The next day, Friday, I had blood drawn for the third time and on Saturday, I used Dr. Duck Duck Go (which, unlike Google, does not track its users or their searches) to look up all the ailments that can elevate the liver enzymes, and found one that perfectly fit my symptoms: mononucleosis, which I did not have when I was a teenager or young adult. On Sunday, Tom drove me in a City CarShare car to Rainbow for my weekly shopping and, in the afternoon, to Berkeley to keep our date with Tom’s mother for lunch and Berkeley Rep. Normally we take BART, which would have been too much exertion, but going in a car and not speaking a word all day to rest my throat, it worked out all right.
On Tuesday Dr. C. called and said my liver enzymes were even higher: my AST now four times the top possible normal level, and my ALT nearly seven times the top normal level! I asked if what ailed me could be mono and she said, yes, it was possible this was an infection. She said she would check to see if some of the blood already drawn could be checked for Epstein-Barr.
In the meantime, she was focusing on the abnormality noticed in my large intestine and had signed me up for a colonoscopy on Thursday. She wasn’t worried I had colon cancer. She was worried I might have lymphoma (cancer of the lymph nodes). How a colonoscopy helps rule that out, I have no idea, but on Wednesday, I fasted and talked to my mother 95 times on the phone. She was very nice about keeping me company during this phase of the whole thing, having to not eat when I already felt extremely lousy.
It dawned on me that I was probably just going to barf the colonoscopy prep stuff right back up after I drank it—that which smells like something used to sanitize a porta-potty—and I called the colonoscopy doctor, who called in a prescription for anti-nausea medication, and Tom went to Walgreens after work and stood in line for an hour to pick it up. Drinking the prep liquid was totally horrible, but I reminded myself that many people were having to do the same thing that very afternoon, and that if I just kept taking tiny sips, alternating with sips of clear apple juice, it would eventually be gone.
Thursday morning I had to drink the other dose of the prep stuff. One bright spot in all of this was reading other people’s colonoscopy prep tips online, many of which are quite funny. One said something like, “After you drink the stuff, get ready to spend some time in the Oval Office.” You’re not supposed to chill the solution, but on Thursday morning, I added a number of ice cubes and used a straw to drink it while holding my nose with my other hand. It was definitely much more tolerable chilled, and I now have a complete colonoscopy prep protocol fully refined for future occasions.
I had the colonoscopy—no problems found whatsoever—and Tom, who has been a remarkable friend throughout this whole thing, left work two hours early to fetch me afterward and I came home and, per the advice to avoid greasy food, ate an entire pizza. It was the first time in weeks that I’d felt well enough to overeat, and I didn’t want to miss the opportunity. There weren’t any ill effects from that at all.
(My colonoscopy doctor, who is a darling young woman, explained that, since the intestines are always in motion, a CT scan, taking a brief snapshot, often captures something that looks suspicious. She said that about once a week, she performs a colonoscopy on someone for this reason and it almost always turns out to be nothing.)
That evening, nearly two weeks after my evening in the emergency room, Dr. C. called to say it was (and is) mono! Which I figured out by looking online. She apologized for putting me through an unnecessary colonoscopy, but I told her all is well that ends well, though this hasn’t quite ended. Also, bills will probably be rolling in for weeks. My own responsibility for the facilities charge for the colonoscopy—not the doctor and not the anesthesia, but just standing in their building—was nearly $500. Plus there is the doctor, the anesthesia, the emergency room, the CT scan, and having blood drawn and analyzed three times. But that’s OK. I’m glad to not have cancer and almost equally relieved not to have an auto-immune problem. Dr. C. said I “probably” won’t have permanent liver damage.
My cousin, who, along with her husband, works in medicine, emailed me, “I’m embarrassed for the healthcare system that failed to look for such a common cause for your symptoms.” I do wonder how many more tests I would have had if I hadn’t suggested to my doctor that it could be mono.
I still have fatigue and dry mouth and mild headaches and minor itching, better or worse depending on the day. Apparently the older you are when you have mono, the more severe the symptoms are and the longer they can last, coming and going for a year or longer. My mental health professional was grumbling about how frightening this experience must have been, but it was actually not frightening at all. There was no moment when I felt scared. I think it’s scary, or highly worrisome and upsetting, when it’s happening to someone else, like your mother or your cat.