Tuesday, August 19, 2008

Complicated Fear

I have had two moments in my db career disrupted by a fear so acute that I felt like I was being devoured.

One was 12 years ago, when I tried Lantus and ended up with a "reaction" which put me in the hospital for 8 nights with symptoms of heart failure. That was a lot of time to think about death and disability. (My heart is fine.) The second was 6 years ago when I had emergency surgery for my detached retina and had to lie face down, not moving, for 7 days as it healed. The doc said the outcome could be anything from being able to recognized shapes to possible 20/60 vision. I recovered to 20/30 vision and remain one of his "best success stories".

I figure that at some point my luck will run out...................and thought I was at that point a month ago.

I'd had a high fever for a couple of days with no other symptoms. I went to Urgent Care and the doc was mystified. She kept going down the list and said in addition to a chest x-ray they would do a urinalysis to see if anything showed signs of infection.

After a long wait back in the exam room, the doc came in and asked if I had kidney disease. I told her no, and that my last a/c ratio (albumin/creatinine ratio) was normal and that had been done 4 months ago. I told her that I had some urine spillage about 6 years ago that subsided after I started on an ace inhibitor. She explained that I had a "huge amount" of protein in my urine and I interuppted and said "well, that could be due to an infection, right" and she then said there were no other factors which indicated an infection and that this was probably "acute onset diabetic nephropathy".
Oh. My.

I got home and my inner monologue was something like this - "....ok, ok.........so my kidney's might be failing.......maybe it's early in the process....... maybe I've lived long enough.........maybe I'll die and then not have to deal with all this crud anymore........". One of my relatives had just been taken off
the kidney/pancreas transplant list because his condition had weakened to the point where he would not survive the surgery.

The next morning I called my pcp's office and asked that the doc review the notes and call me back. The nurse phoned back in 20 minutes and said "the dr. wants to see you immediately - you need to come in today - we'll make room for you". Gulp. By then I was in that robot-like numbness where I send myself when things get too scary.

Dr. Steve came in the room and said that yes, this was a problem and needed to be addressed. We'd start with a 24 hour urine collection. Fortunately, the creatinine level in my blood was normal, but, it doesn't start to elevate until about half your kidney function is gone.

So I waited a few days to calm down and then did the collection. I brought the jug to the lab on July 17 and was told that my pcp would call me with the results, usually within a few days. The next week I jumped every time the phone rang at work and held my breath while listening to my messages at home. I made a couple of significant errors at work and was overtly mean to a couple of good friends. No news.

The next Monday, the 28th, I called the clinic and said I wanted the pcp to call me with the results. I was told he was on vacation. I asked to speak with his nurse and no, only the doc can give you the results. I asked to speak with whoever was covering for him but never got a call back.

I decided that I didn't care if I was dying or not - and conveniently erased the prior 3 weeks from my mind and stumbled about on auto-pilot.

Then, last Friday, August 15th, I got a letter from the doc. He wrote "Kathy, your kidneys look good. I don't know what the episode was about but presently there is nothing to indicate any damage or to be concerned about. See you in 3 months.".
Soooooooo.......I wasted a month of summer walking around like a zombie. I am too emotionally exhausted to be angry, and then, who would I be pissed off with? Maybe it was a lab error; maybe it was the body trying to tell me that I need to pull in the reins and improve my control; maybe it was a higher source reminding me that I am very lucky. Sigh..................

On a closing note, we have a lovely party last weekend for my mom's 81 birthday. She has had several major episodes of illness in the last 2 years and been in assisted living since February. Sometimes when I call her she is in la-la land. But, on the day of the celebration she was extremely good, as you can see on the picture. With her is my precious niece, Emily. Em came to be with our family just before her first birthday, and cracked open all of our hearts with the soft tap of one tiny finger...........sniffle, sniffle.