Friday, April 27, 2012

A Problem of Bilirubinesque Proportions

This morning, shortly after I got up but before I went out for my morning walk, I got a call from my cardiologist's office to let me know that the results of my blood test were in. I thought it was odd when she said, "You may want to write this down." So I opened a text document and began typing in the numbers. HDL, great. LDL, low. Triglycerides, excellent. Bilirubin... extremely high, health-endangering high, indicative-of-major-problems high.

What was that again?

Now I always have elevated bilirubin. Something called Gilbert's Syndrome, which has nothing to do with Gilbert Gottfreid; my bilirubin has been in the 2 to 3 range as long as I've been taking these tests. But this was many, many multiples above that.

"We need to do a conjugated bilirubin test as soon as you can come in," she said. It had to wait a few hours, I told her; this was the day I had scheduled pretty much every appointment I could think of--annual termite inspection, monthly pest control, estimate for lawn maintenance, and so on--so I had to wait for the retinue to arrive and depart. Then I'm off to the lab again, get the blood test done, and try to get some idea how I'm going to adjust store schedules if surgery is needed to send my gall bladder on its own merry way (that's one of the better potential outcomes from all of this, I'm told... as if anything involving more surgery sounds better!).

In the meantime, the cardiologist's office has faxed the results to my doctor, who has in turn forwarded the email to me. I look over the PDF, and as is my wont, I begin reading all the numbers on the printout--multiple pages of them--and looking for any patterns. And there, on the third page, I see it...

The very same value for calcium as for bilirubin. It's one of the few numbers on the five-page document that is repeated.

So, in my head, I quickly begin alphabetizing every measurement on the blood test results, and I realize that calcium would have come directly after bilirubin if the results were alphabetical.

I contact my doctor, who said it was an interesting theory...

I contact the cardiologist's office, and leave a message explaining my weird observation...

And I call the lab, where I'm told that I shouldn't pin any false hopes on that and data entry errors like that hardly ever happen.

And then, a half-hour later, I get a call. "We're so sorry--somehow your calcium levels were entered in the place where your bilirubin levels should have been. Your actual bilirubin level was right where it's been on almost all your other tests--elevated slightly, but within Gilbert's Syndrome range."

You know, your day gets immensely better when the options of surgery or even more dire problems suddenly fly out the window on little flapping wings!

Mistakes happen; I've certainly entered the wrong data in the wrong field from time to time. I really appreciated the fact that, to humor a worried patient, they were willing to pull those results and look at the raw data again, even when no one thought it was very likely that there was any sort of an error.

And I am appreciative of the fact that my cardiologist and his staff were concerned enough to contact me immediately upon receiving the results, rather than wait more than a month for my followup appointment to tell me.

But I will point out that there are easier ways to elevate my heart rate--I can just run on a treadmill, guys!


Jean in Georgia said...

Wow. I'm glad it was something so simple. But I really wish they'd taken proofreading to a little higher level...

paul howley said...

I no longer trust doctors. My 25 year-old brother was having some chest pains on his way to he stopped at the hospital where the head cardiologist examined him and told him he needed a pacemaker installed. They scheduled the surgery for the next day. My brother called me, very concerned. I forced him to get a second opinion. (he was nervous that this would offend the head of cardiology) It turned out my brother had "mono." I guess lots of doctors graduate with a "D-"