Tag: health

  • Surgical Specialists Wing

    This is where I met a man named Niles at reception. His nameplate gleamed under the soft lobby light as he greeted me and asked for my name. I was forty minutes early……pacing at home had done little to pass the time, so I left home just to get this visit over with.

    Niles took my last name and handed me an iPad. The screen walked me through the usual verifications before unfolding into a detailed health questionnaire… women’s health, menstrual cycles, pregnancies, family history of cancer, vision, urinary issues. It felt like a full-body audit. Nothing out of the ordinary for me.

    I took a seat in the waiting area, opened the book I’d brought, and briefly glanced around. Six other women waited quietly, all lost in their own thoughts. My husband sat among them, the only man there….steady, patient, supportive. When they finally called my name, I stood and gave him a quick glance. “You’ve got this,” he said with a smile.

    The nurse took my weight, asked the standard questions, and measured my blood pressure: 120/68, same as always, I think. Then came a few more questions… prescriptions, smoking history, family cancer cases? She then asked me to change into a gown: “Opening in the front. Uma will be in shortly.” and she walked out of the examination room.

    The gown was pink, actually, No, it was fuchsia. I remember the color, because I once had a middle school teacher who drove a fuchsia Saturn and was relentlessly teased for it. Yes, this gown was the same exact lilac pink shade.

    Five minutes later, Uma walked in. Petite, maybe around my husband’s age, fluorescent pink Crocs, white coat. I stood to greet her and shook her hand. She apologized right away.
    “I’m sorry…. you were probably wondering why we said everything was fine at first, then called you back in.”
    “Yes,” I replied, “but no need to apologize. I wasn’t sure what was going on.”

    She explained that ultrasounds are most reliable when a radiologist is on site, apparently, the center I’d visited no longer had one since being sold to new management. She opened the mammogram and ultrasound images and began reviewing each slide with me.

    “You have dense breast tissue,” she explained. “Both sides are full of cysts.” She pointed out dark circles on the screen, showing which were fluid-filled and which were harder. Then she compared the solid ones to….of all things……..cement.

    The word caught my attention immediately. “Cement?” I echoed in my mind.

    She explained how a hardened cyst can cause pain when surrounding tissue shifts against it……“like when a cement filled nodule starts to move among other things” I smiled, finally realizing she meant concrete or perhaps even mortar.

    A common mix-up. I didn’t correct her, of course. She was kind and thorough, describing every image, each black-and-white swirl gradually taking form in my mind.

    Then she paused on one particular area. “This gray wall here, between two dark circle. We can’t be certain what that is. We’ll monitor it closely. I recommend every six months.”

    Next came the actual physical exam. “So,” she said conversationally, “what do you do for a living?”

    I laughed. “Funny you should ask. That cement analogy? Pretty fitting….. I actually work in the cement industry.”

    She burst out laughing. “No way! and here I was, guessing you were an accountant!”

    We both laughed as I stepped on to the examining table. Then she began the exam…..right side first, No issues.

    Then the left. I tried to stay calm as she pressed firmly, but a few winces gave me away to a noted pain and discomfort.

    “I noticed that upper side’s gotten larger since this past September” I said.
    “Yes,” she nodded. “That’s the fluid-filled cyst. But this other one—this is the one we’re keeping an eye on.”

    I thought….”Of course, that’s the same one I have been complaining about…. the one I’ve had since last November…. the one that appears to be getting more firm and painful.”

    She returned to her computer chair and sat. “We’ll order an aspiration for the fluid-filled cyst that has enlarged since last September. While we’re there with the needle, we’ll also look at the one in question.”

    She asked me to get dressed and stepped out of the room.

    A few minutes later, she returned with my risk assessment. “Because you’re over thirty and haven’t had children, that increases risk slightly. And since your paternal aunt had breast cancer, that adds more. Altogether, you’re considered high risk.”

    She recommended adding an MRI screening, alongside ultrasound and mammograms. “Of course,” she said, “this could change once we have the aspiration results.”

    Before I left, she mentioned she’d be retiring in January. “Don’t be surprised if your contact changes,” she smiled. “I’ve been doing this since the seventies……started at Trinity Health when I was seventeen.”

    “Wow,” I said, genuinely impressed and for a moment, I thought about how many patients over the decades had heard her cement analogy and how many probably imagined little sacks of gray powder like I did.

    All jokes aside, she had incredible bedside manner. I felt safe, informed, and oddly very calm.

    Now, I wait… for the radiology team’s call…… for the next test…….for more data.

    Still, I can’t help but wonder…….. Why did she picture me as an accountant?

  • Navigating Healthcare Referrals: A Patient’s Journey

    It’s Wednesday, and I still don’t have an appointment for my biopsy. I had been told to expect a call by today, but no such luck.

    At lunch time, I called Dr. S office.
    “No, ma’am, we don’t have the referral just yet,” said the kind administrator. “But let me go ahead and set up your chart so that once we do receive the referral, our coordinator can move forward with scheduling.”

    I gave her my information, hung up, and immediately called my primary.
    “Hi, I’m calling about a referral.”
    “Yes, ma’am, is this regarding the CPAP?”
    “No, this is about the biopsy.”
    “Oh yes, I see that right here too. We’ll send the referral to the fax number once again.”
    “Ok, Great! Thanks,” I said, and hung up.

    Later that evening, after work, I tried reaching the specialist’s office again, but by then they had already been closed for an hour according to their answering service.

    “I’ll try again tomorrow” I thought.

    Thankfully, work has been an incredible distraction. It always has been. This weekend I’m scheduled to work, and for once I’m grateful. Staying busy keeps me from sitting in the silence of the unknown, letting my mind spiral. It’s the long drives, the late nights, the idle moments when the thoughts begin to eat away at you.

    And today’s driving thoughts? How our healthcare systems need improvement. We’re still using fax machines to transmit critical referrals? There’s no universal system to manage them? No secure real-time dashboards that can track the process without violating HIPAA? The handoffs between patient, doctor, insurance, imaging, and paperwork form a maze that slows care. In medicine, process improvements aren’t just helpful…..they’re necessary.

    During the commute…I tried calling my brother, hopeful he would pick-up so I could inform him of what’s going on, only to discover he had changed his number. Not what I expected.

    When I finally got home, a letter from the mammogram center was waiting.

    It was the report.

    Findings: 1 cm x 0.9 cm x 0.8 cm irregular, echogenic mass with suspicion of malignancy, located at 3 o’clock posterior depth on the left breast. Results labeled “Abnormal/Suspicious,” with a recommendation for an ultrasound-guided core biopsy.

    Of course, I had to look it up. The possible causes range from benign to malignant. My hope is still firmly with benign…. and I’m anxious to see the confirming data.

    Well, in the words of a Courageous Cowboy: Let ’er buck.

  • Doctor Appointment

    At 4:15 p.m., I went in for a short notice doctor’s office visit. They called me into a small waiting room where the nurse checked my weight and vitals…120/60 blood pressure, 100% oxygen, and a resting heart rate of 52 bpm. “Looks good,” she said with a smile. “Dr. C. will be with you in just a minute,” she added in her soft Southern drawl.

    I sat in the cold, refrigerator-like room, taking in its minimalist cleanliness, the bare walls, the neatly organized tools, the set of ear canal testers. It was quiet, almost too quiet, until the sliding door opened and Dr. C stepped inside.

    “Hello,” she greeted.
    “Howdy,” I replied, trying to lighten the mood.

    “Now, I’m assuming they’ve already gone over this with you?” she asked gently.

    I explained that I had received a call from the physician at the Mammography center. They confirmed it was not a cyst…it was a mass.

    “Correct,” she said, glancing at the report. “They want you to get a biopsy, and that will be scheduled at a doctor’s office. I’d recommend N.F. They have two excellent doctors there, and one in particular has an excellent bedside manner.”

    She looked at me carefully. “How do you feel about that?”

    I told her that a friend had recommended a doctor at the F. , Dr. S., and that I would prefer the referral be sent to her office instead.

    She nodded. “That’s fine. Just so you’re aware, if it turns out to be positive, the doctor’s office will take it out.”

    “Positive?” I echoed.

    “Cancer,” she clarified, hesitating, as though the word itself was heavy.

    I had already noticed her body language when she entered, hesitant, with the kind of facial expressions that say I don’t want to have this conversation with my patient. The concern in her posture said the rest.

    “Well, there’s still a chance it could be nothing, correct?” I asked.

    “Yes, of course,” she assured me.

    She reminded me that she had read biopsy reports before that turned out benign.

    I told her, I’d remain optimistic that this too would amount to nothing.

    I checked out, walked to my car, and drove home. But when I stepped out of the garage and made the short walk to my front door, the weight of it all finally hit me. In that hollow stretch of silence, I couldn’t help but shed a few tears.