Considering the preciousness of life and preservation of health

Last night was clear with full moonshine and the owls were busy hunting on our farm, calling back and forth to each other, comparing notes on where to find prey.

Thankfully they were not calling my name. At least I don’t think so, nevertheless their hoots haunted me.

A coastal tribal legend has it that if you hear an owl call your name, your death is imminent. I’ve had no recent brushes with death, thank goodness, but as a doctor turned patient over the last two weeks, I’ve had cause to consider the preciousness of life and preservation of health.

The first was dutifully going in for my annual screening mammogram which became a two hour marathon of the radiologist asking for various wedge and coned down views, finally resorting to an ultrasound to determine that a small simple cyst had developed under a nipple and did not, from its appearance, need further investigation. Whew. My worry meter, working overtime through all the imaging, slid back to zero.

Then a subtle vision change in one eye resulted in an appointment with my optometrist who confirmed new vitreous floaters and opacities, but also noted an abnormal retinal artery in that eye. The next stop was the retinal specialist who documented a small retinal “wrinkle” and tear, but was more concerned about the artery which appeared to show some previous injury, whether from a clot or atherosclerosis was not clear. Initial screening lab work for diabetes, lipids, sed rate and metabolic functioning looked okay so more specific testing was ordered (D-dimer, C reactive protein) with elevated levels suggesting I am at risk for clotting, cardiovascular disease, and stroke, not to mention possible hidden malignancies causing a hypercoagulable state. As a 57-year old with hypertension whose family history contains plenty of cancers, wayward clots, unfortunate strokes and one sudden death heart attack, this certainly got my attention. The worry meter has gone into overdrive. Now I’m going through testing of my legs (no clots but lousy incompetent deep veins), carotids (no plaque) and next week my heart (to look for valve issues and emboli). Whether more testing is warranted beyond that has yet to be determined, so I’m sitting in the uncomfortable position of feeling just fine, thank you very much, but that is my denial kicking in.

There are no good reasons for retinal artery problems. They are all bad reasons. As someone on blood pressure medications for a decade and having gained weight I don’t need over the years (just in case of an unexpected serious food shortage, right?), I consider myself sufficiently warned. Besides aspirin, fish oil capsules and lipid lowering agents, I must change how I take care of myself or things will change for me without asking permission first. The doctor turned patient has been given a chance to make a difference in at least one patient’s future, or I’ll be no use to any patient.

The owls may not be calling my name but their hoots haunt for good reason. I’m listening.

Emily Gibson is a family physician who blogs at Barnstorming.

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