Diabetes Self-Management Blog

I intended to follow up last week’s blog entry, but the content I wanted to share — photographs, some video — never materialized. However, if you’ll allow me to revisit and recycle a topic from October of 2008, with today’s perspective, I will proceed…

The topic? Let’s call it doctor visit anxiety.

Allow me to quote myself from over a year and a half ago, from this entry:

There were two small things in the kidneys, she (my doctor) said, although she was quick to use the word benign, quick to say what she saw is more than likely nothing to be concerned about. The first was a lesion that looked like a cyst — a very common occurrence. The second was a renal angiomyolipoma, a fatty deposit where it’s not supposed to be.

That diagnosis? It came on the heels of my first ever ultrasound. The ultrasound was ordered to get a closer look at my liver. As a person with diabetes, liver function is one of those blood test number thingys that the doctor wants to watch closely. The numbers from my recent liver function tests had been showing fluctuation, so doc wanted a snapshot (ultrasound) of what my liver looked like to establish a baseline.

OK. Fine. In fact, the novelty of the ultrasound experience piqued my interest and didn’t cause me much anxiety, at least not as much as I may have led readers to believe in those earlier blog entries. Sometimes a blogger like me will play up the situation to make for better reading. It’s not dishonesty; just a bit of elaboration with some emphasis on what makes for, I hope, better reading. (It’s a fine line, because when my mother reads my entries, it’s pretty certain that if situations about which I write sound dire, or I sound sad, or portray what I’ve been through as pretty difficult, I inevitably get a phone call from a worried mom!)

Well, the ultrasound was fine, for all intents and purposes. But the liver ultrasound also included a look at my kidneys, and the doctor saw in the kidneys the angiomyolipoma, which (again to quote me), “without the ultrasound, I would probably never know I had it… My kidney function is normal…another thing we simply (simply?) monitor.”

OK, fine. As I said back then and probably many times since in my writing, monitor is an all-too-familiar phrase for those of us with chronic conditions. We must cultivate a keen awareness of what’s going on and be vigilant empiricists of our own bodies; at the same time, our health-care team creates the database of our chemical fluctuations, our anomalies flagged faster than those of the healthy, nondiabetes lot.

It’s something I didn’t really understand back then, the idea of my susceptibility to so many other health issues, that I’d be under scrutiny unlike that of a healthy individual, which meant that many undetected and normal anomalies would catch a physician’s attention simply because I had diabetes. Whether these conditions are related to the diabetes or not is fodder for another time.

Did the diabetes cause the angiomyolipoma or the thyroid cancer? No. But would I be writing about any of this if I didn’t have diabetes? Not at this point, no. None of these other conditions would have been on anyone’s radar screen. The angiomyolipoma goes undetected. The thyroid cancer: still continuing to grow on my thyroid because without diabetes, I’m not going to the doctor much at all, and the doctor’s not looking at me, not examining me, the same way she would a patient with Type 1 diabetes.

So, yes, back to the fall of 2008. Monitor it. That’s fine. I’m good with that. Keep an eye on it meant the doctors would ultrasound again in six months. In the spring of 2009, a second ultrasound.

In the spring of 2009 things came back OK. There’d be continued monitoring, of course, but maybe one more ultrasound in a year (the spring of 2010! Do you see where I’m going with this?), and if that ultrasound showed no change, I wouldn’t have to worry.

However, this was the same series of doctor visits that led to the discovery of a lump on my thyroid. That lump, back then, was minor, just something to have biopsied and then monitor. Most doctors wouldn’t even pay attention to something so small because they (the lumps) are so common. But my doctor? She paid attention to it. She paid attention because I’m a patient with diabetes.

That first biopsy? It came back indeterminate, which, the doctors told me, was probably nothing. Probably not cancerous (the statistics showed a less than 2% chance).

So they’d monitor it with another biopsy in a year or so.

Now, I’ve documented how this played out, and some readers will know this story all too well. Briefly: In November of last year an endocrinologist decided to have another biopsy for the nodule on my thyroid six months earlier. This second biopsy came back positive for cancer of the thyroid. The last six months of my life have been heavily given over to the surgery and recovery from this ordeal.

Monitoring caught the cancer early and I am on the road to 100% recovery.

And yet…

And yet…

You’ll have to forgive me if yesterday, while laying on my side in a quiet examination room while an ultrasound technician ran an ultrasound wand repeatedly over my kidneys and bladder, I wasn’t in a somewhat different frame of mind than during that first ultrasound way back when. This entire week I’ve been unable to excise the unhealthy thought processes plaguing my overactive imagination: too many not-so-good outcomes from yesterday’s follow-up ultrasound.

The techs who do the ultrasounds don’t tell you anything, they can’t tell you anything (they’re forbidden to do so).

I won’t know for a week or so what the result is, if everything’s fine or if what was really nothing is really something.

And honestly, I’ve had enough of nothings turning into something.

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