This began my first of several week-long stays at hospitals. I had slept very little that night in the ER. Imagine that. One strange observation that I made, if you don’t sleep, you don’t have night sweats- so one problem was fixed right off the bat. I called my husband at 3 AM, and in reflection I wish I would have let him sleep one last night, but we now knew we had much to worry about. It is a very surreal moment; especially when you completely understand the severity of the conversation. It is the blessing and the curse of medical knowledge.
Pretty much admittance to the hospital in this day and age means you are pretty sick. If you have to be there, then you HAVE TO BE THERE. I wasn’t unstable by any means…. Let’s focus on that statement for a minute. In medical terms a stable (good blood pressure, good heart rate, breathing on their own) awake, alert and oriented patient is a relative goldmine for a nurse. But remember what I said, for the most part to be admitted under my circumstances (stable but crazy sick insides) means that the doctors were suspecting that I may become unstable because of the unusual nature of my complex problem. I knew that. Honestly, I knew that they were looking for cancer. I felt- THAT was at the top of my differential (differential is short hand for the possible problems (diagnosis) that could be attributing to your hospital admission). There was just too much going on in my picture for them to start confidently telling what it was or was not. BUT then there is also infection, and sepsis (massive multi-organ failure) kills faster than metastatic cancer and that morning my WBC, RBC and platelets had dropped again. So maybe THAT is at the top of my differential. I basically had no immune system- so anything within the environment was a danger to me. Not much blood to circulate (my normal resting heart rate was 40-50, these days it was usually 110, but my blood pressure was within a normal parameter). And a decreased capacity to make a blood clot- in fact entering the area of being able to spontaneously bleed- that sounds like a fun party trick doesn’t it?
I would say I had the recipe for some real fun times wouldn’t you? So let’s bring in the specialists.
(Climbling slowly but surely onto soap box- All of you out there should have a family healthcare provider (primary care provider- PCP). Period. Healthy, unhealthy- whoever you are. They are integral in your care. And this should be a provider that you see regularly- not an urgentcare or emergency room provider- BECAUSE THIS PERSON SHOULD KNOW YOU. These are the individuals who screen you for illness, manage illness if you have any and in general are a partner in your health. Ladies, this is NOT your GYN and men- stop being a big baby and just go see someone who is not your significant other who will nag you about all your bad habits- you are an adult do.it.. Stumble off said soapbox now. )
Infection, Infection, infection (Infectious Disease)
Unless otherwise proven the most common disorder to possibly cause my problems is an infection. Common diseases occur commonly- this is my most favorite thing they taught me in NP (nurse practitioner) school. Now, don’t rule out the uncommon unless you can confidently find infection….Easier said than done (and for all my NP students out there REFER if you can’t find it- that will be on your boards). Many of these tests take days and weeks to months to be finalized. So 40 (not lying here) additional tubes of blood were drawn to start the search.
The C-word (Hematology/Oncology)
Cancer. I am sure that eventually a person going through chemo will stumble onto this. I’m not sure if you had this happen or not… but even before we knew much of anything, I felt that the medical staff looked at me differently and had an element of sadness when they came in my room. Cancer weighed heavily and all I can say is that I could feel it. Palpably. Their choice in the matter was a bone marrow biopsy. FUN! I had heard about these, they bore a hole into your hip- take out some marrow- voila!! NOW- as long as you are asleep-perfect! This was one of my “easiest” procedures. If they won’t sedate you, find someone who will. Seriously.
To sum it up here (at least for now)- “come find us if you can’t figure it out. “
So three groups of doctors, some of the smartest people you know and have worked with in the past, scratching their head without any clear direction. Very re-assuring- NOT!