Madeline, a seventy-four year old grandmother, came into my office complaining of an increasing waistline, bloating, nausea, intestinal cramps, fatigue, and maybe even breast tenderness. "I feel just like I did when I was pregnant," she insisted. I laughed. "Well, at age seventy-four, we both know that's not the cause! Not unless God himself told you you're the mother of the next Isaac."
I examined her then reviewed the differential of what could be causing her symptoms: IBS, ovarian cancer or cysts, endometriosis, celiac sprue, adhesions from previous C-sections, Crohn's disease, ulcerative colitis, diverticulitis etc. I scheduled an abdominal and pelvic ultrasound, colonoscopy, and ordered blood tests.
Imagine my shock when her laboratory report came back the next day with results of a blood pregnancy test (negative, of course.)
I slammed the report on my medical assistant's desk. "I didn't order a pregnancy test on this woman. How did this show up?"
My medical assistant blushed. "I added it. She begged me to."
I scowled and shook my head. "What were you thinking?"
Her head dropped, shame-faced. "I know. It's just that she said she knew she was pregnant. She'd already done two home pregnancy tests but needed a blood one done to prove they were wrong."
I stared at my usually brilliant medical assistant in disbelief. "She went through menopause twenty years ago. How am I going to justify to Medicare why I ordered a pregnancy test on a seventy-four year old? They'll probably revoke my medical license."
She released a hearty sigh. "I didn't think about that. She was just so insistent. Said she knew she was pregnant and that you weren't taking her seriously."
"How could I? She's seventy-four years old," I snapped.
My medical assistant shrugged. "I just wanted to relieve her worry."
"Well, you can let her know her blood pregnancy test is negative and she better show up for her ultrasound and colonoscopy."
In case you're wondering, her colonoscopy revealed ulcerative colitis, an inflammatory bowel disease of the intestine. I was actually relieved, because from her symptoms, ovarian cancer was top on my differential.