Saturday, August 7, 2010

Test Results

On Thursday, Ken, God bless him, drove me to my doctor. I had rehearsed what I was going to say in my head. I rehearse because my doctor, while very friendly, is always in a hurry. I try to figure out a way of telling him all my symptoms in as few words as possible before he dashes off to his next patient.

This time I was going to say: "I've been feeling progressively more tired for a month. I tried to push through it, but I can't even function at work anymore."

I made it to the doctor's office a few minutes late due to a nasty traffic jam. We would have been even later, but Ken knew a side-street shortcut. We drove the last mile catching air off speed bumps and doing the "rolling stop" through stop signs on a quiet residential street. When I finally got there I had only just selected a chair in the waiting room when I was called in to see the doctor.

"How are you doing?" he asked me.

"I've been feeling progressively more tired for a month," I said. As I drew breath to go on he said:

"Let me guess. You tried to push through it, but you just can't function anymore."

I was impressed. I guess he's seen this before. Glancing at my file, he seemed sure that it was my anemia. I'm not sure if I buy that. I've been technically anemic for a few years now, but I was never conscious of it affecting my energy. One's body adapts to a lower level of oxygenation over time.

"Well," he said, "let's see. What could be causing your fatigue?" He pulled out a blood test requisition form and started checking off almost every box on it. Curious though I am to know what's ailing me, I had to stop him.

"I've got to tell you," I said, "that the last time I had more than two vials of blood taken I felt fine going into the lab. But after they took my blood I got the shakes, and then I ran a fever for the next three days."

"In that case," said my doctor, taking a fresh lab req,"let's start with checking your iron, and then we'll move on to other tests only if it's necessary." He checked off two boxes on the paper and handed it to me. Two vials. That seemed reasonable.

When the lab was done with me, Ken and I stopped at a diner for some lunch. I kept trying to slide as far down in the booth as possible, so that I could rest my head on the back of the seat. So tired. I drifted off into a zone of no-thought. Then I caught myself trying to lie down on the seat. I stopped myself. People are going to think I'm stoned, I thought. I felt stoned. I picked at my lunch. Then Ken held my elbow as I shuffled to the car.

I called in for my test results the following day. The normal range for blood iron levels is 60 to 160 micrograms per decilitre of blood. My level is currently 15. That seems super-low. On the other hand, the first time the doctor ever tested my iron levels they were at 12, and I felt fine. Like I said, the body adapts.

So there are two possibilities. My iron levels had gone up with supplementation into the 20's last year. Maybe my body lost its ability to cope with less than that, and since the levels went back down, it's all useless and weak from lack of oxygen. The other possibility is that something else is wrong. My doctor said to take my iron supplement and come back in a month if I don't feel better. A month! I'd better feel better in a month. I can probably get paid for up to three weeks off work, if I pool all my sick days and vacation days for the rest of the year, but that's it. I could afford to take some unpaid leave too, but honestly I don't want to be away from work for that long.

I could go back to the doctor and request that he do the additional blood tests, but considering my anemia and my body's tendency to over-react to having blood drawn, that might just make my situation worse. The last time I had the bad reaction to a blood test was when I did two sets of blood tests only a couple of weeks apart. It was too much for my body to handle. So I should probably wait at least three weeks to recover from this round, and take my iron syrup, before I go back to get bled out some more. Gah.

The other consideration is that I've had multiple episodes of illness and extended fatigue in my lifetime, and all the tests available never yielded any answers. 19 times out of 20, my well-meaning doctors have had absolutely nothing to offer me by way of diagnosis or cure. In the end, there's nothing to be done but to wait it out. Eventually I always get better on my own. At least so far. Yet another reason not to be keen to get an entire pageful of tests.

I've never taken more than one week off work since I started working full-time when I was 23. Until now. I guess the "silver lining" is that my brain is as sedated as my body, so I don't even have the energy to feel bored. This week of doing absolutely nothing has flown by. I'm trying not to stress about my situation. If I have to be off work for an extended period of time, I may as well try to enjoy it. Relax, catch up on my reading, go for a shuffle outside when the weather is nice. I'll pretend I'm retired. Dang, my 94-year-old grandmother is more energetic than me right now.


Jameil said...

First, I'm really, really glad you spoke up for yourself when you saw him ordering all those labs. Now the tough love. Red, you have got to stop being so nice to the doctor who doesn't have time for you!! That's not okay!

You know what I think when I read your blog? She's sick all the time!! 12 & 15 are alarming numbers to me. Have you thought about seeing a blood specialist? You shouldn't be unable to function after having 2 vials drawn and knowing this they shouldn't just let you wander out to deal with it yourself. Thank God Ken is there for you but what if he wasn't?

Do you HAVE to go to this doctor? Can you find someone more nurturing? It sounds like you need at the very least someone you can take the list of your illnesses, many many tests and reactions to those tests so they can study your history and say, "You know what? This all traces back for a while and seems like it must be x. Here's what we can do for you." I hope it's something simple, but at the very least, you need to know. These quick pseudo fixes aren't good enough. You shouldn't have to drag yourself through life. You deserve more!! You see I get really upset about poor medical treatment.

Anonymous said...

I think I'm sort of with Jameil on this one, Spark. You need to have this addressed once and for all. I see your blog the same way Jameil does -- "She's always sick! Someone's not diagnosing her correctly!"

Seems to me you should be checked into a hospital for a week and have a battery of tests done then. But that's me, and I ain't no doctor.

Get better soon. I'll pray for you.

Claire said...

I think there's much to be said for what the two wise commenters above me said. I'm praying for you, sweetheart.


Warped Mind of Ron said...

If you get the impression that you are a mere pitstop on your doctor's list than a patient I agree change doctors. Certainly make sure he's taking all of this seriously!! Hope you are feeling better, eat an iron bar for me!!!

DarcsFalcon said...

Goodness hon, this is sounding more and more serious! Have they even told you what kind of anemia it is? Whether it's iron deficiency, or pernicious anemia, folic acid deficiency, internal bleeding ... it sounds like all they've done is throw some iron supplements your way and dismissed you until the next month when you're still not well. And you should be, with all the supplements you've taken. With all these tests you've mentioned, they should know the cause by now. Repeating the tests isn't going to help. Something different has to be done, because as Jameil said, you can't drag yourself through life.

Jenski said...

Yuck! I cannot imagine feeling that exhausted all the time with no real explanation. Ditto to everyone else - Maybe you can gather up the remains of your energy and with Ken see some more doctors to figure this out? Sounds like your body needs more than an iron supplement...super powers might help. ;-) Take care of yourself!

Kate said...

When I had meningitis, I had to go to the ER THREE TIMES for them to finally figure out what was wrong with me and when they did, bing, bang, boom, I was inpatient before I could blink an eye. But dude! THREE TIMES they missed something that could have killed me. Go back. Go back. Go back until you have answers.