absorption and the times I remember to take it are the times where I am about to drink orange juice or take Vitamin C.) I haven't gone to the gym in a while because of scheduling and tiredness so I do need to remedy that.

I haven't had caffeine (on purpose) in five years and while I drink mainly water, I do drink some sugary drinks like fruit juices and a vanilla bean frappuchino (no caffeine) when I go to Starbucks.

As for sleep, I get anywhere from six to eight hours of sleep a night and I still feel like a truck hit me in the morning. I try to read before going to bed, but I also like playing a word game on my phone before sleep. I talked to a friend and discovered that this is what a hangover feels like...HA! Well, minus the headache. Geez Louise Mr. Freeze. And I don't drink!

Thank you for the advice and the point of view, though! I appreciate it!