Friday, November 20, 2009

Good and Bad

I know I should be sleeping in preparation for my group meeting tomorrow, but I can't sleep. I finally had my long awaited follow-up appointments with the rheumatologist and neurologist this week. Some good news, some bad. The good news, I don't have lupus. I wasn't surprised to get that news, but was a little peeved that I had to take a 30 minute bus ride, wait an hour, and pay $20, just to have 2 minutes with the rheumatologist. She's really sweet and was very thorough, but all she had to say was, "you don't have lupus" and that could have been done over the phone.

Today's appointment with Dr. C was much more eventful. I still had to wait an hour, but I got my money's worth. Since they never seem to listen to me, I came to the appointment with a list of my current symptoms that I gave the doctor as soon as she walked in the door. I included descriptions of each symptom and told her I wanted help with all of them. We discussed them and then she explained that she only felt comfortable working on two at a time and we can work on the list over the next few appointments. She suggested which two she thought were most important (bladder control and depression), but gave me the power to choose which ones I wanted to work on. I explained that my ultimate goal is to get back to work and my memory loss and current level of depression are making it really difficulty to do anything. I mean, I'm terrified of getting lost again and I'm too depressed to muster a smile most days, so leaving the house only happens when absolutely necessary. That's not exactly compatible with most work environments.

Dr. C said there isn't much she can do for memory loss directly, but believed that my mood could be tied into the memory problems. She wants me to see another doctor at her clinic to be evaluated and determine the best course of action for the depression (he's a neurologist and psychiatrist). In the meantime, she wants me to start an anti-fatigue medicine that has helped some of her patients with their cognitive difficulties and mild depression. I see the other doctor in three weeks, though I wish I could have seen me today. Hopefully, the anti-fatigue stuff will help.

Since we're hitting three list items with one pill, she let me pick one more item and I chose bladder. I recently had an accident at home and it's honestly just as hard to deal with, emotionally, as accidents in public. I told her that I have some incidents of sudden emptying, but mostly my problem is urgency that leads to leaking when I can't find a restroom in time. She wasn't sure if my perception of the problem was correct and said that it's more common that I am not fully emptying my bladder when I pee and that could be leading to my problems. To determine the cause of my problem she needed to ultrasound my bladder when full and after I peed. Of course I'd emptied my bladder just before seeing her. She still wanted to do the ultrasound during that visit and presented me with a 12 oz cup of water. I drank 4 full cups before we were ready to do the ultrasound. My bladder was in fact emptying properly and she prescribed and once daily oral medicine to help with the urgency.

All-in-all the appointments went well. I usually take a list with me, but it made a huge difference to give a list to the Dr. and not wait for her to transcribe what I was saying. Or what she thought I was saying. Next time I want help with insomnia and pain.

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