Medical Mayhem

One of the trickier places in the middle these days is the medical place, where my legal name and gender (which differ from the ones I’m using day-to-day) are on my insurance card and medical charts. My regular doctors and their staffs are all down with the program and make an effort to call me by my new name and pronouns, but there are places where I have to face strangers. Surprisingly, it’s been better than I expected.

I went in for a blood test on Friday, to see what my testosterone levels are doing now that I’ve been on the very low dose (25 mg/week) regimen for six weeks. I wasn’t anticipating anything much more than the usual hand-over-insurance-card-and-lab-slip, get-poked, get-bandaid, leave routine. This was because I hadn’t looked closely at the lab slip. Right there where I had to fill in my address and so forth was a big old gender box. Of course the lab needed to know — the reference ranges for normal levels of testosterone are radically different for bio males and bio females. I debated for a moment, then crammed “FTM” into the space allotted for a single F or M.

The phlebotomist, a young Filipino woman, didn’t bat an eye. She just called me in, drew the blood, and pressed on the bandaid. I figured I was home free. But as I was about to leave she called me back. “Um, I have to… this. I have to put it in the computer or I’ll get in trouble,” she said, looking apologetic and pointing to my ‘FTM’. “On your insurance card it’s F…”

“Uh,” I said, momentarily stymied and lacking in glibness. “It’s changing. I mean, it’s not legally changed yet, but it’s changing…”

She looked up at me (she was a good deal shorter than I) with that same apologetic understanding. “I’ll just put F this time, and maybe next time you can change it, okay? The computer won’t let me put anything but M or F, and it has to match your insurance card.”

I agreed that maybe next time I saw her it would be different. And I left feeling like I had an ally in that phlebotomist. It was oddly comforting.

And then there was last night. Last night I had to go to the ER. (Here is my housemate DK’s amusing account of the proceedings. He’s a much funnier writer than I.)

To set the stage, you need to know that I have a Very Special Immune System — which is to say I have a primary immune deficiency that affects about one in 50,000 individuals called CVID. My B-cells don’t work quite right and I can’t make antibodies to certain types of bacteria, which means I am prone to recurring infections, some vaccines just don’t work for me, and I have a few other annoying issues like lung damage, joint pain, and fatigue.

Early last week I developed Yet Another Sinus Infection, and was trying to pretend it would go away on its own because I really just didn’t want to go back on antibiotics for the fourth time in two months, and was being a child about it. But it had gotten bad enough that by Saturday I had decided I’d call the doctor Monday and get the antibiotics.

Sunday I woke up with a crazy bad sore throat, and a weird, painful swelling inside one nostril, on top of the existing sinus infection symptoms. I was annoyed but not alarmed, and resigned myself to calling the doctor first thing Monday morning. (Well, second thing Monday morning. First thing was going to be driving my housemate DK to a job interview.)

Sunday evening DK and I watched a couple videos and hung out, and then as midnight approached, we declared intentions to go to bed, since there would be early rising for the job interview and so forth. As I was putting on pajamas, my body, with epic timing, decided to manifest something entirely new and unpleasant: painful, hard, hot, rapidly progressing swelling under my chin and jaw. Over the course of a half hour it went from “that feels weird, it sort of hurts” to “Oh My God OW” and I couldn’t swallow easily or put my chin down to my chest.

I went back out to talk to DK about it (thankfully he was still awake). He was justifiably alarmed. In truth I was also a little alarmed, but also trying very hard to convince myself I could let it wait until the morning. After all I didn’t want to ruin DK’s sleep the night before his interview, and I didn’t want to go running to the ER for something that wasn’t really an emergency. It clearly wasn’t an allergy, and it wasn’t affecting my breathing. But when I’d gotten an infected puncture wound on my hand and developed cellulitis  it had done exactly the same thing, and cellulitis is a Really Bad Infection and shouldn’t be toyed with. But this time there was no external wound to blame, so how could it be that? But rapidly progressing swelling affecting the throat is scary…

I called a doctor friend but he didn’t answer. DK said hang the interview man, let’s go to the hospital already, that is not right. I called a nurse friend. She also said, essentially, what the hell are you waiting around for? Go to the ER already!

So we went to the ER. The triage nurse was the one who was unexpectedly and amazingly awesome about the whole trans thing this time. She was also Filipino and I’m not sure how that’s relevant, except that it was an interesting coincidence, I guess. I’d written Zach on the sign-in sheet. As she took my information down and had to enter my legal name, I said something like “I don’t really use that name at all. Everyone calls me Zach.” And she looked at me and DK and said, “Oh I understand. I have a sister just like you. My kids call her Daddy B.” She repeated the tale of her sister several times in the course of the conversation, and neither DK nor I could tell whether she meant she had a sister who was now a brother, or a brother who was now a sister, but it didn’t matter. She had a trans sibling, and she understood.

She called me Zach and he, and evidently said something to the other staff, because despite the little hospital bracelet identifying my by my very feminine legal name, the X-ray tech and the other nurses all also called me Zach and he (although one nurse had to correct herself, which was kind of cute, actually, because she did it so spontaneously. She was talking to DK at the time, about me. “He, I mean she, I mean he! He will just be a minute getting his CAT scan, you have to wait here.”

So. I saw a doctor and got a CT scan, and they determined that I had cellulitis in my neck and face, probably related to the sinus infection. They gave me antibiotics and told me to call my doctor and that it was a Very Serious Infection and not to be toyed around with if it showed any signs of getting worse. It had clearly been the right call to go to the ER, since if I’d left it till morning it would have been much worse.

Let me repeat that: I admit it, I was wrong. Thank you DK and Michelle (and Pat, Michelle’s wife) for insisting I go to the ER. I’ve had two doses of the antibiotic now, and I’m starting to feel a little better.


~ by Nezu on 23 August 2011.

10 Responses to “Medical Mayhem”

  1. Oh honey, that is scary.

  2. I’m glad you’re okay — and even MORE glad about your awesome medical experiences. I keep having to remind myself that the horror stories we hear online get reported because they’re bad and rare; that normal stuff doesn’t get reported so much.

    It’s hard to remember, and I don’t always believe it, but that’s my theory and I’m sticking to it. 😉


    • I think you’re right on target with that. The bad stuff gets reported, the good flows by unnoticed. It’s easy to live in a place of fear when you only see the bad experiences. Makes me want to start enumerating the good ones on a regular basis, to remind myself they are the majority. 😉

  3. Oh my, I’m glad you went to the ER! You just don’t get a break, do you… Yay for excellent nurses and phlebotomists, and I hope DK’s interview went well. =)

  4. Yaaaagh! Your life is Far Too Exciting. You need to have a duller life.

    *hugs* Hope the interview went well!

    • Hah, yes. I wonder if I’d even know what to do with myself if my life was duller, though. At least this one gives me excellent material for writing. 😀

  5. Um, yes, scary! I am glad the ER folks were able to help, and that they were on point with your name and pronouns too. That definitely helps ease an already stressful situation. I hope the infection goes away entirely soon.

    • Antibiotics for the win, I’m much improved. And yeah, it was really kind of awesome to have good experiences with the medical people. Thanks.

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