My week without blogging can be explained in three words: ulcer, hernia, kitten.
Ulcer & Hernia:
This time nine days ago I gave in to the increasing abdominal pain I was having and called my bariatric surgeon’s office to request an ASAP appointment. As I explained to the scheduler, I was having an increase in abdominal pain that felt just like ulcer pain, and it was in the same location as the ulcer that perforated on August 1st. I also emphasized that the last time I ignored this pain, I “perfed” (a word that is now frequently used in my bariatric medical records. Sigh.) a week and a half later. The scheduler got back to me with a November 17th appointment as the soonest available.
This time last Sunday I had been up for 10+ hours with significant abdominal pain and heartburn. The heartburn was almost more worrisome than the pain, because anytime I’ve had heartburn a perforation was soon to follow. I called my bariatric surgeon’s on-call line, and because both my bariatric surgeons were out of town for the weekend, I was transferred to Dr. P, the gastro specialist who has done all of my EGDs. As soon as I explained my symptoms and worries he told me “get here ASAP so I can admit you for observation and then run several tests”.
After three hours of trying unsuccessfully to get a hold of my mom via every communication option available (cell phone, text, email, Facebook message; cell phone, text, email, Facebook message to my brother), I gave up and asked Jason to please take me. At that point I was in a lot of pain and worried, and about to drive myself to the damn ER. Dan offered and wanted to take me, but with no one to watch the sprogs and it being a school night, I didn’t want to cause that kind of disruption for them.
Once at the ER (around 10, I think) I was quickly assessed and taken back to a room. There I was given Dilaudid for pain, and in return coughed up a container of urine and a couple of tubes worth of blood for testing. Within an hour I was whisked up to an actual hospital room – the perks of calling ahead and speaking to one of your own doctors? After being set up there with an IV and more meds, I was told I was NPO (nothing by mouth) and that I would be squeezed in for an EGD the next day. Meanwhile, back in August I was given a “first available” EGD appointment for November 25th. Again, the perks of calling before going to an ER and having the luck of speaking with the very doctor who has done your other EGDs?
Do I look as bad as I felt?
By Monday morning the anxiety and worry started to set in. Not about the EGD — as I’ve had probably 10 of them already so by now it’s old hat — but about what the findings might mean. At that point we were all pretty much like, “well fuck a duck, it’s another ulcer”, but the official diagnosis was necessary for planning appropriate treatment. Being NPO was pretty uncomfortable and I freely admit to stealing a few sips of water here and there, and possibly a chocolate M&M or two. The frequent IV administration of Dilaudid helped both pain and anxiety. The only downside to IV medication is that if the nurse giving the medication doesn’t push it in slowly, but shoves that needle plunger right down, the resulting brain rush that locks up my jaw and neck can be really uncomfortable and somewhat disconcerting. Fortunately those unpleasant sensations pass pretty quickly.
Monday morning’s EGD turned into Monday afternoon’s EGD. I remember falling asleep sometime after 11am, and woke up at 1:45pm to a nurse ready to take me to the procedure room. Once there, I amused some of the staff with the story of my second to last EGD including a few freaky moments during which the too-slow IV resulted in me still being not quite under (I likened it to feeling like I was being pulled underwater but my head was stuck at the surface). The last thing I remember is one of the staff being shocked at me being in regular clothes and still having all of my jewelry in (again, perks of your doctor admitting you via the ER on a Sunday night).
I woke up to the unsurprising news of a duodenal (duodenal = in small intestine; peptic/gastric = stomach) ulcer, and it’s in the exact same spot (very top portion of my small intestine) as the last one. But I was horrified at the accompanying information: the ulcer is 2cm in size, and 40% eroded – meaning I have an ulcer the size of a penny that is almost half way through my intestine. I could perforate at any moment. How’s that for feeling like a ticking time bomb?
Obviously nobody wants me to explode a third time. I don’t think I could survive a third ulcer perforation. When I go back to my room, Jason (he stayed with me on Sunday night) and a Protonix IV drip were waiting for me. I was also started on liquid Carafate – 1 gram every four hours. Jason knows me all too well, so when he found out (before I did, since after the EGD the doctor went to see him but my unconscious self was wheeled to recovery) he texted Dan, and they both correctly guessed I’d be both furious and weepy. I kept myself together during the ride from the recovery room to my hospital room, but as soon as I was transferred from the recovery bed to the hospital room bed I burst into tears. Shortly after, once I calmed myself down, I found out (via reading summary/discharge paperwork) I have a hiatal hernia that encompasses a large portion of my stomach pouch. Dafuq, body? The ulcers aren’t enough?
Besides the usual blood and urine tests, plus the EGD, a special blood test called a Gastrin Blood Test was done to check and see if there is an internal reason for my obvious easy susceptibility to the formation of ulcers – such as too much bile being produced, or a malfunctioning pancreas. When I last checked Hershey’s online medical portal for results, it was posted that my preliminary Gastrin results were in – my level was 151, and that’s after several days of hardly eating, and a full 36 hours of nothing but water and some soup broth. A normal level is 0-100. However, the use of PPIs such as Protonix can cause a falsely high reading – and I have been taking Protonix twice daily for two and a half years; and at the time of that blood test, I had been on a Protonix IV drip for over 12 hours. I will be bringing this up at my two week follow-up appointment, so we can figure out if the high 151 reading is “accurate”, or if it’s flawed because of PPI usage.
For the next 24 hours I was on a continuous Protonix IV drip, and given liquid Carafate every four hours; plus more pain meds via IV “push”, as the nurses refer to giving a syringe full of Dilaudid via IV as. I was allowed to drink water, and my Monday night dinner, Tuesday morning breakfast, and Tuesday afternoon lunch consisted of soup broth, Jello, and water.
delicious and filling liquid diet, said no one ever.
Jason stayed with me until early Tuesday morning; and Dan came up with the sproglets on Monday afternoon. Alyssa looked a bit worried but was reassured by me taking a walk with her and Ryan down to the main floor of the hospital; Ryan was very clingy and anxious, and it took more assurances to get him to relax. My poor children. As awful as it is to go through all of this myself, it’s worse to see what my health issues are doing to them. They shouldn’t have to worry about my health. I need to get past all of this. I’m tired of pain, and I’m tired of these brushes with death.
Anyway, I was discharged on Tuesday afternoon. My health insurance company finally removed their heads from their asses and agreed to cover the cost of liquid Carafate, and the doubled dosage of Protonix (I was on 40mg twice daily; I’m now on 80mg twice daily). They might not care if I perforate and subsequently come close to dying; but they do care about money. And let’s face it, a $400-something per-month medication, even for a year’s worth, will cost a hell of a lot less than all of the services associated with an ulcer perforation (ambulance, hospital #1, ambulance, hospital #2 for surgery, 4+ day stay, home visiting nurses, etc.).
So I’m home with instructions to take 1 gram of liquid Carafate four times per day, 80mg of Protonix twice per day, and to get my ass back to their ER if I perforate or if symptoms worsen or suddenly appear (such as worse pain, worse heartburn, blood in stool, etc. I’ve had yes to all of the above yesterday and today, by the way. Keep all of your things crossed.). I have a follow-up appointment on the 17th, and I’ll be having monthly EDGs until this fucker goes away, or tries to kill me again – whatever comes first. As for that hernia? I can’t be fucked to try and deal with that. Trying to manage chronic back pain, chronic shoulder pain, and now stomach pain and the imminent threat of an ulcer perforation is keeping me plenty busy.
On Wednesday afternoon, I received a Facebook message from my next-door neighbors. They had just found a tiny, filthy and sickly-looking kitten, and could they please bring it to me so I could try to save it? They arrived shortly thereafter, and presented a horribly filthy, underweight kitten who was clearly suffering from malnutrition as well as a bad upper respiratory infection. The URI had gotten so bad that the kitten’s eyes were stuck shut because of congealed eye discharge, and its nose was also sealed shut from congealed and dried nasal discharge and dirt. Did I mention the filthiness? How about the fleas? And on top of all of that, he was maybe four weeks old, and all by himself in a chilly November with no eyesight, no sense of smell, and no mother to care for him.
My first order of business was to try and clear the kitten’s eyes and nose. That out of the way, the next thing I did was get out milk and grab a syringe, and proceeded to get some milk into the little guy. I can’t tell you the relief I felt in seeing this clearly dying kitten lap at the milk and swallow it. Dan then figured out safe dosages of antibiotics and steroids, and I crushed the appropriate measurements and mixed them into a small amount of milk and gave them to the kitten. Then out came feline eye and ear washes, antibiotics eye ointment, Vicks Vapor Oil for a small diffuser and Vicks Vapor Rub for placing a tiny bit on either side of the kitten’s nose, and then towels and a heating pad for warmth.
sick kitten supplies
As my neighbors left, I cautioned them to not get too hopeful, because at that point the kitten was in such dire straits I wouldn’t have been surprised if he didn’t make it through the night.
But it’s now Sunday afternoon, and as of Friday morning I knew the little munchkin would be just fine. Dan, Alyssa, and I took care of the kitten ’round the clock from Wednesday afternoon onward: oral and topical medications (antibiotics) first thing in the morning and last thing at night, morning bath to combat fleas, warmed up homemade kitten formula (equal parts condensed milk + milk + Greek yogurt + 1 egg yolk + liquid vitamins) given via a syringe in 10ml doses every 3-4 hours, ensured warmth with warm towels and a heating pad, and almost constant affection – holding, snuggling, petting, talk to, etc.
bonding with Alyssa after eating
hanging with some of the big boys
The kitten, whose name is Bones, is now thriving. To see him go from a limp, starving, nearly-lifeless form to a plump, fluffy little kitten who now has enough strength that he isn’t sleeping constantly has been amazing. As of this morning he has been exploring my neighbors’ living room, letting one of their big dogs groom him, squeaking when he wants to be picked up / fed / put down, and in general looking and almost acting like a normal, healthy kitten his age.
Even though caring for such a young kitten who has had a rough start to his life is very time-consuming, it has been so amazing to have been able to save his life, and to see him morph from a dying kitten to a much healthier, more robust kitten who doesn’t just let the milk fall into his mouth but now actively laps and swallows has been amazing. The only downside is that of course I bonded with such a sweet little baby cat, so now I miss him! But he’ll only be one house away, so it’s not like I’ll never see him again. And most importantly, I’m just glad to have been able to help him.
What did you think was the coolest job in the world when you were younger? Do you still feel that way now?
Up until sixth grade I had my heart and mind set on being a teacher. I was outgoing, smart, opinionated, and social – so why wouldn’t teaching be the perfect job? Then I started sixth grade, and I realized that the majority of students were total assholes to their teacher. At that point I had a change of heart and thought I’d grow up to be a veterinarian or animal rights activist. Obviously neither happened, but I do rescue strays and I reserve the first “open” spots in our home for FIV+ cats, so there’s that, right? I’m still partaking in a cause I’m passionate about. ♥
What was the one toy that a friend had that you wished you had when you were little?
I always wanted one, but never had one.
Two gastric ulcer perforations in a 30 month period plus several active ulcers in between the perforations equals an expedited pass to the emergency room department of Hershey Medical Center, and admission for pain control, blood work, and a first-thing-in-the-morning endoscopy. As much as I’m not looking forward to spending a minimum of 23 hours (for observation as well as plenty of time for tests) in the hospital, I’m relieved to know I’m not the only one to take this pain seriously. I don’t want to mess around with what could turn into another ulcer perforation (the last time I had this exact type of pain, I perf’ed a week and a half later), and my doctors don’t, either.
November is National Blog Posting Month, and this month also coincides with my fervent desire to get back to blogging on a daily, or at least near-daily, basis. What better way to get back into the swing of things than joining up with a group of bloggers who are also posting daily in honor of National Blog Posting Month. Today is the 1st, yet oddly enough BlogHer’s NaBloPoMo for November 2015 doesn’t have a prompt today – so I guess this is similar to a bingo freebie?