The Belly of the Beast

Editor’s note: The beginning of this story was originally woven cleverly and gracefully into my previous post. But after days and days, its denouement was still not apparent, so I decided to pluck it out and save it for later. Why? Because of Small, for whom its unanswered questions would be worrisome. The creative sacrifices I make for her!

Then last night I decided not to post it at all because a friend said it’s foolish for people of our age to become preoccupied with such nonsense.

But in the end, up it goes: the saga of my last two weeks. Feel free to walk on by.

Sunday, October 24

Let’s sing with Julie Andrews to the tune of My Favorite Things. 

Nerve damage, spine woes and issues with my brain.
Side-effects from drugs; insomnia, gut pain…

Regarding that last, you may remember my fascinating posts this past summer about the rather agonizing stabbing sensations in my lower-left abdomen when I was hiking. I contacted my new PCP who essentially pooh-poohed it, saying it might be a diverticula matter but if it were serious I’d be in agony all the time. I wasn’t, so I ignored it on the many occasions it got unpleasant. Weeks later I got in touch with her again after it happened a lot more, and received a similar wait-and-see response, with the suggestion to write her if it bothered me. Uh… that’s what I thought I was doing. Okay, whatever, bye.

Then a few nights ago (a Friday), while slipping into my nightgown, I did a double-take as I passed a mirror. While my right side had the usual matronly paunch, on the troublesome side there was a noticeable bulge. It might well have been like that for a while and I just hadn’t seen it, but why are such discoveries invariably made on the first night of a weekend when doctors’ offices are closed? Startled, I burdened Lulu with my concern. The next day, it was…

Phone calls with Kaiser cuz Molly insisted.
Really long hold times, but doctors assisted.

After virtually reviewing my symptoms and belly photos (I’ll spare you), the medical team said it was a “likely inguinal hernia” and scheduled me for a visit with a surgeon three days hence. 

When I was twenty, I would never have dreamed that I’d spend my late-middle-age years whingeing about physical ailments (all the while keeping relatively silent about my mental ones). In fact, I’d have said, “Kill me first.” Now I say, “Would you please hold off on that for a while?”

Tuesday, October 26

Kaiser just this morning started offering the Moderna booster so I got mine (and a flu shot) on the way to my tête à tête with the surgeon. I regret to say that, this time, I had to cross the picket line: health over solidarity.

Inexplicably, the doctor’s spacious waiting room was unlit. Had every one of the overhead lights burned out? Soon his assistant emerged from behind the locked door to inform me my consultation was cancelled due to a power outage, rendering the windowless exam rooms dark. Worse, she said he wasn’t free again for ten days. But she let me hang out a spell, just in case. 

Minutes later she reappeared. He’d found a vacant office with a window, so we were on. After asking me for a history and reviewing what the call-doctor had written, he told me everything I’d always wanted to know about inguinal hernias. They’re not super-common in women and, unlike for men, they require surgical repair. Google had prepared me for this eventuality so it didn’t rock my world, and I was relieved to have an easy diagnosis. I learned about the operation, anesthesia options, recovery times, risks: not fun prospects, but at least there was a solution.

Then he asked to see the puffy bit, so I gave him a peek. 

“Uh, where is it?” he asked, confused. 

I pointed. “Right here.

“Oh, there. Hmmm, that’s not where I expected. An inguinal hernia is lower than that.” 

Maybe next time he’ll do the exam first. He phoned Radiology and asked if they could fit me in for a CT scan that afternoon. Ha ha; too easy. He tried two other nearby KP campuses, but the earliest opening wasn’t for over a week.

At home later, I glanced at the beginning of his report on Kaiser’s secure website to make sure I’d understood what he’d told me. I’m often struck by the difference between what I’ve said and what a doc has heard. I’d told him that I’d experienced pain on three hikes over the summer. “Avid hiker,” he noted. Trouble is, that misconception could complicate the diagnosis. To wit, he kept referring to sports injuries as though that were an avenue to explore. I’ll need to confess that pretty much my only athletic activity takes the form of pacing to my living room and back.

Here’s my biggest worry: what if they do the test and can’t find anything? Like taking your car to the mechanic and it works perfectly. They’ll think it’s all in my head. Maybe it is! How embarrassing would that be!

Thursday, October 28

What the hell? Yesterday my bitty swollen area was uncomfortable enough that I warned Eleni it might interfere with their Bay Area visit next week, which I’ve been anticipating beyond reason. Today the thing has shrunk—barely more poochy than my normal self—and with hardly a twinge. Now I’m convinced I overreacted and I feel like an idiot. 

Saturday, October 30

Poor Molly, having to put up with me. This morning I zipped over to her backyard primarily for her opinion. Because Bumpy’s symptoms are better some of the time, I was bemoaning my decision to contact Kaiser at all. You see, I’m a proper, stoic Delaware gal who hates to bug doctors and tries to avoid making a big deal over nothing. [Editor’s note: Ahem. This post rather disproves the latter.] I asked her to check out the area and she agreed it doesn’t look as prominent now, but she asked: if she were the one with the problem, wouldn’t I want her to go to the doctor? Well, that’s different. Of course she should. 

At home that evening, I made the mistake of going back to the doctor’s notes online and actually reading them this time.

“LLQ abdominal wall bulge.”

Okay, excellent. He saw it.

“No hernia on exam.”

Wait, what? I was sure he’d said it was some kind of hernia, but just in an unexpected place. 

“Unclear if hernia versus denervation.”

Denervation? What on Earth is that? (The Internet is fairly silent on the topic.) Suddenly anxious about my complete lack of understanding, at 8:30 I texted Molly:

I’m kinda done with today… Guess I’ll turn in early.

So I did.

Sunday, October 31

I should have stayed in bed this morning. When carefully brushing my troublesome teeth, one of the temporary molar crowns flew off. Of course it’s the weekend again and the dentist’s office is closed. It’s the accumulation of dumb little shite like this that gets me down.

Happy Halloween, by the way. For a few years before she moved to Chico, Ember would help me hand out candy. Alas, without the joy of her companionship, these days I shut off all the lights out front and hole up my room until trick-or-treating hours are over.

Monday, November 1

By 7:30 a.m. I ‘d begun my latest daily ritual: calling the radiology departments of three East Bay Kaiser campuses in search of a CT scan cancellation. I struck out in Richmond and Oakland, as usual. San Leandro too. But no: at the last second something miraculously opened up for a few hours later. Unbelievable! So off I went, arriving wayyyy early, as is my wont.

When it was my turn, they put in the IV for the iodine dye, slid me into and out of the tube like a corpse in a mortuary cabinet, and soon we were done. After he’d verified he’d gotten an adequate image, the technician came out and said, “You’re a very nice lady.” Not sure what I did to deserve that. Then he asked, “Now, where was the area you were concerned about?” I knew then that the test showed no hernia.

Sure enough, here’s what I read on my phone an hour later as I sat in the dentist’s chair getting a new temporary crown:

“No acute or suspicious process in the abdomen and pelvis.”

That’s wonderful, of course. But as I said earlier in this interminable narrative, it was the result I’d feared: no clear explanation.

And damn it: once again, I have to postpone uploading this post. It’s getting harder to hide stuff from Ma during our daily calls, since I have to make up stories about where I’ve been during our usual phone times. 

Here’s my thought: the situation is clearly not remotely dangerous, so I’m tempted to give up on pursuing this. But the doc has now ordered an MRI, so that’ll be the next step. I must say, it was a blow just now to find out that their next appointment isn’t for a month.

By the way, the only other observation noted in the scan findings was “severe lumbar levoscoliosis” (that means it leans left, like my politics), which might explain the chronically painful, twisty spine and the loss of more than two vertical inches over the past couple years.

Okay, I’m done writing here till I know more. See you in early December.

Uh, Monday, November 1

I’m back. You won’t believe this:

A couple hours after I made my MRI appointment, I watched Kaiser’s recommended video about the process. It said to inform the department in advance if I had stuff like tattoos (check), permanent piercings (yup) or dental hardware (uh huh).

So I called again and showered the unsuspecting receptionist with queries. The minute she’d reply to one, I’d think of another. Sensing that she was in a hurry, I assured her I had only “one last question.” Well, apparently I must have asked lots of last questions, because she grumpily interjected, “This had better be your last question this time!” I was taken aback not only by her rudeness but by my lack of awareness that I’d kept repeating my empty promise.

It wouldn’t have been unusual for me to have been defensive, but instead I laughed and apologized. And laughed again. “Did I really keep saying that?” And then she laughed. We had a grand time. At the end of the conversation I asked if they ever had cancellations. Yes, but you have to be lucky to get one, since they have no waiting list or other way to notify you. Renita and I parted ways on the best of terms.

Less than a minute later the phone rang. “I just got a cancellation for tonight at 8:30. Do you want it?”

Unbelievable! I practically shrieked for joy: what fortune, and how amazing that she actually called me back! Not a Kaiser-like experience. I thanked her passionately and with profound relief that I don’t have to wait a month after all.

Since I can’t see to drive at night any more I texted Lulu to see if she might chauffeur me to Oakland, but then decided I could do it on my own as long as I took surface streets. But she would have none of it. I verified with Eleni that she was okay with my being in a car with Lulu and Josh right before seeing the grandkids, and she was!

At that hour, Kaiser was practically empty and my wait wasn’t long. The outside of the MRI machine was painted all over with cheerful flowers and clouds. Once inside the barren tube I felt it would have been more effective to put the decorations in there instead.

I’m not particularly claustrophobic, but you know me: I’m in motion pretty much every second. Stillness is not my forte. Forty-plus minutes seemed like forty days and forty nights. I did all I could not to squirm, but then a spot on my scalp started to feel like a spider was crawling on it and my throat kept tickling me nearly into a cough and the machine’s movement slid my bony elbow off the cushion and onto the hard metal (ow) and my left leg feel asleep, and so on. To pass the time and distract myself as the machine made loud and rude noises, I worked on this blog post in my head. I also kept marveling at the medical technology and thinking how lucky I am to have the privilege of access to it.

I was home by 10:00, grateful that stuff worked out so unexpectedly well today, test-wise. I doubt that the MRI will tell us any more than the CT scan did, but we’ll see.

Wednesday, November 3

MRI results are in. Man, am I glad I didn’t have to wait an agonizing month for the verdict, which is: they have no idea what’s going on. There’s nothing sinister lurking in my viscera—I never thought there was—and needless to say that’s great news. The report does mention the scoliosis, of course, and notes some “labral [hip cartilage] tearing” on both sides.

The surgeon just wrote me. His best guess about the cause of the bulge: muscle atrophy, of all nothing-things. Why it’s on only one side is unknown. Maybe a nerve injury, he says, or regular old wear-and-tear. I’ll be lopsided from here on out. What will I do with all those string bikinis in my summer wardrobe? Oh well; symmetry is overrated anyhow. But what a waste of everyone’s time this has been. On the bright side, I’m proud to report that the doc thinks “overall [my] abdominal core is strong.” Ain’t no flies on me.

His conclusion is that the hernia imposter has nothing to do with the pain in my side. Why that’s happening, he still has no idea. So tomorrow it’s a hip x-ray followed by a tele-appointment with a physician’s assistant in the Orthopedics Sports Medicine Department for another opinion.

One thing’s for certain: I’m sure getting thorough care. Another thing’s for certain: I’m tired of this. And so are you. Take heart: we’re almost done.

Thursday, November 4

When this morning’s x-ray came back with only the usual weirdness, I gave in to despair, convinced it meant that the gut pain will remain forever and for no reason, and that docs will never believe me again.

But to my surprise, during our afternoon phone meeting the PA did shed some light on the mystery. Her theory is that my severely crooked spine is creating pressure and “odd wear” on my left hip; those factors, she believes, are the source of the troubles in my bonny ole abdomen. The wee cartilage tears don’t help. And of course the bigger issue, she notes, is my warped back itself and the torture it inflicts on me daily.

I conclude this post with her recommendations:

• Get a steroid injection in my hip to help de-ouchify it and take down swelling, though that’s but a temporary fix.
• Ask my PCP to refer me to Physical Medicine for my back (strangely, this orthopedics department is concerned only with hips), who in turn may or may not send me on to Spine Surgery.

Which brings me to my last step: Though my current physician is kind, knowledgeable and generally responsive, I wished she’d taken my reports of recurring Really Big Pain more seriously. So before I can proceed, I’ll search for another doc, this one at the small new Berkeley Kaiser, which is closer.

Ironic that it was the bulge, which turned out to be nothing, that led me to seek medical attention. Without Bulgy, who knows when I would have gotten around to addressing the bigger and gnarlier things.

I still think hernia surgery would have been easier.

From this point onward, I will follow my friend’s advice and shut up about future medical stuff.

Or not.

~ the end ~