I gave up my blood. The lab said it may or may not get to the doctor in time for my Monday afternoon appointment. Really? This was on a Wednesday and my doctor’s office is about 20 yards away from the lab. Maybe. In the same building, on the same floor. First and goal. Go for the field goal. Or run all 20 yards to deliver the sample. Over the span of three business days. Maybe it has to go to an outside lab and be sent back in. I don’t know. Just trying to take care of my health.
Monday’s appointment with the Doc turned out to not be an issue. I got a message from the clinic that my Doc called in sick. Doctors need to be healthy to mend the rest of us. I rescheduled. The first available appointment was right after Christmas. Perfect.
The nurse weighed me and took my blood pressure. My weight was a little exaggerated because of all of the stuff that I had on me and in my pockets. A ring of mostly useless keys, a cell phone, a mini-book, a pocket calendar and papers in my jacket, heavy boots. Even with that, I’m still a little underweight for a person of my height. No worries. I’ll eat a little more, drink a little less. Very manageable.
My Doc appreciates the card I presented to her post-Christmas. It’s a token, but she’s a true humanist and I probably give her a lot fewer headaches than some of the other folks who frequent the clinic. We’re very cool together. She doesn’t preach to me and I do what I’m supposed to do, for the most part.
“How’s your shoulder?”
“It hurts but the gel is working. Better than Icy Hot.”
“Are you taking the pain killers?”
Doc calls them for what they are.
“Are you doing the exercises to rehab the spasms in your shoulder?”
“I’ve kind of forgotten how I’m supposed to do them.”
My Doc demonstrates how I should do gentle stretches of my shoulder muscles. Hold, then release. Hold again. Release.
“So, you’re not taking the pain killers, right?”
“I know the nurse already asked you this, but what’s your level of pain on a scale of one to ten today?” Ten being the highest.”
“I don’t know. Maybe a two right now.”
“You mind taking off your jacket so I can check your breathing?”
“Not at all.”
“Breathe in and out deeply.”
“Sounds good. Breathe for me again.”
The stethoscope moves from one area of my back to another area, and then to the front of my chest.
“Breathe one last time for me and then we’re done with this.”
“You got it, Doc.”
A deep breath in and out for the Doc and then I can go.
“Ok, you can put your jacket back on. Everything sounds good.”
I am one step closer to getting in my car and going home or any other place I’d rather be.
“I know you don’t like to take pills, but you’re going to have to.
“You have latent tuberculosis.”
“You are not contagious, but at some point you have come in contact with someone who possibly is.”
“So, where do we go from here?
“I’m going to prescribe a medication for you that will suppress the TB.”
“You’ll have to take it daily, OK? Along with a vitamin B6 supplement.”
“Am I deficient in vitamin B6?”
“Not so much, but this medication is kind of hard on the liver and you drink. It will help.”
“How long will I have to take the medication?”
“OK. Is there anything that you can prescribe that would kill this latent TB thing immediately?”
“Nope. It’s a process and we’ll need to monitor your liver and blood samples every month to see how your body is taking to the medicine.”
I already gave up my blood.
“Do you have any questions?”
“No, not really. But I don’t have TB, TB, right?”
“No, you have been exposed to TB. It’s latent. It’s sleeping in your system and we don’t want it to become active.”
“Have a seat in the waiting room. I’ll work up your chart. You’re going to need to talk to a nurse before you pick up your prescription. It’s normal procedure to counsel you on what we’re doing.”
“OK, I probably won’t see you before the New Year, so have a happy one.”
“You do the same and thank you so much for the Christmas card. That was very thoughtful of you.”
“You’re more than welcome, Doc. Thanks for everything.”
The nurse who is to counsel me is in another division of the clinic. Maybe ten feet away. In the pediatric division. I did not know that I needed to reregister to see the nurse. I sat and I sat in the adult division waiting to be called. I read all of the clinic’s health magazines and journals. I read parts of some of the books I brought with me in case I would have down time. Finally an angel came to me.
“Are you waiting to see the nurse for counseling?”
“No, I’m in the adult division.”
“Yeah, that I know, but I think you need to speak to the nurse in our division to get your prescription finalized.”
“Go back to the front desk and register for this section.”
“She was looking for you and she leaves in a half hour.”
I went to the front desk and saw the same new person that I had seen several hours ago when I registered to see my primary care physician and my dentist. Two separate, disparate computer systems. The twain shall never meet.
I registered again and when I came back with a new sheaf of papers, my angel helped out yet again.
“Sit right here. Don’t move.”
Finally, I was in the pediatric wing with the nurse that was going to advise me on taking my new medications, my only medications, without screaming kids.
Did I move? Not an inch. Not a centimeter. I had been in this joint for a very long time. A physical exam, a consultation by a behavioral health counselor to discuss my alcohol consumption (“but only if you want to talk about it”), a tooth filling by my dentist. They were all wonderful and very efficient, but it’s a long ass day when you don’t’ have private medical help and try to cram it all into one visit. But it’s manageable.
The nurse was hard to place in terms of where she was from. A lilting accent from the islands or just a pleasant voice? Very polite and gentle. And she was there to inform me. She didn’t need to take my pulse or blood pressure. Her mission was different. I had never seen her before and she probably knew more about my medical history than I did.
“So what do you know about the medication that you’ll be taking?”
“I think it’s to suppress a latent form of TB that may be in my system.”
“Very good. Just to clarify, a latent form of TB is in your system.”
We talked for a while and then it came time to deal with real issues and sign the forms before the medications could be dispensed.
“This is a 30 day supply of the principal medication that you will be taking. You should always take it with the vitamin B6 supplement.”
“Yes, the Doc told me that’s what I’d need to do.”
“This is very important. I don’t know what your entire health history is, but you can not consume alcohol with this medication.”
“The two don’t mix well. The medication by itself may create some complications for your liver. That’s why the vitamin B6 supplement was prescribed.”
“Got it. How long will I be on this medication?”
“Nine months. And we’ll need to monitor your blood and liver functions monthly.”
So no wine for nine months? That’s all I really drink. Cheap Chardonnay. 12.5 proof wine from a box. Even though the doctor had told me nine months earlier, it still hadn’t really sunk in. I was hoping the nurse would say something different.
“Nine months. No alcohol, whatsoever.”
“What will happen if…?”
“You may not die immediately, but you will hasten your death if you continue to drink and take the medication.”
“But I don’t really drink that much…”
“Sir, it’s a life decision” in her sweet and polite voice.
I had extended her beyond her normal hours by not registering again. She wasn’t mad at me; she just wanted to make it plain.
“I think I understand, Nurse.”
“You have to do it for nine months straight. Do you think you can do it?”
“I think it’s manageable.”
“OK, then please sign the form which indicates that I’ve explained everything to you and you agree to the terms before I give the go-ahead for your prescription.”
“Yes, nine whole months.”
“Mind if I borrow your pen? Mine doesn’t seem to be working.”
“Sir, use the pen on the clipboard. You’ll be fine.”
Maybe it will last forever. I know of a few artists who, for whatever reason, gave up the bottle. I don’t know. It will be difficult and different for me because drinking copious amounts of wine is part of my routine. I rarely, if ever, go out to bars. I generally drink by myself. Not lonely drinking, but I can’t do what I like to do in a public space. Meaning work. Like write, compose music, paint, plan lessons for school. I could, but I’d rather deliver a finished product than create a public display of art while drinking. I don’t make a lot of noise even after a liter of Chardonnay. I’m not that kind of drinker. Vino is very manageable and is either the muse or invites the muse to enter.
And the meds! Now I’ve got six bottles of “stuff” I have to take. Everyday. I’ll need to get a pillbox from the Dollar Store to keep track of the medicine. One of those little plastic receptacles you see at the checkout line. “S”, “M”, “T”, “W”, TH”, “F”, “S” to denote the days of the week. Each day is a compartment with a plastic lid that holds the drugs. Who would forget what day it is and what meds you were supposed to take? Although I do think ”they” should either put an “A” after the “S” for Saturday or “U” behind the other “S” for Sunday. I used to pity people my age and older who had all of those bottles that they had to keep track of. Well, now that’s what I’ll have to manage. Or not.
I could say to hell with it all and continue my mild mannered drinking. I’m not hurting anyone. I may be benefitting the liquor storeowners who are sending their newly americanized kids who don’t have accents like their parents to good schools, but like Johnny Cash, I’m not hurting anybody except myself with my drinking.
Then there’s Tommy. He was warned, so I’m told, that if he ever started drinking again, he would die. He drank and he died. He was in his late 20’s. Tommy and I grew up together and were always in the same homeroom from elementary to high school because we were in the same grade and shared the same surname. No relation, and polar opposites in a lot of ways, but we got along great. Tommy taught me how to play poker at a young age. Tommy’s rules changed from time to time, but he gave me the basics. Tommy was smart as a whip in the ways of the world. Gifted athletically. Always smiling and a handsome young man. Lazy as dust. Even after the bottle starting to rot him from the inside out, smiling and handsome. Gil Scott Heron must have had a prophesy about Tommy before Tommy even knew who Gil was. In the bottle, for sure. And where am I?
I have choices. Continue drinking my liter of Chardonnay per day or take their medications and advice. My brother died about a year ago because he didn’t do what he was supposed to do. He didn’t do what he was told to do by his doctor for a very long time apparently. Yet that doesn’t apply to me. Every time I go to the clinic for anything, the nurses say my blood pressure and the healthy cholesterol levels are amazingly good. My Doc laughs and says maybe it’s because of the wine. Bad cholesterol could be better, but nothing to be alarmed about. Manageable. Liver is distant from the borderline of being dangerous, but needs to be watched. Bad cholesterol and liver are so- so probably because of the grape. The vino giveth and the vino taketh.
Who even knows that I drink? Immediate family, for sure. Nieces and nephews will always tell you when your breath smells “funny” when they are very young and don’t know that it’s impolite to say so to elders. Close friends that I’ve hung out with over the years. Some of them are professional drunks, though. Not like me. My drinking is manageable. My colleagues at school? I doubt it. We’ve never been in a social setting outside of school where there was alcohol. I’m respected by my peers and well liked by my students whether they pass my course or not. I don’t stumble when I walk. I never stumble. My memory is unfortunately too good. I remember things that my elders have long forgotten and that they thought I had never recorded in my head. I do OK with Jeopardy about arcane facts that I learned long ago and thought I would never have any need for. Knowing XYZ or ABC comes in real handy when you’re in the Double Jeopardy round or a Daily Double pops up. “Ok here’s the question contestants. In Latin, the name of this African country means ‘place of freedom’.” “Let’s make it a true Daily Double, Alex. What is Liberia.” “Congratulations my loyal TV viewer, you are our new watching from home Jeopardy champion!” Manageable.
Nine months. Wow. Is that how long it takes for the virus to be unborn? Where in the hell would I have come into contact with someone who has TB? According to the Mayo Clinic:
Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.
Looking back, there could have been multiples of multiple scenarios where I crossed paths or shared a laugh with; got spat, sneezed or coughed on by someone who is a carrier. Maybe I was in the right band with the right singer at the wrong time. Could the stray cat that adopted me last winter be the culprit?
Calm down. You have latent TB. The Doc is just being cautious. Be thankful for that. The medication will suppress it. The vitamin B6 that was also prescribed will help you withstand the punishment that the medication will do to your liver. Calm down. Nine months is not that long a period to go without hooch. When’s the last time you were invited to a party anyway? You can do it. It’s manageable.
New Year’s Eve is two days away. Maybe that’s a good time to start this thing. I’m not going out anyway. Maybe to church around midnight, but that’s about it. I may not even go to church. I have a five-liter box of inexpensive Chardonnay chilling on the roof. What am I going to give it away to the squirrels and the birds? Finish it. Ration it out over two days. What happens after that, I’m not sure, but it’s definitely manageable.
I have choices. No, a choice. Living, in the starkest black and white meaning of the word, requires following someone else’s advice in this case. For nine months. Mark it on the calendar and when you’re free, have a bottle of expensive hooch. No more box wine. Have it all by yourself or share it with someone else that will appreciate that you’ve done something. Something good. Something good for yourself. That’s something to look forward to, I think. It’s manageable. Today’s diagnosis may be the best thing that ever happened to me.