April 25, 2003

Today was D-Day; the day I had my first scheduled appointment with the new doctor. I approached this appointment with absolutely no expectations. You cannot be disappointed about something you did not anticipate or expect. I remain ambivalent about this new doctor so for the next while I will refer to her as Trixy. Once I have sorted out how I feel about this appointment I will give her a more appropriate name.

Trixy wanted a quick run down of my complaints. Lord have mercy; how does one do a “quick run down” when the body is under siege. I had listed approximately 6 of my chief complaints when I noticed her eyes glazing over and the well recognized vacant look appear on her face.  I quickly realized that I had reached my quota of medical complaints for one visit. We must be careful not to overwhelm our esteemed medical professionals. That would be rude. We would not want to tax their brains.

In case any of you are wondering, I have not heard back from the doctor that ordered the CT Scan I had done on February 28th. This however does not surprise me. My intuition is well tuned and I had expected not to hear back. I had asked Trixy to get a copy of the CT scan results for me when I saw her in the emergency clinic at the beginning of March.

Trixy informed me today that she had received the results. The CT Scan reads as follows: “No Clinical Information: possible gastrinoma. CT Thorax and Abdomen (WITH INFUSION): A biphasic study has been performed through the upper abdomen. Comparison is made to a previous study of August 6, 2000. Just anterior to the hepatic artery there is an oblong 1.5 cm. nodular density but this is likely a lymph node and was present on the previous scan. It does not have the enhancement pattern of the usual gastrinoma. The liver, adrenals, pancreas, kidneys and spleen are normal. The pelvic viscera are within normal limits. The thorax is normal. Impression: A definate gastrinoma has not been identified. The nodule described is most likely a lymph node. ”

The CT scan report I have from 2000 does not mention an enlarged nodule or swollen lymph node. I guess they just decided to leave that bit of information out of the 2000 report. Mind you, if this is a “swollen lymph node” it might explain my ESR levels of 53 and 58.

I had the 2000 CT scan films sent to the Hormone doctor in California. He had one of his radiologists read the CT scans. According to the radiologist in California, my adrenals were mildly enlarged and nodular. When I mentioned this finding to my doctors I was told in no uncertain terms that American doctors like to exaggerate. Could it be that the Canadian radiologist missed this mildly enlarged and nodular adrenal gland in 2000? Could it be that the Canadian radiologist just neglected to report this “swollen lymph node” in 2000?

At the moment I have no idea how I will proceed. I have four months worth of medication namely Synthroid, Nexium and Starnoc. I take Starnoc once a week so I can get 3 hours of uninterrupted sleep. Hopefully I will wake up one morning soon with a great idea on how to solve my medical dilemma. I now realize that I will have to solve it on my own.

gastrinoma is a tumor in the pancreas or duodenum that secretes excess of gastrin leading to ulceration in the duodenum, stomach and the small intestine.

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