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When the Paranoia Subsides
October 16, 2008
How to read this week’s blog entry:
1. Read last week’s blog entry ("The Paranoid Moments") if you haven’t done so yet. (I’m asking nicely.)
2. Read the comments several people wrote in response to last week’s blog entry. (Please.)
3. Return to this page and read the rest of this week’s entry. (That right there is sugar-coated!)
On Tuesday afternoon, I got a phone call at work from my primary care physician. She wanted to talk to me about the ultrasound. (See! Right there: If you haven’t followed my instructions for reading this entry [tsk tsk], well, you won’t be completely out of the loop, but there’s not much context to go on.)
At no time in what follows will I directly quote what my doctor said. If anything is erroneous or sounds wrong to those of you with more knowledge on the subject than I have, it’s entirely my fault in the telling. I may get some of the details wrong. The overview, however, is correct; it’s just that I may venture witlessly into medical-speak and get somewhat lost. I’m trying, though.
In fact, I share so much on the blog, but I debated about whether or not to write this week’s blog entry about the ultrasound results. Several of you wanted a follow-up, and because I don’t know how many people read this blog (there are those of you who lurk and don’t comment), I figured I might as well answer the questions of those who give voice. You know, keep you reading!
When the doctor called, she first apologized for not having gotten back to me sooner. She’d been on vacation and had just gotten back into the office. The results regarding my liver and what they saw from the ultrasound were pretty much what had been expected. My liver was echogenic, which I’ve since learned refers to structures in the liver having strong reflectors of sound. When the liver’s echogenic, I gather that it means it’s consistent with the possibility of nonalcoholic fatty liver disease developing.
(Wow, that was a confusing way of saying there’s a chance because there’s a sign that something could happen.)
Yet because my liver enzymes are not dramatically off the mark, the doctor’s not concerned at this point. At least, she doesn’t believe I need see a hepatologist (liver specialist), nor should I go in for a liver biopsy. The treatment we’re doing is sufficient for now, and she just wants to keep an eye on liver function tests in the future. The recommended treatment, she said, would be about 150 minutes or so of cardiovascular exercise weekly. Thank goodness I’ve resumed my spinning classes after a few-month hiatus for other, more mild outdoor activity. With indoor cardio in full effect, I’ll easily surpass the recommended exercise time.
The liver out of the way, we moved on to the kidneys (which, again, if you did your blog homework, you’ll recall are what produced so much anxiety last week). There were two small things in the kidneys, she 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.
The angiomyolipoma is isolated, and without the ultrasound, I would probably never know I had it. It’s asymptomatic. The good doctor, though, talked to me about this in great detail, sensing that the news might be difficult to hear (in truth, it was more difficult for Kathryn to hear it when I told her about it later in the day).
The doctor explained that there are at least two options. If I wanted to ease my mind, I could have an MRI to get a more detailed picture of what was going on in the kidney. However, both she and the ultrasound doctors didn’t think this was necessary. My kidney function is normal—no blood in the urine, that sort of stuff. So, this will be another thing we simply (simply?) monitor. She’d like to re-ultrasound in about six months to see if there’s any change.
Monitor it? That’s a familiar phrase. It’s like most every other thing with my Type 1 diabetes. Monitor it. Keep an eye on it. Watch this, look at that in three months, or six months.
After the conversation with the doctor, about 30 minutes later, I received a phone call from her scheduler: They’d already put me on the books for a March 27, 2009 ultrasound. Would the time and date work for me?
Yes, I said, it would.
I added another doctor’s appointment to my calendar.
(Oh, and I’d suggest going back two blog entries and reading “A Week in the Life”; that is, if you want more context on that last sarcastic little bit.)
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