Tag Archives: kaiser

Should you tip your Phlebotomist?

How many times up Kings, every Tuesday & Thursday morning, no-matter-what? How many trips to France in July to see part of the Tour de France? Clearly I am a creature of habit and ritual. Guess it makes sense that I’ve now grown somewhat accustomed to my new routine of having blood drawn every two weeks, which I’ve now put into a Friday-morning gig, ride down to Kaiser with Becky & Kevin, do the vampire thing, then enjoy coffee breakfast at Sheri’s Java Shack in the patio.

Having blood drawn used to, well, drain the blood from my face. Not the actual process, but even thinking about it. I thought it something I could never get used to, and wondered, seriously, if I would make the wrong choice if my life depended upon having blood drawn to do it. Well, it turns out you do kinda get used to it. Especially, I think, since I’ve worked it into a routine, something you just do, and even more especially when it’s combined with great coffee.

And I have to admit, the Phlebotomists at Kaiser are really, really good. I’m sure they notice that I’m looking away from them, pretty much right at the wall, during the process. They must have some idea that this guy is a pansy. But, I’m something of a reformed pansy, because I no longer collapse my veins, requiring them to poke and jab until they can get the tiniest trickle of red stuff to flow. I’m able to put my mind somewhere else and find a suitable combination of stressed-out relaxing, that allows the blood to flow.

In all seriousness, a year ago I couldn’t have even written this without feeling faint. Yes, I’m that bad.

So now, all that’s left is the waiting. Waiting for those notifications to pop up on my phone that I have “New Test Results” available from Kaiser. Something that, up to now, I’ve approached with massive fear & trepidation because each new test was potentially further pushing the boundaries of bad news, something seriously wrong with me at a time that I really didn’t feel (and still don’t feel) like there’s anything seriously wrong. But that’s now past; my issue has been defined (Essential Thrombocythemia, triggered by a CALR genetic mutation that has no inheritable characteristics and is not likely to affect lifespan). We’re now in the medicate-and-study-results phase. I’m expecting good results but the worst-possible scenario really isn’t that bad; it would simply mean I’d need to increase the dosage of Hydroxyurea to knock down those pesky platelets some more.

That “open book” part of my life? Obviously I’m not a conspiracy sort of person, nor secretive about my life. I don’t use anonymous names in on-line forums. I don’t live in fear of Big Brother using my health data against me. Then again, my generation (I’m 61) went to college at a time when your social security number was used as your basic identification, not something you guard with your life as people do these days. But if that’s the case, then how come so many people my age are hopelessly-addicted to conspiracy theories and Fox news? Yes Mom and Robert, that message is for you… 🙂 –MikeJ

Added 4:20pm- Got the results back. Continuing positive trend in platelet count (meaning it’s going down). As expected, also some reduction in Hematocrit and White blood cell count, a slight negative side-effect of Hydroxyurea doing its job. It’s essentially the opposite of EPO.  I’ll give these test results a C+. That’s better than it sounds, because I’d say my first results were a D-, the latter tests a C-. The trend is in the right direction!

Breathe. Breathe. Hold your breath… Breathe.

IMG_1496kaiserOne more thing scratched off the “things to do before I die list.” My first CT scan, part of my ongoing quest to figure out how to climb faster by breathing better. Part A was my first spirometry test a couple years ago, with Qvar prescribed as a twice-daily ritual, and Albuterol added before each ride. Results were not impressive; my climbing speed continued to decline. I might have just written it off as what happens as you get older, but after getting some really good results taking meds for my Raynauds (ice-cold hands due to “events” that trigger circulation shutdowns to the extremities), I decided to go after my lungs again.

A couple weeks ago, I had another Spirometry test, this time including a test after exercising, to confirm the presumed diagnosis of exercise-induced-asthma. Funny thing though; my breathing actually improved a bit after a tough (320 watt) workout. That unexpected result has led to further testing, part of which was today’s time spent having a CT scan. Let me tell you, it’s a borderline thrill!

Before describing the procedure, I’ll commend Kaiser Redwood City for their efficiency. My appointment was for 9:45am with a request to arrive 30 minutes prior. I arrive shortly after 9am, was brought into the imaging room (sounds like something from Quantum Leap) at 9:20 and was out the door by 9:35! The only drama was figuring out how the darned gown thing worked.

OK, the procedure. You’re lying flat on a table, arms folded above/behind your head (not suspended in air or anything, just lying on the table behind you). You’re asked if you can hold your breath for 10 seconds (um… yeah), explained that a voice will tell you what to do (which sounds a bit creepy, thinking about a line from a song in the 80s “My voice is the last you will ever hear. Don’t be alarmed.”), and keep your eyes closed. The object is to lie perfectly still.

It starts. The voice says “Breathe.” OK, I’m breathing. I’m breathing. I’m still breathing! Then it says “Hold your breath.” Maybe it’s a full 10 seconds before it tells you to “breathe” again, but it seemed shorter than that. You’re told to “breathe” for maybe 20 seconds, and then “Hold your breath” again. Cycle repeats. Over. And over. And over. While holding your breath, you can hear the machine, which encircles you, move forward or backward, a step at a time. There’s also a whirling motion, which eventually stops, then restarts at a different pitch (changes speed).

My assumption is that the “Hold your breath” part is the only time they’re taking x-rays/pictures of you, the idea being that you’re motionless when holding your breath, for a better picture. Or maybe it’s because it helps to maintain a fixed position over time; holding your breath doesn’t allow you to relax into some semi-random state.

Eventually, it’s over. Might have been 10 minutes, but I can see where it might seem far longer than that to some, shorter to others. Not sure why they had me close my eyes; other family members who have had cat scans weren’t told to do that. I do wonder if the entire process could have gone more quickly if they could change the “hold your breath” timing to something longer. 15 seconds would have been fine; even 20 would be comfortable.

Now I wait to see what super-detailed pictures of my lungs look like. My guess? Gross. Just like everybody’s else’s. Last test in this series will be an ECG, to see if there are any heart-related issues that might be the culprit. I’m actually looking forward to that part, as the only ECG I’ve had previously was for a life insurance physical, some years back. Not a bad thing to know what shape my heart’s in, I’m thinking!  –Mike–