Phoenix

Previously on The Diagnosis


Moving cross country to a new city is challenging in any situation. Making it even more difficult for me was also having to build a brand new network of trusted physicians.

First I needed to establish a home base for my treatment. For a kidney patient, this starts with a good nephrologist. I contacted my Austin transplant coordinator to see if she had any recommendations. After doing some research, she came back to me with a group based in Mesa. I made the call. 

The nurse was extremely helpful as I attempted to sum up my medical history. She quickly grasped that it was lengthy and complicated.

"Oh, you're not an easy case are you. We'll need to put you with Dr. Smith.*"

A sound plan. I was indeed not an easy case, so I would love to be seen by their most knowledgeable physician. My appointment was set before I left Austin. It would be in early June, so that would give me time to settle in before the meeting.

My job started at the end of April. My mom accompanied me on my journey west in my trusty green Camry. It was an enjoyable two-day trip as we were expert travel companions and I always treasured being able to spend quality time with her. 

Home for the next month would be a furnished apartment about 10 minutes from my Garmin office. It did not escape me how sheltered I'd been that at the not terribly young age of 27 I was for the first time completely on my own. There were a multitude of conflicting feelings swirling around me. Freedom, responsibility, loneliness, even fear. 

I admit to being a bit of a chicken in that apartment at night. One evening I was startled by a man banging on the door. I handled this by muting the tv and pretending I wasn't home. My heart was racing. About a half hour later I heard a new knock. Through the peephole I spied a young woman in her early 20s. Not knowing what was happening I continued my possum defense.

"I know you're in there!" she yelled at me.

*possum*

"I can see your shadow under the door!"

*possum*

I really should have just opened the door, but at this point I had committed to my cowardice and honestly was too embarrassed at my behavior to turn back now. She left, but about 10 minutes later she slipped a note under the door. 

The man who had been knocking earlier was a repo guy. Apparently the previous tenant had an outstanding debt and Repo Guy had been trying to contact him to collect his car. The woman had seen him before and he'd asked her about the resident. I decided to remain on my current path of doing nothing and thankfully never heard from the guy or the girl again. I'm just happy he didn't take my car.

Ryan and I purchased a modest home in Chandler, which is a suburb in the far southeast corner of Phoenix. It had a nice walled-in backyard for Melbotis and an open floor-plan, which was more of a curse than a blessing. The neighborhood was surrounded on two sides by cow pastures that the realtor claimed would be gone within six months. It took 3 years.

I couldn't move into the house yet as I had no furniture. At the end of May we flew Jeff the Cat over solo. That is a whole story of its own - one that traumatized both Jeff and Ryan. Jeffy spent the next week alone in an empty house, though I would go visit him after work every day.

Ryan arrived with Melbotis and his brother Jason who was along for the ride at the tail end of May. He had remained in Austin to finish up his job at UT and had to pack up the entire house by himself after I left. I was so happy when he and Mel showed up in Arizona. Jeff the Cat was also delighted to see familiar faces.

The day of my first appointment with Dr. Smith came shortly after that. I was ushered into a treatment room and spent about 15 minutes waiting and examining my surroundings. Then I heard a very disgruntled and loud voice from outside.

Uh-oh.

Dr. Smith came barging in looking supremely pissed off. He then proceeded to demand why I had asked to specifically see him. He was a very busy man! He did not have time for new patients!

What. The. F*#@.

First off, I did not ask to see you, sir. I didn't even know who the hell you were until I talked to your staff. They were the ones who determined it was best that I see you. Secondly, I am a new patient at your clinic. Scratch that, I am ANY patient at your clinic. Is that how you talk to people?? 

I did not say any of this, but instead stared at him in disbelief and tried to reply evenly to his questions. After he settled down, read through my file, and asked me some real questions, he came to this conclusion:

"You're in real trouble, Missy."

No shit, Sherlock. He had obviously grasped that I was a truly difficult case and wanted ME to know that treating me would not be easy and the outlook was not good. I think he thought I would be rattled by this information, but none of this was new to me. I kept looking at him calmly and agreed with him with a simple, "Yep."

I informed him that I had been undergoing "experimental" plasmapheresis treatments. He literally laughed out loud at that and informed me that plasmapheresis hadn't been experimental since the 1980s. Nevertheless, he recommended that not only should we continue the treatments, they should be done with more frequency. We wrapped up the appointment and I held it together until I got to my car.

That's when I lost it. I was shaking and crying angry tears the whole way home. This was the guy I was going to have to see every month here? I was not okay with that. By the time I arrived at the house my tears had subsided, but I was still very upset. 

I called the nephrology office and relayed my experience to the nurse.

She apologized profusely and needlessly said he was probably not having a good day. But she also offered up that I was welcome to be seen by another doctor at the clinic. She said the doctors often consulted with each other on cases, so even if I didn't see Dr. Smith regularly, he would still have an eye on my treatment plan. This sounded like a fabulous idea. She recommended a Dr. Lambda and set another appointment for me in a week's time.

My meeting with Dr. Lambda was like night and day from that with Dr. Smith. I liked him instantly. He seemed knowledgeable, did not come at me with scare tactics, and was warm and friendly. This I could work with.

Pheresis treatments in Phoenix would be done at Desert Samaritan Hospital in Mesa. I would become well acquainted with the nurses there over the next four years. There were only five stations for patients in the dialysis room and at least two nurses at all times, so there was a lot of down time and they enjoyed chatting with me. 

My first treatment was done by a man named Terry, who was the head nurse of the unit. He offered me the external blood-warming machine which could be hooked up to the centrifuge and reheat your blood before returning it to you. That sounded delightful! One of my complaints about pheresis in the past was feeling extremely chilly during and after treatments. We got started.

About 15 minutes in, I suddenly became very nauseous and needed to vomit pronto. I did. 

Well that wasn't fun. I had tolerated pheresis well in the past and the only difference was the blood warmer, so off it went. The treatment was finished without incident, though I was still freezing. But I will take being cold over having to barf any day.

After my first appointment with Dr. Smith I was so rattled I forgot to inquire about other doctors. My meeting with Dr. Lambda went so well I felt confident enough to ask his nurse about an internal medicine specialist, a neurologist, and a gynecologist. She had names for two out of the three. I ended up getting an OBGYN recommendation from the receptionist.

I do not remember why I didn't ask about a cardiologist. Probably because I felt I had enough on my plate already, and because I had become increasingly annoyed arguing with my Austin cardiologist about my migraine medication. My nephrologist could monitor my blood thinners, which was in my mind the only thing he was really doing at that point.

My medical team assembled, I settled into my life in Phoenix. I would become well acquainted with Dr. Lambda and my internal medicine physician, Dr. Chang, over the next four years. It was going to be a wild ride.


*Name has been changed out of respect.




Next up: What the Hell is a Sed Rate?




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