A man can live all of his life thinking all is well; well, mostly well. Forty-one years of marriage, seven children, 23 grandchildren, four advanced academic degrees, and a bibliography that is astonishing even to myself. In an instant, however, all this seems to be hardly more than detritus, the kitchen middens of my second estate. Now, lest I be misunderstood, I am not particular depressed about the diagnosis or even the prognosis, I am just a little aggravated about having another thing to think about, something unforeseen, something that I had to learn about from my younger sister, of all people.
About two years ago, Judie called to ask me if I had ever had extensive blood work done. I told her that I had not, that I was perfectly content to let my blood stay right where it was and did not wish to have anyone fiddling with my veins or the contents thereof. I have a phobia of sorts that began when my sister was but two years of age. I fell victim to some sort of bacterial infection and for a period of time our family physician thought that it would be in the best interests of humanity if I received frequent injections of one sort or another to ward off the burgeoning disease running rampant throughout my body. Everyday after kindergarten for about a month I was ushered into the doctor's office where I was administered antibacterial drugs using a 14-gauge hypodermic needle. For those of you who are having trouble imagining a 14-gauge needle, think of the corresponding size shotgun and you will have the 4-year old's impression of what was happening to me every afternoon. As it turned out, the medical practitioners in that particular office were not as accurate nor as exacting as a nervous 4-year old might have hoped. The tabla rasa of my emotional life is, therefore, somewhat blood-splattered and that accounts for my continuing hesitancy to have the medical profession tap into my life force. About ever six weeks or so from the time that Judie first contacted me about the blood tests, she would e-mail me or telephone me about my progress. Eventually, I decided that the only thing that would keep me from having anxiety attacks about any impending communique from my sibling was to actually have the blood tests done.
When I reached my 65th birthday, I assumed the role of being able to depend on the governmental largess of Medicare. One of the first things expected of me was the dreaded Medicare physical which involved all sorts of probing and prodding, the sufferance of which was ameliorated by an occasional dose of Demerol, the effect of which seemed to be something along the lines of "liquid smooth". I unconsciously missed my colonoscopy altogether, though I dare say that CNN bought the broadcast rights. Apparently it was a slow day for the news. Aside from the 14-gauge television camera stuffed into my nethermost part, I was only seriously distressed by one other aspect of the physical: the withdrawal from my personal bank of two rather large vials of blood. While I was trying to remain calm at the prospect of the imminent garden-hose extraction, I told my doctor about the request that my sister had made about a particular blood test. My physician, in his paternalistic way (I am twenty years older than he is), said that I should not worry, it would be taken care of.
When the inevitable consultation came regarding my overall health, I asked about the hemochromatosis test. "Hmmmm," said he, "It appears that it was not done. Not to worry; we can do it later." The point that my physician failed to appreciate that I was in no mood for another wrestling match with his nurse about the extraction device. Another six months would pass before I gathered up sufficient nerve to proposed the appropriate blood test again. By this time I had receive 647 IM's, e-mails, snail mails, and/or phone calls from my sister wanting to know about the results. "Doc Holliday", the master of all things 14-gauge, said that we could go ahead with the hemochromatosis test together with a few other things that he thought that would be useful now that I had celebrated the 66th anniversary of my birth. A few minutes later the doctor's nurse and a young thing of not quite twenty years, flounced into the examination room announcing that they were about to take my blood. The twenty-something was invited to do the honors; she was a student nurse. "Oh," said I, "I suppose that this is your first time taking blood from a patient." "Oh, no," said she, "I have done it, like loads of times." More blood-splattering.
A week or so later, I called my physician about the results, inasmuch as Judie was threatening a two-month camping trip in my den if I did not cough up the numbers. The nurse with who I spoke said, "Oh, your tests were cancelled." "Cancelled?" I said unbelievingly. "Who cancelled them?" "I don't know," she answered. "But I will find out and call you back." Thus, for the next hour or so I was back on proverbial, though hardly metaphorical, tenterhooks. Eventually, she called me back and announced that the labs in Salt Lake City had cancelled the test because the blood samples were lost, or stolen, or contaminated, or became part of some "cock and bull" story being generated by the bowels of the University of Utah. In any event, I was welcome to return to the office where they would again "14-gauge" me free of charge. I was experiencing the transports of delight, I tell you.
I went back to the office, the nurse and her colleagues apologizing profusely for the inconvenience. She asked if there were any way they could make it up to me. I said that Demerol would be nice. "Liquid smooth", however, was not to be. "Once more into the breach, dear friends," Henrietta cried, as she took another fifth. I staggered home.
About this time, I was commissioned to accompany a group of Venture and Varsity Scouts to the Seviere River and its Yuba Lake. I had a glorious time. When I arrived home afterwards, however, I found that "Doc Holliday" had called several times, but had not been able to talk with anyone. He said on the answering machine that he was mailing the results to me and that I should call him as soon as possible. The results came. Lo and behold, I was declared the proud possessor of the genome governing hemochromatosis. Judie and I were really brother and sister. I am certain that was a relief to everyone concerned.
In the report, however, I discovered that I also had abnormally high Blood Urea Nitrogen and, to my horror, Chronic Kidney Disease as indicated by my Glomerular Filtration Rate. According to the chart, I was 36 points away from kidney failure. My Serum Iron was high, my Iron Binding Capacity was low, my Saturation was off the chart. I concluded that I was a Dead Man Walking. For all of this, however, the most frightening part of the whole piece of paper was the note at the bottom "Collect Venous Blood/Venipunct Qty:1" They wanted more!
I called the "Doc" and found out, through a labyrinth of toadies and inepts, that I would not be able to see my doctor for a week, inasmuch as he was on vacation. To make a long story short..... no, it doesn't.... I eventually had a chat with the good doctor who calmed my nerves about everything. Yes, I did have chronic kidney disease, but I would probably die from an interstellar debris fall before it killed me. Yes, I did have high blood urea nitrogen, but that was probably due to dehydration the morning that I had the blood drawn. My Serum iron was high (207) but we were not going to worry about that until it hit 300 or so. Having been prompted by my sister I asked, "Well, what is my ferritin level?" He said, "I don't know. We didn't test for that." "Well,'" said I, "My sister is getting a little ornery about this. I have to have a number." "Alright"," he said, and with that he hailed the 14-gauge sump pump operator and we were engaged once again. As an aside, I have since learned that the treatment for hemochromatosis is phlebotomy, or put simply, "blood-letting". By this time I was half-way through the cure.
Another couple of days passed. By this time I had done a great deal of reading on the subject. I now knew that if this condition were to go untreated I would be regaled with such complications as cirrhosis of the liver, pancreatic diabetes, and kidneys that would function only insofar as their shape was concerned. One morning I received a phone call from the clinic. It was my doctor. "Well," said he, "It would appear that your ferritin levels are at 827; another 173 points and you will cause a reversal of the magnetic poles of the earth. We need to have you draw blood."
I will not, at this point, describe the rather winsome conversation that I had with the American Red Cross about the acceptability of my blood, except to say that if I had been calling from Portland, Oregon, they would have taken my blood without hesitation. Apparently my level of ferritin is less of a threat there. Eventually I was sent to the Infusion Center in Provo. I thought that it would have been more aptly named the "Diffusion Center", given the circumstances. I came up with a bevy of rather clever jokes about Stephanie Meyers and the reason why I was there. Not everyone was feeling as lugubrious as I. I spoke about the bag of ball bearings that they were about to take from me. The nurse said, "No, it will be more like buckshot" as she pulled out her 14 -gauge.
Waters Blue - This morning I was prancing through the text of the first volume of my autobiography, in preparation for its printing in a month or so. As I was reviewing...
7 years ago