The night before a doctor's appt.

The night before a doctor's appt is always a tough one.

Lots of anxiety. 

I can't sleep.

I can't eat.

I can't relax.

I'm edgy, nervous, cranky and bowing my head in prayer frequently through the night into the wee hours of the morning.  Asking God to please let tomorrow go well.

And though I read my Bible for comfort, while everyone else is asleep, and have committed several verses to memory, one of them being:

“Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus” (Philippians 4:6-7).

My mind still goes in a million different directions, with a million different questions:

What will my wbc level be? 

• Higher than 4.3 x10^9/L and things are looking great. 
• Lower than 2.3 x10^9/L and the doctor is not going to be happy and we're going to have to try another combination of drugs/dosages.
• How will my body respond to this?
• My normal is anywhere from 1.8 to 2.5 x10^9/L - this is incredibly low and has great side effects on how I feel on a daily basis.  Not to mention how susceptible I am to getting sick.  Germs are a big concern for me because of this.  One cough, one sneeze, could make me very ill, even hospitalized.  My immune system is so weak because of the lupus and the medications I take to control my lupus.

What will my rbc and HGB levels be?

• Lower than 4 x10^12/L and 12 g/dL and I'm anemic
• my "normal" range since lupus, is around 3.7 x10^12/L and 10 g/dL
• I've been anemic for 4 years

Will there be protein in my urine... probably, but how much?

• Last October there were over 3 grams of protein spilling in my urine... not good

Will there be anything else show up in my urine?

• Ketones
• blood
• Epitheleal cells
• casts
• bacteria
• crystals
• wbc's
• rbc's
• I've had all of these, sometimes periodically, sometimes all at once

Is the doctor going to tell me that I need more tests ran because another organ has been attacked?

What will my SED RATE be? 

• Hoping for less than a 20 mm/HR, means lupus activity is low.

Is the doctor going to RAISE my prednisone level... dear God I hope not... my jeans are already busting at the seams from the last increase in prednisone

If my blood work shows that everything is fine, can we LOWER some of my meds?

What medications do I need refills for?

What things have bothered me since my last doctor's appt?


Then I worry about the effect this has on Emma, she usually goes with me.

• Does she, being that she's not 2 yet, understand anything that is going on?
• Will she grow up thinking its totally normal to go to the doctors every 4-5 weeks?
• Am I harming her by taking her, or preparing her for what very well could be in her future?
• About 5% of children born to individuals with lupus will develop the illness. At present, there is no genetic screening test that can determine who might go on to develop lupus later in life.
• If I get less than positive results from the doctor, will I be able to be strong in front of her and hold back my tears for when she is taking a nap?  Dear God, please give me positive results.
• When I was told last October about Stage 4 Lupus Nephritis (kidney failure), I broke down.  Right there in the office.  Emma was there sitting in the chair beside the table I was sitting on. 
• I cried. 
• I cried out of fear. 
• I cried for her. 
• I cried out of ignorance of what it all meant. 
• I cried because I immediately thought of my beautiful cousin Diane and how her kidneys shut down 2 weeks before she passed away... yeah, my mind went there... it always does when my doctor tells me that another organ has been attacked. 
• I cried because I was crying at the doctor's office.   =) 
• It was a very emotional day and even though the below photo was NOT taken on that day, this is the look I saw on her face.

I'm usually pretty good at keeping my emotions in check until she takes a nap or Brian gets home.  But sometimes, I am weak and break down

Let's all just pray for good results and then I won't have to worry about Emma seeing how scared I can get.

My appt is not until the afternoon, I think Emma and I will enjoy a nice long walk in the morning and maybe (weather permitting) have a picnic lunch.

“Trust in the LORD with all your heart and lean not on your own understanding; in all your ways acknowledge Him, and he will make your paths straight.” (Proverbs 3:5-6).