Monday, May 24, 2010

A back ache isn't always just a back ache

This story starts two Wed nights ago when I started having a pain in my lower right abdomen.  It was just a tinge but continued to get progressively worse throughout Thurs.  Thursdays are my really busy work meeting days so I ended up going to urgent care after hours at my local Kaiser Permanente office.  They ran blood work and a urinalysis which came back normal and the doctor barely hid the fact that she clearly thought I was making it all up.  (side note: The lab downstairs had only one employee and was so backed up the doctor was calling every 20 minutes to scream at them for not having test results in yet.)  She said to call for an ultrasound appt, maybe it was a cyst and just to take ibuprofen in the meantime.  When I called the next day for the appt the earliest opening they had was the following Thursday-6 days later.  For someone with a history of burst cysts this seems asinine but what could I do?

On Friday we left for a camping trip, side pain and all (though the side pain wasn't as bad as it had been), Saturday night it randomly got worse for about 20 minutes and then disappeared.  Sunday morning I woke up and felt fine, was doing dishes after breakfast and bam! my lower back felt like it was on fire.  I blamed it on the lower than normal sink and the fact that I had been camping, sleeping in a tent on a small air mattress.  When we got home I had dinner club already planned and I grinned it and bared it through the back pain until curling up in bed with a heating pad on it that night.  The heating pad seemed to help.

Monday morning I woke up feeling fine and the morning was okay but by mid afternoon I could barely move my back hurt so badly.  Walking, sitting, lying down all hurt.  I chalked it up to sitting in an office chair that isn't the most supportive for the back for too long and went home where I promptly attached myself to the couch and heating pad, only moving to the bed with heating pad later.  I called the Kaiser line to tell them of this new symptom and once again, I honestly believe they thought I was making it up.  They said to take ibuprofen and if I wanted to come into Urgent Care again they'd make me an appt.  Here's the problem with urgent care- they have no ultrasound equip so if it's a cyst like they believed there would be literally nothing they could do until my already scheduled appt which I just had to make it to because they could not move it up.  I would not think it was anything else since the doctor told me all my other tests were normal.

Tuesday morning I once again felt better when I woke up but by Tuesday midday I made this tweet:

At this point, the only thing that made me feel at all better was the trusty heating pad.  My husband was starting to think that I had injured a vertebrae but it wasn't just in my back.  The pain was in the original right lower abdomen spot, along my entire lower back and wrapped around my hips.  By the afternoons I was in tears from the pain.  Now many of you might question why I was even at work in the first place, but that's just how I am.  If I have work to do, I'll be there.  If I have meetings, I will be there.  I have been at work in pretty much every stage of various illnesses.  I take off work for two reasons: 1) migraines because they mess with my vision enough that it would be dangerous for me to drive and 2) anything gastrointestinal because being at work during something like that is just uncomfortable.  That's it, and when I do take off I am always working from home.

I get home on Tuesday night, skip the couch and go straight to bed.  The heating pad isn't even helping at this point, the only position at all comfortable is on my back with my knees pulled to my chest... but when I say comfortable I mean on the scale of having needles stuck directly into nerve centers or next to them it was next to them.  The ibuprofen I was taking was no longer even taking the edge of the pain away.  As I went to sleep I tweeted this:

Wed morning, as was the pattern by now, the pain wasn't so bad when I first woke up but then progressively got worse much earlier then in previous days.  I also had a training class Wed morning at work requiring me to sit in a chair and not move for 3 hours.  I am not exaggerating when I say that it was like torture.  When I got back to the office I called the Kaiser line again saying that I know that my ultrasound appt is the next day and I've been trying to wait but I can't anymore.  It's just too much.  The advice nurse actually literally scoffed and said that she could not believe that they hadn't brought me in sooner for the tests.  My doctor was completely booked (she always, always is) but she'd send an emergency note to them to try to get me in ASAP.  I waited, and waited... and waited.  At 4 I called back because I had heard nothing.  Because this is an HMO you don't have the option of just going to the ER unless it's life threatening or your doctor gives the okay so I basically was just like "look, I am in pain.  I cannot even fully describe how I feel right now so either I need an appt right now with any tests you need to run or I need an okay to go to the ER."  I guarantee my doctor's nurse didn't believe me either.  That seems to be the theme of all of this.  I am sure that's partly my fault since to most logical people it would make sense that if I was really in that much pain 1) I would not be calling them from work or 2) I would have already gone to the ER.  However, they underestimate my work ethic and how incredibly cheap I am.  Unless I have a reasonable expectation that they will actually pay for the ER trip I'd probably sit on the side of a road bleeding to death so afraid of the eventual bill.

Finally the advice nurse said the doctor says she can see you tomorrow afternoon or you can go to the ER tonight.  The fact that the earliest they could do was the following afternoon at 3pm shows how incredibly unconcerned they were.  To fully explain why this is ridiculous (and probably a bit of TMI), I have a history of reoccurring UTIs due to a birth defect (my urinary tract is much shorter than normal people's), a hiatal hernia that predisposes me to ulcers and a history of at least one ruptured cyst that sent me via ambulance to the ER.  If for no other reason then those items in my history one would think they may have taken me a tad more seriously.

I get home, go to bed with the heating pad and finally declare that the pain has won, we are going to the ER and hopefully won't get sacked with a massive bill.  Best decision I have ever made since my issue had nothing to do with something you'd find on an ultrasound and the test that shows what was wrong was one they already ran and apparently tested incorrectly.  So what would have happened instead was I'd go in for the ultrasound, which would have been normal (I know this because they also did one at the hospital), go to the doctor where she'd look at all the tests they already ran and maybe give me a pain killer and dismiss me.  Obviously I don't know this for a fact but I've had Kaiser long enough to know what they do.

I had a kidney infection.  Now for those of you who aren't aware you can't get a kidney infection without first getting a UTI/bladder infection and then the infection moves up into your kidneys.  Where it then festers and causes a lot of pain in addition to other symptoms.  On the informational sheet they give you from the hospital about kidney infection the number 1 thing is get prompt treatment for UTIs so it never moves into your kidneys.  But I tried to do that!  I get enough UTI's (see above) that I know the symptoms like the back of my hand and went in back in April with symptoms.  They said I was fine.  I got another urinalysis when I went into urgent care almost exactly a month since I went in in April, once again got an all clear.  Then someone with a history of urinary infection problems is calling you almost daily saying they have defacto flank pain (abdominal pain that streaks to the lower back) and you are so unconcerned that you don't at the very least have them come in for another urinalysis much less make room in your appt book?  Fail.  Massive, massive fail.

They gave me a narcotic pain killer while at the hospital and it didn't even fully take away the pain I was in, if that illustrates it for you any better.  However, after just two doses of antibiotics the pain was gone.  That's it. Thank goodness to the ER doctor who insisted on running a urinalysis again after I told her they had just run one and it was fine less than a week before (which, by the way would be impossible).

Thank you Kaiser for being incredibly incompetent.  Thank you for your insistence to not put me on the same protocol that most with reoccurring UTI's are on, giving them a supply of antibiotics that they can take when they have symptoms to try to prevent this from occurring.  Thank you for making me live with that pain for a week for no reason at all.  I'm sure it just made me stronger in the end, after all it did not kill me.  I also thank you in advance for not attempting to reject the ER charges and send me a bill for thousands of dollars, I guarantee you do not even want to start that game after all we are in America and this is the land of malpractice suits.  Love, Kim.

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