Field Reports, Writing

Base Report: sob Edition

When I was young and had an illness, my parents would take me to the doctor, giving me the explicit instruction to not downplay it when the doctor asks what is wrong. I rarely listened, choosing the, “I don’t feel great but it’s not that bad” route more often than not. The doctor wouldn’t be able to get a good read on my symptoms unless someone who observed me stepped in and told them.

One of my favorite memories is when I had some sort of cold/flu thing on the day of a basketball game. My mom insisted I go to the doctor; I insisted on going into the appointment alone. Obviously, I was not in great shape so the doctor told me not to play that night. I said I was fine. He said he would be writing a note to my coach telling her that I was unable to play. “That’s fine,” I said in my finest adolescent defiance, “but I’m not sure who you think is going to actually give her that note.”

It’s somewhat funny because I don’t have any issue going for preventative care. That was a belief instilled very young: It’s easier to prevent than cure. I don’t worry about physical exams or a medical professional seeing me naked or any such thing. That’s just the cost of trying to stay healthy.

But random illnesses require something significant for me to go in. Random illnesses during a pandemic are a whole different animal. “Don’t stress the healthcare system right now. Don’t go in if you suspect you have COVID but your symptoms are manageable. Don’t be a hypochondriac.”

On Wednesday last week, I began having shortness of breath. As you know, I work a job with a lot of movement, a lot of lifting, and a lot of talking. I am also 40 years old and obese, though my body is significantly stronger than it was three years ago. Or ten years ago. Or probably ever. I also have had more anxiety regarding COVID in the last week than I’d had prior to it. I’d also been wearing a mask at work more than usual. It was hotter than it’s been. And we’ve been working very, very hard since the first stay-at-home was ordered.

All of these things exist so when the shortness of breath began, I assumed it was any combination of these factors. Mostly, I assumed it was in my head. Students doing education in a healthcare field often go through the period of time where they feel they have any variety of diagnoses they’ve been learning about. If you talk about the pink elephant enough, you suddenly can’t stop thinking about the pink elephant.

I could brush off Wednesday and Thursday based on those elements alone. On Friday, I was exhausted and had the same feeling of shortness of breath. I was thankful work was fairly quiet because moving around too much definitely caused me difficulty. Breathing felt labored and I had to concentrate in order to take a deep breath. Again, I assumed it was in my head and that I was just “checked out” before my long weekend. I needed to sleep, maybe.

I slept. And when I tried to wake up, I slept more. Colonel was at the cabin and I could hardly stay awake long enough to message her to tell her I was having trouble staying awake. My breathing felt funny. Everything hurt. It was Outpost Commander’s birthday and I told her that I wasn’t going to be up for much. She joked that she was hoping to go for a jog. The sheer thought of going for a walk made my chest hurt. That’s a tough feeling to ignore.

She came to the house to watch a movie and looked at me and goes, “There’s something…. wrong with your face….” by which she meant I looked feverish and pale. She, too, is dealing with an injury and can’t move her left arm. So we took our rightful spots in two recliners and argued over who had to try to reach the remote — the one who can’t reach or the one who can’t breathe.

Within a couple of hours, Outpost Commander and Colonel were fully conspiring to get me to go to Urgent Care. It was 16:40. They closed at 17:00 so I knew I just had to wait them out. What were these two going to do?

My greatest concern was being a person who went to Urgent Care where a doctor would probably look at me and be like, “Cool. My 81st person today who thought they had COVID. Very exciting.” I didn’t want to be that person.

In exchange for them agreeing to not tell my mother, I filled out a SmartExam online portal thing about 17:20. The automated response said I would hear back sometime after 0800 the next day.

About 17:30 I received a response telling me to be seen urgently in the next 24 hours. Again, I pointed out that if the symptoms were manageable at home, we are not to go to be seen. Colonel arrived around 18:30, marching in to take over the situation. Outpost Commander told me all she wanted for her birthday was for me to go to the doctor. They are so sneaky. I said I wanted to sleep on it, see if I felt better in the morning.

I had a good four hours Sunday morning where it wasn’t overtly noticeable. But then, it got worse, hitting all at once around 1. I agreed to go in so Colonel took me on the 1.5 minute trip to the hospital. I made her sit in the car because there’s no reason for another person to come with me. I bribed her to not feel guilty about going home by reminding her that Dairy Queen was right next door.

There are two Urgent Care locations set up. The four symptoms that move you to the COVID corner entrance are cough, fever, sore throat, and shortness of breath. The only wait time I had there was the amount of time it took the nurse and doctor to put on their hazmat gear. (It’s not full hazmat — just the face shield and gown and Darth Vader oxygen tank.) (Just kidding about the tank.)

I wore a mask which felt great on a humid day with shortness of breath. They told me I could pull it down when I was alone. They put me in a negative pressure room which consistently sucks the air out while cycling in new air. A piece of paper being sucked to the vent read, “If this is still up here, the room is okay.” It was oddly comforting.

The nurse did a COVID test. This test goes into your throat instead of poking your brain through a nostril. “Your tongue is really fighting me on this,” she said. “Yeah, it has a temper,” I responded after she got the sample she needed.

We ran through my vitals (my blood pressure is annoyingly good, temp was 98.8, heart rate was too fast but I was working hard to breathe). I stressed that I did not think it was COVID and she said she understood. The doctor came in next and I told her the same thing. I mentioned that I’d been having very pointed pain in my left calf muscle for about two weeks and she said, “Well, then, we’re going to begin blood clot protocol.” I was somehow relieved at that as I’d wondered if that was a possible issue. She did a great job outlining what would happen and said, “This is going to be a long visit.”

“The blood test is going to probably take 40 minutes,” she said.
“Oh,” I replied. “You said long so I braced myself for at least 4 hours.”
“Well good. I love beating people’s expectations without trying.”

An EKG followed the blood work. The tech doing that told me stories of her time in Labor and Delivery. I am wholly convinced those people have the best stories. (This Is Going To Hurt by Adam Kay fully supports this theory.) EKG was normal. Then I went for a chest x-ray. I was the only patient in the entire ward so these things were going quickly.

I went back to the room and the doctor came in. “Blood work is good. If you had a blood clot, the D dimer would be elevated and it’s normal. Your white blood cell count is 11.1 when 11 is the top end of normal. So that’s sort of unhelpful. And now for your chest x-ray.” **pulls up picture on computer** “The radiologist saw an atelectasis in your left lower lobe.” <She tried to explain an atelectasis> “Huh. Sorry about that. I’ve never really had to come up with an atelectasis metaphor before. It’s basically a partial collapse of part of your lung. Just know that it’s common when there’s a bacterial infection which is represented by this.” <points to blurry little circular spot underneath line going through lung where it COLLAPSED BUT DON’T WORRY THAT’S COMMON> “It’s basically pneumonia. People with COVID sometimes develop them but only after the virus is present and then usually the entire lung is a little blurry. But we won’t know if that’s the case for 24 hours or five days, depending on when we get your results. You have to quarantine until then.”

“Okay,” I replied. “Let me get this straight. In the middle of an incredibly communicable viral infection pandemic that affects the respiratory system, I have somehow developed a bacterial infection with a partially collapsed lobe of my lung that we’re pretty sure has nothing to do with said pandemic?”

And I can’t describe this perfectly because it really was “a moment” between a doctor and a patient, but she looked at me through her semi hazmat suit and goes, “It really is poorly timed.”

That’s me! I’m the queen of poorly timed weird diagnoses that look and feel like the thing we’re supposed to be concerned about but it isn’t so here’s an inhaler and an antibiotic and sit the hell down and we’ll call you about the pandemic results.

At least it was something and I wasn’t just making it up or going in unnecessarily. And this morning, I told the Colonel that I read one treatment for atelectasis is a Belgian waffle.

And even though she never believes me, she still provided me some treatment shortly thereafter. Do your magic, syrup! /Mary Poppins’d

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