Disclaimer: This is just an update on my health. I am not asking
for sympathy, prayers, or contributions to a Go Fund Me page. In the pantheon
of things that can and do break down as we travel the joys of aging pathway of
life, this is merely an annoying detour, not some big obstacle. I expect this
piece to be of limited interest to many people (thus, I will attempt to treat
it lightly, with what passes for humor in my world), but it does play into the general
conclusions I will draw later on the American health system.
Soon to be a stage play and then a movie. Think we need to punch up the title, though.
First, a recap
and/or update, depending on where you came in. I apologize that this reinforces the stereotype of people talking on and on about their health as they age. I used to laugh about that. No longer.
The last week
in September I awoke one morning to complete deafness in my right ear. No
warning, no symptoms, just, “Damn, honey, I can’t hear out of my right ear.”
Tried a couple days of antihistamines, then contacted my doctor (via email) and
he called me back within a couple hours. Suggested other OTC stuff and said if
that didn’t work to get back to him and they’d get me into an ENT. No change.
Sent him (yes, you have a personal email if your doctor does the concierge
thing) another message. Even though he was on vacation, he called his office
and told them to get me into the first available ENT they could find. Which is
how I found myself out at St. Luke’s a week later. Audiologist confirmed that I
had CHS (Can’t Hear S*¶¡), also known as Sudden Idiopathic Neural Deafness in
my right ear. ENT doc then suggested a steroid shot into the eardrum and a
2-week Prednisone regimen. Also ordered an MRI to rule out the unlikely
possibility of a tumor on the ear.
The shot could
be repeated up to 2 more times, at which point if there was no improvement, it
was time to look at mechanical options. Set up another appointment two weeks
later. Prognosis: about one in three patients recover completely, one in three
recover some, and one in three are toast. Because, and I’ll repeat this later
when it’s more to the point, I started treatment within 3 weeks of the onset of
deafness, my odds improved slightly. However, because this was so sudden, they
also decreased, perhaps to even worse than the original despite getting started
quickly.
MRI results
came back with good news, bad news. Good news, as expected, no tumor. Bad news,
it revealed a growth in my nasal cavity somewhere. Good news, it probably was
congenital, nothing to worry about, and only revealed because of the MRI. Bad
news, CT scan needed to confirm there was really nothing to worry about.
Back to the
ENT. CT shows, as expected, nothing to worry about but one more thing to
monitor. However, the CT also shows a growth on my thyroid. Now I need an
ultrasound to determine what that is.* Audiologist confirms no progress on the
hearing front, despite the shot and Prednisone regime. (However, I did write
lots of blog articles, sided the house, composted the garden for the winter,
chopped down the big Sweet Gum tree....okay, only the increased writing
productivity is true.) Second shot in the ear (redefining what it means to have
a pierced ear. May have to wear a big earring so people know which one to talk
into). New appointment scheduled for a couple weeks; doctor offers no
encouragement, essentially saying that I can have another shot if I want it but
not holding out much hope for improvement.
I’m about ready
to skip the third treatment at this point because, while it’s not that big a deal,
why waste the money (even if it’s not really mine) if it’s not going to work.
But then (thank you social media) I get a text from a friend of mine (another
former I’m proud to call both a personal and professional friend – thanks, KC)
telling me that this happened to his wife, as well, and that while she was
discouraged, too, she took the third shot and eventually bounced. So I told the
ENT that I’d be taking the third treatment.
I’m also going
to tell him that, intentionally or not, his words would not play well at home
on the range (“where never is heard a discouraging word”) and that he might
want to find some different/better phraseology to temper unrealistic hopes without being overly discouraging.
And then I
began to wonder, this being the season and all that…. Politically is this doc
on a one-man crusade to save your Medicare dollars? Is he a conservative
concerned about government “waste” and spending? If so, did that (inadvertently
or advertently) color the way he made recommendation or phrased the options?
Not accusing, not angry, not even the slightest bit upset, but something to
think about (and it’s a train that runs both ways). We want to believe that
those who give us advice are completely objective. However, because it is human
beings giving that advice, we cannot discount their political bent. Sometimes
it’s easy to figure out (such as a financial adviser showing off his
Krugerrands), more often not so much. But definitely worth thinking about. Always consider the source.
But I digress (yes,
still, yes, again). Next is the ultrasound. The technician is competent and thorough,
confirming the existence of the thyroid masses. Again, 90% of the time this is
nothing, and even if it’s something, it’s “easily treatable,” which, of course
means it’s easy for someone else to treat, maybe not so easy for you, the
treatee! Apparently there’s no rush, so the (essentially a) biopsy, even if
they don’t call it that (an FNA – insert your joke here, but it is neither a procedure I would
volunteer for nor an acronym I would want. FNA actually, that stands for Fine
Needle Aspiration, or sticking a needle up your nose)
is scheduled for the end of December. Good. Let’s make sure I qualify for my
medical expenses deduction for 2016. The meter keeps on ticking and I haven’t
seen all the bills yet. I will share the expected final big number when I have it, because
it’s an important part of the point of a future piece.
The FNA shows that the thyroid
growths are benign and, because I’m on my doctor’s self-imposed short list, I
get the good news within a couple days. There is bad news down the road, and
while it’s definitely personal, it’s not mine, although I would prefer that it were. But I’ll get to that in the next installment, Adventures
in Health Care Part III.
Meanwhile, I head to Central
Institute for the Deaf for more testing and options. There are a couple of
hearing aids, ranging in price from $3,000-$5,000; hearing aids are not covered
by Medicare or insurance. I’m leaning in that direction, but keep my
appointment with a surgeon who does cochlear and other implants.
Because I am only deaf
in one ear, Medicare will not cover the cost (unlike in Europe, where that
wouldn’t matter), $30,000. The other option is a Baja Implant, a bone
conduction implant, which would at least pick up sounds on the deaf side so
that I would actually pick up sounds on the right (do I really need
to hear more “stuff” from the right; I’ve kind of had it up to here with that),
even though only left ear would be transmitting to the brain. He then suggests
that maybe, just maybe, I can qualify for a study for a one-sided cochlear and
that he would let me know.
As time moves (slowly)
I start to think that because the bad news is slow in arriving, maybe there’s
good news. Alas, not to be. My left-side hearing is too good to qualify for the
study. I arrange for surgery at the earliest available date (early March, with
full implementation of the device around the first of May). This, Medicare
covers (mostly). And I get two free options (plus, there’s an app for that!). I
get to pick my color (I guess I’ll be a blond for life!) and will have a remote
control to adjust the volume without fiddling directly with the device, which
kind of snaps onto my head like an organic Lego or something, and a microphone that I can pass to the end of the
table or something in large groups (or conceivably, to the back of a classroom
should my retirement resolution not quite stick, but this development is hardly
an incentive to get back into the saddle). But that is where things stand now. Parts III & IV &? to follow soon.
*Full disclosure: my primary care doctor is
actually the one who felt the thyroid growth and ordered the ultrasound (but it
would have been ordered due to the CT results in any case, just not as
quickly). My description above makes the point about how trying to solve one
problem leads to the discovery or creation of another problem. Just like
political issues lead to proposed solutions which lead to new problems which
lead to new solutions which -- welcome to the Fun House!
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