March 31st - MRI and ER Visit - Mean Jean (worst mean nurse EVER!) Doylestown ER

On March 31st - I reported to Doylestown hospital early in the morning for an MRI. I was feeling good (I usually did in the mornings). The guy doing the MRI asked me what kind of music I wanted to listen to. I picked Country. Turns out, he LOVED Country music and so we started talking about what concerts he'd been to, who he liked the best. He was very cool and made me feel totally at ease. Funny thing was, he mentioned also why I would be getting an MRI if I'd already had a CAT scan. I, who generally felt I was "in the know" when it came to my health (getting copies of reports/labs/etc) started to question if I was really as proactive as I thought. Two medical people questioned why I was getting an MRI when a CAT scan had already shown what was wrong. But here's the thing - I'd liked Dr. Minissale, so when he said, "Get an MRI" - I just said, "Okay!" Perhaps I should have asked why, and what information would it provide that wasn't provided by the CAT scan...

Anyway. After the MRI, they gave me a copy of the MRI on CD so I could give it to any doctor who may ask for it in the future. I thought that was awesome. I think we should automatically receive copies of our labs/EKG/reports - we shouldn't have to request them.

I'm in a great mood. I'm feeling positive! I feel I'm NOT dying! I get home and go on line and start to work and I'm working for about an hour when suddenly - I feel 3 strong very forceful palpitations from my heart.  BOOM! BOOM! BOOM!

What. The. Fuck.
I had to fast the night before the MRI and had been given injection dye. After the MRI, I had a Diet Coke...I wonder if perhaps it's the caffeine on an empty stomach? I wait for it to pass but those three original palpitations seemed to set off a constant parade of palpitations. Fuck! I don't have time for this! I just WANT TO GET BACK ON TRACK WITH LIFE AND FEEL HEALTHY AGAIN. I take a Xanax and lay (lie) down. They don't go away. Now I'm having shortness of breath but think this is because I'm beginning to become fearful. What if this is the end? Should I go to the ER? Should I wait for it to pass? What if I was having a heart attack and am wasting time. But what if it was just my excitable heart being...well, excitable?
Finally, I turn to John and say, "Let's go - just to make sure."
Of COURSE, on the way over, my heart starts to calm down a bit.
Upon arriving at Doylestown ER, they hook me up to a monitor and take a quick look at my heart. It looks good. It ALWAYS does when they do this. Back in 2006 when I was in ER for palpitations, they did the same thing and everything looked fine. Then they hooked me up to bedside monitor and the PVC's were so frequent they kept setting off alarms!
They take me to a room, hook me up to the monitor and things look ok. A bit fast, a rare PVC, but nothing for me to freak out about. The nurse, Jean, seems really annoyed by me. Is it because this is my third visit in a month? Perhaps. But I'm being extremely co-operative and nice (as I always am). I worked in EMS, I know ER nurses and docs are often overwhelmed and are treated like crap from a few patients (and nurses are treated like crap from some docs too). But man, is this old lady nurse named Jean REALLY giving me attitude. My blood work comes back - my red cells and my  hemocrit are down and my MCH is high. This concerns me. During my other 2 ER visits, my blood work came back abnormal also. SOMETHING WAS WRONG. Since the end of February when this all started, I'd seen 7 doctors, been in the ER 3times, and though everyone seemed to admit something was wrong, no one could seem to figure out WHAT.
Dr. McHugh was the ER doc and he seemed nice enough - but very busy. He sent me for a chest Xray and when I came back - I was suddenly thirsty and had a raging headache. My blood pressure (which is normally 90/60 - was now 134/86. My heart rate was climbing - I felt the pounding in my chest and started to panic. I buzzed the nurse. Jean came in all but rolling her eyes. "Yes?"
"My blood pressure shot up, I have a sudden headache - my heart is racing." - I pointed to the monitor which my heart rate was 140 and rising.
She sighed as if I'd just told her I shit the bed and she'd have to clean it up.
"It's just because you're in the hospital - your blood pressure is actually fine."
"Not for me, my pressure is very low normally."
"Well, your fine."
OHMYFUCKINGGOD. She was a royal bitch and instead of calming me down or reassuring me, she was making my situation WORSE. When she left, I took out my iPhone and recorded the SVT rhythm that my heart was now in. I buzzed again.
Jean shuffled in. "I want a new nurse - you're not taking me seriously."
"Fine."
In comes the nurse in charge. She took Jean's side. She was a bitch too. I couldn't believe this. I wasn't in the ER looking for drugs. I didn't get any and didn't ask for any. What I wanted was answers and to be assured I wasn't having a fucking heart attack! And instead of calming me, they were provoking me.
Dr. McHugh came in the room and said all reports (except my labs) looked fine and I was free to go. He saw the SVT on the monitor and while he talked to me, the rate slowly climbed down. While he was nice enough, and I understand there's really not much he could have done, he failed to mention my run of SVT in the report. Nor did he mention in the report the spike in my blood pressure. The EKG report mentioned that my ST was now depressed when compared to the EKG they had taken on 3/13/2014.
The nurse that came in to give me my discharge papers was very very cool. He explained that Jean was close to retiring and she wasn't just that way with me, she was that way with most people. He said the staff had the same complaints about her!
I left that ER feeling beaten, mortified, embarrassed, and angry. Now I seriously was starting to distrust the Doylestown medical system. Again, the reason why I'm frustrated is that when it comes to my cardiac history, I went to Doylestown ER in 2006 with palpations, followed up with cardiac testing only to be told it was "nothing" and "harmless" - so I believed this. Then when I had surgery in 2007 - I went into bigemny and trigemny under anesthesia. Even when I came out of that, I blew it off because I was told a year prior, all was well. So the past few years, I shrugged off palpitations and now am wondering...wait, could it be my heart causing all this abnormal blood work? Is my heart causing my fatigue, and anemia? And yet, I guess because there is no OBVIOUS flags (I'm not unresponsive!) they just send me on my merry way.

DR. Kmetzo

On March 25 I had two appointments: Dr. Kmetzo a cardiologist and Dr. Eddy - a family doctor that was recommended by Dr. Jennifer White.
This entry is about Dr. Kmetzo.

I needed to see a cardiac doctor to clear me for surgery because of my cardiac history.

Dr. Kmetzo was recommended by a friend of the family. Later, when I decided to really get pro-active about becoming in charge of my health, I would learn that Dr. Kmetzo had reviewed my echocardiography report that I'd had on 10/23/2006. It noted mild mitral, tricuspid, and pulmonic regurgitation and mild buckling to the mitral valve (I was never told about this, however, I wouldn't learn this until 8 years later after searching for and requesting reports).

Kmetzo was nice enough. His nurse who set up the EKG was totally nice. Had just moved to the area and she was very friendly.

Kmetzo - he was okay. Not a great bedside manner, but not a cold one either. He seemed a bit dismissive of me - a young cheeful woman healthy woman compared to the 80 year old blue haired wispy ladies using oxygen tanks shuffling in the waiting room.

He gave me a script for a Nuclear Stress test.

Dr. Eddy - Thin Office Walls

Though I really like Dr. Rachel Notte - her office was quite a distance away. I'd made an appointment with Dr. Jarrod Eddy on the advice of Dr. Jennifer White from the Doylestown ER. She seemed to really like him.

While I liked Eddy - I disliked IMMENSELY the office. When I walked in, the receptionist at the window was leaving a message about a medical issue on someones voicemail. She said, "Hi Mr. Mercury, we have your test results back. You do an pneumonia and we've called in a prescription for..." (I've fictionalized the name and medical condition) - I was horrified. Though in a day and age where we seem to give up privacy freely (Facebook, Four Square (now Swarm) Twitter, etc) - I do feel there should still be some privacy and the doctors office should certainly be one of them! The waiting room was just...blah. Horrible music playing. And it smelled like diapers. Dirty diapers.
I waited about 15 minutes for the doctor. I don't usually mind waiting if there are good magazines, but there were none.
The exam room was horrible. Looked like it had been around since 1966. I was given a paper thin gown and told to wait. While I sat on the exam table in the horrible flimsy paper gown (this was a far cry from Dr. Notte interviewing me while I had all my clothes ON first) I waited. Again. And while I waited, I could hear someone getting upset in another room about someone not calling back her mother about a message. There was an argument. Again, I was mortified that I could hear SO MUCH. Dr. Eddy finally came in after about 15 minutes and apologized for running late. He seemed to think my symptoms pointed to a hernia. He gave me some Xanax for my palpitations and/or two take 2 prior to bedtime (I wanted to try and get off Ambien). . He also gave me a script for Protonix something for acid reflux (I didn't fill that script). He told me NOT to take any antibiotics - he thought what ever was wrong with me didn't need any Cipro or anything similar.
He questioned why Dr. Minissale was sending me for an MRII had no idea. I was going for the MRI because Dr. Minissale recommended I go for an MRI.
"You don't need the MRI. The CAT scan you've had already shows you have diverticuli and a hematoma on your liver. I don't really think you need the MRI."

Huh. Now I was confused. Did I really need an MRI? Now again, I had conflicting ideas from different doctors about what was possibly wrong with me. The only one thing I knew for sure, I was super tired of doctors, and getting no better.

I liked Dr. Eddy - but I did not like (at all!) the lack of privacy from the front office leaving messages right in front of waiting patients to the thin exam walls that allowed me to hear a very unhappy patient to the crappy exam rooms.

Dr. Rachel Notte - Super Smart & Fairy Dusted

On March 20th - I had an appointment with Dr. Rachel Notte. She is the wife of my former family Dr. - Dr. Christopher Notte (whom most people love - must be that fairy dust Dr. Ukropec states was sprinkled in his hair!).

At this point in my medical journey - I'm still searching for a new family doctor; it's important to me that I feel I can trust my family doctor. That we mesh. That they listen.

She is not taking new patients - so I was very grateful that she made an exception to see me. Her office is located in Warminster and that's about a half n hour from my house. During my illness - I've become very apprehensive about driving. Not only am I tired, but my heart palpitations have started to return and I'm scared to death that I'll have some sort of attack while driving. My mind has been very forgetful also, and I've been having trouble "finding" the right words - I know what I want to say, but I can't seem to get the correct word out. The pain in my lower left comes and goes and it also seems to hover right above my pelvic bone. Most troublesome is that when I try to walk Jack, I become very short of breath, and in the shower, short of breath and have to lay (lie?) down for about 20 minutes after I shower. In the morning, I have energy and feel like I'm fine - but around noon - I start a fast slide downhill - my heart races, become exhausted, the pain increases, it's crazy.

Anway - the front office staff at Dr. Notte's is great. Super sweet and friendly. The exam rooms are nice. Clean. Dr. Notte spoke with me for about an hour - while I was fully dressed! I love when doctors talk to you while you are wearing clothes BEFORE they exam you. It makes you feel like they are treating you with respect - and not like you're simply a medical object. Dr. Notte really listened. And I mean, I threw a-lot at her - my cardiac history, my gyn history, my current pain, symptoms, my abnormal labs. Can I just point out - she's married to a doctor and has two children? I don't know how she does it - but she does and she does it brilliantly!

She ordered more lab tests and I made a follow up appointment. I think she might have fairy dust in her her also.

Dr. Gerstein - One More Time!

After seeing Dr. Dinesen, I got a call the next day from Doylestown Gynecology. They wanted to know why Dr. Dinesen was requesting a transfer of my records. I was honest. I told them about my horrible experience with PAC Frederick.

They asked for another chance.  So, I was quite touched that they actually wanted to win my business back and so, on March 19th, 2014,  I went to see Dr. Gerstein. She was extremely nice. Really took time to talk to me...but, honestly, she didn't seem to take my symptoms seriously and tried to talk me out of hysterectomy (which I was considering and which Dr. Dinesen had agreed given my family history and my current problems and ongoing cyst, it might be a good thing). She also totally contradicted Dinesen and backed up Frederick and said, "Ultrasounds Don't Lie, CAT scans do!" So I decided to get a third opinion and in between that time of waiting to see the new doctor - the cyst is now complex and hemorrhagic. So, I can't recommend this practice who kept assuring me there was nothing to worry about and didn't take my concerns at all seriously (and they also tried to point out Dr. Dinesen delivers babies and they do NOT, implying that my best bet is their practice because he is so busy). Also, people, remember you are your own best advocate and know your body best!

(update: On July 25 2014, that cyst that allegedly didn't show up on the ultrasound on March 4th, yet showed up on CAT scans, is now reported to be a complex hemorrhagic cysts after a second ultrasound). 

An Emerald Ring, St. Patrick's Day, Dr. Dinesen

The days following the ER visit with Dr. White, I scheduled appointments with the Doctors she recommended: Dr. Dinesen and Dr. Eddy. I called out sick at Wegman's (I was supposed to work the weekend) and was just so tired. Like, I couldn't even lift my iPad to read - my arms were just so weak. I also started to have shortness of breath - not terribly - but when I would get out of the shower, I would have to lie (lay? - never really sure) down on the bed for a while. Weird.
Anyway, on March 17 - while my friends were getting blottoed since it was one of the greatest holidays EVER - I was visiting ob/gyn Dr. Dinesen.
Great things: He got me in immediately (I had to wait over a month for Ianieri). The waiting room was nice. What I LOVED: the exam room was clean and nice. Dr. Dinesen came in and talked to me while I was still dressed. I told him that I felt I really did have a cyst on my left ovary but it didn't show up on an ultrasound (but it did show up on CAT scan) and he said "Ultrasounds do lie. They lie often." He answered all my questions and when I brought up I might just as well get all my lady parts out since that ovary gave me nothing but trouble and those parts weren't functioning anyway, he agreed and asked that I get cardiac clearance first since I'd had a problem under surgery before. He gave me a NICE pink cloth gown to put on after I got undressed so he could examine me. I was impressed, most ob/gyn give you these horrible paper gowns and are about as comfortable as wearing sand paper.
I liked him a-lot, he was no nonsense yet friendly, and took time to make his patients feel comfortable. Now, the only thing that made me hesitant, was the fact that he was sort of bragging how busy his practice is and how he pays his front office more than what other doctors usually pay - how he spends more (on the gowns/sheets) to make patients feel comfortable. I've been in sales, I've studied marketing and business - so those were things I'd noticed immediately. I felt like he was trying to really sell me on his practice - which actually made me start to question why he felt he had to sell me on it. I believe people should be proud of their accomplishments, and perhaps that was all Dinesen was doing - but it came off just a wee bit like bragging. Looking back now, even though I'd ultimately choose Dr. Ianieri, I would have chosen Dr. Dinesen. But now, I had two conflicting Dr.s - one assuring me taking out my bothersome lady parts was a pro-active plan - the other (whom I didn't trust anyway!) saying nothing was wrong with me and it would be a big mistake to take out my lady parts.
I had the appointment with Dr. Ianieri in April and in the meantime, now would have to get surgery clearance from a cardiac doc (which meant now I needed to find one of those also). Sigh.
One positive thing: I bought an "emerald" ring in the gift shop at the Doylestown hospital. I had nothing green to wear and I wanted a bit of good luck. And...it was 20% off. Hopefully, my luck would be changing!

Doylestown ER - Dr. Jennifer White Restores My Faith In Doctors

On Thursday, March 13 - I was feeling quite crappy. Literally. Running to the bathroom every hour because I had a case of the runs and feeling really bloated and crampy. Still the pain in my lower left area. John invites me out to lunch - anywhere I want to go! I normally love going out to eat but feel so horrible I turn him down.
Around 2 or so, the pain in my lower left is now in my back and upper abdomen. What. The. Fuck. I call Dr. Ukropec. She is with a patient so I leave a message that the pain is bad and should I go to the ER? I'm starting to have shortness of breath - but I'm not sure if this is from the pain or something else is going on. Did something burst inside me? WTF??
While I wait for Ukropec to call - I call Dr. Minissale and they say they can't help me - it doesn't sound like a GI problem because my stool isn't loose and if I'm having trouble breathing, that's not a GI problem. WTF! I'm hesitant to go to the ER again because on March 3rd - Dr. Choi really didn't take me seriously and when the ultrasound didn't show a cyst, I second guessed myself. Maybe I didn't know my body as well as I thought I did.
Finally I give up and go to Doylestown ER.
Dr. Jennifer White is on duty.
She is the doctor that saw me in September 2013 when I initially went in with left sided pain and she had focused on possible kidney stones.
Well, she treated me seriously. She did a contrast CAT scan and did blood work and I was starting to have palpation's so they hooked me up to the heart monitor.
I DID have a cyst on my left ovary after all. It was the same size and in the same place as it was in September. I also had a lesion on my liver (was told not to freak out, it's probably just like a birth mark). And I had a large diverticuliti on my duodenum (which, she thought, might be why I was having upper GI pain as well now).
My red blood cells, hemocrit, and lymphocytes were all abnormal (low).
Now - what I wouldn't know until I requested copies of my report in late July a few months later, was that the EKG came back as abnormal with possible left atrial enlargement).
There was also a mild amount of fluid around my lungs.

She gave me some oxycodne, she gave me the name of her ob/gyn, and she gave me the name of a family doctor. Most importantly, she treated me like a patient and was sympathetic and took my symptoms seriously.

I left feeling hopeful that at least we were on the road to figuring out what was wrong - the faster we pinpointed what was wrong, the faster I could get back to my old energetic self!

While in the ER, I got a voicemail from Dr. Ukropec - she left a message advising me not to go the ER - there was nothing they could do for me.

I couldn't believe it. Seriously??? What doctor would EVER tell a patient who calls complaining of shortness of breath to NOT go to the emergency room? I couldn't fucking believe it. And thank god I had gone, because it showed the cyst, and bruise on my liver, and screwed up blood cell counts, and diverticuli on my duedenum and palpations!!

I really did not like Dr. Ukropec and I could now understand why no one gave her a gift of bacon of the month.

March 11 - GI Doctor Minissale

Not getting any better. The pain in my left side is still bothering me. Growing more tired. I tried communicating with Dr. Ukropic via email but she doesn't seem to think there is anything wrong even though my blood work from the ER shows my cell counts are off and I'm still not getting better. Advice to others: Make sure you find a doctor you like BEFORE you get sick. Though Dr. Notte left and me getting sick was relatively a short time frame, perhaps knowing he was leaving, I should've started asking around. It seems to me that medical care should be very much like choosing a hair stylist or a contractor for your house: Why should I choose you? There should be a consultation in which we discuss their beliefs (are they aggressive in treatment? Do they believe in a wait and see approach? How do they feel about trying natural/nature remedy first?). There should also be price lists. Seriously. This is one big complaint of mine. When I didn't have insurance (I was quite healthy for almost 8 years w/o insurance! Sometimes I feel that having insurance can make you run to the doctor - and many doctors are all too happy too write a prescription or send you for testing when a wait and see approach is actually better). Anyway.
So I ask my friends for family doctor recommendations. Dr. Fissel comes up a few times. I make an appointment, but since I'm "new" even though I'm sick, I have to wait until April 25th. I take it. I make an appointment with an ob/gyn that my sister in law uses who also comes highly recommended - Dr. Ianerei but again - can't get in until April 17th.
My GI doc (who I've been seeing since the incident in September of 2013) fit me in and he thinks my pain is not GI related - no bleeding from my poop chute! He orders blood work for me and suggests I  and wants to schedule me for a colonoscopy.
I totally balk on the colonoscopy. I don't want to be put under anesthesia because of my cardiac history of being put under anesthesia and because he seemed quite convinced it's not GI related.

On March 12 I went to have get my blood work done at Quest (I despise Quest. Again, prices should be listed. There is always a wait. There is only one nice tech who works there. They don't post lab results online and they always try to double bill me. Always.  Abington lab is RIGHT behind the one in Chalfont and the lady is totally nice (I wouldn't discover this till later) and there is never a line and you get your results the NEXT DAY!). I was feeling a bit better on Wednesday. I thought perhaps I was getting better. Yay!
And then Thursday, March 13th rolled around. Now I know why the 13th is an unlucky day - though looking back now, it was probably a lucky day for me!

Ultrasounds Don't Lie!

On the advice of Dr. Minissale (who gave me a few OB/GYN names, it happened to be the first one he gave me) - I went to see Shannon Frederick PAC – Doylestown Gynecology. The reception staff was fabulous and they were kind enough to fit me after I called when I got home from my ER visit on March 3^rd.  On March 5^th, I brought them some homemade coffee cake to show my appreciation for fitting me in and to start, what I had hoped, would be a lifelong relationship with a new gynecologist. Hahahaha.

Shannon Frederick probably had the worst bedside manor ever. I was still having pain, bloating, growing extremely tired. I explained about my lack of periods for the past several years and that in September of 2013 I had a cyst on my ovary. I explained I’d been in the ER a few days before but the ultrasound showed I didn’t have a cyst – but I still felt like I did. She did an exam (painful!) and said she didn’t feel anything and she said, very curtly, “Ultrasounds DON’T lie.”

Now, as a former paramedic, we were always taught: Treat the patient, not the equipment (heart monitor, bp monitor, oxygen monitor, etc). So Shannon made me feel like, well, if the ultrasound didn’t show a cyst (or something wrong) then I guess it must be all in my head.  I left that office like a dog that had just been scolded. She did a pap smear and the one positive was that she sent me to have my blood drawn to see just where my hormones were (why I was only having a period twice a year).

Like I said, fabulous staff, but she made me feel like I was a moron.

“Ultrasounds Don’t Lie!” I will never forget that. And luckily, I would soon meet an Ob/Gyn who did assure me that yes, ultrasounds do lie, and they can lie quite often! 

First ER Visit of 2013

On March 3rd, 2014 - I was having severe lower left side pain and pressure low on my pelvis. My back hurt. Again, it felt like a ruptured cyst.
John and I went to Doylestown ER - and AGAIN, the doctor focused on kidney stones. Sigh. He gave me something for the pain and I had an ultrasound of my kidneys and ovaries. Interestingly enough,there was bilateral hydropnephorosis in my kidneys and my right ureter was mildly dilated. The ultrasound said my ovaries were clear. I was shocked. He told me to take Bentyle (I didn't). My labs did show I had low: white blood cell count, red blood cell count, hemocrat, and high MCH. I also had high leukocyte in my urine (but now, no blood).

I was discharged and decided it might just be time to actually see an OB/GYN and Dr. Minissale. Something was obviously going on.