I'm not exactly proud of myself

But I'm not really sorry either.

Early last month, I had blood drawn for what was to be my very last CEA level. Hopefully ever. Yes, that's Carcinoembryonic antigen. It was 4.9 when I was diagnosed with colon cancer 5.5 years ago. The highest it's been since then was in the range of 0.7. Until last month. It hit a whopping 1.9. Normal, but still enough to worry me a little, considering that for the last 4 years, it's been < 0.5. All I really wanted was to repeat the test, but my internist referred me to the oncologist who, for reasons unknown to me, did not return my phone calls. For 3 weeks.

I dropped by his office on Monday and asked the secretary whether he'd gotten the messages. She said she'd see if he had a minute to speak to me. Half an hour later, she returned, chart in hand, to inform me that the doctor said I had nothing to be concerned about. The result was normal. Wrong answer. Even from him it would have been the wrong answer. I can read lab reports and I've been very much aware of the normal values for this particular test for more than 5 years.

"Probably nothing to worry about, but if you'd like we can repeat it in a couple of months just to be sure" would have been OK, but by the time a patient, or in this case former patient, calls 4 times and drops by twice, with no response from the doc, sending out a secretary to pat her on the head is definitely NOT the best approach.

I don't remember everything I said, but the gist of it was that I didn't plan to bet my life that he was guessing correctly. Pretty much what I'd told the internist who thought I didn't need that first colonoscopy. I also remember demanding a copy of my chart. The secretary said she'd have to talk to her manager and 20 minutes later ushered me back to speak to the oncologist.

That's how I ended up in the PET/CT scanner this morning. Overkill, I know but I hope the doctor was right.


Update, 12/13: The doc called today. He was right. Now I just have to worry whether the insurance company will consider this medically necessary. If I have to pay for it myself, it will be worth it for the peace of mind - but don't tell them.

Thank you one and all!

Thank you for being so calm and reassuring when you answered my 911 call. Thank you for asking all the right questions to keep me focused and breathing. I was terrified.

Thank you for coming so promptly. It only seemed like forever - it was probably about 5 minutes.

Thank you for being so gentle with my son. He was frightened too. Probably not as frightened as his mom, but scared.

Thank you for not laughing when he scored his pain as a 2. We thought he was just being a tough guy. Fortunately, the truth was that your ice pack was pretty much all the treatment he needed.

I felt so bad when the little guy caught his foot in the strap of my purse and fell headlong onto the concrete garage floor. I was afraid he'd broken a bone or torn ligaments because he hit so hard. When his EMT brother cut away his sweats and we saw the rapidly swelling bruises, he ordered me to the phone to call 911 -- probably as much so Matthew wouldn't see how frightened I was as because we didn't think we could safely move him in one of our vehicles. Matthew thought the ride was "cool" - must be because you were so nice to him. Thanks for that too.

The Sword

I just came from Maddog Medic's story about Bouncing Babies and Bleeding Heads. I do like happy endings. He reminded me of episode at my house several years ago.

I left my youngest son in the care of his older brothers (then teenagers) while I was taking a shower. As I was getting dressed, the little guy started pounding on the bathroom door:

"Mom! Mom! Big brother cut himself ..........


With a sword!


There's blood everywhere!


3 big puddles!


Needless to say, I wasted NO time getting downstairs where I found.........



Not a drop of blood anywhere and the 2 older boys sitting at the kitchen table calmly discussing whether or not they needed to call 911.


I made the mistake of peeking under the dressing covering the wound. No, that injury didn't need a 911 call, but mom very nearly did. The brother who controlled the bleeding and applied the dressing is now a student in the paramedic program at our local community college. The other one is barely has a scar, despite the many sutures required to close the wound, and he's still collecting swords - but he has learned to be VERY careful with the sharp ones.

Apology

I had to turn on word verification on my comments section. I was getting spammed. I know some people have difficulty with the word verification, but I was getting tired of deleting a comment seconds after posting.

I hope this works. I hope my spammer smashes his/her knee on a big rock very soon. It wouldn't hurt my feelings if s/he broke a wrist in the process. Both of them, even.

Transition

Double whammy Friday night: Charge nurse AND admissions. Sometimes it's entertaining.

The shift started with a bang -- 2 high risk deliveries. First one, no problem. Second one, C-section. Baby was nice and pink, but wouldn't stop grunting. In case you've been out of pediatrics for a while, that's a behavior newborns display when they're struggling to get or keep their lungs fully expanded. The nurses in the well-baby nursery, very wisely, will not accept babies engaging in this particular activity. We suspected that this baby was just slow making the transition from intrauterine to extrauterine life, but after 15 minutes of stimulating (making him cry), suctioning (also making him cry), and applying PEEP (positive end expiratory pressure to help expand the lungs -- and make him cry), we decided that we'd have to take him back to the NICU with us.

Once there, we made the baby cry some more by drawing blood to send to the lab. This is jokingly called a "theraputic" workup when the baby ceases all disturbing behavior (grunting) after being caused to cry so much. Net result, we had a CBC (complete blood count) which had some minor deviations from the norm (13 bands) and a baby who was, by then, asymptomatic. The neonatal nurse practitioner on call decided to repeat the test in the morning, but went to bed without actually writing the order and I hustled the little guy back to the waiting arms of his mom - still in the birthing center.

6 hours later, the first year pediatric resident covering the well baby nursery sauntered into the NICU in search of the nurse practitioner. He allowed as how he wasn't sure whether to wake her, since she attended the delivery, or his senior resident. On the advice of the NICU staff, he was about to go wake his senior resident when I thought better of that suggestion and asked him which baby was causing concern. Baby #2, of course.

Since his concern was focused on that CBC, I thought I could put his mind at ease by assuring him that the nurse practitioner had already decided to just repeat the test. He was almost convinced, but there were these complications:

The baby was still asymptomatic, but there were factors in the mom's history that worried him. Did he know something we didn't? After reviewing his list of concerns, we found only one thing the nurse practitioner hadn't known - but we really don't worry about abnormal pap smears. He's certainly thorough - and concientious. He even listens to nurses. I think he might be a keeper. Oh and he did go order that repeat CBC.

Spruce Lake Outdoor School

I spent 3 days last week enjoying the wilds of northeast Pennsylvania with my 10 year old. OK, it wasn't really very wild. We slept in beds and used flush toilets and ate food cooked in an actual kitchen, but it was fun - and very educational.

That body of water in the picture? It's the lake. That speck in the middle of the picture? If you look very closely, you'll see that it's a 10 year old boy wearing a harness and a helmet and flying over the lake on the zip line. I think it was the high point of the trip -- well, that and playing air hockey with a friend during his few free moments.

My son learned quite a bit about how deer impact their environment and about how farm land returns to its previously forested state over a period of many years. I learned that while I can keep up with 10 year olds for about 2 hours in the mountains, 3 hours is a little more than I can handle without more advance preparation (training). Tripping over that log didn't help much.

We also had great fun studying "Skins and Skulls" and doing a little forensic study in a CSI format (Critter Scene Investigation). My son made his first attempt at the climbing wall and was very proud that he made it halfway up. Next year, the ceiling!

I learned some new techniques for redirecting challenging 10 year olds which will come in very handy in my Cub Scout den this year. I also learned that bifocals are a BAD idea when walking on uneven ground. I've fallen several times since getting the bifocals. Two falls in 2 days finally got my attention. Call me a slow learner. My knee will recover, according to the orthopedist. He advised me not to fall on any more big rocks. He didn't even snicker when he said it. Maybe I should try knee pads while I'm waiting for the new glasses.

IV therapy escapades - part II (Uh-oh!)

Me: "Uh-oh."

Patient: "That doesn't sound good. What do you mean, uh-oh?"

Me: "Just a little tape sticking here, really no big deal"

Patient: "You need to be careful saying things like that when you're working on someone's central line."

Me: "Sorry. I'm used to the babies in the NICU. They don't notice things like that. Thank you for the reminder that adults can actually understand what I'm saying."

Patient: Laughs "Just don't do it again!"

That was my first day on the IV team. I saw him many more times in the 3 years I worked there - he was a regular, and always with a central line. He never let me forget that intro, either.