the future is just stuff and nonsense

a week ago last thursday i woke up with my left shoulder hurting like a sumbitch. it was 4 am and i couldn't go back to sleep. i figured i'd rolled over on it in my sleep and pulled it really bad. pulling or straining it has happened a couple times over the last few months. i'd wake up with it sore, and not really be able to bend it all the way back or whatever.

by the time i got home from work on friday night, it was pretty sore and hurting so awfully i didn't sleep at all, and saturday it was hurting so bad i kept crying.

due to the fact that it was christmas weekend, unfortunately, all the physicians were out of the office at the clinic i normally go to, and i sure didn't have the money to go to the emergency room over it, so i figured i'd grin and bear it. you know, grit my teeth and make it to the following tuesday. i have pioneer ancestors. this should be a piece of cake. c'mon, a sprain is nothing. they'd break their legs and keep crossing those plains. suck it up, chels.

moving the arm hurt. not moving the arm hurt. it hurt to sit, it hurt to lay down, it hurt to rest it on anything. ice didn't help. heat didn't help. i wondered if i'd popped it out of joint somehow, and so in desperation i bit my lip and tried to move it in every direction i could, using a wall to hold it in place while i was bending it the wrong way. i was screaming and frustrated. in retrospect, that was a really, really stupid idea.

i took some naproxen. nothing. two naproxen. still nothing. two advil? nil. two advil and a naproxen and some acetaminophen? no relief. dad's hydrocodone from his kidney stones was finally the only thing that took the edge off enough that i could do anything besides lay on my bed and try not to be a gigantic sobbing baby over a muscle strain. i made it through christmas on two of dad's hydrocodone pills and one of his percoset tablets. by monday night, i was so desperate for any sort of relief i asked dad for a blessing. i was administered to, and with the help of that and two percoset, i finally got a night of fitful half-sleep, which is better than anything i'd gotten since thursday.

on tuesday, (a week ago today,) i went to work completely miserable and absolutely doped on painkillers. i thought about sneaking a shot of the crown royal or the gin in the back of the coffee cupboard at the office just to dull something, to make me not care that it hurt so much. i didn't. i had made a doctor's appointment first thing that morning, scheduled it for 1:30 that afternoon. i called the physician's office at 12:30 and asked if i was just going to get referred to an orthopedic specialist, (that's what they did for mom's foot pain earlier this summer) and if i was, i didn't want to come pay the copay to get told the doctor couldn't help me. thankfully the receptionist was forthcoming enough to say, yeah, they'd probably just refer me to the orthopedist, and she gave me the number for the orthopedic center in provo and cancelled my appointment. i went home from work anyway, and curled up on my bed and tried to balls up about the whole thing and stop crying.

seriously, what a baby. i was kicking myself for my ridiculously low level of pain tolerance. it was embarrassing. who freaks out that much over a sprain? sheesh. you dumb girl. you'd never have made it across the plains.

i go to the orthopedist's office, this was last thursday, and after waiting for an hour and a half (because most of the doctors were out for the holidays) i finally got in for some x-rays, but then having confounded a orthopedic assistant, i saw dr. larsen, a real live orthopedic surgeon. he took one look at my x-ray, looked at me, and then asked if i'd ever injured my shoulder before. i told him no, not that i was aware of. i've never seen an x-ray like this on a patient of mine, he said.

"see this dark heart-shaped part at the top of your humerus?" i nodded. "normally, that whole bone would be the white, solid color that you see along that top edge, and down lower on the bone. see the little line down the middle of the heart and the other little lines all along the right side of the dark spot?" i nodded again. "those are fractures."

oh. i guess that explains why it was hurting so badly.

"the dark spot of weakened, thin bone tissue is caused by either a cyst or a tumor that is growing in the bone, that weakened it enough that it either got too big and the bone fractured, or more likely the bone was weak enough that when you rolled over on your arm in your sleep, it just twisted and fractured the bone all down that edge."

oh.

"it looks like there might be two cysts, which are making the two sides of the heart shape. this particular type of cyst is called an aneurysmal bone cyst, or ABC. but it might also be a tumor. if it's a tumor, i have to tell you this, it might be cancer."

oh. ok.

"the location of it on the bone, and with how much of the bone has been damaged, this would be a very aggressive tumor. we need to get a ct and an mri, with the cancer risk, we'd have to see the cyst or tumor or whatever is growing on/in the bone to diagnose it properly. do you have time to do that right now?"

uh, i think so. yeah, that should be fine. a tumor? wow. ok.

"do you have any questions?"

oh. uh, no. i'm just... processing.

he took me up to the reception area again, and he told one of his office aides to call down to imaging and see if they could get me in right then.

"after that," he told her, "call lor randall up at the u of u and get her an appointment to see him as soon as they can fit her in. tell them we've got a patient with pathological fracturing of the proximal humerus caused by either an ABC or an aggressive bony lytic tumor."

he turned to me.

"i want you to see dr. randall right away. he's an orthopedic surgeon, and specializes in bone tumors. he's up at the huntsman cancer institute. you head down to imaging, and i'll text him today."

i already had my phone out and was texting mom, who was out in the car waiting for my appointment to end.

my shoulder / humerus has a fracture from a tumor or an aneurysmal bone cyst. he said it could be cancer. they want me to get a ct and an mri right now, and set up an appointment to meet with lorr randall, a specialist up at the u.


what the heck is that?


dr. larsen said he wants them to call him as soon as they get the ct and the mri and he's texting dr. randall about it right now.


want me to come in?


basically either cysts or a tumor have eaten away the bone at the top of my humerus and i rolled over on it funny thursday night and fractured it. they want to do the ct and mri right now.


i'm coming in.


mom came in, and we got the go-ahead to make our way down to the imaging wing. i paid the $50 specialist co-pay listed on my insurance card, and had my name put in the queue. mom was talking, and it was all just washing over me in my attempt to still process everything "...but if we wait a couple days, it'll be the new year and the insurance will roll over. you'll have to pay the deductible twice. that doesn't make sense, you don't have that kind of money. i'll go talk to dr. larsen and see if it has to be done today. you call the insurance company."

i nodded as she left back down the hall, and called the insurance company. the customer service chick said, yes, even with it so close to the end of the year, i would have to meet the deductible of $1000 for anything done in december, and then again for whatever was done in january or later.

mom called me, she was talking to dr. larsen. he told her that we could wait and get the mri and ct scans when we went to see dr. randall. i got my $50 back from the imagine receptionist, and dr. larsen gave me a sling, a cd of my x-rays, a few prescriptions for percoset, some anti-nausea stuff in case the percoset nauseated me, and some motrin as a back-up for the percoset.

larsen's office called dr. randall's office again and left a message, his staff was out for the holidays. mom and i drove to target to drop off my prescriptions.

at the pharmacy counter, the pharmacist told me that i wasn't showing any current insurance coverage. i told him he was wrong and pulled out my card and had him put the number in again. nothing. what the hell? i'd been paying for COBRA every month since i was laid off in august to keep the insurance i had with my former employer. i called the insurance company.

oh, we're sorry, your former employer forgot to check the box on your COBRA form that says 'yes, i would like to opt in for COBRA coverage.' you aren't currently covered by SelectHealth...

great.

i sure couldn't afford full-price for my prescriptions, so i took the scrips and went home. i called my former employers and told them what was going on. oh, sure, they were getting the $300 checks every month for my coverage from the national benefit service, but i'd been taken off the group insurance plan.

good thing i'd opted out on the mri and ct just hours earlier, or i'd already be $6k in the hole for out-of-pocket medical expenses.

there was a rush all friday of faxing in paperwork and emails and letters and copies of checks and check registers, only to find out that the guys in SelectHealth's compliance department weren't going to be in until tuesday (today.)

awesome.

we call dr. randall's office, who had called on friday to schedule an appointment for tuesday morning at 7:30. sorry, we have to cancel, apparently i have no insurance and we won't even find out until tuesday.

a long new year's weekend followed with more of my now fully father-sanctioned swiping of dad's percoset to deal with the pain in my shoulder. dr. randall's office said i needed to be icing my shoulder every hour.

the percoset takes the edge off enough that i've stopped crying over the pain. apparently my tolerance for pain is a lot higher than i was giving myself credit for. i drug myself heavily during the night so i don't roll over on my shoulder in my sleep. i don't even move. makes it kinda hard to wake up on time in the morning, but the office is understanding.

i heard back from the compliance department at SelectHealth today. they are going to back-cover my insurance from september, and i will have coverage going forward for 14 more months, as long as i keep paying my premiums.

i spoke with dr. randall's office this afternoon. i see him next monday, the 9th. insurance will only cover my ct and mri if i have it done at the hospital in provo, so i have to get that done sometime this week, and take all that info with me up to dr. randall.

but i learned something.

i'd always wondered what it would be like to get told you had, or might have, cancer. it's not the way you think it'll be. it's not the way it is in all of those stupid Lifetime dramas or in the soaps.

you just say oh, and you keep going.

because life keeps going, and that's all you can do.