Differential Diagnosis

Justin has been sick ever since since he started his drive home from Texas almost three weeks ago. At first, it was a sore neck and headaches every night, then it progressed to a sore throat, fever, and malaise, and finally to fevers approaching 104° and a throat so swollen that I was afraid he wouldn't be able to breathe.  

I took him to the doctor and despite a negative Rapid Strep. test, the doctor was sure his throat looked "very streppy" and prescribed amoxicillin. I asked if he could please do a Monospot test because I had seen first hand how much Justin was sleeping and how difficult it was for him to even get out of bed, but the doctor assured me I was just a worried mother, infectious mononucleosis wasn't a possibility, and Justin would begin recovering from his Strep. throat in 24-48 hrs. 

Seventy-two hours later with no improvement and worsening symptoms we were back at the doctor's office. Another negative Rapid Strep. test, another request from me for a Monospot test to no avail, but we left this time with a prescription for Augmentin and an assurance that this more potent antibiotic would do the trick. 

Two days later when Justin began his 104° fevers and was having trouble breathing, we went to the doctor one last time before heading to the ER. I insisted on a Monospot test, and you can likely guess the result - positive.

So after three visits to the doctor within five days, three different antibiotics, seven different medications prescribed, nine different lab. tests, and a demand from a very worried mother, we've finally got a real diagnosis. 

I understand that doctors are busy, don't need or want patients telling them how to practice medicine, and can't respond to every request from every worried mother, but I think that with a little more listening this could have been more easily resolved with the second visit. Justin is now on steroids to control his throat and tonsillar swelling, and I would be far less willing to be forgiving of the doctor's inability to listen if Justin was in the hospital on a respirator, which would have been the next step without the steroids. 

I originally intended to write a weekending-type post, but this is what I did this weekend. I feel a bit guilty because this is what I went to school for (to be able to identify those atypical lymphocytes in the photo above that are a pretty good indicator of infectious mononucleosis) and I should probably have taken charge more at the second doctor's visit and insisted upon a Monospot test. But I didn't, Justin is not in the hospital on a ventilator, and will recover with time and plenty of rest. Hopefully I will learn my lesson to be a better medical advocate for my loved ones in the future. No matter whether your kids are 3 or 23, mothers worry and should be listened to. 

If-Then

If-then statements are used in math and computer science as conditional statements of a hypothesis followed by a conclusion. These statements are written as p→q, which is read as "if p, then q".

For example, if you exercise, then you can reward yourself with a piece of zucchini bread. These can also get more complex with if-then-else and else-if statements to combine several conditions, but these are probably beyond the scope of this sometimes-knitting blog.

Justin has provided me with another example. 

If you insist on sending photos of gigantically long Texas indigo snakes* to your mother,

Then your mother will send you a pair of snakeproof boots. 

Wear them. 

*Texas indigo snakes are large (6-8 ft.), nonvenomous, and sometimes even eat rattlesnakes. Still, wear the boots and don't play with snakes.

Friday Letters

I haven't written any Friday Letters for ages, but I do have a few this week to say what's on my mind, wonder about things, and take the opportunity to offer a thank you. Let's open the mail ...

Dear Fort Duncan Hospital ER,

Thank you very much for stitching Justin up on Saturday night. Yes, he is expressing his creativity and artistic ideas by making his own knives, and yes, I do tell him to be careful at almost every opportunity, but accidents happen. I appreciate you making him feel as comfortable as possible and not laughing out loud at his electrical tape bandage. He told me it was the best he could do to stop the bleeding and not faint during the drive in from the ranch. As grateful as I am, I do hope he doesn't have to make any repeat visits, especially for a rattlesnake bite. 

Also, thanks to Subway. Nothing makes a 23-year-old feel better after a harrowing ordeal than a sub (or two).

P.S. We had this exchange on Wednesday, so he may indeed be back for a repeat visit (or just some super glue).

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Dear Bill,

You are a lovely person and a rank quite high as a brother-in-law, but I may have to ask you to stop enabling me with more delicious beer. Raging Bitch entertained me first with its name, 8.3% alcohol content, and interesting art work, but turned out to be simply delicious beer. You now have me stalking local liquor stores searching for it, and their Blood Orange Ale sounds equally delightful. Next time you visit and bring beer, please bring two six-packs, one for us to drink and one to leave here with me.

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To The Person Who Discarded Christmas Decorations at Walmart in September,

I don't know why this scenario affected me so much, but I have been thinking about possible explanations all week. You didn't want to make the trek across the parking lot to the Salvation Army donation bin and instead just put the decorations down by the trash can? You found them scattered in the parking lot after they fell off of a Walmart delivery truck and placed them there so the guy that collects carts while singing loudly would see them? You were forced to move out of the house after a difficult divorce and an overflowing Walmart trash bin was the best place to dispose of Christmas decorations that held painful memories? This is some sort of social science experiment and you were sitting in a car nearby to tally how many people took pictures of this odd scene? (At least one!)

On the remote chance that you are the person who did this and happen to be reading, please let me know why! 

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Wishing everyone a good weekend, free of cuts, stitches, super glue, and sad discarded Christmas ornaments!

Ten on Tuesday

I don't think I've ever looked forward to reading others' Ten on Tuesday lists quite as much as I am today. The topic, 10 Things You Do To Calm Down, is one that I can definitely use, and I hope to gather ideas that I can put into practice. I don't think of myself as a very angry person, so when I need to calm down it's most often due to worry and anxiety. It feels like I've been worrying about things more than usual for the past year and a half; most often about a family member's health or safety, but there is also my own health, money, when will the axle on my Subaru break again, what do I want to do in this next stage of my life, have I been/am I now a good mother, am I eating enough fruits and vegetables, global warming, the rise of pseudoscience, am I worrying too much ...

I know that worrying isn't useful or productive, and can even be a bit of a wallowing self-indulgence, so here are some of the things I do to calm down.

1. Knit - There have been plenty of studies showing the calming effects of knitting, and I think we've all experienced how very effective this is.
2. Shop for yarn - I have to be careful not to overdo it, but often times even browsing The Loopy Ewe online is a calming experience. Calm Downing is the most recent addition to my wish list!
   
3. Walk - Getting out into the fresh air, walking away from worry and towards peace is a very good thing.
4. Breathe - Simply taking some deep breaths and concentrating on the exchange of oxygen and carbon dioxide can be soothing.
5. Meditate - This is a relatively new practice for me and I'm still trying to find what works best, but focusing on my breath, observing thoughts without judgement, and letting them go is a good beginning.
6. Drink tea - There is a good reason that hot, sweet tea figures largely in British novels. The simple act of making tea and feeling that warmth entering your system is restorative and restful.
7. Read - Reading allows me to enter another world, one away from my own concerns. A nonfiction book about meditation or a great novel can transport me.
8. Get outside of myself - When I need to calm down, it's very helpful to direct my attention and energy towards others. Bake zucchini bread for a friend, change the batteries in the smoke detectors for an elderly neighbor, donate blood, or do some volunteer shelving at the library -- all of these have helped me to calm down and put things in perspective.
9. Music - Whether it's calming Zoe Keating on cello or something more raucous to "dance it out", music has charms to soothe the savage breast.
   
10. Balloon or the box - If I recognize that what I'm worrying about is something I need to let go of, I'll picture placing that worry in a balloon and watch it peacefully drift away into a lovely blue sky. Sometimes anxiety is about an issue I need to deal with, so I imagine placing that into a box to deal with it when I'm better able to. That helps with calming down, which in turn helps with actually resolving the issue.

So, what are your favorite ways to calm down? I'd love to hear what works for you!

Ramblin' Man

Packing all the important things. Can you spot the knitted item?

And, he's off again. Justin came back home in January after his internship at a deer ranch in New York state ended. It was great to have him home for a while, and he used the time to relax, regroup, and look for a job. Full-time jobs for a Wildlife Management major are a bit difficult to come by, so he's expanding his skills, resumé, and horizons by heading to a very large deer ranch in Texas. This could be a short-term thing, or if he likes it (and they like him), the possibility might exist for longer employment. We shall see ...

I worried when he drove more than 2,200 miles to Montana, and I'll be worrying for the next three days while he drives 1,920 miles to Texas. As before, I'll be keeping very busy, walking my miles, saying quite a few prayers, knitting, waiting for texts that tell me he's stopped for the night and the eagerly anticipated and most welcome one that tells me he has arrived safely at his destination. Knitting seems to offer something practical, soothing, and calming to do instead of useless, incessant worry, and I feel lucky to have that in my life.

So, Justin, be careful, safe travels, and have fun!

Homeward Bound

This is a beautiful song, sung beautifully. I promised myself I wouldn't listen to it while he was gone, but Justin left Montana yesterday and is now homeward bound. Since he's out west, he decided to stop and visit Ryan in Colorado. The first eight hundred miles of his trip are completed, and I was glad to receive his text (even at 1:08 am).

Only 1,803 miles to go!

Homeward Bound

This is a beautiful song, sung beautifully. I promised myself I wouldn't listen to it while he was gone, but Justin left Montana yesterday and is now homeward bound. Since he's out west, he decided to stop and visit Ryan in Colorado. The first eight hundred miles of his trip are completed, and I was glad to receive his text (even at 1:08 am).

Only 1,803 miles to go!

Miles

We all have some important mileages in our lives. Mine are the five miles (10,000 steps) I try to walk each day, the 2.5 miles to do the dreaded grossery shopping, 55 miles to visit my father, the 1700 mile distance between here and Ryan's house, the 69 mile drive to the airport so I can hop on a plane to travel those 1700 miles at 500 miles/hour.

Today, another mileage is looming large in my mind - 2,243 miles. That is the distance Justin is driving from here to Montana. That means I'll be thinking about him (and possibly even worrying a bit) for the next four days. He likes to drive, but he has also never driven for four very long days by himself. We couldn't talk my brother-in-law into going along with him, and he refused my offer to go along as another driver and companion for safety's sake. Just think of the knitting I could get done!

So that is what I'm going to be doing anyway. Keeping very busy, walking my miles, making gallons of potato salad for a family picnic, saying quite a few prayers, waiting for texts that tell me he's stopped for the night and the eagerly anticipated and most welcome one that tells me he has arrived safely at his destination, and knitting. Knitting seems to offer something practical and soothing to do with my worry, and I feel lucky to have that in my life.

I've said this almost every time you've left the house, Justin, but I've never meant it more. Be careful and safe travels.

Friday Letters

I've written a few Friday Letters to recap my week, say what's on my mind, and take the opportunity to offer a thank you or two. Let's open the mail...

Dear Guardian Angel,

Thank you for watching over Justin at the end of March. Even though he drives drove a big diesel truck, his truck was no match for the last surprise eight inches of *%&$#*! snow and ice that sent him careening into a marble post, mailbox, and tree. I'm so incredibly thankful that he was okay, even though his truck was totaled. Every time I complain about endless calls with the insurance company, all the other associated details that have to be dealt with, being without my car for the past several weeks because Justin needs it to get to school, and now the process of looking for another vehicle, I stop as soon as I catch myself, and say another prayer of gratitude that he was okay. Please continue to watch over him; he is a 21-year old boy man male and could possibly even use an extra guardian angel if there is one to spare.

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Dear Verizon,

Just a customer service tip, "Oh, crap" is not what your customers want to hear from you after being assured by three different associates that you can easily transfer contacts and photos. After two and a half hours and a suggestion from a helpful customer that happened to walk in, then you were able to easily transfer things. Good job!

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Dear Life,

The past four months have been a little trying in many different ways. If there is any possibility, could I please ask for a slight reprieve for the next month or so? It doesn't have to be anything big, maybe just an hour or two to sit peacefully, concentrate on reading a real book, knit without making so many mistakes because I'm worrying about other things, and not feel cold dread in the pit of my stomach every time the phone rings because I'm expecting bad news. Thanks for considering my request!

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Wishing everyone a happy, healthy, safe, and smart weekend!

The Best Laid Plans...

Change quickly when Youngest Son's x-ray looks like this:

While it's not the end of the world, the bone on the far right isn't supposed to be broken and pointing in an odd direction. Calling it a displaced fracture of the distal shaft of the right fifth metacarpal doesn't make me worry less. Now we have to wait and see if a closed reduction will work or if he'll need surgery to pin it, and try and figure out how he's going to take finals this week. I'm keeping my fingers crossed for good news and I wish his hand wasn't so swollen so he could cross his fingers also!

Update: We spent all day at dr. visits and testing, but Justin now has surgery scheduled for the 16th. It's a relatively minor same-day procedure to pin the bone so it will heal properly; this is important for a kid who lives for archery, fishing, and working on his truck! He's got some understanding professors who are allowing him to take finals this week with me as typist/scribe, so I've learned about limnology (freshwater science); later in the week I'll be broadening my horizons with ornithology, alternate ag. animals (alpacas!), and GIS! Thank you all for your concern, good wishes and healing thoughts; they helped calm a worried mother!