The Medical Field . . . of Dreams

A Rant.  Well, not really a rant.  More like a caffeinated clamor.

Today I had a medical diagnostic test.  I say “today,” but technically it was yesterday since it’s now past midnight.  It’s past midnight because I spent most of the afternoon and evening, after being driven home by my sister, in my recliner sleeping off the wonderful sedative they gave me at the outpatient center.  The test I had is called an “upper endoscopy,” or EGD for short.  The EGD stands for esophagogastroduodenoscopy.  I only say that because I love medical terminology.  The reason I love it is probably because I think it makes me sound intelligent.  In reality, I know a vast majority of you couldn’t care less what EGD stands for, nor even that I had any kind of medical test at all unless it were something very serious.  But please hang with me for a little bit.  I will try to entertain you a little with my story, and in the process maybe even get you to care a little bit — not so much about me, but about the people you do know that have to navigate the healthcare system more than their fair share.

As I’ve briefly mentioned in previous posts, I have some, let’s call them, “health challenges.”  I like that term, because it makes me inwardly chuckle a little.  It has a ring of positivity and encouragement to it.  Much more so than if I were to say I have “health problems,” or that I’m in “poor health.”  Most people like a good challenge, right?  But nobody wants to have problems or be in a poor state of any kind.

Now I’d like to make a couple of disclaimers before I move forward here.  I hope to make it clear, first of all, that I have a great deal of compassion and empathy for those afflicted with health challenges that are far, far greater than mine.  I am a truly blessed person, and inordinately fortunate in what I have in this life.  With regard to health, for the most part I can function normally, or at least pretend to function normally, and I appear normal and healthy in most light-duty everyday pursuits, until fatigue or tremors set in.  Many, many people are far less fortunate than me in this regard, and have to deal with far more challenging, painful, or life-threatening conditions on a constant or day-to-day basis.  I’m not so vain as to think my relatively mild level of suffering is either unique or on a par with vast numbers of other souls around the planet.

Secondly, I’d like to make it clear that I respect doctors and other health care professionals in general, and a vast majority of those I’ve dealt with in particular.  In large part I truly believe these people are caring, knowledgeable, and really want to help.  I can’t help but poke fun at some of these individuals, however, in the sense that they are products of a system that I far too often find I lack respect for. (Don’t worry, writers out there, I read somewhere recently that it’s really okay to end a sentence with a preposition, something I’ve suspected all along.)

The test I had today was performed by a gastroenterologist, a specialist, a person with extra experience and credentials in his particular field of medicine having to do with guts.  The test procedure involved sticking a camera-and-toolbox-in-a-tube down my throat into said guts and having a look around.

This is the kind of test that I don’t mind, by the way.  Yes, they were sticking something into my body that did not naturally belong there.  But at least they sedated me for it, and I didn’t feel or remember one moment of unpleasantness.  And in addition, at least that foreign object they were introducing into my body was going in the right direction.  I think you get my meaning.

Prior to this procedure today, I have, over the course of decades, provided the medical field with a lengthy and comprehensive record of both major and minor medical abnormalities I’ve experienced over the years, along with lots of normal baseline information, and family history that could provide hereditary or genetic links to problems I may experience.  I have done my utmost over the years to keep this record on-going, continuous, complete, and available to any and all medical professionals who see to my care, whenever practical or possible.  I’m not hiding anything, people.  I want to give doctors every possible clue that could help them take care of me.  Everything from repeatedly requesting, calling, mailing signed permission slips, and driving to doctors’ offices and hospitals, to have records mailed or hand-carried personally or transmitted from one facility to another . . . all in order to provide that continuity of medical history, which I hoped would enable a continuity of care.  Still, even with all this work on everyone’s part to create, maintain, and propagate this huge mass of records, lab test results, imaging studies, signs, symptoms, exam findings, etc . . . and even with today’s data-keeping technology, computing power, secure file transfer capabilities, and other present-day forms of information management magic . . . even then, I still dutifully fill out new forms every time I am referred to a new provider or facility, forms that ask all the same questions over and over and over again, and rely on my memory of the moment instead of already written or digitized, and far more accurate and detailed information that is, or should be, one could argue, already instantly available to my every healthcare provider.

The medical building where I had my test today, I would like to add, is just across the street from my primary care physician’s building, where last week I saw said doctor, and also had an ultrasound of my abdomen done.  My doctor then referred me, over two business days ago, to this facility across the street to get my EGD test done today.

I am lying on a gurney this afternoon, prepped and ready for my procedure.  The gastroenterologist who has been assigned to perform my EGD stops by my nice, private, patient care cubicle to introduce himself, and apparently in 15 or so seconds familiarize himself with my half-century of medical history.

After politely telling me his name and shaking my hand, “So, we’re going to look in your stomach today,” he says.  (Unfortunately I cannot remember our exact words, but I will endeavor to make the conversation as close to reality and true-to-life as I can.)  “What kind of problem are you having?”

“Pain,” I said.  “Not bad, fairly mild.  Only a few days a week, but it can last for a few hours at a time, and it’s been going on about two months.”  I tried to describe the pain in pretty much the same way as I had described it last week to my primary care doctor and then the next day to the ultrasound technician, and then a third time fifteen minutes ago to the nurse who prepped me.  At the same time as I described my discomfort, I touched with my fingers the area near my upper right side where the pain seemed to originate, some eight or ten inches away from my stomach, the organ he seemed most interested in discussing.

We briefly discussed an over-the-counter medication I was already taking daily, prescribed to address mild acid reflux/heartburn and the resulting mild damage to my esophagus that had been found on a previous EGD I’d had a year and a half ago.  The doctor seemed quite interested in this, and reassured me again he’d have a look in my stomach.  Again, this concerned me, because my current pain complaint felt nothing like heartburn, nor was it anatomically anywhere near my stomach or esophagus.  Nor, by the way, was it anywhere near the “fullness” my primary care doctor had mentioned last week with some concern when he palpated my abdomen, right over the area of my pain.  Perhaps I would have felt better today had the gastroenterologist said, “I’m going to look in your tummy.”  Then at least I could imagine he was a pediatric gastroenterologist filling in for someone.

Next, the gastroenterologist asked me if I’d had any tests done prior to this, to investigate my pain, such as an x-ray or ultrasound.  (You mean like the ultrasound I had six days ago across the street? I thought.  But never mind that, I was just glad I was still awake and aware, not yet sedated, so that I could verbally make sure this specialist had all the information he wanted.)  “Yes,” I answered.  “I had an ultrasound last week.”

“And that was normal?” the gastroenterologist asked me.  Again, thank goodness I was awake for this consult.

“That’s what they told me,” I said.

By the way, I do want to explain further, in case I haven’t been all that clear, that doctors and I go a long way back.  I could probably write a thousand blogs about equally disturbing clashes with me and the medical field.  Well, maybe a hundred.  But I won’t put you through that.  I promise.  Maybe only one or two dozen, spread way out so you’ll forget about previous ones.  You see, I have a small but fairly comprehensive collection of health maladies, which feed on each other and, I think, end up amounting to more than the sum of their parts.  The four biggies I have are conditions called hemochromatosis, celiac disease, essential tremor, and depression.  There’s also a smattering of other things I deal with like recurring urinary tract infections, a couple of kidney stone episodes, some other other unexplained neurological symptoms . . . Yes, I’m a mess.  But what a blessed mess it is.

So, anyway, after my procedure, when I was conscious again, the doctor did explain that he took a couple of biopsy samples, one of them from the acid reflux damage to my esophagus, and one of them of a small polyp he found in my intestine.  So at least he did look beyond my stomach, closer, at least, to the area of my current pain.  And he did, also, give me something for that pain.  A prescription for heartburn medication.


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