I spend a fair amount of time in clinics as part of my job, and over the years I’ve learned some…things. For one, GI nurses have the best sense of humor of all the specialties, but colonoscopies and the tools used to perform them are no joke. Two, ICD-9/10 codes are amazing:
301.7 Does opposite of what is asked (otherwise known as being a dick?)
787.03 Vomiting alone (as opposed to with others?)
E883.9 Accidental fall into other hole or other opening in surface (just curious…what exactly qualifies as “other” here?)
E917.4 Walked into lamppost initial encounter (??)
W22.2XD Walked into lamppost subsequent encounter (ah, of course)
799.89 Bizarre personal appearance (…)
Three, people get really attached to their primary care providers, so much so, they sometimes feign illness just to see them. Many nurses have told me about their repeat offenders who make frequent appointments, seeking attention. I recently witnessed an elderly lady (and repeat offender) who was complaining of all sorts of things, heart palpitations, SOB, dizziness, vomiting, basically death. The doc instructed her to go straight to the ER, and as her daughter wheeled her out, she asked if they could stop and eat lunch first. Oh, sure. It’s just death.
I tend to be on the opposite end of the spectrum. I prefer to avoid doctors at all costs, deathly afraid of what they might tell me. (Although once when I was little I remember faking an earache because I really wanted a sticker and a sucker, and maybe to get out of washing dishes for the evening. Sorry Mom, I still feel really bad about that.) Maybe this has something to do with getting older or maybe it has something to do with my PCP mentioning she thought I might be somewhere within the Bipolar family during my second visit ever. I remember feeling offended, partly because she had just got done examining my lady parts and partly because I’ve always known that whatever was going on upstairs was probably definitely not normal, but this was the first time someone had the nerve to say it out loud.
Despite that, she’s been a pretty incredible PCP, so eight years later, there I sat, discussing my inability to focus, my recent anxiety attacks, mood swings, and the general mess of my life, explaining how yoga and writing seem to be the only two things that help steady my thoughts. She concluded that I probably had a highly functioning mind and my job was too restrictive of an environment to support it, that I had been operating in a box, and quitting was the first step to breaking free. She hesitated to put me on any sort of medication, because she was afraid it would interfere with my creativity and thoughts, no matter how crazy. When she learned I enjoyed writing, she said, “I mean, Ernest Hemingway, James Joyce, Faulkner…no one told them they had ADD and had to be medicated.” Ahh, perhaps not, but they were all preeetty intense alcoholics, which may or may not have lead to their death. Sooo…?
Because every office visit needs a diagnosis, she chose Adjustment Reaction for mine. She scribbled a word on a card and told me to read up on it at home and to let her know if it described how I felt.
Then she invited me to find her on Facebook after my insurance ran out (because of course you can’t be FB BFFs with your patients), which I thought was kind of strange and something I definitely can’t do now in fear she will read this.
Cyclothymia. That was the word she scribbled.
According to the Mayo Clinic Staff,
Cyclothymia (si-klo-THIGH-me-uh), also called cyclothymic disorder, is a mood disorder. Cyclothymia causes emotional ups and downs, but they’re not as extreme as in bipolar disorder type I or II.
With cyclothymia, you experience periods when your mood noticeably shifts up and down from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.
Uh, maybe I’m confused, but isn’t that just called Life?
Then I had dinner with my friend Alex, who is a marriage and family therapist, specializing in LGBTQ individuals and their families. While literally none of those traits apply to me, talking to him has always set my mind at ease.
As per usual, I word vomited all over my delicious sticky pork buns from Umami, and Alex listened in the way only Alex can. When I was done, he pointed out my emotions only partly had to do with the journey ahead of me. They also had a lot to do with what I am leaving behind. I am leaving my Madison life of 15 years, my family of crazy wonderful friends, my Wisconsin roots of 33 years. I am leaving life as I know it, never to return. When (If?) I come back, it may not even be back here.
This is a huge goodbye. And I am in mourning. But it’s starting to feel like the longest funeral ever.