Pieces

Do you remember that old minstrel song titled Dem Bones? You know the one that went:

“Toe bone connected to the foot bone
Foot bone connected to the heel bone
Heel bone connected to the ankle bone
Ankle bone connected to the leg bone
Leg bone connected to the knee bone
Knee bone connected to the thigh bone
Thigh bone connected to the hip bone
Hip bone connected to the back bone
Back bone connected to the shoulder bone
Shoulder bone connected to the neck bone
Neck bone connected to the head bone
Now hear the word of the Lord.”

They should make that song mandatory for graduating from med school. I’m so tired of trying to connect the dots for my various doctors so that they treat me as a whole individual. I shouldn’t have to do the research or pose the questions, but I do. Some of my questions are dumb, but I’m afraid if I don’t ask them, something important will be overlooked because an individual doctor is focused on one body part or one disease or one med instead of seeing the big picture.

I had breast cancer five years ago. After surgery my oncologist put me on an estrogen-suppressing drug, which I was to take for five years. A common side effect of the drug is that it leaches calcium from your bones. Because of that side effect, she put me on a hefty dose of a calcium supplement and vitamin D. My bone density tests indicate that I am right on the edge leaning toward osteoporosis. I resisted treatment for osteopenia because the current treatment is loaded with side effects. I discontinued the estrogen-suppressing drug recently as scheduled. We will do another bone density test next summer and if my bone density score hasn’t improved in the absence of the cancer drug, I told my doctor that I would reconsider treatment for osteopenia.

I had blood work done a few months ago and my calcium levels were high, indicating that my body is not absorbing the calcium as hoped. My doctor told me to reduce the amount of the supplement that I was taking as the excess calcium could cause kidney stones. There wasn’t any mention of risks to other organs.

A few weeks ago I started having heart palpitations. They were annoying enough that I finally asked to see a cardiologist. I’ve been on blood pressure meds for decades. A GP in Arizona recently added a diuretic and a potassium supplement because my blood pressure was high. I wondered if that change in my meds might be responsible for the arrhythmias and wanted to check with a cardiologist to see if I’m on the right meds in the right dosage.

I had to wear a heart monitor for three days before I could even schedule an appointment with a cardiologist near me. I won’t recount the long back story leading me to the appointment yesterday with the cardiologist. I filled out the multiple page questionnaire listing my health history and that of my ancestors prior to the appointment. I liked the new doc. He was personable and seemed caring. He spent several minutes in small talk asking me about my family and current life style. He ran an EKG in the office and it was abnormal. He said I MAY have calcification of my aortic valve and scheduled a stress test and electrocardiogram for November 13. In the meantime I am to monitor my blood pressure.

To the doctor’s credit, he did ask if I had questions, but I was too stunned by the abnormal EKG and order for additional tests—when I was just expecting a med tweak—to ask questions. Of course, I came home and consulted Dr. Google and read that calcium supplements and vitamin D are contraindicated with aortic stenosis. I have a question in to my oncologist about continuing the supplementation in light of the issues with my heart.

The rub is that I try my best to take care of myself—diet, exercise, following doctor’s orders, staying current with required tests and treatment. Do we all reach an age where we have to choose which ailment to attend to and which to ignore, if someone doesn’t help us decipher the connections? Human physiology is complex. I need a professional, who isn’t looking through the narrow lens of his or her specialty, to look at how everything might be related and suggest a sensible way forward.

Instead of the time spent talking about my grandkids, I wish the new doctor had read my questionnaire and looked at my chart to see my whole history. I expect to be my own advocate these days, but I worry about my lack of knowledge and what I might fail to ask or the connections I might miss.

The best I can tell from Internet research is that the calcification of the aortic valve is caused by the breakdown of protein collagen on the valve leaflets that results in calcium deposits due to aging and not from lifestyle choices like the calcium deposits in the coronary arteries that lead to a heart attack, but I’d like a medical professional to reassure me that what I am currently doing at least won’t hurt me.

Remember when the slang term for a doctors was “bones”? Dem bones!