Questions I Never Asked My Doctor

My personal physician of over 30 years has passed away. Suddenly. 

This is very strange, the mix of emotions are confusing to me. I knew this man for what seems like forever. He was there for my kidney stones, my colon cancer, various surgeries and procedures I've had over the years. He managed my medications, ordered my blood work, and applied his smart a$$ sense of humor liberally. 

And suddenly, he is gone and I feel like I'm grieving the man. I'm shocked, in disbelief that he is no

longer in his office kvetching about other doctors but always spending time and never rushing me through an appointment. He isn't there working past office closing, eating chocolate at his desk and giving instructions to his nurse. 

He actually isn't there anymore. It's real.

I'm angry because about a year ago I told him I needed him to give me the name of another doctor in case he retired, I did not want to be passed to one of his partners, I wanted someone he would recommend because - it was going to need to be someone he would approve of. He said he would think about it, but he wasn't going to retire for another 10 years. I never got that name.

This man played a big part in my life for the last 30+ years and I realized I never asked him "how are you doing, how are you feeling?" My visits were always about me, not him, although he did tell some funny stories about his son or his mom. But I never knew how HE was.

His name was Richard Cash. He was an internist and a beloved one at that. And as I searched for an obituary I realized I didn't know what his family called him, his wife - did she call him Dick? No, he wasn't a Dick - although he would beg to differ. :) Rich? Maybe. I do know his mother called him god (with a small g) because medically he was EVERYTHING. What did she call him, I wonder? Besides god, I mean.

There was  a string posted on social media about someone losing their primary care doctor, and it went on and on and on - once everyone realized the post was about Dr. Cash. People adored him, they trusted him, they were feeling at a loss just like I was. And someone said he was a twin! How come I didn't know that? Apparently his twin has passed as well.

He was my doctor but he was also a human being and I feel terrible that I did not ask him questions about HIM more than I did. It's a very selfish feeling. There is no obituary, except a couple fake ones. Even some guy with a thick Indian accent talking about him on a YouTube video, basically repeating what one of the fake obits said. What is THAT all about, anyway? Fake obituaries?? People are vultures.

So, no obituary, no pictures, he rarely allowed them to be taken - and never - for his profession. It's like he's been erased. Makes me sad. I will miss him greatly.

Rest in Peace Dr. Cash. You deserved more time.

A diagnosis might have been nice.

When did I go to the doctor? It was February 5th. At that visit the doctor went over my blood work which wasn't great, decided to give me some new meds, my blood pressure was a little high, my sugar wasn't great but my thyroid was better than expected. Yay. I left the office with an order for more blood work in a month to make sure the new meds he gave me weren't killing me. Another appointment in 3 months. Got it.

So I wasn't expecting any correspondence from my doctor's office in the meantime. That's why I was confused about the envelope that arrived today but I was like - okay, whatever. I opened it to find a 2 page instruction sheet, basically, titled The Type 2 Diabetes Meal Planner. Like seeing THAT wasn't scary! What the hell? It was enough to make me want to go dunk my head in a bowl of chocolate which I've done a good job of staying away from since I announced I was giving up eating.

So .. does this mean the doctor decided between February 5th and today that I am a diabetic? Do you think maybe he should have mentioned that when I was there? If not, and he just wants me to attempt to follow this type of diet, do you think maybe a letter accompanying said diet explaining that would have been helpful? SHEESH!!!!

I guess I'm calling my doctor tomorrow. But I think his office is closed on Wednesdays. Of course.

I need to go back to the doctor.

I should have known my doctor wouldn't be mad at me when he saw my bloodwork. He doesn't care enough for that! He ordered some more tests, raised the dosage on my thyroid meds and told me to lose weight. Then in response to my complaint about aging he told me how his wife told him that he's so old now none of his female patients bother to shave their legs for him anymore. I bit my tongue because I really wanted to point out that he's losing his hair too but he looked like he was having a bad day.

Actually he's a good doctor, just a smart-ass so I give it as good as I get from him. Usually. He looked tired and I was in a good mood so I gave him a break.

Did the grocery shopping after the doctor, I know I have mentioned how I hate to do it. I went in to get a few things and $260.00 later I was done. Yikes. All I wanted was the stuff to make meat loaf. I've had a taste for it lately and I figured that I needed to start cooking more so I stopped at the store.

I cook so rarely that when I do - my son always thanks me like I've done something extra special for him. I almost have to give him permission to eat it, that's how pathetic it is. But true to form - he's working 2:00pm to God only knows when tonight, one of the reasons I stopped cooking anyway. Nobody was ever around to eat what I made. Still - I want me some meat loaf and I aim to have it.

The scary part though, is that I bought the stuff to cook on other days too. And I just popped into the kitchen and made a cucumber salad. Something is wrong with me. Seriously wrong with me. I think I'd better head back to the doctor.

I suppose my trophies ARE a bit tarnished ..

Everybody has something they are good at. Something they have worked really hard at or something that comes as naturally to them as breathing. Or – sleeping.

I have always excelled at sleeping. If there was a gold medal, a blue ribbon, or a trophy for snoozing, I would have it. I would have to have a separate room just for my awards; I have always done it so well.

But I have been so tired this past year or so, all I have wanted to do is sleep. I have to force myself to get up in the morning, yawn all day, and daydream about taking a nap as soon as I get home from work. Frequently during the day I can be heard exclaiming “I’m dying here.”

On the weekend it’s not unusual for me to simply not wake up till noon or later. And then – 2 or 3 hours later – curling up on the couch for a nap. Except my naps are like a nights’ sleep for some people. 3 hour naps would be considered the norm for me.

I have always marveled at people who just wake up in the morning – early in the morning, which means any time before 10:00. And not only wake up, actually get up and out of bed. If I wake up early it’s only to trudge to the bathroom or clumsily turn over – and then I’m back to sleep again before you know it.

My doctor suggested that maybe with all this sleeping and never feeling rested, I am not sleeping well. My reaction was “What??? I sleep like a champ!” It never ever in a million years would have occurred to me that I am not actually getting good sleep. Heck, I thought ALL sleep was good sleep!

So when he suggested I try taking something to help me sleep, a test, to see if it would be a different kind of sleep, I balked. “I don’t need anything to sleep, wanna see? I’ll lay down right here on this narrow paper-covered exam table and show you! Just give me 10 minutes.”

I ended up agreeing to his little experiment, more out of desperation than anything else. I am so tired of being tired.

I have been taking mama’s little helper for a week now. Getting to bed at approximately the same time every night, and getting up at my usual time in the morning. I haven’t taken any naps, although there have been days that by 8:00pm I am just waiting for it to be 10:00 o’clock so I can take a quick shower, get my stuff ready for morning, and climb into bed.

This morning, Sunday, I woke up at an ungodly hour. I laid there for a while, looking at the cats that were surrounding me sensing that I was awake and would soon be the bearer of food. I looked at the clock, closed my eyes again, somewhat confused. Confused, because I was awake. I probably could have gone back to sleep if I tried, but I didn’t feel like I needed to try.

I don’t really have an addictive personality, unless you count cigarettes which I did finally quit, and carbs which I haven’t. But I have had diet pills – nah – tossed them in a drawer. Anti-anxiety meds – quit taking them when I felt I didn’t need them anymore. So I am not worried about taking this medication for too long or in a way that isn’t good for me.

It’s only been a week. I don’t want to get too excited. I can’t jump to any conclusions or give my doctor any credit (especially since he’s such a smart-ass) when the experiment is only 7 days old.

But this morning? This morning I woke up all on my own, without an alarm or a cat touching my face with her paw. I didn’t wake up because I had to pee or to turn over. And this morning, I got out of bed at 8:30 am. And not because I had to.

For a lot of people that’s normal. For me? Momentous!

It's not time yet

Another darkened room, another hospital gown, another female technician who is calm and quietly professional. The gel she uses is warm, unlike what I remember from my pregnancies. I am slightly anxious but more because I overslept and barely made it to my appointment on time, than about what I may be told today.

On my back with one arm raised above my head, turning my head to the side I can just see the screen Ingrid my tech, is looking at. It all looks like a messy tangle of fibers and wavy lines, there doesn’t seem to be anything I would recognize as breast tissue or a mass of any kind. Of course I have no idea how to read what is on the screen, and wonder idly if that’s why Ingrid lets me see it.

It seems to be taking a long time but I am sure it is really only 10 minutes or so, it just seems like forever. I am not used to lying still without something to occupy me whether it be my laptop, the TV, my beading, a book, or the face of the person I am talking to. It hurts my neck to turn this way for any length of time, but I force myself to do it so I can see the screen. I need to look at something.

Finally Ingrid is done. She places a washcloth on my breast and pulls my gown closed. She moves with purpose across the room where she sits in front of another screen to, as far as I can tell, review the shots she has saved and will give to the radiologist. She tells me she will go consult with him and will be back in a couple of minutes. With nothing left to look at I close my eyes and hope to drift. Peacefully.

Not long after, the door opens and the rest of the overhead lights come on. I shade my eyes, complain about my nap being interrupted and I smile. Here is Ingrid and Dr Something I Did Not Hear. He tells me that the ultrasound would show if the spot they were looking at was a cyst, but they could not see it with the ultrasound. Not a cyst. It could be nothing, still not time to worry, but because it was not there when I had my previous mammogram in 2003, it still needs to be identified. He will pull the previous films again and review those with my new film, as well as the ultrasound. Then he will let my doctor know what he recommends. It may be an MRI, it may be a biopsy, but it will definitely be something.

Please, he says, follow up with your doctor tomorrow.

Of course.

Two hours later my doctor calls me at work. She is a nice lady, comforting and reassuring but direct and to the point. “The radiologist is recommending a biopsy.”

She tells me how it shouldn’t be too bad. I will be on my stomach on a table with a hole in it which will allow my breast to hang through it. How flattering. They already know it will ‘hang’. Then my breast will be flattened like when doing a mammogram, and the needle will be directed with something akin to GPS technology, minus the voice telling the doctor to turn left at the next cross street. She says she has had it done and it’s not that bad. Yet my mind flashes back to Jenn at Serving The Queens, with that needle in there poking around and around until they hit something. Ugh. I have a high pain tolerance. But that does not mean I like pain.

Then she tells me what I repeat later when I am explaining to my daughter and my BF, and what I will repeat here as well.

“It is probably nothing to worry about. Over 80% of biopsied breast abnormalities are benign, and if it does turn out to be something” she pauses “then that mammogram just saved your life because it will have been found so early.”

See? Still not time to worry.

There is just nothing easy about it. Part IV

It's a bit bewildering and can be very frustrating trying to find the right medication for depression. First you have to stop denying something is wrong and get diagnosed which is a huge step. In my case, talk therapy helped with immediate issues like damaged self-esteem and all the other gifts that go along with divorce. But when the talk stopped helping, it was time for drugs. For me anyway.

My therapist was a psychologist which meant he could not prescribe drugs. He wrote a request for me to bring to my regular doctor who is an internist, asking that he prescribe an appropriate medication for someone with dysthemia. Low level, chronic, depression. My favorite description for that is "a lack of joy."

I remember sitting on the chair in the exam room that day when my doc walked in. He is an excellent doctor (driver, excellent driver, buys his underwear at K-Mart) and he is also a smart ass. A gi-normous smart ass. He asked me the usual, how was I feeling, anything new, why did I come that day, etc. I handed him the note from my therapist feeling every bit the little girl handing a note from Mommy to the teacher. No, maybe the principal. He read the note and said "I won't be anybody's prescription pad. Hop up on the table."

After taking my blood pressure and listening to my heart, thumping on my back and pushing on my belly, he finally said something else. "So. What makes you think you are depressed?" I think he was sorry he asked. I immediately burst into tears. I tried to tell him about my divorce and my husband sleeping with half the western world and how I had anxiety attacks and would get diarrhea and I could barely leave the house and I was afraid I was a bad mom and.. and.. and .. by the time I took a breath I saw my doctors face with the look a lot of men get when women cry. The - 'I will do anything if only you would stop crying!' face. That may have been the only visit to his office, ever, that he did not make a crack about his wife, tell me how brilliant his son was or give me a tip on the ponies.

I left with a prescription for Prozac. It was the drug of the moment, everyone was doing it. It was not necessarily the answer for me but it was a place to start. Unfortunately the only way to find out if a med will work for you - is to try it. And if you don't know what you should feel like, don't know what "normal" feels like - it's an arduous and sometimes very long process to find the right drug for you. I tried many many drugs, some for as long as a year, some for as short as a week or two, and when I was asked if it was helping my answer was generally close to the same thing. "I don't know. Maybe. It's hard to tell." Which I know now, for me, meant NO. Because when I did find the right medication - or actually - combination of meds - I knew it.

It was night and day for me. But first I went through going to the OB/Gyne because I was sure I was experiencing peri-menopause and was put on the pill for a while. I tried drugs that made me physically ill and some that made my mouth so dry I could not spit. I took meds that did seem to help. A little. When I found the right med it just so happened it was at the same time I was on the pill. I thought hmmm, why not find out if it is the birth control pill or the anti-depressant that is helping me. Hormones on one hand, depression on the other. I'm a nutcase on one hand, I'm a normally hormonally crazy woman on the other. Hmmm.

I went off the anti-depressant first. I realized about 2 weeks later that there was this sort of darkness creeping in. Irritability, apathy, the hopelessness was starting to envelop me. It wasn't as bad as it had been - but I recognized it. It was almost like pulling a light blanket over my head, just enough to dull the world around me and put up a barrier. I knew for a fact that the blanket over my head would become heavier and more than I wanted to bear again. I went back on the meds. A few weeks later the light started to show through again. Ah-h-h. Picture a hammock, sunshine, and drinks with umbrellas ahh-h-h-h-h.

When I say it was like day and night for me - I do not mean the change was apparent immediately. It was a gradual thing, I needed to recognize 'happy' - and learn how to not be frightened to apply the word to myself. Surprisingly, coming out of depression can be a scary experience in it's own right. Sadness may be the only thing some people remember feeling. Being happy - or knowing just what that is and how to BE it - can be a daunting task when all you have known is NOT. It doesn't happen overnight but it is so worth it. It's much easier to learn 'happy' when you don't have bad feelings dragging you down. Hope becomes something you can feel - and oh what a gift that is!

I still have days when I get in a mood, feel down or sorry for myself, but the difference is that those days don't last. Everybody has those days and they don't frighten me anymore. I wish I could say now this is what you have to do to feel better. This is the way to achieve happiness. I don't hold the key, or any keys for that matter. I just know what I went through.

As far as trying different meds and wondering how to tell if one is effective or not? My advice - give it at least four or five months if it doesn't have side effects that bother you. Then ask yourself how you feel. If your answer is "I don't know" or "okay I guess" - and not - "good!" - then move on. You should know when you feel good. You need to have faith that you will recognize 'happy' when it hits you.

Some people never need medication, and some people suffer from a much more debilitating depression than I ever have. It's a complex thing, there isn't one answer for everyone and God knows I'm not a doctor - hell - I don't even play one on TV. So that's always the first place to start. Your doctor. And if your doctor doesn't listen to you - get louder, say it again, let them know you're serious. If that doesn't work - find a new doctor.

Being happy is not over rated I'm telling you. If you think you may need to seek help - you probably do. Just like millions (and I do mean millions) of other people out there. We aren't alone. It just feels like it when you are depressed.

Nite. :)