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Kind of a cortisolic morning

October 2, 2007

It was a two-latte morning.

I know I’m frail and I know I can be lousy at things but events this morning drove this home with screams and bruises.

I knew the cortisol test involved an injection of an adrenal stimulating hormone and a blood draw, and another blood draw an hour later. That sounded simple enough, and I thought merely getting up early and going up to Seattle having fasted from last night would be the hard part. I was thinking beyond that to enjoying breakfast and a caramel soy latte.

But the injection and blood draws were to be done with a butterfly valve, presumably a relic of the Spanish Inquisition, and an implement of torture that has never successfully coaxed blood from my veins. And I was to lie there for the hour with the Thing in my arm till the second draw.

But things became awful when it took nearly 15 minutes to adjust and readjust the needle in my vein till blood would flow. Then it flowed. Then it stopped. Then the doctor removed the valve and reinserted it. I can’t remember which hurt worse. No blood. Why can’t you just bloody bleed, Miranda? Other girls do it all the time.

So the doctor gave me a shot of Novocain so that he could attempt another draw through the butterfly valve without destroying my will to live.

I have never understood the rationale of Novocain. Why is the injection of Novocain less painful than the injection it is designed to desensitize? It isn’t. Especially when injected at the site of a welling bruise. Well, Miranda, if you are not going to bleed, you could at least faint like other girls.

I was terribly cold and positive my blood was simply frozen in my veins. I asked for a warm compress to distend the vein. What a novel idea I introduced to this office! I warm my Cat’s ear this way every time before sticking it to test his blood glucose. At last, my doctor had a vial of blood. We were battle buddies for life.

My husband was at my side throughout all of this and for the hour before the second draw. He rummaged around and found a blanket and pillow for me, gave me sips of water, gave me my chapstick, and kept me humored. By the time the nurse returned for the second draw, I was confident this would be simple. After all, the valve was in place; all she needed to do was uncap it and fill the tube. No blood.

At this point I was more concerned about her tension than my discomfort. I knew she needed confidence to make this work. She tried again, but my arm was so sore I began shaking. I screamed. Dr. M rushed in. No doubt other patients wondered when their endocrinologist started delivering babies.

The nurse removed the butterfly, which had done its job of injecting the stimulant, and went to my other arm. After two or three tries, blood flowed into the syringe and we were done. The large deep-purple bruises on the insides of my elbows cannot begin to detail my ordeal. The nurse and I hugged vehemently, I think she as glad as I to have survived our mutual travail.

I will have the cortisol result, along with another thyroid result, at the end of the week. In the meantime, we do know that I am virtually estrogen-free, in spite of my diligent Prempro regimen of 10 years. Evidently, my vibrantly efficient liver has targeted Prempro for destruction. My liver tends to do this, making me highly resistant to medications. I am to take heart for having such a healthy liver. So I will be adding more estrogen to my regimen, and it is hoped that this will allay the hot and cold sensations, anxiety, and other symptoms that have leveled me over the past two months.

Our frail frames are created with many complex templates. Low estrogen, high thyroid, and low adrenal symptoms are all identical. The pituitary gland can confound any of these. Gland malfunctions can be inter-related or singular. In this case, the likely problem is simply overly efficient metabolism of an estrogen replacement. Anticipating questions and suggestions, I will add that switching between synthetic and natural replacements is not an easy solution because of other adjustments that would be necessary.

We left my gentle, soft-spoken top-doc’s office to get breakfast, having spent two hours to complete my one-hour test. With my breakfast burrito, I had a soy caramel latte and then a soy latte refill. I clutched each one with two hands, fighting tears, savoring my freedom from being a patient. What lousy work it is.

We took the parking garage elevator three times to different floors where we thought we might have parked. Nineteen years of higher education between us, and we still forget that Floor A is below Floor 1.

  1. Jane permalink
    October 3, 2007 7:38 am

    What a horrendous ordeal. Tests were undoubtedly designed without ONE THOUGHTregarding their effects upon the patient. Reminds me of the time around 20 years ago I had a sigmoidoscopy (no anesthesia) immediately followed by a barium enema (again no anes.) (Here I cherish my relative anonymity except to Lauren). I thought I would die. The doctor and nurse yelling at me didn’t endear me to the procedure. The Spanish Inquisition gets my vote too.
    Thank God for a husband who was there to get you through all of this! I’m glad you’re home, safe and sound.

  2. October 3, 2007 7:43 am

    Aaggghhh! Your ordeal far outclasses mine. Yelling at you?! At least everyone was constantly apologizing to me, though attributing the problems to my sensitivity. Their awareness of two lawyers in the room must have been keen. Jane, we simply must Reform Spain!

  3. heidi permalink
    October 3, 2007 10:46 am

    My mother’s in law’s first midwife pounded and pushed on her stomach to make the baby come out. But that was in Mexico. My previous pastor’s wife had a DNC without anesthesia — the hospital was out. Of course that was in Jamaica. Here in Spain my sister came out of anesthesia in the middle of a colonoscopy and was ignored, moaning in pain. The poor nurse was very upset. The doctor was nonchalant and a complete jerk.

    That is rather ironic, about the novocain injection to spare the needle pain of the shot. I do hope your poor arms heal quickly. You certainly earned your two lattes.

  4. heidi permalink
    October 3, 2007 10:48 am

    (Oh -actually my mother in law would have been in Uruguay at the time)

  5. October 3, 2007 11:06 am

    Oh dear. That doesn’t bode awfully well for Uruguay, does it? Pity she didn’t hold out for Iceland.

  6. October 3, 2007 12:36 pm

    Two lattes!?

    What a serious trade-off! While lying there patiently enduring the treatment, you would rather stay there patiently under the painful care rather than slug through several more weeks of awful symptoms! Now that’s restraint! The flesh wants to get outa Dodge quick, but Lauren says, “Nope. We’re gonna stay right here!”
    Paul said he beat his body into submission. Another verse comes to mind where Christ learned obedience by the things that he suffered. School sucks!

  7. October 3, 2007 12:50 pm

    Well, you might be overestimating my patience just a tad, but I was trying to look beyond the needles to breakfast and those lattes! But you’re right on, a bad-needle day in October way beats waiting till December and then going through a bad-needle day!

    May God grant me more trust in his loving mercies this day than I’ve ever known before.

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