The week of October 5, 2014, I had yet another stay in a veteran’s hospital with another weird diagnosis. It’s only a matter of time before I recognize my case in an edition of Scientific American’s Mystery Diagnosis article.
Monday was busy, and Tuesday ended with a trip to the ER, presenting with neck pain and difficulty swallowing. My neck felt like I had whiplash. I hadn’t done anything to injure myself, and wrote it off as a strained neck from to much driving. But something wasn’t consistent with pulled neck muscle. It was like a bad episode of Sesame Street’s “Which One of These Things is Not Like The Other?”
I assumed it to was allergies. Which is stupid, because I knew better. After twenty years as a medial anomaly, I just knew better. But I didn’t think anything of it until my cousin asked if I had any flu-like symptoms.
So I packed a bag, got in my car and drove myself to the ER. I always drive myself because I hate taking people with me. I end up feeling like I need to make them feel comfortable. I get those worried looks, and I hate them. It’s not their fault I view my ER visits as somewhat routine. Mostly because I never let things get so far out of hand, I couldn’t drive there. I’d rather go to the ER and ‘cry wolf’, than ‘Suck it up, Buttercup’ until my condition becomes catastrophic. I’m proactive that way, I guess.
I did notify my family I was going, which I hate to do, but I am also thankful to live far enough away they can’t just jump in the car and come to the ER. Not because I want to leave them out, I just hate not having answers to their questions. I view ER visits as fact-finding missions, in addition to emergency care. I’ve been doing this 20 years now, and a trip to the ER is just normal to me. Not because I have fallen through cracks in the system. It’s because whatever the complication, waiting for a doctor’s appointment in a specialist clinic, held once a week, is usually not an option.
My greatest fear of living in Long Beach since the beginning of the 2014, is that things might get so bad, an ambulance might be needed one day, and I would not be taken to a facility that is equipped with doctors who know how to treat a patient with scleroderma and sarcoidosis. Instead, I would be taken to the Long Beach VA, for another botched diagnosis.
The ER in West LA, appeared to have their act together. Well, except that ER nurse profiling me as a drug addict. I made sure to tell his supervisors, but that’s a whole other post.
Back to the ER: First, using a CT scan with contrast, observations of signs and notation of symptom, I was diagnosed with a retro pharyngeal infection. well, sort of- it was worst case, but there were missing symptoms specifically a fever and evidence of an abscess. Luckily, I was fortunate enough to work with a team of doctors who were interested in answers, and getting them correct. So, they followed the evidence.
I thought when diagnosed wasn’t as bad as a progression in scleroderma or sarcoidosis. Of course, it is a very serious infection that could be fatal if not treated in time. But the doctors were a little puzzled. I had swelling, but no fever and no sign of an abscess, which are both criteria for diagnosis. I was still treated with antibiotics until the diagnosis could be proven otherwise.
I was seen by an ENT, who then requested a second CT scan with contrast, and later, that diagnosis was changed, thanks to the very capable rheumatology department and lucky me, my attending doctor in the hospital was a rheumatologist. I think she is also the chief of rheumatology. The diagnosis was changed to calcium hydroxyapatite deposition in the periarticular soft tissues of my neck. In English: Calcinosis in my neck tissue, specifically the tendons.
And there was a treatment. And of course when the in-patient doctor told me the diagnosis, I of course asked to have the infection instead, because to me, anything scleroderma related in a new region of my body, no matter how treatable, in my mind is always the worst possible outcome. Of course, I had a much better prognosis with calcinosis in my neck than an infection in my neck, but it was scleroderma and it took hours to get my head out of my butt over it. (Seriously, what kind of an idiot would rather have an infection that a treatable symptom of a chronic illness? Oh, right. I’m that kind of idiot.)
So I was given medication to break apart the calcinosis, kept on antibiotics just in case and my condition improved in about thirty-six hours. I was sent home. The very next day, I went to my high school reunion and had a blast.
And here I am seven days after discharge, feeling completely recovered, and packing my things to move to LA. I wish I could stay in Long beach, but I cannot be guaranteed continuity of care at the Long Beach VA
Sometimes, I would like to have a gentler, familiar diagnosis instead of scleroderma. A diagnosis other people have heard of, like chlamydia. At least that can be treated. And when I tell people what I have, I would not have to explain it. Everyone has heard of chlamydia, and that can be cured.
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