Tuesday, May 13, 2014

To Bi ... or ... not to Bi......

Minor update......

I got a call, yesterday, from the now legendary Dr. Yan Bi, GI Fellow.

Seems she accidentally ordered the stool specimen when she meant to order a blood draw.  She was only looking for one obscure thing -- alpha-1-antitrypsin deficiency.  Since that was all she ordered, they didn't look for infections ... or anything else.

Of course, if she had looked, that blood test had been done in California.  Hmmm.

She seemed pretty genuinely apologetic for her mistake.  I appreciate that.  She's young, though.  She'll learn ;-)

Perhaps more interesting ....

I told Dr. Bi that I was disappointed in Gastroenterology's unwillingness to consider an immune-mediated problem, and orchestrate a referral, or pick up the phone and call a Mayo colleague.  

"But we don't have any expertise in DRESS Syndrome or Anticonvulsant Hypersensitivity Syndrome."

I went on a bit.....

"I know.  I know you don't.  I get that.

But wouldn't you think somebody in the Mighty Mayo MIGHT know something about it ??  Isn't this a teaching hospital ?  Aren't you famous for collaborating inter-departmentally to try to puzzle through the tough cases ?  Even if it IS this DRESS/AHS thing ... because it HAS GI/liver involvement ... wouldn't it be a good thing for you guys TO recognize ??

I think it's the wrong move to send me to another GI guy in North Carolina when we haven't looked at the immune suppression > reactivation of latent virus > DRESS/AHS hypothesis.  I think there's a LOT more that could be accomplished here before bypassing all other options and sending me half-way across the country to yet another liver guy, particularly if he's 'just' a liver guy ... like the Mayo GI/Hepatology folks."

Dr. Bi was quiet for a moment, and then said .... "I actually agree with you."

Hallelujah.  That's uncommon among doctors, and probably even LESS common among Fellows at the Mayo Clinic.  You're not supposed to disagree with The Company.  

Again ... she'll learn ;-)

She went on to reiterate what my upcoming appointments looked like.  You're seeing Allergy, again, and then ......

"Dr. Bi: I'm really grateful for your call, your willingness to take responsibility for a mistake, AND your honesty ... but I know what my schedule is.  Thanks for all your help."

Dropped off the saliva/DNA specimen, and had a fasting blood draw, this morning.  Then, had to have my BP checked.  Despite two large coffees, 100/70.  Unfortunately, it still looks like I'm going to live forever ;-)

Going to have a BIG, greasy, NASTY hamburger for lunch, today.  If they have milk shakes, I'll probably have one of those, too.  That'll teach 'em ;-)

By the way ... having had not one drop of ETOH (alcohol) since 11/21/13 (I just checked the date), I've now asked a couple of the docs if they think I can safely have a beer, or a glass of wine, with dinner.  Nobody's biting.  They won't answer.  They just look at me.  

How dry I am ;-)  Cough, cough, hack, hack.....

Ciao for now ... from the blood-depleted, all-out-of-saliva, totally-cotton-mouthed satellite offices of ... The Gulag.

With admirably low blood pressure, I might add :-)

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