Urgent Care

Yesterday was highlighted by a trip to urgent care.

I’ve been feeling somewhat out-of-sorts for a while. I think it started on Tuesday, when I had a general mid-range feeling of crumminess. I chalked it up to having slept poorly the night before, but skipped playing frisbee anyway. Wednesday I felt better, but not perfect. And in the evening while sitting reading comics I keenly felt my heart pumping and my blood pulsing – not that it was fast, just that it was strong and noticeable. Thursday I was again not feeling great, but had a bevy of meetings in the afternoon (one of which I was running), so I was at work anyway. I came home with a headache, which turned into a debilitating headache – possibly a migraine – by 7 or so, and I went upstairs and napped until 8. I felt better, and came down and had a Diet Coke and some Hormel chili for dinner (Debbi prepared it), and felt better afterwards. (I rarely get migraines, by the way – maybe one every 2 or 3 years.)

But Friday and Saturday I again was feeling kind of off. I had a recurrence of soreness and stiffness in my hip joints which I’ve had a couple of times before, and general soreness elsewhere, including some in my torso. So at this point I’m starting to wonder if I’m on the verge of having some heart problems, or if something else serious was going on. So while we were at lunch yesterday Debbi asked me if I was okay, and I said “I don’t know.” So we headed off to the urgent care center (in the cold, wind and rain).

(Aside: the Palo Alto Medical Foundation uses medical office software from the company I used to work at, Epic Systems. This always amuses me. I make a point of telling people there about this, and I always end up getting feedback about it, even though it’s been 12 years since I left. That entertains me, too.)

This is my first trip to urgent care in nearly 20 years, when I went to the center in Madison the morning after developing an unbelievably painful sinus infection. They gave me antibiotics and told me to go home and sleep. I felt more equivocal about going this time, since it was more a combination of milder symptoms that was making me worried rather than feeling clearly sick. Yet the potential outcome if I was right to worry made me decide to go.

The wait was almost exactly the advertised 1 hour, and I saw a very nice doctor (actually all the doctors I’ve ever met at PAMF are friendly and personable) who ordered some blood tests and took an EKG (the first one I can recall having, but honestly I expect I had at least one EKG and some other similar tests when I was a kid, but I just don’t remember them). We talked about various things that could be happening, but ultimately none of them were borne out by the tests, all of which came back within normal ranges. Here are some of the possibilities:

  • I could simply have an infection, but am not exhibiting any of the primary symptoms for some reason.
  • I could be under stress and it’s throwing off my body chemistry. Given what we’ve been dealing with in house-hunting and Blackjack’s cancer, this is plausible. Plus of course worrying that I’m, developing a really serious problem is just going to increase my stress level.
  • I could be under stress and it caused my thyroid to go out of whack. (The thyroid test came back normal.)
  • I could be developing an irregular heartbeat. The EKG didn’t show anything, but of course if it’s irregular then it could just have not shown up at that particular time. The doctor suggested I contact my primary physician and see about getting a 24-hour heart monitor to see if it happens in a longer span of time.
  • I could have developed a blood clot. I guess they did a blood test which indicated that this isn’t so.
  • It could be neurological. They didn’t have a way to test for this at urgent care. The doctor said they could do an MRI or even sample my spinal fluid (!) to test some theories in this direction, but also that these are much more invasive tests.

The blood tests said my liver, kidney and thyroid functions all appeared normal.

So, as the doctor said, we’re left with a puzzle. He suggested I go home, make sure I eat and drink enough (“Eat a banana” he said, in case I’m low on potassium – I did that), and get enough rest. So we spent the evening lying around at home, watching Harry Potter films and cartoons, and got take-out for dinner.

Today I feel better. So I’m starting to think it was either or both an infection or stress. I do stress out often and easily, I just don’t show it on the outside (I’m much less laid-back inside my head than it appears). But I will still call my doctor tomorrow and see what he thinks. But it’s encouraging that it seems I’m not about to have a heart attack.

Blackjack’s Progress

Today we took Blackjack in for his examination. The vet said she’s very happy with how he responded to his radiation therapy! He’s even gained some weight. We can take him off two of the three medicines we’ve been giving him, which will make everyone in the house happy. (Well, okay, Newton and Roulette probably won’t care that much.) The vet does say she wants to put him on chemotherapy for the next six months, since that greatly improves his chances over the next few years, in her experience. Meanwhile, he gets another week off before he starts weekly visits for treatment.

It’s not the ideal outcome, but it’s not so bad as things stand. And we’re encouraged that she’s pleased with how he’s reacted to treatment so far.

We both took today off for the check-up, but with the rain we’re supposed to get all weekend, plus Debbi having twisted her ankle working out yesterday, we ended up spending the day hanging around at home. We took a nap in the middle of the afternoon, and had all three kitties curl up with us, including Blackjack, who’s been a bit standoffish recently, so we were happy that he was willing to join us.

We topped off the day with an evening of Batman and Justice League cartoons. A pretty good day, really. And the best part is that we don’t have to go back to work tomorrow, because the weekend’s just starting!

After Treatment

Wow, it’s been quite a while since I’ve updated.

We’ve been mostly focused on Blackjack’s treatment for cancer these last few weeks. Two weeks ago we took him in on Wednesday for his CT scan (a.k.a. CAT scan – heh-heh), and then Thursday was his first radiation treatment. The night before each treatment we had to take away the cats’ food when we went to bed. So Debbi and I each woke up to starving, ravenous, whining cats the next morning. It was especially hard for me at times since I then had to bundle Blackjack into his carrier, then feed Newton and Roulette, and then take him out the door while they were eating. Poor kitty!

I dropped him off each morning around 9, giving the technician an update on how he was doing. Then I headed to work, and Debbi picked him up at the end of the day. I understand he was knocked out for the first treatment, but then merely sedated for the later ones. I’m not sure how that worked, but he is a pretty mellow kitty.

He had Thursday and Friday treatments, and then Monday-Wednesday-Friday the next week. There was one more treatment planned for this past Monday, but it was cancelled because he was starting to get some blistering in his mouth and throat, since the mass is behind his throat.

Since then he has been getting a steroid pill twice a day, and a different pill and a liquid rinse in his mouth three times a day each (the liquid rinse contains Maalox as one ingredient). Unlike Newton, who loves pill pockets for his daily pill, Blackjack isn’t really interested, so we have to pill him the old-fashioned way. It’s getting old pretty quickly.

The vet said after treatment that Blackjack might get worse before he gets better. He has been low on energy and been lying around a lot, and harder to convince to play with us. We have a sense that he’s turning the corner, but it’s hard to tell. Especially since all the medications I think make him unhappy.

We have a follow-up appointment tomorrow, where we will hopefully find out if the radiation put the cancer into remission, and whether we have to keep giving him all the meds. Plus whether they want to do a round of chemotherapy with him, which I’m sure will be equally disturbing to all of us.

But most I just hope the treatment works and that he’ll have several more happy years with us.