Several days ago, I wrote about how my condition had worsened and it got so bad that I needed to head to the hospital on Sunday evening. I had hoped to hold out till Monday after the kids went to school but I hit a wall and could not go any further. I will start this off saying that my self diagnosis was wrong but not completely wrong.
We got to the ER to see a relatively full waiting room and I thought we would be sitting for quite a while but I must have looked quite miserable because, after checking in, we were called back just 5 minutes later. I know they take people in order of criticality but I never imagined that I looked that bad but there didn't appear to be any broken legs or car wrecks waiting to be served.
Stephanie and I got put in a room and immediately started the second of many recitations of my medical history and they put in an IV. I am normally a difficult stick but the tech got my line going on just his second attempt. Shortly thereafter, they started me on IV fluids and ran about 2 liters into me in the span of 3 hours. The doctor also ordered an x-ray, looking for signs of an obstruction but, as with the CT earlier in the week, it came back negative.
This did make a noticeable improvement in my condition but I was still extremely fatigued and spent most of the time with my eyes closed, answering questions when I had to. As the second bag was finishing, the ER doc said they would admit me and we took a ride up to the oncology floor of Penrose Hospital. Again, I kept my eyes closed as we made the trip and it was a bit like a surreal amusement park ride as we started and stopped, waited for doors or people and made sudden turns in a new direction while going up and down various ramps.
I slept the night away and woke Monday morning, feeling enormously better. Of course, that is just getting lots of sleep and actually becoming normally hydrated for a change but it felt better and I actually looked quite a bit better as well. Stephanie returned, feeling a bit refreshed as well and let me know that I did look much better than the previous night's 'death warmed over' appearance.
So, in comes the doctor from my local oncologists' group to chat about what is going on. His theory is that my obstruction is not mechanical as in there is nothing physically blocking the way. What he thinks is going on is Ileus but he actually used air quotes when he gave this diagnosis.
To understand this diagnosis, you need to understand a bit about how your gut works to digest the food that you eat. The bowels work by slowly squeezing food along, extracting nutrients as it passes and adding enzymes to break it down. This is called peristalis and you can think of it a bit like stuffing sausages. The way your hands squeeze the casing (intestines), moves the sausage meat along is similar to how the intestines squeeze the digested food along, advancing towards the rectum.
His theory is that my intestines, after all the surgeries may now tend towards getting confused about how to perform this process and/or may go to sleep, not bothering to move the food along. Once they do this, it is like trying to stuff sausages by only pushing on one end of the casing. It just isn't going to work and is going to behave like an obstruction.
So, we have started a liquid diet and I do have some faint bowel noises and am starting to pass some stool again. Today, they have moved me to a full diet and will continue to monitor me and how I pass the food. I have been taking anti nausea medication which has helped some and it may be a part of my continually expanding list of medications now.
For me, the big concern is the future. Will this happen again? Possibly. Is there anything we can do at this point to prevent it from happening again? Most likely not. What do we do when it happens again? Same deal, hospitalization until I can tolerate food again. Eventually, it may come to a point were my bowels simply never start working again and I may have to go on TPN at that point for the rest of my life.
As to the short term future, I hope to be released from the hospital in the next few days and then will start getting my strength back and returning to work and play. I will update again when I get out and want to say thanks to all the well wishes I have been receiving. Hope to see all of you soon!
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