Tuesday, March 4, 2008

D-Day, Part 2

Continued from March 3

By the time the ball dropped to bring in 2003, motherhood had gotten a little easier. I was still getting up in the middle of the night to feed our rapidly-growing baby, but she was beginning to sleep in her own bed and to give me blocks of sleep longer than the 2 hours that were the norm the first 3 months of her life. But things were about to change: I had to go back to work.

Winter 2003 was the polar (ha!) opposite of winter 2002. From January through February, we didn't have a full week of school. Every week brought bad weather and at least one snow day. For a new mom, this was perfect. It was like working part-time.

Not that work itself was easy. My new library had just been completed, and I only had until mid-February to unpack 10,000 books and a thousand videos and countless pieces of equipment. I chalked a lot of my fatigue to the stress of organizing a new facility. I got out of breath easily; I thought it was because I was out of shape. My body, my legs in particular, ached as though I had the flu; I thought it was muscle strain. Even after we got Ainsley into a good routine and she finally started sleeping through the night, I was tired all the time and wanted to nap whenever she did. I got a terrible chest cold in mid-January that knocked me out and made me miss two days of school; I had never missed more than one day for a cold before. And then the itching started. I felt like armies of ants were moving under the skin on my arms and legs. I scratched bloody welts into my skin. I felt like a hamster on a wheel, running and running and getting nowhere. But what working mom doesn't feel that way?

My insurance had changed with the new year, and by February I was concerned enough about my health to see a doctor. I had called the lactation consultant when by Christmas the lumps under my arms were still sometimes painful and always huge; she referred me to a breast specialist who talked to me over the phone and thought the lumps were probably extra breast tissue still swollen from hormones, recommended a surgical evaluation if the lumps still hurt after I stopped nursing, and mentioned that I should see my primary care doctor. Problem was, my PCP was not on my new insurance plan. I randomly picked a new doctor from a large internal medicine practice close by; the main thing he had going for him was that he was accepting new patients. I scheduled an initial appointment.

I look at that one thing, that random selection of a new primary care physician, basically picking a name off of a long list, as one of the most fate-guided things I have ever done. If I had picked another doctor, I don't know if I would be sitting here writing this today.

I met my new doctor on a snow day in February. My chief complaint was the horrific itching I had suffered with that winter. He examined my skin, drew up orders for some blood work to check my thyroid, and was just about to send me on my way when I mentioned my lumps.

I mentioned them solely for him to put on my chart in the event I needed the surgery the breast specialist had mentioned to me. I remember the look he got on his face when I told him, with complete confidence and certainty, that the growing masses under each arm were breast tissue.

"Did your obstetrician ever image that? Ultrasound? MRI?" he asked. Of course they hadn't. Why would they when it was so obvious what was going on?

I also told him about the "milk ducts" swollen all across my chest. When he felt the knots above my collarbone, his demeanor changed. "I don't think that's breast tissue," he said, "I think those are lymph nodes," and wrote an order for a CT scan of my neck and chest and a complete blood count.

I appreciated his thoroughness, even though I knew it was going to hurt our wallets. We had a high deductible and co-insurance percentage on tests and surgeries through Jason's insurance, and I almost cancelled the CT scan the day before the appointment because I knew we would be out hundreds of dollars from that one test. But I figured they might be able to use those films later if I had to have my "breast tissue" removed.

The Monday after the blood tests and scans, February 24th, I got a call from the nurse that my white cell count was extremely high, and my red count very low, and that to make sure it wasn't lab error, I had to have the test repeated. When she told me my counts, I jotted them down to look up later on everyone's favorite medical resource, the Google. What I read made my heart jump. Counts like those usually meant leukemia. I told myself there was a mistake, had more blood drawn, and prepared for the 25th, which was parent-teacher conference night and an open house for the community to come see our new library.

I was very busy on that day. Too busy to worry about my tests. I decorated the library, made sure all boxes were unpacked, and put the finishing touches on my handouts. With a little over an hour left in the school day, I heard the phone in my office ring.

To be continued...

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