Recently, I changed hematologists. I liked the new one immediately, not least because she actually spent more time with me than I had spent in her waiting room (at my old hematologist's the typical trip was: one hour past appointment time in waiting room. Another hour in exam room. Three minutes with doctor who obviously hadn't read my chart and couldn't keep track of my treatment. Wonder why I didn't go back?). She also impressed me by actually following through on something she said she'd do: she said she was going to write a letter about my treatment to all my other doctors. And the next time we saw my o.b., lo and behold, he had a letter from her. I have a lot of doctors: a reproductive endocrinologist (done with him for now), an o.b. (actually a team of o.b.s so large I probably won't manage to meet them all before this baby is born), a perinatologist (also done with him for now, unless we need a consult before delivery), a hematologist, and a partridge in a pear tree. By which I mean my general practitioner, whom I actually have only seen twice in my life, once for my annual physical last spring and once for a rule-out melanoma biopsy (ruled out. We knew it would be. But when you're as moley as I am, it seems like a good idea to scrape one off every now and then just in case). Then I got pregnant and The Pregnancy Support Team took over, which makes me wonder what the g.p. thought of the hematologist's letter. "Su Penn? Who the hell? She's pregnant? What the hell?"
I've only met her twice, by the way, because I changed general practitioners this past year, too. And obstetricians. "I'm not a doctor-hopper, really!" I found myself telling the new hematologist.
Anyway, the first thing the new hematologist asked me (I need to call her something else, because I can't keep typing that over and over: OK, we'll call her doctor McD. Imaginative!) was, "Why did you leave the old hematologist?" (we won't give him a nickname because we don't plan to mention him ever again). I said that I had lost confidence in him. She was nonplussed. "I know Dan. He's a good doctor," she said.
Then her next two questions went like this:
"What the hell are you doing on Lovenox [a blood thinner] when you only have 40,000 platelets to begin with?"
And then: "What's with this tiny dose of prednisone? That's not doing a thing for you! It's like pissing into the wind!"
And she then proceeded to take me off both the treatments the old hematologist, bless his soul, had put me on.
It takes a long time to go off steroids. You can't do it quickly because, among other reasons, being on them shuts down your adrenal gland (it thinks it's not needed anymore and goes off in a huff) and it must be coaxed gently back on-line. It took me five weeks to taper off the tiny tiny dose, and on the very day I took the last tiny pill--after a blissful week during which the dose had actually gotten low enough that I was sleeping through the night every night--Dr. McD called at suppertime and said, "How are you?"
"I'm fine," I said, "unless this is one of those phone calls where the doctor gives you bad news."
Well, my latest complete blood count was not exactly bad news. Turns out she was wrong about the tiny tiny dose doing absolutely nothing for me, because once I went off it, my platelets dropped fairly dramatically. Dramatically enough that she wanted to put me on a huge honkin' therapeutic dose of prednisone immediately. And she didn't even want me to go to the drugstore to get it myself. "I don't want you running around until you've started it. Do you have someone you can send to the pharmacy?"
This was the first time in the four years since I was diagnosed with Idiopathic Thrombocytopenic Purpura that anyone has suggested to me that I was actually in any danger of, you know, bleeding. Not that my platelets are so low I'm in danger of spontaneous bleeding while just sitting around--I'd have to lose a lot more platelets to get to that point. When she said, "I don't want you out running around," she really meant, "I don't want you running into anything with your car and, say, whacking your head against the steering wheel and getting a scalp lac that would be no big deal for a regular person but could leave you bleeding to death all over the otherwise spotless beige interior of your 1999 Toyota Camry."
I forgot to ask her whether bleeding to death next to the Pennsylvania Turnpike is also a bad idea. I'm hoping I don't have to cancel my trip this weekend, but am waiting for the nurse to call back with the doctor's thoughts on that, and of course I'm not going to take any foolish chances.
Oops. The point of this post was going to be that I sometimes long for the uncomplicated days when a single doctor could provide for all my needs. Instead of having a whole bunch of doctors for my various parts: This one specializes in my cervico-uterine area! This one is actually the fetus's doctor more than mine! This one just pays attention to my blood!
The phenomenon reaches beyond me: Eric has a pediatrician and a cardiologist! David has just been referred to a pulmonologist! I have a new blessing: May you and your loved ones never need an -ologist!
As I am rambling, I will just finish by saying that the waiting room at a hematology office--which is always also an oncology office--is a sad place to sit. When I am there with Eric, I find myself wanting to reassure the obviously very sick but nonetheless friendly people around me that neither he nor I have cancer, than I am not at risk of losing him, nor him, of losing me. "It's just a little blood problem. Or two. But nothing to worry about, really." But the waiting room at a pediatric heart center is even worse on a bad day (Eric's defect is just a little mild pulmonary valve stenosis, probably won't ever need treatment, just gets looked at once a year. That is obviously not true for some of the little kids we see there).
Could I be more gloomy? I've been struggling with a down mood the last few days, and should be trying to cheer myself up. So let me finish with a quick blessing count. I have been aware lately of a few things in my life I especially love. Here they are:
I love listening to Eric and David talk in the next room. Have you heard that dippy country song, "My front porch looking in"? Oh, it's cheesy. But it pretty well expresses a feeling I have. I'll be in bed, listening to Eric and David do their wash-brush-and-potty routine in the bathroom, or I'll be in the kitchen loading the dishwasher while they read books on the couch. Their conversation can be completely mundane ("Are you done peeing?" "I'm all done." "OK, ready to brush your teeth?" "I want the Bob the Builder toothbrush." "OK, open wide so I can get the back teeth. Now let's wash your hands." "And dry them, too.") but my heart melts. I love them both so much, and when I hear them loving each other, it just makes me love them more.
I love watching Eric go to sleep. This afternoon, I lay down with him to help him settle for his nap. We were sharing a pillow, facing each other, and I watched his eyelids droop...droop...droop...close all the way...drift open...droop...droop...droop...close and commit. Sleeping boy.
Posted by Su Penn at February 12, 2004 12:47 AM | TrackBack