Take it easy...

I thought I would share with you what Vampyra did to my hand. You can't even see a bruise on the other hand, the one that actually got a successful IV insertion.

But enough about the damage. The good thing is that my gallbladder was in bad shape for a long, long time and I didn't even know it. Since the surgery I've eaten all the things I normally eat with no problem. I've even eaten some things I don't eat all that often, like lobster. We had a lobster feast Saturday night, just two days after surgery!

I enjoyed lazing around for a few days without any obligation to do anything at all. It was sort of weird, but really nice.

I had planned to return to work Monday morning, but when I got in my car and tried to operate the gas and brake pedals, my abdominals objected. I tried again later in the day. You know how you always feel better as the day goes on? So I went out to my Monday night AA meeting and did just fine. I did better than just fine. I stopped at the grocer's on the way home for some must have items like toilet paper and milk. When I went to start my car it was dead. Deader than it's ever been. I've just replaced the alternator in the past year and I didn't notice that the amp meter was not registering so I'm thinking battery. I got four years out of a two year battery so I'm happy with that. Fortunately the grocery store was just down the street from Wally World and the tow truck was able to get me there before closing so I put another two year battery in it. Needless to say I was exhausted when I got home.

Vampyra

So let me tell you about my friend Katie, aka Vampyra. Katie is a nurse at unnamed surgical center. She took me back to the cubicle that was my surgical prep area. This is the area where I change into the wonderful hospital gown they love to make you wear, give you pre-op drugs, ask those last minute questions and make you sign the waiver (right after you've packed your eye glasses in the bag of personal items) absolving the medical team of all liability should things go dreadfully south when they're performing the procedure. Oh, it's also where they hook up your IV.

Katie became affectionately known as Vampyra after two failed attempts to hit a vein when hooking up my IV. I have bruises on the back of my left hand and on my left wrist that might go away before 2010. She was persistent. She dug and dug in each of the piercings in a vain (pun intended) attempt to hit the mother lode. Now I have huge veins. You'd have to be blind to miss them. If I wasn't so squeamish about needles I could easily be a heroin addict. Granted, I may have jinxed her by mentioning my fear of needles, but still, she's a fucking nurse. What is this, her first day out of school?

I had, at this point, decided that if she failed on the third attempt, I would put my clothes back on and reschedule this for her next day off. Three dry holes was gonna be my sign from God that today was not gonna be my day. Katie, sensing that she was very close to death, decided that cowardice was the better part of valor and passed the task of starting my IV off to another nurse. A nurse named Red. I took that as a good sign.

It''s All a Blur...

So Sunday, Monday, Tuesday and Wednesday were all spent getting ready for Thursday. I had to be at the surgical center at the butt-crack of dawn. The surgery went fine. It took a little longer than expected because my gall bladder was a little more fracked up than they expected. Turns out it's been in bad shape for quite some time and is probably the cause of much of the upper back pain I've experienced over the past few years.

I'm sort of angry about a couple of things right now.

One, I think that the medical community should have connected my back pain with my gall bladder a long time ago. One of my back issues is a classic sign of gall bladder trouble and since nothing else they did to relieve that issue resolved it, you'd think they'd dig a little deeper for the cause.

Two, my partner is totally worthless when it comes to having my back in a hospital setting. I know she doesn't like hospitals and doctors and all that shit. Probably because she likes to ignore when something is wrong with herself in the hope that it will just go away. Well fine, that's you and your shit. But don't tell me you're going to be there for me when you aren't capable of being there for me. We were talking yesterday evening when the anesthesia had finally worn off and I was mentioning something or another that I'd told her before. She said no, she didn't remember what I'd told her. She'd tuned it out because it was yucky and she didn't do yucky. Excuse me? So when I was still in out like a light recovery and my doctor came and talked to you about what went on in the operating room, you just tuned him out? And you call that being there for me? When I had the nerve to be upset about this revelation she got pissed...at me. I'm not quite sure how I'm going to handle this one. Personally, I think it's a deal breaker.

House sitting

That's where I've been all week. Not one, not two, but three houses. My own, owing to the Missus being out of town until Thursday past. My best friend's owing to the fact that she too travels for the same company and a co-worker had a business trip where she needed child care. My house is a piece of cake now that the fence is up and the dogs can be left to patrol their little piece of paradise.

Friend's cats are low maintenance. Towers of food and water so it's just checking to make sure they're well supplied and a scoop in the dish for the neighborhood cat she feeds. I hesitate to call him a stray. He's never been malnourished. Even if he was a stray, he wouldn't be malnourished with the wealth of mice and birds in mid-America. He's just neglected. Perhaps someones outdoor cat. We've treated him for ear mites which he tolerated quite well and gets along with her cats when they're all out in the yard together. He tried to come in the kitty flap one time and that's when her guys set the boundary, "NO, you are not coming in the house." So this past winter friend picked up a smallish igloo dog house on close out and a round foam bed and kitty's pretty much set any time he wants to come around.

Co-worker has a dog, cat and teenage daughter. The kid is out of school so she can care for the animals during the day, it's just the overnights alone that were a concern. The kid is a really good kid. Not snotty, not reclusive. Doesn't think she's a woman trapped in a teenager's body so she's low maintenance too. In fact but for the night we came back to my house for BBQ with the Missus, she cooked every night. Eats healthy so there was nothing on the menu to disturb my gall bladder.

I'm starting to lean more towards the surgery. I'm amazed at how many people I work with or know from around town that have been walking around for years without a gall bladder. And I've eaten with these people and I see that they eat well. They all say that every once in a while they pay for eating something extra fatty, but that occasionally it's worth it. And the really cool thing is that pretty much every one's had it done by the same doctor, the one that I have an appointment with on the 26th.

I didn't get all my questions answered by the nurse, because she didn't have the answers, but the surgeon will. She did look into finding out if there's anyone doing the sonic therapy that pulverizes the stones, but the few she found indicated that the size of my stone is an issue and they've not had success with larger gall stones. She also pissed me off the day I went in to talk to her. I was looking for a dialogue, not some health care professional handing down unquestioned recommendation, but someone to listen to my concerns, my opinions and if warranted, poke holes in my beliefs. I was of the opinion that the stone was a relatively recent development. She is not. But rather than say that while we were in the exam room discussing my limited options, she waited and made a comment over her shoulder as she was walking down the hall away from me. She said, "I don't think this happened in just three months." and was gone. Wait a minute. I don't give a shit what you think if you don't have some facts to back up what you think. I'm not there for your opinion, I'm there for your god-damn medical expertise. Trust me, I will revisit this with her when next we speak.

I have not heard back from my regular doctor since I dropped the letter off at his office and frankly I'm surprised. I thought he would have called and said he wasn't going to change his mind or yes he was. Either way, I at least expected the courtesy of a call back. I'm not as pissed as I was at first but I'm still mad enough to make some nastiness float about the 'net.

Everyone's back in town now so I'm down to watching one house again and I'm doing pretty good on the pain front by keeping my diet low fat. Tylenol keeps it manageable during the day and the kick ass meds the nurse prescribed knock me out an night. I'm getting some good rest. Hey, I hear having your gall bladder removed is good for about a 15 pound weight loss!

You haven't seen the last of me...

So I call the clinic of the physician I see since I moved to Kansas to discuss treatment options for my condition. I hardly ever go to the doctor. Firstly I'm incredibly healthy in spite of my former drinking habits, my former obesity, and my continuing addiction to nicotine. Second, my lack of health insurance has made it so that visits to the doctor are a necessary, not just an I don't feel so hot proposition. I haven't had a drink in almost 10 years, I'm not as slender as I could be, but still 65 pounds below my all-time high, and I'm not going to beat myself up about the fact that I can't quit smoking. Sure, I'd live longer if I did, but what they don't tell you is those extra years are the bedpan years. I'll pass thank you. Besides, there's no way for me to quit smoking without going postal on everyone in a two hundred mile radius so you can all thank me now for not quitting.

I speak with Dr. X's nurse who listens to my brief description of why I'd like to see the doctor and after a few minutes comes back on the line to inform me that Dr. X doesn't do second opinions (which is not at all what I've asked for) and that since they have a doctor that just quit the practice leaving them short handed and I've only ever been to see them once, Dr. X declines to set an appointment with me. I am dumbstruck. First, I know I've been there more than once. Three occasions come to mind immediately (I'm sure I can think of more given time), plus he is the primary care physician of my nephew, who lived with us for years and he's the primary for my life partner. WTF? I thank her and hang up. After a night sleeping on this development, I decide to write Dr. X a letter asking him to reconsider his decision:

Dear Dr. X,
I am writing to protest your refusal to set an appointment for me to discuss with you a diagnosis I recently received after a trip to the emergency room at Unnamed Hospital.

Your staff could only find one record of my visiting you, which is incorrect. I personally have seen you or another physician at your clinic on at least three occasions over the past 5+ years. My very first visit to you was when my life partner and I were adopting our nephew and the process required that each member of our household undergo a physical examination. We were very new to the area and chose to keep our healthcare local rather than go to Manhattan or Topeka. I am ridiculously healthy and am not one of those people who calls the doctor every time they get a hangnail so my visit count with you is low. Sorry, I'm not going to be the patient that funds a new wing at the hospital. The low visit count is also due to the fact that until recently I had no health insurance so a trip to the doctor for me was something that was done only, only, only when absolutely necessary.

My life partner is a patient of yours and you are the primary care physician for our nephew. They have received frequent treatment from you and other physicians at your clinic. I feel I may have been penalized in this instance because there is not a familial relationship of blood or marriage noted in your clinical records reflecting the fact that we are indeed a family that is treated by you and Clinic X.

My recent visit to the emergency room has resulted in a diagnosis of stones in the gall bladder. I do not disagree with this diagnosis and am not looking for a second opinion or someone to either confirm or refute the diagnosis. The emergency room doctor, Dr. Z, is not my primary care physician (due to my good health I don't declare a primary care physician, I've had no need to) and since he is affiliated with the healthcare clinic at Unnamed Hospital, I elected to continue seeing him on this issue for the purposes of medical care continuity, not out of any physician preference or loyalty. What I do disagree with is his recommended course of action. He will not detail any options but one for this condition and I wanted to speak with someone else regarding all the options, however remote they may be, for this condition's successful outcome.

Therefore, I humbly request that you reconsider your decision and grant me a few moments of your time to discuss what my healthcare options are for this condition.

Sincerely,
Your Patient (who is in great deal of pain)

Now, I truly hope he will reconsider. If not, I fear his name will arise in a negative connotation in every blog I can possibly post to every time someone Google's his name.

The Hope Diamond?

...and so begins my frustration with conventional medical care.

The results of my endoscopic exam were no ulcer. So why am I taking medication for an ulcer? I thought this was a good question. So when I called my diagnosing physician on Wednesday to discuss the endoscopy results, schedule something to take another look at my gall bladder (which had previously been dismissed as a cause), and ask if I should continue the ulcer medications I was told, "The endoscopy did not rule out an ulcer lower in your system so continue the drugs." This instruction came from the clinic nurse as Dr. Darey was a little too busy to come to the phone. But they did in fact schedule a sonogram of the gall bladder for Thursday morning.

The technician who performed the procedure did not offer any information as to what she might have seen, the results must be interpreted by a radiologist and then forwarded to my doctor. Fortunately the referring physician's clinic is located there at the hospital where the ultra-sound exam was performed so I didn't think there would be too much lag time. I was not disappointed, he called shortly after I left to tell me I had a stone of large proportions in my gall bladder and probably several smaller ones keeping it company. He continued to explain that the hospital had a surgeon that could perform a removal of the offending organ this coming Monday. Excuse me? Do not pass go, do not collect $200, go directly to surgery?

I don't think so. I'd already researched gall bladder disorders and knew that there were at least two less invasive (and also less successful) treatment options that could be taken prior to surgery. He was not even willing to discuss them saying, "In my experience, surgery is the most successful way to deal with this condition." You're all of 28 years old you little whipper-snapper. I'm old enough to be your mother so don't you dare use the phrase "my experience" in a sentence with me!

The before-you-go-to-surgery methods are drugs to dissolve the stones (slow going), a procedure that injects a flammable anesthesia into the bladder to dissolve the stones (very dangerous), and a sound wave therapy that pulverizes the stones into a size where they can pass naturally from the bladder. Since my stones are likely cholesterol stones that are a direct result of my excessive chocolate and donut consumption of the past three months, I see no reason why I can't do the following:

1. Quit stuffing my face with donuts.
2. Quit stuffing my face with chocolate.
3. Take the stone dissolving drugs.

Since my attending physician is unwilling to discuss alternate methods with me, I have an appointment to meet with the nurse that I normally see at his clinic. I trust her and I know that she'll give me the straight line on whether or not this is an option for me. I also plan to make an appointment with the physician I've seen the most (which is not much as I'm ridiculously healthy most of the time) since I moved to Kansas.

Today sucked

The pain was about a 3-4 all day. It woke me at 2:43 pm. God I shouldn't have had that Big Mac and fries for dinner. I tossed about for an hour before I decided I'd be more comfortable just getting up and having some cereal. My stomach has been gurgling and I've been belching all day long. Nothing seems to offer any relief except the Tylenol which I take sparingly. I debate returning to what works best for pain, ibuprofen. Hey, I have no ulcer, why not use the good stuff?

I'll tell you why. I've spent a good deal of the afternoon researching gall bladder disorders and it's not pretty. Chances are the ibuprofen is partly to blame due to it's effect on the liver. And everything I've read tells me that gall bladder stones start in the liver. Of course conventional medicine want to immediately rip the gall bladder out, and while that does appear to make the pain cease and desist, it has a very negative effect on your digestive process---for the rest of your life. I have no intention of ruining my perfect track record of no invasive procedures to the body if there are other options.

So tomorrow I go for a sonogram of my gall bladder to see if it's well and truly stoned. I expect this to be the case. If the current crop of stones cannot be eradicated with ultrasound, then I expect I will take the homeopathic route and make diet modifications (I have a sneaking suspicion that my high donut consumption as of late may be a contributor), I may even go so far as to try the gall bladder cleansing that I've read so much about today. Seems like everyone but the MD's are behind it. I should probably also consult my chiropractor. I read a blog entry by a woman who swears by her Chinese Herbalist but I doubt I will find anything like that in the middle of Kansas. Still the Herbalist's gall bladder cleansing routine sounds much like the other only with nasty herbs instead of oil.

Today's food intake: Cereal for breakfast, Macaroni and Cheese (apparently cheese is a no-no, but it's my favorite food) for lunch and I'll probably have the rest of the Mac n cheese for dinner along with a bagel. Drinks were my two cups of coffee, lots of water and ginger ale left out to go flat before drinking. I should probably skip the fatty ice cream tonight. Nothing after midnight, but the sonogram doesn't involve drugs to knock me out so I'll be ready for breakfast when it's done!

Sun comes up, it's Tuesday morning...

Well Tuesday all the meds had worn off and I definitely knew someone had stuck a tube down my throat, but it was just irritation, not pain. Work was crazy, but I'm going to stick by my policy of only mentioning that subject in passing. Suffice it to say I slept well, two hours on the couch (during the hockey game) and then the rest of the night in bed. Up before the alarm due to the "extra" sleep.

If neither the hernia, nor the Shatzki's Ring are responsible for the pain I am feeling I guess it's time to look a little more closely at the gall bladder...

Not an ulcer...

...but not out of the woods yet. Hmmm, does this mean I have to change the label for these entries? Naw, that's what we started out thinking and that's what we'll leave it as.

It's not an ulcer, it's a combination of two things. That nasty almost pneumonia I had a while back? The one that had me coughing like a lung was going to be expelled? Well apparently that gave me a hiatal hernia. It's a small one and it will in all likelihood heal on it's own. It's treated with the same medications as the ulcer as the main symptom is acid in the esophagus.

The other issue is a heretofore undiscovered birth defect called a Schatzki Ring. It's an area of the esophagus where it's much narrower than above or below. Normally not a problem until you add in some stomach acid. Once the hernia's healed it should cause no problems but if it does, it's a simple balloon dilation procedure done by the GI guy again using the endoscope.

Yes, I'm relieved, but not thrilled about the other two items. Still they are non-life threatening and manageable. I now know why no one blogs about the actual procedure. No one freakin' remembers it! The last thing I remember before the procedure is nurse Michelle spraying the local on my throat and telling me to swallow. The next thing I remember is the Missus stroking my hair and asking if I was awake. Demerol good. Demerol very good.

More research...

So I'm looking for personal accounts of endoscopic exams today. Not a whole lot of blogging going on about the subject, probably due to the aforementioned drugs. No one seems to actually remember the procedure. Did find one post from a woman who's friend underwent the procedure without the mind-altering drugs, just the local and the friend's recommendation was: TAKE THE DRUGS!!!!!! Have yet to find any horror stories and, quite relievedly, no posts where the last post ever made to the blog was, "I'm undergoing an endoscopy tomorrow..."

I believe I've mentioned that my digestive tract is operating at a snail's pace and I constantly feel bloated. My stomach looks distended and yet I've lost 10 lbs. over the past month. How I managed to do that on a steady diet of chocolate and doughnuts is beyond me and if I think about it too long, I'm sure I can diagnose myself with some rapidly progressing form of cancer quicker than you can say Dr. Kevorkian was just released. The whole point of the previous is that one of the things they do during the procedure is to pump you full of air in order to give the camera some room to maneuver and have a clear view. I pray that the drugs will make me ignore that feeling and hope one of the medications does something to suppress my gag reflex. I would hate to be the patient that hurls all the contents of her stomach across some unsuspecting doctor. It's a small town, I'm sure the word would get around...

On the sleep front the news only gets better. I'm used to performing some combination of sleeping positions during the night to fend off lower back pain. My modes are:

1. On my back with a pillow under my knees
2. On my left side with the body pillow tucked between or under one knee and right arm slung across the top of it
3. The reverse of item 2

Because of the odious discomfort and pain caused by my condition, I've only been able to sleep in position 3 which does nothing for my low back. This morning I woke up in position 2, the first time I've been able to sleep on my left side without pain for over two weeks. And that's a victory, folks!

Research

...so I'm researching endoscopic exams on the internet, the great font of all knowledge. Lot's of stuff from the medical community on the subject. Sounds pretty straightforward. Wondering though if I shouldn't have the best friend accompany me on this outing instead of the Missus. Would hate to be grilled by her whilst still under the effects of the supposed truth serum-like drugs they will apparently pump me full of. Not that I have anything to hide, mind you. I'm faithful and true as the day is long, she just doesn't like to hear my truths when they are in direct conflict with her unique view of Our World According to the Missus. On the other hand, I'm totally looking forward to being stoned again...

Another good night

Seems like the new combo of meds is doing the trick. I'm far from 100% but I really started feeling better Wednesday night and that was my first good night of sleep in a while. I don't get enough sleep to begin with (and I'm not complaining really because that's my own damn fault) so when I'm sick enough to make the little sleep I get even more ineffective, it just colors my whole life.

I got the appointment for the endoscopy set for this coming Monday. I was a little upset that it wasn't made for sooner, but really, the way my stomach has been feeling it's probably a good thing that it's taking a little while. Don't think I would have gotten it any sooner living in a larger city so I'm satisfied. Had a moment of comic horror in making the appointment. They weren't sure if the paper work I need to fill out would reach me via mail so I said it was OK to fax it to me at work. I figured I could either go haunt the fax machine until it came in or if the receptionist got to it before I could, I wouldn't be too embarrassed about the information being seen by someone else. WRONG!!!! They faxed the wrong paper work. Well, the forms were right regardless, but the instructions were for an entirely different procedure with an entirely different approach. Do you see where I'm going here?

My departmental co-worker brings me the eight page fax and I think there was a smirk on his face, but he's always smiling so who knows...I flip the cover page and there in huge letters at the top of the page is the word Colonoscopy. WTF? Excuse me, you people are not taking the scenic route to get a look at my ulcer. The shortest distance between the nearest entrance and my ulcer involves a mouth approach! In a panic I dial the doctor's office to confirm that I understand which procedure I'm scheduled for. The woman who faxed the info is gone for the day, but the receptionist checks my record and says I'm scheduled for an [insert acronym here] . I say I don't know what that alphabet means will you please tell it to me in layman's terms. She replies they'll be going down my throat. I say thank you, because if you're going the other way I'll pass and just suffer out the rest of my days. Still, before I go I believe some felt pen on my ass that says, "Exit only. Do Not Enter" is in order...

So Thursday I felt well enough to make the Appleby's run that we IT people had planned for last Thursday when I first got sick. We got a gift certificate from one of our co-workers for some work we'd done on her personal computer and wanted to spend some quality time out of the office together so we could eat drink and bitch and moan with impunity. We had a great time. I really like the guys I work with. I'm sure there are times when I piss them off as much as they piss me off, but when all is said and done I think we are a great team and work well together. I probably ate too much on this little outing, but I was not as uncomfortable as I have been over the past week so it was a victory. I just wish my digestive tract would speed up a little. It just seems to take forever to get things to make it from going in to coming out but I'm told that's a side effect of the meds. Can't wait for all this to be over.

To sleep, perchance to dream

Well I don't know if I dreamt last night but I do know that from the time my head hit the pillow until my alarm went off, I did not awaken once (that I remember). I started feeling better about 9:30 pm and slept lying down. I felt rested when the alarm woke me up.

I'm still really tender in the top of my abdomen, but I was actually feeling good enough to cancel the upcoming endoscopy. Then I decided that I didn't want to have to make that appointment again if this should recur a month from now.

Still think it's an ulcer

So the doc and I went over all my notes from the weekend. I kept track of what I ate and when. What meds I took and when I stopped the one that I thought was hurting more than helping. What made me feel better; what made me feel worse.

He still thinks it's an ulcer, but it may be a biggun. The mother of all ulcers. He agreed that two of my complaints may have been a result of too high a dose of the p*r*e*v*a*c*i*d so he cut that in half and threw a new med into the mixture. He's also going to schedule me for an endoscopic exam. If it is a big ulcer, it's going to increase the healing time and we need to know that. If it's not an ulcer, we need to know that too so we can move on to a more appropriate treatment. He mentioned hernia and of course, the C word as other possibilities.

Last night I was able to sleep all night in my bed, only waking up once at 12:30 to swig some Pepto, but then I was awake again at 3:30 for good. I call that an improvement.

A Six

That's what I've gotten up to on the ulcer pain scale between Sunday and today. Not enough for another trip to the emergency room, but enough that I will be calling the doc in the morning because I don't think I should be feeling this much pain. Fortunately my attending is also the doc that saw me at the emergency room so there'll be no catch-up factor.

Don't ask for whom the bell tolls

...it tolls for me. I don't remember Tuesday night, but Wednesday night is firmly etched in my brain. Pain. Lots of it. Up all night. Chest pain on the internet. Knowing my history I vacillate between heart attack and ulcer. Two grandfather's dead in their early 40's of heart failure and the knowledge that women's heart attacks are frequently mis-diagnosed as severe indigestion have me worried. On the other hand ibuprofen abuse, caffeine and nicotine addiction and the unusually high level of stress in my life over the past year have me 99.9% sure it's an ulcer.

When my hot-hot morning shower still leaves me pale as a camp-bunk sheet, I opt to go to the emergency room at the Podunk hospital. Based on the average age of the local residents, I figure they are well versed in heart attack protocol and I'm not disappointed. Before I am finished spelling my last name I am whisked to a bed and hooked up to an EKG. When the first dose of nitroglycerin lessens the pain, I really start to panic and my blood pressure crests like a tsunami in Indonesia. After assurances from the nurse that nitro makes everything feel better, I subside to a more normal level of fear.

EKG looks good. Subsequent doses of nitro lessen the pain no further and I start to wrap my head around the fact that I've finally managed to develop one monster of an ulcer. Treatment? Knock off the ibuprofen, cut down on the caffeine, quit smoking (riiiiight) and reduce stress levels. Oh, so I'm supposed to quit my job and girlfriend?

Hot tip from the heartland...if you have stomach acid, for god's sake don't take Tums. Turns out that added calcium actually increases stomach acid. Go figure. The manufacturer adds something that causes stomach acid to their product.