Doc Talk

Last week I had appointments with 3 of my doctors. (I have “doctors” now – plural – aren’t I posh?)

First Appointment

The first appointment was with my endocrinologist (diabetes). This was a pre-scheduled appointment to check up on my A1C numbers. An A1C test is a blood test that reflects your average blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher your blood glucose levels have been. Standard range is 4.8-5.6%. As a diabetic, my goal is to be under 6.4%.

Back in December 2018, my A1C was 10.7%. This time, my A1C was down to 6.2%. This was a huge victory – and a reflection of finally finding the right mix of medicine and diet to keep me in a good place sugar wise. The surgery may impact this, so we’ll have to keep a careful eye on it. But it’s a good place to be in before the big day.

Second Appointment

The second appointment was with the hematologist. Back in November, I was diagnosed with a pulmonary embolism (PE) in my right lung. For those who are not aware, PE occurs when a blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung. Blood clots most often originate in the legs and travel up through the right side of the heart and into the lungs. Blood clots can happen for several reasons, but in this case it was determined that it was as the result of my recent hospitalizations for kidney pain and resulting stent placement. The doctors felt it may have happened due to a lack of mobility.

The treatment for PE is to go on blood thinners as this will typically cause the blood clot to dissolve. Treatment is typically for 3-6 months, although blood thinners may be continued for life if you have a clotting disorder or cancer that increases your risk of another clot.  I have been taking Eliqis twice a day since November.

My urologist wants me to discontinue my current blood thinner pills at least 3 days prior to the surgery to give it a chance to work its way out of my system. Instead, they are going to switch me to heparin injections, so that if there is an issue during surgery they can use another shot as a fast-acting antidote. (The whole thought of complications during surgery is not a reassuring one, but knowing that this doctor has thought ahead about it is somewhat comforting.)

Since I will have reached the 6-month mark right before surgery, the blood clot should hopefully be dissolved by now. Her nurse took 6-8 vials of blood to do some genetic marker testing, and I just received the results back today that my blood shows no sign of clotting and I should be in very good shape clot-wise for this surgery.

Of course, a big key to avoiding more clots will be to make sure the blood keeps flowing in my veins. Although I’m limited in the amount of walking I can do, things like compression sleeves can be put on my legs to massage the veins and keep things flowing.

Third Appointment

My final appointment last week was to the dermatologist. At my annual physical back in February, my GP had noticed some “weird spots” on my back that she wanted to have checked out. When I didn’t make an appointment within 2 months, she sent me a rather stern letter urging me to go, in spite of all the other health issues I was dealing with and now with the pending surgery, I decided it was best to just cross it off the list.

It is the first time I have ever been to a doctor where the paper gown they give you is literally a crop top. It barely covered my chest, and definitely did not cover the roll of fat that is the bane of my existence. So that was fun.

The nurse who first triaged me wanted to know how long the spots had been there, if they were itchy or hot or red, and a myriad questions. I had to be frank – the weird spots on my back where out of sight, out of mind in the midst of all the other medical stuff. I was here because I was told it was important, but I had no idea what it was. He was sympathetic and left the room.

The dermatologist was kind and thorough. She mapped the various spots on my back, analyzed them through a handheld medical device, and deemed them all benign. She wished me well, and suggested I need not return until next year when hopefully I was in a medically-improved place.

I thanked her for time and left the office in relief. It was nice to not have to add anything new to my list.

Next Up

3 down, a few more to go. I’m supposed to get all my womanly checks (mammogram, pap smear, etc.) and also have my eyes examined. And at some point, I need to re-visit the latest issues with the Ledderhose Disease (aka plantar fibromatosis) on my feet and see if there are any new treatments we can try. Of course, the big day is still June 17th – only 32 more days. I’m looking forward to being on the other side of that.