Areas of Unrest

5 April 2000 - Hypochondria 101

QOTD: "They don't ask about enriching their spiritual lives either. They want to know where to catch fish." - anonymous channeler

Reading: Nancy Lord, Green Alaska

Listening to: Eric Bogle, Plain and Simple

I alluded, in the last entry, to having done something nasty/painful to my shoulder. It was painful enough to keep me from sleeping Sunday night so I had to bite the bullet and go to the doctor. Now, this should be simple enough. I have a good job with good benefits and all, so it's just a matter of a phone call and getting over to Kaiser and all, right? So it should be no big deal and that would be the case if I didn't have a serious problem.

Namely, I own several home medical references and have an overactive imagination.

Consider, for example, a sniffle. You would decide that the clogged nostrils and the sore throat and the like are cold symptoms and take some simple over the counter remedy. I, however, obsessively reread the sections of the references that describe "serious illnesses that resemble the common cold" and try to decide if I could possibly have contracted Rocky Mountain Spotted Fever. (Which, by the way, is actually more common outside the Rocky Mountains.) That gets me worried about tick bites and I remember walking through the woods of Eastern Long Island a few years back with my friend, Debby, and her very shaggy dog. Shaggy dogs are perfect tick reservoirs and, of course, Eastern Long Island is rife with Lyme disease carrying ticks and so I can interpret any muscle ache ever in terms of the possibility of having contracted Lyme disease.

It is from these home medical reference books that I have learned that you don't have to be bitten to contract rabies, but that the mere lick could be enough. Also, bats are most likely to carry rabies and bat bites don't hurt, so you could conceivably be bitten by a rabid bite and never know it. The fact that bats don't easily get inside Los Angeles apartments is only minor reassurance.

Not that I actually go to the doctor with these hypochondriacal ravings. I'm far too embarrassed to do that. Besides, I don't want to hear the awful truth that I have mere hours to live. No - I suffer in silence.

Somehow or other, I have managed to spend many months traveling through the Third World, with little more than a day or two here and there of trying to persuade myself that a bout of traveler's diarrhea was not a near-fatal case of cholera. I was perfectly aware that I was risking bilharzia by swimming in Lake Malawi, but dismissed the risk as low. I remember reading stories in the Hindi Times about how the Indian government was dealing with an outbreak of dengue fever in Delhi by arguing about how to pronounce "dengue" instead of by actually trying hard to eradicate the mosquitos that carry it. I have napped under palapas on Mexican beaches, an activity that carries at least some risk of Chagas disease, which is the leading cause of heart disease in Latin America. And I have taken Lariam (an anti-malarial) without worrying about its reputation for psychological side-effects. I have done all that for the simple reason that The Home Encyclopedia of Dreadful Illnesses is too heavy to pack.

Anyway, what all this has to do with making a doctor's appointment this week was that I didn't think that intense pain keeping me from sleeping qualified as an emergency so I waited until morning before calling for an appointment. But I couldn't sleep, so I pulled out the reference books and looked up shoulder pain. They mentioned normal stuff like tendonitis and bursitis and warned of frozen shoulder which takes months of painful physical therapy to recover from. Fortunately, it was my right shoulder so I only had to worry about referred pain from gall bladder disease or from a perforated stomach ulcer, instead of a heart attack. Not that that is all that reassuring, since perforated stomach ulcer comes with one of those blue warning boxes that says "this is a medical emergency and you could die if you don't get it treated." Still, the odds were I was just looking forward to anywhere from 6 weeks to 6 months of pain.

Monday morning came. I called my boss and my secretary and told them I wouldn't be in. I called Kaiser and got an appointment for 11 a.m. with a nurse practitioner. Some people are firm about seeing M.D.s but I often find the N.P.s are better at listening to you and spend more time, so this is not a huge problem. Fortunately, I left myself a lot of time to get over there as traffic was bad. Of course, I was in more pain from having done such strenuous things as getting dressed and changing radio stations in the car. The traffic stress was exacerbated by the City of Los Angeles having decided to start tearing up the street in front of the medical center about 5 minutes before I arrived. By the time I was actually checked in for my appointment, I was in the midst of a low-grade panic attack. My overactive imagination had decided to distract my attention from traffic to inventing a rare cancer of the shoulder, which would require amputation of my entire right arm. Naturally, this is the point at which they call me in to take my blood pressure.

"Are you on blood pressure medication?" the nurse asks. I mutter something about being stressed from the traffic and the pain. I'm too embarrassed to admit that I'm in a growing state of panic, feeling my pulse race and my forehead break out in sweat. They send me back into the waiting room. For 40 minutes or so, enough time for me to be glad I have a mystery magazine with me because there are only magazines in the waiting room. Eventually I get called in and told to take off my blouse and put on a gown, with the open part to the back.

Have you ever tried to tie the neck ties of a medical gown when you can't raise your dominant arm more than about 5 degrees without intense pain? I can tie knots one-handed, actually, but only with my right hand. I leave the gown untied.

When the N.P. comes in, she asks me several questions about what happened and has me try to move my arm various ways. She moves it around some, while feeling my muscles. Diagnosis: a simple strain. She writes out prescriptions for an anti-inflammatory and a pain killer to help me sleep. She also tells me it should take a week or so to recover from and that I should stay home for a few days and that I should see if moist heat helps. Since I was imagining anywhere from 6 weeks to 6 months to heal, this is good news indeed. She also takes my blood pressure again and finds it perfectly normal. Not only does the subsiding of the panic attack make a difference, but the machine the nurses in the outer office are using needs to be recalibrated because everyone's readings are coming in sky high, she tells me.

Anyway, the upshot is that I filled the prescriptions, drove (painfully) home, and have now spent two and a half days watching videos and reading, with repeated applications of my hot pad. (I have one that has a sponge thing you put in to provide moist heat. It is a wonder of modern technology.) My shoulder is definitely starting to recover already, though still not up to my full range of motion.

As soon as my shoulder is completely healed, I am going to take at least one of those home medical reference books, lift it up and heave it into the nearest body of water.