Thursday, January 15, 2009

And we're waiting, and we're waiting...

... with apologies to Bonnie Hunt from the movie Dave ("and we're walking, and we're walking, and we're stopping")

The last 24 hours have been nothing like I had planned. The weather started looking nasty in the afternoon, so I left work at 4:30 in hopes that 2 hours would be enough time to get 30 miles across town to pick up the girls. Uh, try 2 hours and 45 minutes. The road surface was not that bad where I was but the traffic was gridlocked. Jim was having trouble getting away from his office too; fortunately my sister had made it across the divide and was able to get the girls.

When I walked in the door at 7:15, Becky informed me that her throat, which had been sore on Tuesday but looked fine, "burned" when she swallowed. She also complained that she was cold and was wearing her jacket in the house. I looked up symptoms of strep, because there was a note up at school that someone there has it, and then looked in her throat. It was much redder with some telltale white spots. We quickly took a few more bites of the sandwiches we were eating and I took her to the urgent care, which is about 2 1/2 miles from our house. They are listed as being open until 8 pm. We arrived at 7:45 but I could see that in the waiting area, which is viewable from the parking lot, they'd turned off the lights. I had Becky come with me to try the door but of course it was locked. I could see employees putting their coats on in the office area. I guess they wanted to go home early since the weather was bad.

We bundled back into the car, so we could decide where to go next. Our insurance allows us to use hospital emergency rooms as urgent care; we still have to pay the $50 ER copay instead of a $10 office visit copay. One hospital, L, was closer to where we were, but F, the farther one, has a peds ER and our pediatrician gets their records electronically. However, I really didn't feel like driving that far. I called Jim, who called is brother, a paramedic who works with L. His brother called the nurses there and found out that their urgent care area of their ER was not busy, so that was where we headed.

We only ended up being there about an hour and a half. The longest wait was just to be sent back. The nurse took two swabs; one for rapid strep test and one regular. Poor Becky is the gaggy sort so this made her vomit the partial sandwich she'd had. The nurse got her some paper emesis basins, and she ended up taking one home as a souvenir. She felt better after that, and laid on the bed relaxing. The doctor came in and checked her; he agreed that it was possible strep and that he would write a prescription for antibiotics just in case. He popped his head back in a few minutes later and told us that the rapid strep came back positive. He asked me if she was allergic to any medicines and I told him that she is allergic to amoxicillin. When she was 5 months old she got her first of several ear infections that plagued her first two years. The amoxicillin gave her a "lovely" rash all over her body, scaring the wits out of her poor day care teacher who discovered it two days into the prescription. (This was my first Mother's Day, actually, which was spent with a sick babe, but an awfully cute one.) Anyhow, he gave us a prescription for Cefzil, the nurse gave Becky a popsicle for the road and we were off. We headed for the closest XXX, as our XXX closes at 10pm but I knew they could pull up her record at any XXX. (name changed to protect the innocent)

Well, I didn't notice as we pulled in at almost 10 pm, but the store I picked is no longer a 24 hour operation as I thought. We went straight back to the pharmacy but the drop off window was closed. An employee told me they were still open so we went to pickup. The pharmacist and tech (both young women) looked at me and told me it was too late to fill a prescription. I felt my face fall and the pharmacist asked what it was for. I told her it was Cefzil for my daughter's strep. She agreed to fill it, then started looking B up on the computer.

Pharm: "Have you ever been to XXX before?"

Liz: "Not to this XXX but yes, to another one."

Pharm: "Which one?"

Liz: "The one up the street" (they are on the same major road, several miles apart and in two different suburbs)

Pharm: "Oh, the 24 HOUR one..."

Liz: "What? When did they go 24 hours? Are you talking about the one at the intersection of X and Y?"

Pharm: "Oh, no, I thought you were talking about the one at _____." (A few miles in the opposite direction.)

Becky and I sat to wait and then the Pharm called me up. We can't fill this - her chart says she is allergic to Omnicef, which is a cephalosporin like Cefzil. You'll have to take this to <24> and have them call the doctor. I can't do it because we're closing.

I tried to explain - she is not allergic to Omnicef, but to amoxicillin. Pharm kept repeating that the computer said Omnicef so the doctor would have to be called. I was in tears at this point. I looked at her and said "you mean to tell me that they have to call THIS doctor (pointing to the ER doc's name on the script) to ask him a question about information he only knows because *I* gave it to him a half hour ago???" She backpedaled a bit and said that she just had to make sure it was safe for Becky. I totally understood that but was looking at more driving in the bitter cold, snowy roads, waiting for the pharmacist at the other place to reach the doctor, while my sick baby was hurting, all because the computer at XXX had the wrong drug listed as her allergy. I was crying in earnest at this point, babbling about 2 1/2 hours in the car, the urgent care being closed and now this. The pharmacist softened at this point and started saying "maybe there is an error on the computer. Do you know why it would say Omnicef?" In fact I did know. Since she can't have cillins, Becky got Omnicef for a subsequent ear infection. She developed a raging case of diarrhea as well as thrush; it was far from pretty. So we tried to avoid that too. When I told this to Pharm, she made a note of it in the computer and gave us the medicine... finally. We got home sometime after 10, B had her first dose and something to eat since she was pretty hungry, and went to bed.

I truly understand that Pharm was concerned about making Becky sick from the medicine. I just didn't feel like I was being listened to. Maybe it was the lateness of the hour, and her desire to get home after a long day. Hopefully in the future when a customer walks in at closing time, she will remember me and realize that sometimes the customer COULDN'T make it there any sooner, and that sometimes the customer knows more than the computer.

This morning we had our plan mapped out. Jim would take Becky to his mom's while I took Carly to school. We would meet up at the Clinic, and after the appointment I would go back to his mom's to get Becky. Shortly after I left the school but before I got to the freeway, Jim called. The freeway is a parking lot he says, so take side streets to get to the Shoreway to get downtown. So I did this and was making my way north and east. I was planning to drive through the suburb Jim's parents live in on my way to the Shoreway. My phone rang and when I looked at the display I could see that 1) it was a call from the Clinic, and 2) it was not my sister, who works there and for whom I'd left a message about parking. Instead it was Dr. Rini's secretary, P, canceling my appointment because Dr. Rini had, of all things, STREP. Poor guy... it made me laugh though, that my week has just gone this way.

I called Jim who was still at his folks' house and told him I was just a few blocks away and would pick up Becky. He wanted to know if they were going to release my test results anyhow. I didn't even ask P, because she can't do that herself and if Dr. R was too sick to work, I figured he was too sick to call. When Becky and I got home I logged into my work email and read a message from P, with a possible rescheduled appointment time. It wasn't a good time for either Jim or me so I replied with some other options. I asked her to also let Dr. R know that I was being "bugged" by my husband for test results, so maybe I could talk to him ahead of the appointment. She said she would pass along the message so I don't get in trouble with Jim. :-)

I debated whether or not to even request the call. The thing is, if the results are good, then knowing sooner would be great. However, if the results are not good, he may not want to discuss them until we meet face-to-face. Or if he does give them to me by phone, then I will end up obsessing about possible next steps, my mortality, etc. until we meet. Frankly, I don't want to waste my energy like that. So, I'm going to try not to read anything into it if he doesn't call me before the appointment, which is now on 1/21. Instead I will assume that he is super busy since he had to take at least one day off work, and so will just wait to talk to me in person.

It's weird, but I'm not feeling the nervous upset that I usually do before I get CT results. My mind is pretty much split between two extremes. One is the assumption that the news will be bad and that I will end up on systemic therapy. The other is that the spot they saw is the same or smaller now, and so they won't need to do anything but scan me again periodically. Definitely the two ends of the spectrum. I have no gut feeling about which way it will go; I believe that cancer doesn't work that way in my body.


1 comment:

Another Julia said...

I like the "spot getting smaller" scenario. I vote for that one.
Wishing you all of the good luck there is--hoping you get reassuring news soon.
Sorry to hear about your strep/pharmacy nightmare--sometimes it's just too much on an already overworked brain, isn't it?