Wednesday, April 6, 2011

The Wubbulous World of Endocrinology

A few days ago, I sat by as all  3 pediatric endocrinologists bantered on about how fascinating it was to see a pancreas just disappear. Yeah flipping frig frog HIGH larious. I guess I'm a little less fascinated being the owner of the new 24 hour ops world of confusion regarding blood sugar, ketones and insulin due to aforementioned vanishing pancreas. It does however give me a fascinating appreciation for the human body and how it manages to keep running after all the torture we put it through. I had just about shut out the banter when one doc turns to me like a kid with a new toy- wanna see it?   Um, yeah.

There it is. Now it's gone. See, here is the pancreas slightly post trauma- somewhere Mayish 2008- the doc points to the screen. I look at the MRCP(MRi with Contrast of the Pancreas) and am fascinated at the clear resolution of my son's pancreas. It looks just like all the artistic renderings in the books of knowledge I was trying to cram into my nugget.  The only thing off is the pancreatic duct, which was still obviously dilated- or dilatated as the docs say- don't ask me why- probably some goof ball who likes to make up new words- I don't know anyone like that. To me the pancreas looks like a chicken tenderloin- a nice round head that tapers to a point.  He pulls up the MRi from last week. It is gone. All you see is some vein and he points to a bit of the head that is still hanging on. It's creepy. I guess in some circles it is fascinating- it's too soon, too soon.

It occurs to me how different each of the endocrinologists is. The senior doc was the one who tended to Phillip on the ward as we were introduced to the finer elements of diabetic treatment. We talked for hours about how fascinating the case was- and by we, I mean he. In his mind, Phillip is a fascinating case study of why- but the treatment is still standard.  Everytime I tried to ask a question or offer input, he switched topics or talked right over me. Although knowledgeable and friendly, I can't say I was disappointed to find his retirement was less than a month away. The other endocrinologist we have met a couple times and is very upbeat with a booming voice and comes highly reccommended by staff and patients. He is a bit more proactive with treatments. Our endocrinologist is soft spoken and knowledgeable. She is one of those docs that you wonder how exactly fits all of that information in her head. She has a good bedside manner and you definitely feel like she is taking her time and is thorough. As I get to learn more and more about the field of endocrinology, I realize what a special brand of doctor this is and what a complicated field it is. That and it deals with way too much chemistry and biochemistry for my liking. They deal with what we all intuitively know- hormones are some whacky shit.

I really like our endocrinologist. She takes her time to listen and process what I tell her and takes into consideration the emotional and non quantifiable issues I have with my kids' treatment. We met her 3 years ago because Phillip busted his pancreas, we came to know her through Lily's adrenal insufficiency and now we are going to get to see a lot more of her. This is the part where it becomes important that both my kids  and I are comfortable with her. I know that it may take 10-20 minutes waiting in the waiting room for our appointment. I also know that she will stay with us until we feel comfortable with the visit. She commands her own schedule- which obviously drives the front desk staff nuts- but I like knowing she knows when and who she is seeing.  Every visit, she takes the kids to get an accurate height and weight on her special scale majiggy. It didn't surprise me that the scale was located in a closet across from the exam room, it made sense. Especially since there is such a premium on square footage. There were tons of pharmaceutical and diabetes related care packages and piles and piles and piles of books.  It did however surprise me when she kept referring to it as her office. At first I laughed at the joke- like when the kids have a questionable potty issue and I usher them into- my office. Or when I am sleeping and they have a bad dream- again, they get to enter- my office. I actually appreciated the dry sense of humor. Until about 6 visits in, when I realized that we were actually in -her office. On careful examination- the piles of books were not uniform- there were some on a chair, which was actually in front of a desk- also completely covered in books and files,  next to a book case which was almost totally obscured.  Some might run out of there in terror- not me. I liked her even more. She's human. And obviously reads, a lot. I like a good bedside manner, but I don't need her to hold my hand- I have a support system for that. I like that she takes my well being into account- a sane mommy is needed in the partnership , but I need her for her extensive knowledge on causes and treatments for the diseases my kids have. And I know for sure if I ask a question she can't answer( there's only been 1 so far) she definitely has the resources to find it. And she did- somewhere in her office.

No comments: