Results

Not.

(This is a follow-up to the Snowball Appointments post)

The orthopedist was terrific – once we got through the layers of bureaucracy to actually see him.  He looked at the written history I provided, asked us questions, said that he thought that whatever is going on is outside his area of expertise, examined my daughter, and agreed with me that there is something very wrong.  But it’s outside his area of expertise.

He thinks my child needs a rheumatologist.  Even though we’ve already seen a rheumatologist and had a workup, he thinks that’s what we need.  He will fax all our information to the medical school tomorrow and ask their pediatric rheumatology department to take a look.  They will look everything over and decide whether or not they think they can help us.

It’s nice that we don’t have to go in for yet another appointment unless they think there’s something they can do.  It is not nice to have my daughter feel like a ping-pong ball.

In addition to the tentative referral for a pediatric rheumatologist, we have a definite referral for physical therapy.  The kid hates obtaining medical care, and is supposed to go to PT twice a week for the next six weeks.

Snowball Appointments

“You need to cancel that appointment.  There’s no reason to go.  I told you the last person wouldn’t be able to find anything, and I was right.  This doctor won’t be able to figure out what’s wrong, either.  It’s a waste of time!”

Have I mentioned that my normally-polite daughter is less than enthusiastic about my wanting to figure out why she never feels well?

If there were nothing to find, I’d be happy.  But there’s something wrong and the sooner it’s figured out, the sooner she’ll feel better.  This has gone on for a few years, and it breaks my heart to see her like this.  The other kids want to go to the fair, but she doesn’t think she can walk around all day.  She’s been talking of selling her horse because she never has the energy to do anything.  We’ve got to figure out what’s wrong!

A couple years ago I mentioned to our doctor that this child is always tired.  No obvious cause, blood draw with normal results, so we didn’t pursue it.  Then her hips started hurting.  Last year, x-rays showed nothing specific, so she learned to live with it (and not tell me so that I wouldn’t take her back to the doctor).

When she started vomiting from the pain, she couldn’t hide it anymore, and back to the doctor we went.  A cortisone injection helped, and while I was happy to have her feeling better, I’m a little afraid of the implications when steroids are beneficial.  Lab work and more lab work, on someone who hates needles, and she was getting discouraged about “all these appointments,” and got mad that she had a referral to a different doctor.

With her referral to see my rheumatologist came massive amounts of paperwork.  I’ve had plenty of chance to talk more with my daughter.  I don’t think she has RA.  There’s no joint swelling.  There are, however, other symptoms that I’ve pried out of the kid so we could work together to fill out her paperwork.  I told her, “The more accurately you’re able to describe what’s going on, the more chances there are that the doctor can figure out the problem and find a solution.”

It was distressing to learn that she had many more symptoms that she hadn’t been telling us about.  In addition to the fatigue, fevers and loss of appetite we’d noticed, she also marked off:

  • dizziness
  • headaches
  • pain in hands/feet
  • painful eyes
  • feels like something in eyes
  • difficulty swallowing
  • easy bruising
  • chest pain
  • shortness of breath
  • low back pain
  • joint pain (hips, ankles, knees, neck, wrists, shoulders)

How depressing.  No wonder she never feels like doing anything!

We finally got to see the rheumatologist, who said it’s not RA (I never thought it was) and not SLE (not sure how that was ruled out).  Despite what one hears about doctors never talking to one another, the rheumatologist left the exam room and phoned our family physician to discuss my daughter.  Together they decided what to do next.

After stopping at the lab for a blood draw, and radiology for x-rays, we dropped by our FP’s office to pick up the written referral to a pediatric orthopedist.

My daughter is livid.  Every doctor’s appointment leads to extra tests and another doctor’s appointment.  Just like a snowball rolling downhill, it keeps getting bigger and bigger, with more appointments and more tests.

She’d be happy to never see another doctor again, but I’ll be dragging her to yet another appointment, where (she is convinced) they’ll order even more tests that won’t help her.

I’m concerned that there’s a physical problem, but at this point I’m even more concerned about her hopelessness.

And on that cheery note, I bid you a good weekend.

It’s Not A Cold

But it doesn’t appear to be pneumonia, either, so that’s good.

I have bronchitis.  Confusingly though, I was given a prescription for an antibiotic.  Antibiotic are recommended for pneumonia, but not bronchitis, so I’m guessing that this is part of the “be extra careful to prevent infection” that comes with taking a biologic medication.

Even better, I got to discuss with my doctor the circumstances in which I really need to phone, versus when it’s okay to use home remedies.  It’s difficult to discuss anything when talking makes me cough, so in this case “discuss” means that I typed my little half-sheet description of what’s going on, along with my question, and I was able to keep the speaking/coughing to a minimum.

There’s a prescription cough syrup, too.  It makes me sleepy and dizzy.  The above paragraphs were written earlier, before I’d taken any of the new medicines.  Now that I’ve taken the cough syrup, I keep staring at the screen and wondering if any of this makes sense.  So I think I’m done writing, and will go get some sleep.

There’s nothing like skipping a dose of Enbrel to illustrate just how well the medication was working.