My Doctor's Appointment Today
Today, I had an appointment. It ended up being one which I am unlikely to forget.
First, I want to describe my primary-care doctor: she is a young white woman, maybe early to mid 30's, always has great accessories (she has a pair of striped socks I just love) and unlike many doctors in this day and age, she actually LISTENS to my concerns and best of all, she treats pain in a serious and humane manner. She's worth her weight in gold for that alone, as far as I am concerned.
Today, she had a third-year medical student assisting her: a very eager and attractive Asian man; a polite, scholarly type. He had a lot of questions about MS, and kept apologizing for being so inquisitive. I told him it was in his best interests, and in the best interests of his future patients, for him to learn as much as he can. I hope he keeps his curious nature intact; he may be a good one for medical research, or an excellent diagnostician.
Anyhow, I came into the doctor's office today for a few reasons:
1) The baby is finally weaned, so I wanted to go back on amitriptyline for nerve pain. I've had a lot of success with this medication, and I think being without it was one of the reasons why my trigeminal neuralgia has been so persnickety lately.
2) I've been having a lot of problems with naseau lately, and the phenergan isn't doing anything to help. I asked for, and got, a prescription for compazine. I have hopes that it will help put an end to the almost-constant sick stomach I've dealt with for the past week.
3) I'm concerned about how rapidly my MS symptoms are getting worse, as well as the emergence of several new and in my view, severe symptoms, such as momentary paralysis and tremors in my hands.
The first two were easily dealt with: prescriptions were written. The last required a neuro exam.
Neuro exams are part and parcel of the MS experience. It involves a lot of testing of reflexes and variations on "pull my finger," without the unforunate need for air freshener that accompanies your uncle's playing of the game. Basically, it tests your strength and responses.
This is when the appointment took an unpleasant turn. My reflexes in my right leg, which have been weak for years, are now pretty much non-existant. I'm also having some minor strength issues in my right arm, which is completely new for me. And my strength in my right leg? It doesn't appear that I have any. The student would say to me, "Push down on my hand," or "Pull your leg up," and I would do it...at least, it SEEMED like I would do it, but nothing happened. Or, nothing much happened. It was frightening; imagine someone telling you to close your eyes and kick your leg out. Well, you closed your eyes and you kicked your leg out, as far as you were concerned...but no one saw it, and your leg didn't move. Well, that's what was happening for me. It was confusing, and scary, and I can't say I enjoyed it.
It was the worst neuro exam I've had to date.
I didn't really notice until then, just how weak my right leg had gotten. I knew I'd been having a lot of trouble with it: increased muscle spasms, increased weakness when walking. Sometimes, my leg would turn to Jell-O under me, and I've been having some pretty unfortunate falls. My knuckle on my right hand is still healing from the last time it happened, and I fell in the bathroom. I reached out to break my fall, and slammed my hand onto the bathroom sink. Owie.
Logically, I knew all of this. But it wasn't until I was on that exam table, that I really noticed how bad it's gotten, how weak my leg is and how heavy it feels, like lead. Like dead weight.
The looks on the faces of my doctor and the student were the worst part of it. They looked as if I had stepped in something extremely slimy and foul-smelling and they weren't sure what was the polite way of letting me know about it.
I smiled and joked about it, and made a lot of nervous chatter. I complimented my doctor's earrings. I spoke to the student of the importance of knowing how to treat a patient with MS, as there are many people with the disease. I wonder if they noticed how anxious and afraid I was.
When the exam was over, and the doctor looked at me with that look, the one of "I have some bad news for you, and I'd rather slam my pinky finger in a sliding glass door than tell you this." I spoke up and said, "Look, I think I know what we're all thinking here. I know lately it looks like my MS is going secondary-progressive. I think it's time to see a neurologist again." She very readily agreed, and a referral was made. She then told me she was very worried about this change, about how my MS has quite suddenly taken a turn for the worse and it's not behaving at all like it has for the past 8 or 9 years. She intimated there was some testing I should get done (evoked responses, is my guess), some "issues to be addressed" (my mobility, clearly) and that I really, really needed to see the neurologist again. She was very clear about not being comfortable in treating this herself. That, more than anything else, really sent home the message to me that this is SERIOUS. She also seemed very relieved that I understood about the secondary-progressive issue, and that I've come to terms with it.
Which shows what she knows, huh? Or that I'm just a damned fine actress.
As soon as I came out into the waiting room, Jonathan knew something was wrong. I made it out to the car before I began to cry.
Silly of me, isn't it? I mean, I have known for years that this day was likely to come. I knew that this disease could turn progressive, I knew that my right leg was getting weaker and weaker and that eventually I'd have to consider the "w" word.
So why have I been such a wreck since that appointment?
It seems that knowing something in your mind, and experiencing it emotionally, are two very different things. I thought I was prepared for this, and I wasn't. It feels like it is happening so suddenly, which is quite illogical, as I've had MS nearly a full ten years now. It doesn't make sense to feel this way, but I do. I am ambivalent, I am depressed and I am just plain scared.
Jonathan keeps telling me, "It could be worse." He's right, of course. It could be. But that doesn't help right now. What does help is knowing that he is there for me, and will be there for me through all of this.
And for now, I feel another pity party coming on. Bring on the chocolate ice cream....