Wednesday, August 25, 2010

The illnesses of interesting patients fall into three categories:

The illnesses of interesting patients fall into three categories: rare disease, pseudodisease, and atypical ordinary disease.

I found that on this website....click HERE when I Googled "the interesting patient". I thought that it was kind of funny that they have something called The Interesting Patient SYNDROME.

Syndrome definition: In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs (observed by a physician), symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others. In recent decades, the term has been used outside medicine to refer to a combination of phenomena seen in association. (Found that on Wikipedia so it must be true!) LOL

I don't know what category I am but thought it was interesting.

Anyway...today I had a follow up visit with Dr. Nandeeshwar. My dear Dr. Kazi is no longer in practice, he works for the Veteran's Administration doing research. He suggested that I go back to the rheumatologist that saw me initially. He was confident that she could handle any issues I had and that he would be in touch with her. I trust him so I went back to her today. True to his word, he had already been in contact with her and updated her on all of my issues.

My appointment was scheduled for 8:45. I try to get the first appointment of the day because she ALWAYS runs late and true to form she didn't come into the room until 9:30! How can you run 45 minutes late after only 1 patient? Sheesh! It is irritating. Her office is small and the exam rooms are like closets. As I sit there all I can do is look at the posters on the wall that look as if they've been hanging there since the Creation! Some of them are barely stuck to the wall with yellowed tape. They were all free too...from pharmaceutical reps. For someone who is making a bucket load of money from my insurance company can't they have some pastoral scenes on the wall. Make it more homelike and not so institutional. Thank goodness I had my phone and could get on Facebook and check my email while I waited, and waited, and waited!

I tried not to get irritated because lets face it, the last time I saw her I wasn't doing all that great and I am 1,000 times better than when I saw her in February. She came in and was very pleasant as was I.

Here's the 411....

On Friday, I'll come off the prednisone and will only be taking 400 mg of Plaquenil. Dr. Nan says that I will have to be symptom free for a year before we talk about coming off of that. She thinks there is a chance that I will have pain again after I come off the steroid and that if necessary I'll have to go back on the prednisone. I pray NOT!

I won't see her again for 2 months and at that point she will decide whether or not I need to have an MRI on my left index finger. I have developed some kind of nodule on my joint.

Here is a picture. My hands are VERY dry and so my skin looks more wrinkled and old than it is...well, maybe I am wrinkled and old!




You can see the bump on the inside of my finger. It's not painful but it is obvious to me that it's there. She thinks it might be a cyst. What the?!!! It's not hard like bone but it's not squishy either. It's just weird. But hey...this whole thing has been weird so why not!

I had blood work done, we'll see what that says, and for some reason she also wanted a urine specimen.

As a side note...Can someone out there figure out a better way to do that please!? I mean really you want me to pee into a cup that's the size of a small Dixie cup and sit on a disgusting toilet in a doctor's office. (Ok it wasn't filthy when you looked at it but it is a public toilet.)


And the process....sheesh...straddle the toilet, hold this little tiny cup in your urine stream and pray you have a stream and pray that you don't overfill the cup at the same time! Then you pee on hand. Remove the cup out from underneath you, and set it........WHERE DO I SET IT!? Oh...wait...I see where I set it, I set it on top of the stainless steel toilet paper holder where everyone else sets it. And how do I know that? Because I can see the rings from the various paper cups that have been set there, while people finish up the paperwork, and the uric acid has etched the stainless steel?!! EWWWW!!! But what choice DO you have? Set it on the floor? Ummmm...NO!

Some offices have a private bathroom with a little box with a door between the bathroom and the lab. And you KNOW that someone is on the other side of the box and they CAN hear you as you pee and place the little Dixie cup in the box. At least in the box there is usually a paper towel to sop up the pee on the outside of the cup. I am totally neurotic about the cup though. I have to wash off the outside so that there is no pee on it. Anyway...someone needs to figure out a better way. How about some sort of funnel? Ha! That thought makes me laugh out loud!

So...I will know by the weekend how the blood work and urine test came out and what I need to do or not do from there.