Friday, March 23, 2007

My Faith In The Medical Profession Is Getting Restored:The Tale of Two Doctors

Well, I'm home! Last weekend I had the flu. But this flu was a bit different. I had 2 little episodes in which I went from laying down to getting up in which I fainted. I thought to myself that maybe this was some sort of middle ear infection or something and decided to see a doctor. But this time, my wife insisted that I see her doctor. She got me an appointment with him and for the first time in a long time, I got to really see the medical profession at work.

Let me introduce you to Dr. Michael Marsh. A real doctor, with a real personality. I typically expected to see a doctor who would look in my ears, look in my throat, make me cough and then tell me that's it's the flu that's been going around. Then he'd give me a couple of samples of some drug along with a prescription to get more (hey, everybody's gotta make some money off the sick) and send me on my way. But not Dr. Marsh.

As soon as I got in there he decided he needed to give me a workup. I thought that this ought to be good. He then sat with me and ordered a blood test, EKG, chest x-ray and to have my ears cleaned out. Within minutes, members of his staff had me going from test to test. About a half hour later, he came back (I had barely finished the tests) and said he had a problem with my blood results. He said that I was extremely anemic and on a scale in which "14" is considered normal I was only a "6"! Well, he then decided to pick up his cell phone, call St. Joseph's Hospital across the street to see if they had a bed for me as I needed a blood transfusion and needed it fast.

But, like most hospitals, beds are at a premium. He gave them my cell phone number and told them to call when they had a bed available. He also arranged to have a Hematologist (Dr. Arzoo) see me. So I went home and waited for the phone to ring. And it did ring!

At about 3:30 that afternoon, I got called to the hospital and was admitted quickly and effortlessly. They took some blood to the lab nd within a couple of hours, Dr. Arzoo came by and gave his basic prognosis. He wasn't 100% sure but I was low not just in iron but in red blood cells, white blood cells and platelets. Why? Could it be the many years of mal-absorption sue to my gastric-bypass surgery? There was not easy way to tell but his initial diagnosis was called Pancytopenia. Most people in my condition with my levels would not be walking. But due to the fact that my body is so freakin' abnormal, it compensated to not having been correct for a long time.

By definition, Pancytopenia is a medical condition in which there is a reduction in the number of red and white blood cells, as well as platelets. Pancytopenia is generally due to diseases affecting the bone marrow, although peripheral destruction of all lines of blood cells in hypersplenism (overactive spleen) is a recognised cause. Bone marrow problems causing pancytopenia include myelofibrosis, leukemia and aplastic anemia. Increasingly, HIV (Human Immunodeficiency Virus) is itself a cause for pancytopenia. Rarely, drugs (antibiotics, blood pressure medication, heart medication) can cause pancytopenia. Pancytopenia usually requires a bone marrow biopsy in order to distinguish among different causes.

It was decided that I would get 5 liters (yes, that's 5 liters) of blood along with a bunch of B12 and Iron. Since my condidition was so severe, he decided to spread out the transfusion over three days. That sucked for me as most of you know how stir crazy I can get. Well, yesterday we finally topped off the oil (ok, the blood) and Dr. Arzoo decided to do a bone-marrow biopsy as he still couldn't figure out what the heck was causing my problem. My levels were looking better but not superb. I was around an "8" now, up three points from my admission. With all the new juice and stuff, I was up and at 'em every morning at 4:00 AM and feeling great. So, after the biopsy and another dose of iron, it was go-home time!

So now I am home with scheduled doctor's appointments next week. I anticipate going back to work on Tuesday and hope to get some sign of results from the biopsy soon. In the meantime, it'll be some pills for me until we come up with a definitive diagnosis and course of treatment. In the meantime, stay tuned for more of this saga.

In conclusion, I think I have finally found two doctor's in the entire medical profession that actually give a crap about the patient and are dedicated to solving and explaining the problem. These guys may not have the answers as of yet, but they seem like they aren't going to stop trying until they do. My hat's off to them. I have finally found some people in the medical profession who are doing "intervention" style medicine instead of "body-shop dent repair" after it all happens.

Ah yes, my faith in doctor's and medicine are being restored.