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Showing posts with label needles. Show all posts
Showing posts with label needles. Show all posts

6.13.2012

Your Thyroid Advocate

The company I work for has great incentives for employees who want to stay healthy. This winter we were offered $300 gift cards if we’d see our doctors for an annual physical. I was able to squeeze my doctor’s appointment in five days before the deadline. My appointment was on the last Monday in March. I checked and double checked that a blood test would be absolutely necessary. I was told that a blood test was indeed required to complete the annual physical and qualify for the gift card. As I sat in the laboratory waiting for my name to be called I kept thinking, “This will probably be worth $300. The best thing is I won’t have to worry about getting another blood test for an entire year.”

The only blood test I remember getting was eight years ago when I was filling out my mission papers. Back then the excitement of being called on a mission was enough to get me through the ordeal. Nowadays I need cash waved in front of my face in order to take a needle willingly. It’s sad but true.

When my name was finally called and I entered the draw center I had no choice but to put my trust in my randomly selected phlebotomist. Actually, maybe the selection wasn’t so random. She was very nice and I didn’t feel embarrassed to ask her for the smallest needle she had. She didn’t fight me on it at all. The best part of all was she was able to find my vein on her first attempt. The worst part was it seemed like the needle was in there forever. My nurse practitioner had ordered a ton of blood work. I dared not look down at my arm to make sure my circulatory system was surrendering all of the required blood. The phlebotomist asked me how I was feeling and I said, “It kind of hurts.” I asked her if everything was working and she said it was. After a few more seconds she started removing all of the equipment. She mentioned that my veins were so small I probably wouldn’t be able to donate blood. That sounded completely fine to me.

I left the lab that day knowing I had done a good thing. After passing through that major hurdle I bought myself some special French toast at a local drive-thru and headed to work. During the next three days I waited for a follow-up call from the doctor’s office but it never came. I called them on Thursday and after a little shuffling I was transferred to someone who had my results. She ran through the tests they had done. I had expected everything to come up normal but that wasn’t the case. She told me my thyroid number was off. After a little explaining I understood that my thyroid was slightly underactive and they wanted to start me on a small dose Levothyroxine immediately. I would need to take it for two months and then return for another blood test. “Which pharmacy would you like us to send your prescription to?”

Wait, hold up.

The day before I had this conversation I had read an article titled, “Student survives cancer thanks to BYU class.” The student’s classmate and teacher noticed a suspicious lump on her throat while they were learning how to do physical examinations in class. The lump turned out to be thyroid cancer. Here’s the news story:


I wasn’t concerned I had cancer but I thought it was a weird coincidence. More than anything I was troubled I had a problem that would never go away. (I didn’t really understand that I’d likely be on medication for the rest of my life until I talked to my mom.) The biggest bummer is that the medication has to be adjusted throughout the years so that means lots of blood tests.

When I picked up my prescription at Costco I was pretty upset. I was in line with people who had embarrassing problems and I didn’t want to be one of them. I didn’t want them to look at me and wonder what I had. At least the prescription was inexpensive.

I went about my business and diligently took my pills for the next few days. Then on Sunday night I got another thyroid bombshell. I was watching the new episode of the hotly-anticipated fifth season of Mad Men. One of the main characters made her first appearance of the season and boy did she look different. Betty Francis (formerly Betty Draper) had gained a little weight. She went to see her doctor who at first brushed off the weight gain as “typical for middle-aged women.” (Yikes! She’s supposed to be in her early 30’s!) He quickly changed his tune when he felt a suspicious lump on the front of her throat. That's right - the lump was on her thyroid. I wanted to yell, “Again?!”


 Betty had a biopsy and by the end of the episode she knew her tumor was benign. She is one of the most polarizing characters on the show but for that hour I imagined her slow demise and I felt very sorry for her. It wasn’t a pretty picture. The things I imagined reminded me of my grandma’s struggle with throat cancer. I was glad that Betty would be okay but I did become a little paranoid that my next blood test could reveal more serious problems with my thyroid.

A week and a half ago I went in for my second blood test. My phlebotomist had a slightly different but extremely efficient approach to finding my vein. Since she got it the first try (using a baby needle) I didn’t mind one bit. She only needed a fraction of the blood they took the first time and I was out of there in no time. She told me, “You did great,” and I really appreciated that.

Fast forward three days. I sat in an examination room with my nurse practitioner as she searched for my results on her computer. She asked me if I had been feeling better and I told her that in the first month of taking medication I definitely noticed a difference. By the time the second month rolled around it was harder to tell the difference because it just became part of me. The tricky thing about my situation was I never knew I had a problem in the first place.

The good news was that my thyroid had normalized. There was still room for improvement. We decided to keep me on the same dosage and check again in three months. Irgh! Three months!! After that it will probably be every six months. That means if I live for 50 more years I will have 100 more blood tests. Holy crap.

What does it all mean? I think it means a few things.

1) Having a thyroid problem is no big deal. I have told a lot of people about it and everyone seems to have a thyroid problem or know someone who does. It looks like we’re all in the same big fat boat.

2) I have to face a few inconveniences on a daily, monthly, and semi-annual basis. (That is 365 + 12 + 6 = 383 inconveniences a year, to be exact.) I have to remember to take a pill every day, get a prescription refill every month, and surrender myself for a blood test twice a year. I’ve already been at this for two+ months and I know it’s for my own good. I’m going to keep at it.

3) Blood tests are no longer allowed to be a big deal. They are just going to be a part of life. However, I’m still entitled to a sweet treat after every blood test.

 4) You may not know you have a problem, and you probably won’t have a $300 incentive to get checked out “just for the heck of it” but I strongly recommend you get an annual physical exam. Don’t forget to get a blood test as part of the grand finale.

As your thyroid advocate I hope this information has been somewhat helpful. I still have moments when I get mad I’ll be on medication for-ev-er but I know that this is a simple problem with a simple solution. I’m still eternally grateful for modern medicine and I can’t imagine life without it – even if I have to haul a tiny orange pill container everywhere I go. 


8.05.2010

Count the Hummingbirds

I have an oddly vivid recollection of elementary school. In particular, I remember the late summer day I got a physical for Kindergarten. I was five-years-old and my mom and I went to the school nurse’s office for sight, hearing and balance tests. I guess they wanted to figure out if I was physically cut out for the big “K.” I found the whole experience to be quite pleasant with many smiling women saying, “Good job,” along the way. After several tests I thought it was time to leave but instead I was led into a new room with white walls and appliances. It felt a little… antiseptic. I should have been clued in but no alarm bells went off. One of the kind women said she had something to show me. My mom was nearby so I knew nothing bad could happen. The nurse pulled out a small plastic version of a Neapolitan ice cream bar. She held the stick of the fake popsicle and told me to insert my finger into the opposite tip and hold still. I did as I was told and she pulled some kind of trigger and a hidden needle snapped out of its holster and found purchase in the pad of my pointer finger. I pulled my hand away and looked at my finger in shock as a big glob of blood seeped out. I screamed and bellowed and she quickly pulled a nano version of an Otter Pop out of the freezer and put it in my hand. I was trying to figure out if this was a real treat or another trick as one of the other women rolled up my sleeve and dabbed a cold liquid which quickly evaporated. Before I had time to process the sensation I looked down and saw a syringe coming my way. I just about flipped out. Not only had they tag-teamed me, they had also distracted me with another fake popsicle. Perhaps I remember the rest of elementary school because I was convinced I had to watch my back (along with my fingers and arms). Needless to say, thus began my lifelong embittered battle with needles.

Luckily enough I survived Kindergarten and the following summer I was headed for first grade. Maybe my mom was still feeling bad for the whole popsicle incident because she took the family to Disneyland that summer. My parents had friends in Anaheim and we were lucky enough to stay with them the day we arrived in Southern California and the day before we left for home. The family had at least six kids in it and best of all – a dog! I never had a dog growing up so other peoples’ dogs quickly became my surrogate pets. Disneyland was a great experience and on our last night in Anaheim we had a big family dinner with our friends and I got to reconnect with my pal Buddy. I didn’t know anything about dog breeds at the time but apparently Buddy was about as big as they came: a mighty Great Dane. Well, that didn’t concern me one bit. I was small and he was big but everything was bigger than me. I was playing with him on the living room floor when I did something that startled him (I’m too embarrassed to say what it was) and he lunged at me and clamped his jaws around my skull and tried to pick me up by my head. It had happened in an instant - a low warning growl followed by the more feral snarls that indicated he’d lost all control. He’d snapped and I was trying not to snap in his grip but he kept picking me up and I couldn’t hold onto the carpet. Somewhere in the numb panic I had time to feel embarrassed that this dog was biting me and everyone was watching. I had done something wrong and it was my fault.

The two oldest sons realized what was happening and quickly pulled Buddy off. They managed to push him outside and despite his best efforts to break through the sliding glass door, Buddy remained there. Luckily I was in shock and for a second everything in my view slowed down, held still and went quiet. I could feel someone slowly wiping a warm blanket from my forehead to my chin. A warm, wet blanket. My vision was obstructed by a red glow and I realized this warm blanket was my blood pouring over my face. Oh. That was scary. I took a choked breath and everything around me returned to normal speed. Someone put a dish towel in my hand and then pressed it to my forehead where most of the damage had been done. The two sets of parents quickly fired up the minivan and got me into one of the backseats with a second dishtowel. I hoped they’d forgive me for ruining their towels. Our makeshift ambulance sped to the emergency room. By the time we were there I was done crying. This was a hospital visit, and despite my ingrained skepticism of the school nurse’s office, I trusted my doctor at home and generally liked medical staff. Again, they were kind and encouraging. They tried to control their looks of disbelief as the parents told them what had happened. The lead doctor showed me a trunk of toys that I would be able to choose from once this was all over. I was pretty excited about that and decided that this all just might be worth it.

I didn’t have the slightest clue what stitches were or what they entailed which was a darn good thing. Unbeknownst to me the doctor was using numbing injections to make the raw burning stop. Whatever he was doing stung a little but he always warned me first and I appreciated the cooling sensation. I kept hearing the word “stitches” but it didn’t bother me. Everyone in the room laughed as someone told a story about a boy who needed stitches in his hand but had to be tied to a board because he was too scared to hold still. I couldn’t imagine what would be scary about this – we were having fun talking about all the things I’d done in Disneyland. Nevermind that my skull had been exposed and I’d given my family the fright of their lives. Nevermind the fact that a needle and thread were being strung through three layers of skin and tissue. It was “all good.”

Twenty-one stitches later I got a huge Minnie Mouse Band-Aid I could wear once the wound had set for a day. The doctors weren’t concerned about scarring and best of all I got to pick four toys from the chest. They said it was the most they’d ever given to anyone. I guess they appreciated the fact I wasn’t screaming my head off but I think some part of me was just trying to make up for the stupid thing I’d done and the mess I’d made. Before we left the doctors told the two sets of parents that a three-year-old girl had come in the week before with similar injuries but her skull had been fractured and she had died. The dog that bit her was younger and had more teeth than ten-year-old Buddy. I was “the lucky one” but it was hard to fathom that a slightly harder skull and a few missing dog teeth could make such a big difference. I didn’t feel like the lucky one the day I came home from first grade and my mom sat me down saying she had something to tell me. It was bad news. Buddy had been put to sleep. He could no longer be trusted around the small children in the home. In my foolishness I had inadvertently snuffed out a life – the life of a family’s best friend and loyal companion. I felt horrible. The inch long, paper thin scar on my forehead is my tribute to him. I have no hard feelings toward him or any dog, and honestly I still have a hard time remembering to keep a safe distance.

The next monumental medical experience happened to my sister. Our two older sisters had moved out and we wanted to take over their rooms. Aimee was moving boxes to her new room and my mom was vacuuming in the hall when we heard her scream. My mom turned off that vacuum and ran in, for surely this scream was bad enough to indicate a lost limb. I guess sometimes the minutest injuries can be the most excruciating: Aimee had stepped on a toothpick. Over half of its length had gone into her foot. I don’t remember the details of extracting the toothpick but I know that our parents have stomachs of steel. We didn’t need to go to the emergency room but the next day we went to the doctor’s office because Aimee needed a tetanus booster. I have no idea why I went along (I was probably too young to stay home by myself) but I really wish I had missed that particular outing. Aimee was really worked up about the shot and was openly considering hiding behind the curtain or running out of the room when the doctor came in. I tried to help her imagine ways of getting out of this but there was really nowhere to go. Mom, as usual, was on the doctor’s side. There’s simply no talking your way out of a potentially lifesaving vaccine. In the end Aimee got her shot and I think there were more tears on the way home than in the office itself. Every time my mom turned the car my sister wailed and made me believe her arm might just fall off. Thanks to her, I associated tetanus shots with not only an unbearable injection, but also lingering arm pain that made it too painful to lift a pencil.

Fast-forward to my junior year of high school. I had miraculously made it through life with very few syringe encounters. I was eternally grateful that I didn’t have diabetes (my mom had been diagnosed with type II diabetes six years earlier) and although my mom was a faithful blood tester and avid blood donor, her saintly example still couldn’t convince me to voluntarily take a needle. I had a high school elective option to do volunteer work on Thursday afternoons from 1-4 at the local hospital. I was very interested in becoming a paramedic and although I knew that profession required working with needles, I figured I could handle it with exposure and practice. I went through volunteer orientation and just about fainted when I found out we’d have to be TB tested in order to work at the hospital. When I found out that a TB test either involved being simultaneously stuck with four needles or having a needle slid horizontally under your skin, I thought twice and thrice about my first baby step into the medical field. I decided to go through with it and as I followed the directions to the nurse’s office I half hoped I’d get lost and fall into a black hole. I had no such luck but I when I knocked on the nurse’s door she answered with a smile and let me in. She had a small office with a desk and I was too scared to look around. I immediately told her I hated needles and she assured me this wouldn’t be too bad. I sat down as she pulled an alcohol swab out of her pocket and applied it to my left forearm. She pulled out a desk drawer and withdrew the TB test apparatus (I tried to deny the fact that there was an actual needle somewhere in the sterile packaging) and I held my breath. She sensed my anxiety and as I tried to pretend she was invisible she told me to count the hummingbirds. “What?” “Count the hummingbirds. Out loud.” I looked up and saw that this little cell of an office was full of crystal hummingbirds suspended on fishing line hung from the ceiling. “Ooh, pretty! Um, okay… One… two… three… four…” there were some on the desk and pictures of others in the window, “five… six… seven…” There were more on the wall and – “Owwwwww.” Just like that, it was over. The buildup was much worse than the actual test itself. Maybe there was something to this whole hummingbird thing.

One year later my number was up and it was time for my dreaded wisdom teeth extraction. This was something I’d been anxious about since I was a kid and my sister Dawn had her teeth taken out. Her swollen “chipmunk” cheeks were actually less worrisome than the deep bruise the sedation IV had left in her hand. I knew that wisdom teeth = needles, and needles = terror and doom. I also knew there was a way out of it: laughing gas. I’d had an oral surgery seven years earlier and survived on nitrous oxide and I was confident I could do it again. Sure enough, I opted for nitrous and stayed awake during the whole procedure – the numbing, the incisions, the chiseling, and closures. I made it through my rite of passage without succumbing to the lulling draw of general sedation. The experience wasn’t pleasant (is it ever?) but I survived! In retrospect, maybe it would have been easier to count a few hummingbirds and take an IV, but I was just glad to have it over with. I had used my only “get out of jail free” card and I knew that if I was going to continue doing things I really wanted, a couple of inevitable vaccines and tests were on their way. Two years later I decided to be brave and attempt donating blood at a blood drive I was running. I knew my parents had notoriously difficult veins to stick and I figured I was in for it but my mom was there and I thought I could make it through. Unfortunately, after the girl’s third attempt to get into my vein only a disappointing dribble of blood speckled the clear plastic tubing. Everyone else was proudly spurting blood and filling their bags but I couldn’t get more than a few ounces out. The crook of my arm had been through enough and when she said we could try my other arm, I sternly refused.

Fast-forward one year. I was in the process of submitting my mission papers and I had to push through a veritable gauntlet of smiling, needle-bearing medical staff. In order to complete the papers I had to be completely current on my vaccines, TB negative, and know my blood type. Oh crap. That meant a blood test. I’d never had a blood test that I could remember (no joke). This was going to be horrible, but if I really wanted to serve a mission, I had to do all of it, all in one day. I was very close to begging my mom to stay home from work and take me to the doctor’s office so I wouldn’t have to be by myself. Instead, I resolved to do it alone with the goal of not bursting into tears at the sight of the first needle. I got the Hep C shot and TB test done by my family doctor, but the hardest thing I did that day was drive to the nearby blood lab and turn myself in for testing. The phlebotomist was a true pro and she talked me through the procedure. The worst part of it was I could see people being tested all around me. There was no way to ignore it and although my heart was beating faster than a hummingbird’s wings, I made it through the test. I didn’t even cry. A few weeks later I received my call to Brazil and I knew that only meant one thing: more shots. I delayed as long as I could but eventually my mom and I went to the health clinic and for the first time I was able to laugh at the sight of a syringe: four to be exact. They were all lined up on the counter and I asked if I could have two in each arm. The lady smiled and said she would do me a favor by putting them all in one arm. (I have learned that needle-wielders have different views of what entails a “favor.”) I just talked nervously and she did the deed as quickly as possible. Hummingbirds whirled in my mind’s eye but I could tell they were on their way to a bigger and better place. They were my ticket to Brazil.

You may think the occasional needle prick or blood test is no big deal, but for some reason they are huge to me. I avoid them like the plague but I value my health and the health of those around me and won’t negligently put others at risk if I can help it. Sometimes the things we hate most are required of us in order to progress towards our final destination. For every stepping stone along the way hopefully there is someone standing ready to steady our hand. It helps if they’re smiling and take time to coax us along during life’s busy day. Even if these guides occasionally have to trick us into taking the next step, they’re doing it for our good. Other people are lucky and seem to zoom along the path on energized wings beating so quickly they’re invisible to the naked eye. It appears they have no problems and nothing is difficult for them. They skip the step-by-step process which has become second nature to us groundlings. We watch them, count their rare forms, and wonder how they’ve been so fortunate. The truth is, they’re an illusion. Count the hummingbirds. The closer you look at them the more clearly you'll see they are transparent, flitting mirages dancing in rainbow prisms. Everyone has problems, struggles, trials. No one is free of the occasional needle stick, toothpick piercing or dog mauling. It may be embarrassing but we have to ask for help because sometimes we’ve never even heard of the cure. Count the hummingbirds, but don’t envy them. It is better to live through life’s day, even if it is punctuated by pain and dotted with discomfort.