Wednesday, December 29, 2010

in and out of lions' dens

my right lower leg, from below the knee to the ankle, has been swollen from may 2010. some of you may know that i suffered 3rd degree burns in that leg in 1978, and the area has been susceptible to some discomfort when i stand in one place for long periods of time, say 10 minutes. it was traumatized when i participated in our ppcrv in the 2010 national elections, when i had to go up and down 4 floors in 3 different schools, checking on the election proceedings.

dr jimmy gave me some supplements for the blood clots, but the swelling didn't subside. i guess because i never slowed down my activities, and went on as if i was a 30-year old.

anyway, my leg started to get tiny cuts because the skin was stretched tight. there was some secretion of blood and something else. cris was really worried and kept asking me to see a cardiologist, because dr jimmy did say i had leaky heart valves and blood clots. i kept resisting because of the lions.

you know the lions? ferocious animals that stand square in front of you, and stare you down. when they have you sufficiently paralyzed with fear, they pounce, leaving you like humpty dumpty, in a hundred tattered pieces, with no one to put you back together again. that's how i see regular doctors, lions.

but you can never run away from a determined woman. sooner or later, they wear you down. so after a month of cris' constant, uhmmm, insisting, i gave in and agreed to see a cardio, who would prescribe tests to be done.

on nov 26, cris and i walk into the cardio's office. seems like a pleasant enough young lady, until she responded to my english greeting, in tagalog, which rang my warning bells. this usually means one of two things.

first, they answer me in tagalog because they can't speak english fluently. if i think that's the case, i'm cool with it. pilipino naman ako, kaya mag salita tayo sa ating sariling wika. but since this lady was a medical doctor, with an office in makati med, the first scenario couldn't be true.

the second scenario, scares me especially with doctors. they don't think you can understand the english they speak because they're doctors. that puts me in a disadvantage already. even more worrisome, is that they want to make sure you understand them because it's a matter of life and death. your life; your death.

the cardio starts off with (in pilipino), "i'm not going to inspect your leg just yet. i just want to ask some questions to get some background information." you can hear the unspoken addendum, "there are no right or wrong answers here, but God help you if you say the wrong thing."

  • "how long has your leg been swollen?" since may.
  • "are you diabetic?" cris: "not really. he has elevated fasting blood sugar levels though. or did, when he had his radical nephrectomy."
  • "do you have a heart condition?" me: "no." i didn't feel like telling her about the leaky heart valves and blood clots. one, let her diagnose me herself. two, she'll never believe me when i tell her how dr jimmy diagnosed it.
  • "do you smoke?" me: "no." cris: "he did, until the operation. before that, he didn't just smoke cigarettes. he smoked cigars and unfiltered cigarettes." me: rolling of my eyes. trust my wife to give more information than is necessary.
  • "have you gone back to your (kidney doctor)?" me: "no."
  • "no? why not?" me: (shrug of the shoulders.)
  • "are you taking any medication?" me: "medication as in medicines? no." and i start thinking, "uh-oh. here we go". cris: "he is very committed to his alternative medicine treatment. he diets and takes food supplements. i had to really convince him to come and have tests done."
  • "oh? what supplements do you take?" cris and i look at each other. we have this small joke about how very appropriate the names of my supplements are. 'heart valve" for my leaky valves; "clot" for my blood clots. "heart ease" to strengthen my heart. and so on and so forth. me: "just herbal supplements."
  • "what herbal supplements? can you bring them next time? and any literature you have." me, thinking only. "literature? you think this stuff is made by astra or novartis or smith-kline? you want to see the supplements? would you understand the ingredients?" obviously, i'm starting to get irritated.

then, she says, "ok, can i see your leg?" and i lift my right leg on cris' chair, pull up my pants, and let her start poking around.

"oh, it has tiny wounds already. and there is some secretion. and it's hot to the touch, which normally means there's considerable infection. could you lie down? i'd like to check it out closer." and i know, this is not going to be good for me.

finally, she tells me to sit up and blasts me, "you know? i'd like to have you confined right away, for about 3 days." there you go. lions. they try to get you every time.

me: "uh-uhh. nope, i don't think so. no way."

cris, ever the reasonable one, asks: "why do you want him confined?"

cardio: "i'd like to give him antibiotics via an iv. then, have a vascular surgeon run some tests for a blood clot. and we can have the leg debris-fied (or, in simple words, clean up the dead skin of the leg)."

me: "oh, i see. no, thanks."

cardio: "well, having anticipated your answer, i will now prescribe an anti-biotic i would like you to take orally."

me (showing a bit of reasonableness): "fine."

while she writes out the prescription, she also mentions some tests she wants done – Doppler ultrasound on my leg, 2d echo, ecq, fbs, blood chemistry. to which cris adds her 2 cents: "urine and stool?"

cardio: "i will still recommend you see a vascular surgeon just to get his opinion. and your kidney doctor to check on your diabetes."

by this time, she had got me scared shitless, what with her diabetes and blood clots and her heart condition, and my need for a vascular surgeon and my diabetes doctor. i hate being scared especially about my health. so, as usual, cris had to bear the brunt of my anger as soon as we left the doctor's office.

me: "so, what did we learn that we didn't already know going in? dr jimmy already said i had blood clots, and how many, and where they are. we already knew i had venous thrombosis (that's my swollen leg). so now, i have to go through more tests to tell me the same things we already know?"

cris, as always patient and reasonable: "let's just get the tests done, then we'll have confirmation of dr jimmy's diagnosis."

me: "i don't need confirmation! i already know."

but because cris is who she is as a person, and what she is to me, i finally relent. we get the authorizations for my tests. and later on, using my senior citizen privileges for the first time, i buy my antibiotics. by that time, i was sufficiently calmed down so that cris didn't have to accompany me to make sure i bought them.

the next monday, she drops off my urine and stool samples. tuesday, we go for my 2d echo. cris goes to the hospital 2 hours before i have to be there to make sure i have a firm appointment and so i don't have to wait too long. she was probably worried i'd get impatient and walk out of the test.

15 minutes after i get there, the technician comes for me. we enter a fairly large bare room, containing the ultra-sound machine, a cot, and small desk and 2 chairs. as is the standard practice, the lighting is dim (what is it they don't want to see, or they don't want you to see clearly? they're not going to allow you to sleep, anyway). the aircon is close to freezing.

she starts the probing. the machine emits its blurbs, beeps, pings, and ga-zhoos, ga-zhoos (i realize this last is the sound of my blood rushing thru my veins). this goes on for a minute or two.

then, another person comes in, says a soft, "good morning" and joins the technician . must be a doctor cause she's got a white gown on while the nurse is dressed in blue scrubs. she sits beside the technician, and they talk in low, subdued tones, just enough for you to know they're talking, but no loud enough for you to make out what they're saying. and you know they're talking about you while the machines goes, "ping. ga-zhoos, ga-zhoos. blurp. ping. ga-zhoos, ga-zhoos."

then, it's over. you dress up and leave. now, you start your wait for the results on tenterhooks. they work hard looking for something wrong with you.

two days later, with all the tests done, we go see the vascular surgeon. the results are encouraging. no clots found in my right leg. fbs is normal.

the surgeon is an elderly, but energetic man about my age or a little older. he's friendly and very informal. i like him immediately.

he checks out my leg, which has noticeably improved because of the antibiotics i've been taking. he prescribes medication i have to take for a month, and some exercises for my right leg. he knows that my leg hurts when i stand in one place for some time, and that the pain subsides when i walk around. he says walking is good because it makes the blood circulate. standing still or sitting down does not force circulation, so i need to do the exercise while i'm on the computer or when i'm reading. he also advises me to keep my leg up when seated.

he asks me how i take care of my leg and i tell him i wash it with soap and water, then apply bactroban to the wounds. when the leg itches, i massage it with coconut oil. he says i already know how to care for my leg, except he wants me to use petroleum jelly instead of coconut oil. grist for the pharma industry.

after the surgeon, we go see my cardio. as i expected, she found something negative in my test results. they normally do, no matter how good your test results are.

she's satisfied with the doppler test on my leg showing i don't have any blood clots in my right leg. my 3-month sugar level average is in the normal range but my fbs is elevated. so, as expected, that's what she zeroes in on. not that my 3-month level is normal but that my fbs level on the day i had my blood test, is kinda high.

since she can't get a hold of anything specific on me, she wants me to repeat the blood test in 2 weeks and go back to her, and to see my kidney doctor, because i have slightly high creatinine and have only 1 kidney left. then, she subscribes metformin. i say i don't like taking medicine, so she says it's up to me, but she'll prescribe it in case i change my mind.

a week later, i see my kidney doctor, a young, pleasant guy. at first, he cannot place me. i tell him i had my right kidney removed a year ago. he asks how i am. i tell him, i'm good. he asks, why i'm seeing him then. i tell him, it's my wife. she's worried about my creatinine level. she insisted i come see him.

that's when his memory kicks in. he remembers cris, sight unseen. he asks me what treatment i've had for my cancer, though he doesn't mention the dreaded "c" word. i tell him i'm on alternative medicine, basically dieting. i explain that since renal cancer didn't respond to radiation or chemotherapy, and medications would only extend my life, not cure the cancer, i made a decision to go with alternative medicine.

he says that removing the tumor would work. i said that's what i did. he said, "yeah, but didn't they find traces after the operation?"

me: "and that's what i needed alternative medicine for."

he looked at the results of my blood and specimen tests, and pronounced them very good. he told me to tell cris that an elevated creatinine level and higher that normal fbs results are to be expected when the patient has only 1 kidney. otherwise, i'm good. the reason for alarm with my cardio (having only 1 kidney), is the same reason why my kidney doctor is comfortable with my creatinine and fbs levels.

just to be on the safe side (and to keep the medical system rolling merrily along), my kidney doctor told me to have an x-ray and an ultra-sound for my abdominal cavity area, which i dutifully did, with cris right behind me.

another week later, i'm waiting for my cardio to pronounce judgment over me. i've seen the x-ray, fbs, and ultra-sound test results, and everything's ok with me. as the results say, unremarkable, which i take it is remarkably good for someone my age, having been through what i have.

these tests confirm the magic diagnosis that dr jimmy makes. the 2d echo says i have mild mitral regurgitation, which is consistent with my leaky heart valves dr jimmy said i had. the fact that it's mild is probably because i'm on the last leg of my alternative medicine treatment for that. i have no clots in my right leg, again, probably because i've been taking my supplements. my aorta is athroscerotic, which is probably connected with the thick blood dr jimmy diagnosed.

i'm glad i consulted with dr jimmy before taking these tests, or the doctors would probably have given me a heart operation, a venous surgery, and whatever bloody procedure they dream up. as it is, they're catching the tail-end of my defects.

it's nice to know that on God's green earth, there are many wondrous things, including alternative medicine and traditional medicine. they have their uses. we only have select whatever fits your needs.

they will all work in varying degrees. especially when you're comfortable with the treatment and believe in it. i don't believe fear helps at all, other than to make sure you follow your doctors' orders. but if they explain how their treatment works and it sounds logical to you, i don't see why you wouldn't follow it.

hang on a minute. my appointment with the cardio's up.

i was finishing this update while waiting for the cardio. she looked at all the good test results, and focused on the one result that was not perfect. my fbs reading was 110.48. maximum normal is 110. and she goes, "i'm really concerned about your fbs level. but you're taking the metformin i prescribed, right?"

wrong! "no, i'm not."

shocked! "why not?!!"

"i'm into alternative medicine, remember?"

"well, there's nothing i can do for you anymore then, if you won't listen to my advice. cardio-wise, there's nothing wrong with you. the rest is between your kidney doctor, your vascular surgeon, and you. good'bye!"

and she flipped me off. well, maybe not quite, but that's the feeling i got. no problem. i hope i never have to see her again.

and that's life as benjie after 60, looking for help anywhere, and generally finding it with the grace of God.

oh, a merry christmas to all, and to all a happy new year!