The Doctor Is The Patient
I became a patient instead of a doctor last night. The day before yesterday, I flew home from North Dakota for a few days at home before going on a trip to South Dakota. Yesterday, I experienced sudden left calf pain for no reason at all. I hadn’t had a cramp, nor had I injured the leg in any way. Sudden unexplained calf pain can be a sign of a DVT, or a deep venous thrombosis, which is quite dangerous as that blood clot can be thrown into the lung, which in severe cases can result in instant death. Travelers are at high risk for a DVT because sitting for long periods of time can impede blood return from the legs to the heart, and with the blood pooling in dependent areas, it can set up as a clot. I am also over forty years old and am on estrogen in the form of birth control, which increases my risk for DVT even more.
I considered the pain for a while, and I could think of no plausible reason for it to be there. And knowing I had another plane trip in two days, it would seem very foolhardy to hop back on a plane and risk throwing a clot at 30,000 feet up, where there is no medical care available. So I made the decision to take myself to the ER, as they would need to perform a number of tests, most of which are not available at an outpatient clinic.
I arrived at the ER, in my own hospital where I have worked for ten years, and signed in. I was recognized immediately and was signed in. Membership does have its privileges. They instantly brought me back to triage, before an entire waiting crowd of people, had my vitals done and they whisked me directly to a bed.
They immediately drew bloodwork pertinent to the diagnosis of a DVT. Everyone who came into the room recognized me and chatted with me. The lab tech came in and said she’d drawn bloodwork a million times with my name on the order slip, but had never drawn blood on me. She confessed she was a little intimidated. I told her not to be; I have amazingly beautiful veins and I told her she would have no trouble accessing one. Indeed, I was an easy stick. While we were chatting, she told me she was pregnant, and that her doctor was my former partner, who is a great person, so I told her I was happy for her.
Next the ER doctor came in, and he is one of my friends, which was great. He’s also brilliant, by any standards, which is also great. He’s also qute eccentric, which I enjoy. He was always calling me when I was on call, and he always starts his explanation with “I’ve got this girl here…”. Doesn’t matter if the girl is twenty or eighty. So he came in and chatted with me about what the problem was, and he checked out my leg and checked pulses and all that good stuff. Then he ordered leg dopplers and headed back out.
The doppler tech came in, and I know her too, so we started chatting about all the crazy things going on in the hospital, and about how everyone is so scared for their jobs, because they are slowly shutting the hospital down. She scanned the leg, and everything turned out OK. Several years ago, I had contacted the CEO regarding equipment that they needed for the vascular lab and weren’t getting. I asked if she ever got the equipment. She smiled and said she got it the next day. It was good to see her.
The RN came in to see if I needed anything. We chatted too, about the job situation. She’s a former EMT and firefighter, and she has maintained her certification in both so she may have more options than some. She adjusted the thermostat for me and got me tucked in to wait on lab results.
The doctor came back in the room. My clotting labs had come back abnormal. He wondered if I had already thrown a clot from my leg into my lung. If it was a bad one, I would have died already, so I would likely be OK. But the abnormal lab meant I needed a chest CT to make sure there was no clot in my lungs, because if there was, I was going to have to take blood thinning medication to get it to go away and prevent future ones from happening. I knew the CT would be done with contrast. I’ve had a CT before, so I knew how weird it feels when they push that stuff into your vein. You get a massive hot flush from your head to your toes, and a cough reflex when it hits your lungs. It’s not a lot of fun.
That means I needed an IV. The RN came back into the room to start it. She too confessed that it was a bit intimidating to start an IV on a doctor. I told her number one, I am not at all intimidating, and number two, I have beautiful veins and she would have no trouble getting one. As advertised, she nailed it on the first try. I didn’t even feel it much. She told me I would have to keep my arm straight as it was at the bend of my elbow.
They came to pick me up for my CT. I was wheeled down the hall, and the CT tech informed me that this contrast would be twice and much, and pushed twice as fast as the contrast I had had for my previous abdominal CT. Great. He also told me that the chest CT was the equivalent of 300 chest x-rays. Double great. We laid me out on the table and he did one pass without the contrast dye. Then he rolled me back in and BAM I felt that stuff hit my body, a mile a minute, head to toe. I was in the breath holding phase of the scan and the urge to cough when the stuff hit my lungs was almost impossible to control. But I made it through, and it wasn’t even as bad as I had remained. It gave me a really weird afterglow feeling in my privates for a minute or two though. Then I was wheeled back to my room to wait for results.
The results took about forty five minutes. I laid on the bed and kept my left leg straight because it hurt, and the right arm straight because there was an IV in it. Then the doctor came back into the room and told me there was no clot in the lung. Thank God! Now I could travel to my next assignment and not have to be stuck in the hospital. There were some other weird findings on my chest film though. There were some areas that looked like I might have had TB, which as far as I know I’ve never had, as I am tested for it every year since I started med school. Another possibility was histoplasmosis, which is common in the South and many people carry it asymptomatically in their lungs. It only reactivates if you are somehow immunosuppressed. Hopefully that will not happen. Also, my blood sugar was a little high, and my blood pressure was a lot high, which kind of worried me. Now I will have to go see my primary care doctor and have all these things worked up.
I didn’t get home until after midnight. Hubby and daughter were passed out in the bed. I was very relieved I didn’t have a blood clot, as I leave for South Dakota for work tomorrow. My husband wondered in the morning why I didn’t wake him to give him the news when I got home. I reminded him that he has insomnia and if he was asleep, I wanted him to stay that way. So when I get back, I’ll be following up with my regular doctor to explain all these adjunctive findings that we came up with while ruling out the DVT.