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Physician, heal thyself

So, I may have previously mentioned that I'm not the best patient. In fact I have a mug in my office that states, "Take my advice. I'm not using it anyway."  I may have also mentioned the irony of being a doctor with no health insurance. But now I've got a new job with benefits...that kick in January 1. I had all these grand plans - I'm gonna go to the dentist, and go to the eye doctor (and hopefully ditch my 3-4 yr old glasses), and I'm gonna go to the doctor. For reasons. First, I just need to have a check-up and get plugged in with a PCP.  It's just a good idea.  I recommend it to others. But then I've also been having these annoying little pains off and on for several months.  Maybe a year. IDK. At first I wasn't sure what it was, and it wasn't so bad. Then one night I thought maybe it was a heart attack - this intense epigastric pain radiating to my back.  But then I figured out that it happened more after I'd eaten something greasy like pizza. That makes the gallbladder the most likely culprit. Sure enough, when I had my friend do an ultrasound, my gallbladder was full of stones. So, I've know for months that it had to come out. I was just waiting to get insurance before I did that. No biggie. My mom had gallstones for more than 20 years before she had hers out.

Well, you know what they say about best laid plans...actually I'm not sure what exactly they say, but I know the gist. Over the last few weeks I'd noticed the episodes had gotten a bit more frequent, but I chalked it up to stress. I had developed my own little gallbladder attack routine - 2 Aleve, 2 Zantac, and an antispasmodic. Wait 30 minutes, and the pain goes away - or at least gets better. Wednesday night this routine didn't work. 4 hours later the pain is worse instead of better. I was nauseated. I was pacing the floor until I started having hard, shaking chills. Then I started thinking worst case - I could have a ruptured gallbladder and rampant infection. I could have a blockage that would cause damage to the surrounding organs. I decided that a trip to the ER was the better part of valor, insurance or no insurance. I didn't think I could drive myself so I called my nurse at 1:30 in the morning. She came and got me, bless her, and dropped me off for my first ER visit ever. I was the only patient there, and of course everybody knows I'm the new doc in town. So, I got straight back, got an IV placed and labs drawn, and a CT scan. The diagnosis? Pancreatitis. Gallstone pancreatitis due to passing a gallstone which transiently blocked the common bile duct and essentially allowed the pancreas to start digesting itself. My pancreatic enzyme Lipase, which is normally <160, was >33,000. So it was pretty legit. Made me feel justified in going to the hospital, anyway. Needless to say, I was admitted to hospital and started on IV fluids, pain meds, and nausea meds. I'm NPO - nothing by mouth. We're waiting for my enzymes to normalize. So far, they've dropped dramatically. The pain is better and I'm starting to feel hungry (at first the thought of putting something in my mouth made me hurt).  The main problem now is the migraine/caffeine withdrawal headache...Maybe if I'm good I'll be able to get clear liquids today and go home tomorrow or the next day. Kind of a sucky way to spend my birthday...

So much for waiting until January before I had to seek healthcare; though I can wait a little longer 'til I have to have the actual surgery. And I didn't plan on meeting the staff and getting familiar with the hospital by availing myself of its services in the first month of my being here. It's weird being on the other side of healthcare. It's weird receiving the treatments and tests and meds that I have only ever prescribed for others before. And it's weird for the staff to be treating a doctor! I think the nurses drew straws to see which of them would have to take care of me! But everybody's been very nice and all in all I can't complain.  C'est la vie!


( 21 comments — Leave a comment )
Dec. 21st, 2013 03:13 pm (UTC)
Happy birthday, anyway. May next year bring you better health.
Dec. 22nd, 2013 04:51 am (UTC)
Thank you! Hopefully next year I can have my gallbladder out and put all this behind me! :-)
Dec. 21st, 2013 03:37 pm (UTC)
I'm sorry you're having to deal with all of this without insurance. But I'm very glad you're feeling better!
Dec. 22nd, 2013 04:52 am (UTC)
Thanks, dear.
Dec. 21st, 2013 03:43 pm (UTC)
First - *GIANT HUG*
I'm so glad you didn't wait it out, insurance or not. My grandfather nearly died from close to the same thing and that was because he refused to go to the doctor/hospital on principle.

Second, I understand so, so much about the insurance, or lack thereof. And the best-laid plans. I had no insurance for years and I was always on pins-and-needles when I started getting sick. Do I have to go to the doctor? Can I afford this? Truly, it's like being between a rock and a hard place. You don't want to get majorly sick but when money is tight you don't want to go into debt just because you have the flu. It sucks, hard.

Finally, I know so many people who have their gallbladders removed. It's a standing joke at my work's AP dept that they have none to spare (that's because 7 out of 9 don't have them at all). I have to wonder if it's so prevalent because of our dietary habits.
Dec. 22nd, 2013 05:01 am (UTC)
*hugs back* Thanks so much, dear. It is a fine line you walk when you're uninsured - wait 'til it's bad enough but not too bad. Thankfully, I've only been without insurance for about a year and a half, and I'll have insurance again in Jan. It definitely makes me more aware of the issue, though!

The biggest risk-factors for gallstones are the 4 F's - fat, female, fertile, and forty. I meet three of those criteria, unfortunately. So definitely the fast food way of life impacts that risk. It's also genetic, and most of my family has had gallbladder disease. Guess it was pretty unavoidable for me. :-/
Dec. 21st, 2013 04:04 pm (UTC)
Oh, m'dear, how wretched. All good wishes for a speedy recovery, and I hope you get to actually celebrate your birthday later on.

And I'm sorry to bang on, but what a stupid, stupid excuse for a health "care" system. Not even doctors themselves are necessarily covered? Bah.
Dec. 22nd, 2013 05:08 am (UTC)
Thanks, dear. I appreciate your good wishes.

And yeah, the system sucks. Unless my employer provides health insurance I'm unable to buy any because I am actuarially unsuitable - even though I have no chronic medical problems, I'm just too high-risk for them to want to insure me. Things are changing with the ACA, but it's not a perfect fix. That said, my insurance with my new job will kick in Jan 1. I hope to put surgery off 'til then, at least.
Dec. 21st, 2013 04:20 pm (UTC)
Oh noooooo. My niece had pancreatitis about 10 years ago and it was a months-in-hospital experience. I'm sure there are different kinds -- hers had nothing to do with gallbladder -- and I'm hoping that your home in a day or two prediction comes true. Sending you all the best wishes (and happy birthday hopes for caffeine!)

And it's certainly interesting to learn that doctors play the oh-it's-nothing I'll-get-it-checked-later game as well. ;)
Dec. 22nd, 2013 05:10 am (UTC)
Thanks so much, dear.

And yes, I put my health at the bottom of the list until it absolutely demands attention!
Dec. 21st, 2013 05:21 pm (UTC)
Happy belated birthday! That does sound like a horrible way to have spent it, but I'm glad that they found the issue and you can wait until your insurance kicks in for the surgery. *hugs*

(You really made it through your childhood without going to ER?! I was first in at 3, then at least 3 more times while in grade and middle school, foot, sprained ankle, broken collarbone, and cracked arm bone.)
Dec. 22nd, 2013 05:14 am (UTC)
Thanks, dear! *hugs back*

And yeah, at least I have no memory of ER visits as a child. Maybe when I was a baby? But unless one of us were bleeding out or comatose, we'd wait it out and go to the pediatrician the next day or whatever.
Jan. 14th, 2014 08:25 pm (UTC)
Actually, we may not have gone to the ER for the sprained ankle because I limped for a few days before anyone realized a doctor needed to look at it. But the rest was pain, help now!
Dec. 21st, 2013 06:53 pm (UTC)
Oh dear. I came over to send b-day wishes, only to find you need "get well soon" wishes even more :-( I do hope you feel better soon *painfree virtual hugs*
Dec. 22nd, 2013 05:15 am (UTC)
Thanks so much, darlin'! *hugs back*
Dec. 21st, 2013 09:44 pm (UTC)
Heal swiftly and well. I wish there were something I could do to help. Good luck not terrifying or annoying the nursing staff!
Dec. 22nd, 2013 05:15 am (UTC)
Thank you, dear. I'll try my best to be low-maintenance. ;-)
Dec. 22nd, 2013 03:53 am (UTC)
Oh my goodness. I'm glad that you did seek treatment before it got worse. (and who the heck employs doctor without offering them medical insurance benefits? Irony in the worst way.) Are you in the US? Maybe next year will bring ACA? :D
Dec. 22nd, 2013 05:19 am (UTC)
Yeah, it was pretty crazy. Even more so since in my last job I was treating mostly Medicaid patients. I was only uninsured for a year and a half, but it sure opened my eyes! I'll have benefits with my new job, but they don't kick in 'til Jan. At least the ACA will make sure that my pre-existing gallstones will be covered! Yay!
Dec. 22nd, 2013 09:41 am (UTC)
Oh man hope you feel better soon dear, BTW I got yr Christmas card, thank you soo much dear.
Jan. 11th, 2014 11:29 pm (UTC)
So sorry for the late reply! I think my email buried the alert! I truly appreciate your well wishes and am so glad the card made it! I got yours as well. Thank you! I hope 2014 is getting off to a good start for you. Take very good care. :-)
( 21 comments — Leave a comment )