Friday, January 15, 2010
Men, what more can I do to dissuade you from reading further? What I am about to relate will make you squirm and alter your image of the eternal feminine. I bid you go watch football and we'll catch up later.
Ladies, now that we are alone, let me say that I have endured much biological unpleasantness of late. I had been having breakthrough bleeding since Christmas, for going on three weeks. This happened to me once before, a year ago. Back then, my doctor prescribed a progestin to right my waning cycle, and it jolted me back into another year of normal, relatively regular menstruation. This time around, my doctor was off when I called and I was rerouted to a nurse practitioner whose training apparently empowers her to prescribe medication. I know all about these nurse practitioner types from writing pharmaceutical advertising. Several of my clients won't let me use the word "doctor" in their marketing materials because so many people don't end up seeing one when they come in for a check up. Instead, they see a "healthcare practitioner." Could be a doctor, yes, but could also be a specialized nurse, or, who knows, a shaman. Thus the catch all phrase, "Just ask your healthcare practitioner if (INSERT DRUG NAME HERE) could be right for you."
As it turned out, this healthcare practitioner had no bloody clue - OK, poor choice of words - what was right for me. I described my situation over the phone and she agreed to phone in a prescription for a once-a-day progestin. "Wait a minute," I said. "The last time, the doctor (as in the person who actually went to medical school) put me on something that I had to titrate." "Oh no," the "healthcare practitioner" replied with chipper confidence. "I'm looking at your chart now. This is what we gave you last time."
Well, what do I know? I'm perimenopausal. My brain's getting fuzzy. Sometimes, I call my son by the dog's name. Sometimes, I tell the dog he can't have the car keys. Recently, I lost the car keys. Permanently. So I figured my recollection was faulty and started taking the medicine. Within a matter of hours, I began bleeding to a terrifying degree. After day two of hellacious blood loss, I called my doctor. She thought it was weird but suggested I give the progestin another day to work. I gave it three because I was too busy. I couldn't really leave the house, for fear I'd find myself too far from a bathroom, and I was working on three radio spots I had just written for– are you ready for this?– a gynecologic surgery group. So I holed up in my home office, bleeding and looking at estimates, bleeding and rewriting, bleeding and casting, bleeding and making music selects.
By the day of my recording session, my hands and feet were a little tingly and my energy level was way low. I took the BART to San Francisco, but rather than attempt to walk the ten blocks to the recording studio, I sprang for a cab. Once the session was underway, I managed to remain totally focused on producing the spots, coaching the voice talent on the proper way to say "laparoscopic hysterectomy", patching takes together and wringing my hands at the difficulty of finding the right music, all the while hemorrhaging non-stop.
I went to the bathroom and called the doctor's office, leaving a message that I was bleeding to death but please not to call back 'til after two so as not to interrupt my recording session. (The doctor later told me that when she got the message, she thought "This woman is crazy." But hey, we had a media buy and a budget and you gotta do what you gotta do.)
My i-phone, which has crap reception indoors, never rang, but I eventually noticed that my doctor had called back and left me a voicemail stating, essentially, "Get thee to a hospital."
I resolved to go to the emergency room as soon as I finished my spots. My session was going over - over an hour over. I had originally asked for five hours of studio time, but I had also pressed for a reasonable quote. The studio rep had probably cut the time back to four hours to get the quote down, assuring me that four hours would be plenty. Against my better judgement, I had agreed. Ultimately, the poor engineer had to finish the mix on his own time, after completing the session that followed mine. Two lessons to learn from this: 1. Don't let anyone else tell you you can do the job in less time than you are comfortable allocating. And, 2. Don't skimp on the charm. A few choice comments like "If there's one thing I've learned, it's trust the sound engineer" and you have bought yourself a reservoir of good will. But I digress.
At 3 pm, they kicked me out of the studio - the next client had arrived and they needed the room. I took another taxi, dragged my increasingly anemic carcass onto the subway and eventually made it home. My husband and I went immediately to the hospital, where I spent five hours getting examined, IV'd, catheterized and ultra-sounded. Eventually, the ER doc called my doc to confer, and they decided to try a different progestin rather than do a D&C. I took the first dose before I left the hospital, with instructions to see my doctor the next day. My husband and I stopped to pick up a takeout burger, medium-rare, e-coli be damned, to boost my dwindling iron levels. I got home in time to listen to my spots and email the sound engineer instructions for some last minute tweaks. (The guy, bless his heart, actually came in an hour early the next day and made adjustments on his own time without billing me).
By the time I got to my doctor's office at 4:50 the next day, my radio spots were safely trafficked in time for airing, and the bleeding had subsided to a trickle. As we formulated a plan, the doctor assured me that she had made a note not to put me on that other progestin ever again. Turns out synthetic hormones are like anti-depressants: How you respond depends on your body chemistry. "Strange," I said,"That drug worked so well the first time around". At which the doctor, who was adding my recent travails to my electronic health records during our conversation, suddenly exclaimed,"No wonder. Looks like the last time, I prescribed the same thing we put you on at the hospital."
Which brings me to that darn healthcare practitioner/nurse/witch doctor/slacker/cow. Obviously, she never looked at my chart. Worse, she lied to me over the phone when she claimed she was looking at it as we spoke. I realize there are corner cutters and competent folk in every field. I apologize in advance to all the healthcare practitioners out there who would have actually read the chart. But the moral of the story, ladies, is get your prescription from a doctor. Period, no pun intended.