Doctors (sometimes) Make the Worst Patients

Kelvin and I are thankful to have been remarkably healthy in our (now) middle age!  We also are the type of people that tend to minimize our own physical pain/discomfort, etc. and I don't think either of us has taken a sick day in the history of our employment or higher education. Pre-COVID (which we have also still, to date, not tested positive for, although I'm having a hard time believing we haven't had it given our exposures), we frequently worked through colds, probable influenza (Kelvin, twice), stomach bugs (I did leave early one time from clinic after puking in an exam room), and more (it's very arguable whether this is wise, or good practice and I think COVID has changed a lot of caution levels). However, we never want to let down our patients or colleagues (and we don't have separate "sick" days compared to "vacation" days-- it's all PTO, undistinguished, so we prefer to save our days off for travel!).  

We are also (as family medicine doctors) used to reassuring nervous patients about the "normalcy" and "non-life-threatening" nature of so many illnesses, that health (and our own health or pain) is not really a big source of anxiety or stress for us (despite other areas of life that bring us worry). We are just about the farthest thing from hypochondriacs (= pathologic minimizers?). We were pretty convinced that Iver, a newborn vomiter, probably had really bad GERD until, at close to five weeks old, the projectile vomiting got so alarming one night that we took him in for a weight check the next day (which confirmed poor weight gain) followed by an urgent ultrasound, which showed pyloric stenosis, a rare stomach outlet obstruction that required urgent neonatal surgery called a pyloromyotomy (OOPS! First major parenting fail!). I also thought, for two or more hours in my first labor (obviously in denial), that I was just having GI cramps and arrived at the hospital fully dilated and ready to push. I drove myself to hospital with my second labor, thinking I was in super early in the process but actually being 8 cm, popping out baby Niall  about an hour and a half later. 

In any case, we flew back from Fargo on Monday, returning in the afternoon and, on Tuesday, Kelvin started complaining of moderate peri-umbilical abdominal pain. It wasn't terrible, he had an appetite, and there was no nausea/vomiting, fever, or other red-flag symptoms classic for a surgical problem. We guessed that it could be a stomach bug (, excessive spicy food, OR other) but he did look uncomfortable enough on Wednesday that I asked him if he wanted to take time off work or pepto bismol (he, predictably, declined. He's a busy/important guy and not a med-taker. I was also on a switched OB call so we were a little stretched, unless we could find another adult to be on back-up kid duty if I were called out if he needed to go in urgently). 

Symptoms were the same (no better) on Thursday morning, and we started to really think he really may have appendicitis, with localizing right lower quadrant pain and some guarding (but still, not the classic anorexia or vomiting). It was a good thing he trusted his intuition and our own diagnostic skills (and that we have doctor friends that could squeeze him in on short notice), prompting an urgent CT scan (completed during a lunch hour in-between his seeing primary care patients all day) which showed definitive acute appendicitis as communicated directly by the reading radiologist, whom we also know. Kelvin was able then to get in touch with the hospital's on-call surgeon (without having to go sit in the ER- yay!), reviewing the risks/benefits of antibiotic treatment (with possibly a 40% failure rate in months) vs. surgery but opting for a late-day add-on appendectomy for which he was to be COVID-PCR-swabbed, then put on only clear fluids, then NPO). (He was even free to finish up his afternoon clinic [!], even, at times, partially doubled over). Neither of us has had surgery before so this was a pretty new experience!

  

I brought him some supplies/toiletries and clothes just in case the recovery included an overnight stay, but surgery (and minimally invasive--laparoscopically) went smoothly.  Not having any family locally, it has been tricky to figure out how to juggle it all, but we had great friends who were able and more than willing to step-up for pinch-hit kid babysitting (Kellie!) and rides to/from the hospital (you're the best, Sara & Lori!) after the short (same-day or same-eve) procedure which he had around 7:30 pm or so (out by 8:30). I trust medical providers and was not nervous about the procedure at all even when he was under. Kelvin did well but was quite loopy afterward from the general anesthesia (not remembering that he called me to tell me that he was out of the OR). He's having mild incisional pain today and opted not to go into the office this morning on post-op day #1, but had nothing uncontrolled by ice/tylenol/NSAIDS (and I wouldn’t be surprised if he decided to go back to a work retreat this afternoon and tomorrow morning).

We know we're extremely fortunate and privileged as physicians to  have good health insurance as well as expedited access to health services and VIP treatment (but think we tend to pay it back in overworking ourselves through our various illnesses so as to not disrupt other patient care so, with hope, it's forgivable). We are so thankful to our Humboldt friends and medical village for getting us through this surprise and whirlwind diagnosis which, thankfully, was very acute and pretty minor in the grand scheme of things. (We're especially happy that this illness didn't happen while we were in the Swiss Alps or far away from home like we were last week! Timing could have been waaay worse!). Now, in our immediate family (including the dog!), only Niall and I are without abdominal scars. Whose health issue will come next?