How I was diagnosed

A week from today will be the five year anniversary of when I was diagnosed with Acute Promyleocytic Leukemia.  I remember that Sunday very well.  I had been battling what felt like a typical Cincinnati cold all week, but some of the symptoms were strange.  For instance, I would wake up with a fever of 101 degrees, and it would go away by 10am.  No big deal I thought, but it was very strange,. Since the fever was gone by 10am, I would get up and go to a full day of work.  In 2007, I was a regular attendee of Climb Time of Blue Ash, an indoor rock climbing gym, on Thursday nights.  Since I was feeling sick, I was very tempted not to go climbing that Thursday.  I have a very distinct memory of thinking, “I’m probably going to take the next week off of climbing to get over this cold, so I had better make it to the gym tonight.  I probably won’t get to go climbing again for a while.  “  I arrived at Climb Time as usual, and by all accounts, I had a successful evening of bouldering.  I even completed a rock climbing problem that I had been unable to finish for the prior three weeks.  Perhaps my cold wasn’t a big deal after all.  

After I was finished climbing and I was packing up to go home, I noticed something that was unusual.  I had some strange bruising on both of my big toes.  I had never seen anything like this before in the four years I had been climbing.  For those that don’t know anything about rock climbing, climbers wear really tight shoes that are typically 2 to 3 sizes smaller than normal.  This provides extra support to the feet and toes for standing on really small out crops of rock.  Although the smaller shoe can be uncomfortable, it definitely aids in climbing more difficult surfaces, and typically, one doesn’t notice the discomfort when they are climbing.  It was really out the ordinary to see bruising however.   I thought nothing of it, and I went home and woke up for work after my fever had subsided at 10am the next day.  I noticed that I was feeling a little more ragged and tired than usual.  I figured it was a long week at work combined with great workout the previous night that was causing fatigue.  Friday came and went.  

    Things started to get a little more concerning Saturday morning.  I woke up with a fever that didn’t break at the normal 10am.  I also had some more bruising that was on my legs, forearms, and face.  I knew I was sick, but I really didn’t think I could be that sick.  I thought to myself, “Perhaps I have pneumonia.  I don’t have time for this. “  I contemplated how much work and rock climbing I might miss if it turned out to be pneumonia.  My girlfriend started to become very concerned about my symptoms.  A few years later, she told me the bruising on my body reminded her of the character played by Tom Hanks in the movie “Philadelphia.”  She thought that I could possibly have AIDS.  When my symptoms did not go away on Sunday, she called my mother and urged her to take me to see a doctor.  Of course, my mom was very worried about my condition and agreed.  I didn’t want to be bothered on the other hand.   I figured I would just rest a little bit Sunday afternoon and that I be fine on Monday.  I was starting to feel a little better anyways.  After some coaxing, my mother convinced me that it would be best if I went to an urgent care just to get checked out.  I agreed to go along with this idea.    

    We called the closest Urgent Care and described my symptoms.  “It sounds like pneumonia, and we can’t diagnose that here because we don’t have an X-Ray machine.  You should probably go to the emergency room, “the nurse on phone said.  I really didn’t want to be bothered by a trip to the emergency room, and I was beginning to not like the idea of going to the doctor.  I knew it would be a very expensive trip if I went to the emergency room,  and the insurance at my new job hadn’t kicked in yet.  Furthermore, I was convinced they would just send me home with a Z-Pack, some very strong flu medicine.  Fearing the emergency room at Jewish Hospital would charge me an exorbitant amount for Tylenol; I even packed my own.  With Tylenol in hand, I jumped in the car with mom and headed to Jewish Hospital.   

    For the first 2 hours at the emergency room, the first prognosis was that I had pneumonia, and I was going to be sent home with a Z-Pack and instructions to rest just like I had thought.  I was in a very good mood and I didn’t think I was very sick at all.  The hospital staff was amused that I insisted on taking my own Tylenol when they tried to prescribe it to me.  Things seemed to be ok.   Right as I was about to be discharged, my emergency room doctor asked me if I could be troubled to have one more test.  She said, “Something doesn’t seem right, and I would like to do one more test. “  Being the cheap-ass that I am, my first response was, “is it expensive?”  “No, but I think it is very important that we check.”  From there, everything changed.  When she ran the “inexpensive” test, it showed that my platelet count was only 5% of normal.  More and more tests were ordered, and my heart began to sink into panic.  After 2 hours after confirming the “inexpensive” test’s results, my ER doctor confronted me with some scary news.  “Rick, you either have AIDS or Leukemia.”  I thought for second, and then I asked “Which one is better?”  “Well some forms of Leukemia are curable.” At I pumped my fists in the air, and exclaimed “GO LEUKEMIA.”  It turns out that my ER doctor was a leukemia survivor herself, and she was concerned about the similarities of my symptoms and hers.  My platelet count turned out to be so low that had she not recognized my symptoms, I probably would have died that night from spontaneous internal bleeding.  

Rick Payne


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