2018 in Review: Medical Care

Oh, 2018.  When I look back on the time we’ve experienced together, I think of all the medical hoops: insurance changes, doctor changes, so many tests, so much pain, and my new diagnoses.  I am extraordinarily grateful for the diligent, hard-working, and inquisitive doctors who manage my care and for the insurance that means I can afford all the tests, medicines, and doctors’ visits I’ve had.  Let’s recap.

This year, as President-Elect of the Ethical Society, I did much of the prep-work to launch the Society’s pledge campaign.  I was doing many things differently than had been done in the recent past, which caused more work for me and increased my stress level dramatically.  Let’s be clear.  Running a campaign is a lot of work and it was going to increase my stress level anyway, but I was especially worried about some of the changes and whether I was financially gambling with the Society’s income stream.  I have a motto: “only worry about things you have control over and, if you have control over it, work so that you don’t have to worry about it.”  So, I worked a lot, December – March, running this campaign.  I ended up in the ER, convinced that I had developed ulcers from the stress.  In January, the doctor diagnosed me with GERD (a fancy name for acid reflux), prescribed me meds, put me a strict low-acid diet (no tomatoes, no citrus, no spices, no chocolate), and assured me that I’d feel better in a month.  Three months later I finally improved enough to drop the meds and the diet (thank goodness!) and I happily moved on.  [My improvement in health coincided with the end of the pledge campaign, which was not a coincidence, as it turns out, but a causal link.  Stay tuned for more.]

In February, while running, I stepped into a hole and slammed my knee into the ground.  I spent a lot of time in a knee brace, trying to coax my body out of inflammation and into healing.  Three months later my knee had healed enough for me to do a hamstring curl; six months later it had healed enough for me to directly put my knee on the floor so that I could scrub the bathtub or do a child’s pose stretch.  The knee injury sidelined any running plans I had for the spring season so I diligently kept to walking and steady improvements in mobility and strength.

I felt steady enough to start jogging in May/June, so I tried exceptionally short distances, like from my house to my neighbor’s house three doors down.  My knee could manage that without too much pain, but my feet and ankles could not.  I thought that my body needed to “warm up” and I found that if I kept at it my knee and ankles stopped complaining, maybe after a quarter-mile.  So, confident that I was on the path of being a runner again, I picked up the distance and started running with Eric every Sunday morning.  And, every Sunday morning, Eric got to watch as I cried through portions of the run.  It just hurt, and kept hurting, and the length of time it took to stop hurting kept increasing; it was a quarter-mile, then a half-mile, then a full mile, then the whole run. It was so frustrating and made me panic that maybe I couldn’t be a distance runner anymore.  Realistically, I couldn’t even run a half-block without pain in my feet and ankles.  It was time to meet with my podiatrist again and see if he could fix me.

My podiatrist was adamant that nothing was wrong with my feet and that, instead, something was wrong with my joints.  He encouraged me to talk with my primary care physician about joint pain and that maybe I should be meeting with a rheumatologist again. 

At this point, my insurance company changed, which meant that I had to find a whole new set of doctors in July.  The turning point in my health this year hinges on my insurance company change.  If the insurance company hadn’t forced me to switch doctors, I would not have and then my health issues which had been under the surface for a while might not have been uncovered.  So, while it was a hassle, I’m grateful to have made the switch. 

At my July appointment, my new primary care physician asked questions.  Lots of them.  She wanted to know how long I had joint pain (tracking back to 2009), how long my white blood cell numbers had been low (tracking back to 2005), and what else wasn’t I telling her?  She ordered my first of many complete blood count (CBC) tests and then immediately connected me with a hematologist.  She saw that I didn’t have any rheumatoid arthritis factors but still believed me about the joint pain, so she prescribed me turmeric, an arthritis pain drug, and a regular stretching routine.  And she noted that my vitamin D count was low, and given my skin cancer history she couldn’t just order me outside, so it was time to start supplementing with vitamin D pills. 

I want to say, emphatically, that I was skeptical about taking turmeric and, because my new doctor had prescribed it to me, I also became skeptical about her.  But it was worth a $20 investment so I tried it.  Oh goodness.  Turmeric is a miracle concoction.  My joint pain lessened, my swelling decreased dramatically, and I began to feel more like myself again.  On a whim, about a month later, I wondered whether I was just feeling better on my own.  I deliberately skipped three doses of turmeric and I literally was hobbled.  I couldn’t get out of the bed and put my feet on the floor without hurting.  I quickly popped my turmeric pill and felt better.  Turmeric, everyone: I now sing its praises, I defend it to those naysayers (like myself, previously, and some of my other doctors), and I encourage you to try it if you’re dealing with joint pain or inflammation.

August – October was my series with the hematologist.  I liked Dr. Wilkes and his team immediately.  He described the process simply:  I would undergo a series of tests as he eliminated reasons for why my white blood count was lower than normal.  We’d hope that the reason would pop up when casting the net widely and, if that didn’t happen, we’d narrow and narrow down into the more obscure until we found out why.  Twenty-eight different blood tests, one abdomen ultrasound, and one bone marrow biopsy revealed my diagnosis – systemic mastocytosis – and then a CT scan, bone density scan, and tryptase test helped determine the severity of the condition.  Stress makes the condition worse; I suspect it was directly linked to my GI system’s malfunctioning earlier in the year.  The doctors are hopeful that my white blood cell numbers will increase over time and I have regular CBC tests to keep track.  Thus far, my numbers are decreasing a bit but mostly holding steady.

November saw my father’s heart condition progress to the level of needing a bypass surgery, and he had the procedure in early December and has been recuperating since.  Monitoring someone else’s health from afar is not easy to do so having my parents here in Saint Louis and helping them get the care they need has been wonderful.  I’ve spent much of December arranging doctor’s appointments for my mom and I’m glad to see she’s healing as well.

I closed out 2018 with a final visit to my primary care physician and yet another set of blood tests.  This round revealed that I have hypothyroidism, which makes sense based upon the symptom list.  Treating this condition is easy:  I’ll add another pill to the set that I take each day and I'll continue with the blood tests on a regular basis. Not too bad.  

Last night, when I reviewed my most recent testing and newest diagnosis, it really hit me:  this is the high point of my health.  Everything from here is a fight to stay at a constant level.  So I’ll continue to eat right to avoid my family history of heart disease and diabetes, I’ll do cardio exercise for my heart and weight lifting for my bones, I’ll practice mindfulness for my mental well being, and I'll laugh hard and find joy everywhere I can.  

Again, I am so, so grateful for doctors who ask questions and pursue answers, for health insurance that made it affordable for me to figure out about my health this year and will cover these pre-existing conditions going forward, and for my family – related and not – who have supported me through this somewhat wonderful, somewhat terrible health year.  Here’s to 2019!