Tuesday, March 25, 2014

Age isn't just a number anymore

Today I finally saw my gastroenterologist for the first time in a couple of years. I'm supposed to see him yearly so he can keep tabs on my ulcerative colitis (UC), but that usually means that I have to take at least a half day off from work. Plus, I felt fine and I didn't want to go all the way to Brighton just to be told that I seem to be doing well (duh - I would've let him know if I wasn't) and 5 minutes later I'm out the door again. My GI wouldn't write another script for my immunosuppressant unless he saw me again. Fuck. That kind of forced my hand since I'd already been out of meds for a week due to UM's shitty online patient portal, where Rx requests apparently go to die. So off to Brighton I went.

A 1:30 appointment ensured that I didn't get jack shit done during the productive part of the day. Once they got me into an exam room, I sat and waited about 15 minutes before some doctor I'd never seen before came in. He asked me the standard questions - how have you been feeling? How often do you have bowel movements? Are they a normal consistency? Do you ever see any blood or mucus in your stools? Fun stuff and no room for modesty. This new doc didn't have any discernable facial expressions and he had an eastern european accent - not a good combination for putting a female patient at ease (I know it's not fair, but all I could think of was the movie "Hostel"). He eventually finished interrogating me, but not before advising me that I should only use ibuprofen sparingly because it can tear up my gut.  He didn't know that I already know this or that I gobble that shit like candy during my period, or when I have a headache, or when my maimed foot hurts, or...whenever I think something might start to hurt at some point. I told him that I try to limit my use of it.

Dr. Hostel left and a few minutes later he came back with my regular GI doc, whom I really like. My regular GI apologized for strong-arming me into coming to see him and said that it's really important to keep close tabs on me because of the medication I take. This particular drug is an immunosuppressant because it inhibits DNA replication - which particularly affects T-cells, but can affect anything with DNA that needs replicating. I have to have labs drawn every other month to make sure that I still have enough white blood cells and to make sure my liver is still functioning normally. He told me that he's had some patients, who were stable for ages, suddenly have a precipitous drop in the numbers of white blood cells (WBCs). The lack of WBCs is called leukopenia and initially presents without noticeable signs or symptoms, but can quickly become life-threatening. Yeah, yeah, I've heard it all before. Every time I get bullied into going and getting my blood drawn, I always check my lab results online to make sure they're normal. I used to work at UM processing these very blood samples, so I know what to look for. I never depend on someone else to tell me if I'm okay or not.

Anyway, he proceeded to tell me that at my next annual follow-up we'll have to schedule me for a colonoscopy. People with ulcerative colitis have an increased risk of developing colon cancer starting within 8-10 years of the initial diagnosis. Next year will be my 8th year living with UC, so my rising cancer risk necessitates undergoing a screening colonoscopy every 2-3 years for the rest of my life. Shit just got real. Life is all fun and games until you learn that you have to have a camera with a cutter shoved up your ass every couple of years until you die. Can't wait to start having regular boob squishings too - woot!

So far, I've got a messed up old lady foot with matching trick knee, a spastic colon, wicked hangovers that last for days longer than they used to, enough white hair that it can be seen from a pretty good distance - not to mention the hair that no one ever told me would turn white (sex-ed part 2 should take place between the ages of 30-35. Seriously). Finally, the only remaining milestones in my life are getting regular colonoscopies at 39, mammograms and black birthday balloons at 40, and membership in AARP at 50 (hello senior discounts!). At this point it's even debatable whether I will have a real job again before I hit retirement age. And I still feel stuck in that awkward age between my coworkers in their mid-late twenties and my friends who are literally counting the days until they retire. And who says age is just a number? Right now it's everything.

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