Friday, April 6, 2012

My New Normal

Alert: If talking about poop or constipation grosses you out... take a pass on this one! deals you a hand and you can scarcely believe it's yours, you wonder how you're going to play the cards....Looking for a royal flush might not have been reasonable, sure...but you also weren't anticipating that the best you could hope for would be a pair of 2's or 3's.

Generally, you wake up in the morning with a plan, and you do your best to follow that plan. Of course, there are variations or some detours, but normally - I would venture to say - there are normal limits of acceptable variations to that plan. This...we count on.

Tuesday, March 27th, was not a day for which I could count on any resemblance of my plan taking place. 'Course, I never went to bed Monday night in order to WAKE UP on Tuesday....maybe that was part of the problem!! :)

Card #1: 3 of Spades
Monday, March 26th, I began feeling abdominal discomfort around 3:00...watched a movie with my boyfriend, Jim, and didn't feel much better when he had to referee two basketball games at 6 and 7 that night. We headed to the gym for his games and I took the opportunity to just walk around the track, hoping the bloating and cramping would subside after the walk and a few visits to the restroom. It wasn't getting any better, and I thought I was just really constipated. We grabbed some Magnesium Citrate at the drug store on the way home around 9pm. My biggest concern was taking the Magnesium and then driving home in the morning since I had a full client load that day and would be working until 7pm.

Nothing had really improved, but it hadn't spiraled into oblivion yet, either. I'm really very uncomfortable, but I go to sleep, hoping it will resolve through the night. I wake up about 11:30 with sharp, shooting, gripping abdominal pains that rivaled giving birth, deep in transition at 9 cm. I think oblivion's spiral just caught me.

Hobbling to the bathroom. Sitting on the toilet. Panting. Sweating. Moaning. Stripping off my clothes. Shaking uncontrollably. Getting dizzy. Hearing getting dull. Seeing stars. "Wow...this is worse than labor... (did I REALLY just THINK that??). I must be REALLY constipated. That laxative isn't working." Pain subsides slowly. Clothes back on. Climb into bed. Try to sleep. Another trip or two to the bathroom, but nothing like that again...

Until 1:00am or so...more oblivion. Same deal. Uncontrollably shaking. Sweating profusely, instantly. Dripping wet. Vision, hearing are off. Trying to 'breathe' through the pain. "Wow...maybe I have an intestinal blockage." Finally, some bowel movement and gas passes... "Maybe this will work itself through."

Card #2: 2 of Diamonds.
Me: "It's going to be a long night, babe. I think I might need to go to Urgent Care."
Jim: " won't find what you need at Urgent Care. You need a hospital. I think you have appendicitis." (I thought Jim was keeping himself busy online with sports news...he was lovingly researching my symptoms and a hospital that would offer good care and assistance for the uninsured).

I cry. I have no insurance as a result of the divorce and my limited income as an intern with no benefits. He holds my face in his hands and gently but firmly corrects me, insisting that we are not worrying about the financial pieces right now. I agree that if I have one more bout of that horrendous pain, I'll go to the ER. I hold out hope that the laxative is working and it's just going to be a long night with many bathroom visits.

Round Three of excruciating pain sends me to the bathroom again. Barely breathe. Rock back and forth. Dizzy. Seeing stars. Sweats again. Shaking horribly. "Hospital. I need the hospital." Hobble out of the bathroom. Hand holding me upright against the wall...

Me: "Let's go. I can't do this anymore."
Jim: (already dressed) "Okay...let's get in the car."

Barely walk. Wrapped in a blanket. Hunched over. Panting. Holding my stomach. All I can think is, "Help me." Jim all but carries me to the car and into ER. Fills out my paper work. Somehow....I remember my social security number, my birthdate, address, etc.

Whoever developed Dilaudid should receive the Nobel Prize for Peace...not Medicine...but Peace. I needed two doses within 20 minutes...and after another intense bout of pain ON the meds...after a third dose, my mind and body were instantly not at war anymore. Just peace. Could breathe. Stopped shaking. Body relaxed. Doctor asking about my symptoms; vaguely remember describing the pain. Doc touched my belly...."That hurts." Doc moves to another spot. "That hurts." Doc asks, "Does it hurt more to press, or release?" As he releases...."Ouch! Yeah...hurts more to release." Yup... Jim was right, doc suspects appendicitis.

Jim...rubbing my back, holding my hand, stroking my face and hair, telling me he loved me and I was going to be okay. Hearing him talk to doctors for me...something more about appendicitis, CT scan, drinking highlighter neon yellow fluid. Still floating, feeling warm, feeling calm. A few trips to the bathroom....stuff is finally coming out of me... Guess that laxative is working after all!

Card #3: 2 of Clubs
3:00am ? Maybe?
Bright lights. Rolling down the hallway. CT Scan. "Breathe....Hold your breath." Four times. Rolling back into ER. Falling asleep. Waking up. Voices. Jim. Holding my hand.

Doctor comes in. "Well, the good news is your appendix is GREAT. So, you don't have appendicitis. But you DO have diverticulitis with a micro-perforation. Size of the head of a pin. We'll keep you here for 24 hours, give you some antibiotics and monitor you. The infection should heal up and the micro-perforation will likely heal up as well. We'll move you to a room for a bit and then admit you."

Relief. No surgery. Dad had diverticulitis. Must be bad gut genes....

Doctor comes back in. "We looked again, it looks like the perforation might be bigger than a micro perforation, and you may have some air in your mesenteric veins. You have air where you shouldn't have air. We're having a surgeon look at your films for a consult. He should be here in the morning. Surgery may be necessary." after all then? This can't be good. Air...veins.... that sounds REALLY bad to me. So tired. Need more pain medicine. Jim is so tired, but by my side...still holding my hand, rubbing my arms, my back, my face. What a sweetheart, really...

A friend shows up at 4:30 or 5:00am and helps Jim give me a blessing. I hear the comforting words as Jim places his hands on my head, and blesses the doctors, and my body for a full recovery, to have peace of mind, to know I am well-cared for. Floating. Warm. Giving into the fatigue. Exhausted.

Moved to the hospital floor... no idea what time it is. Light begins filtering in the window. In and out of sleep. Musical alarms at the nurses' station...every minute or so. Jim is on the bench/bed in my room. Must be around 6:30 or 7am. More pain meds...Nurse's shift change. Someone taking my blood. Blood pressure. Temperature. Jim has stayed with me all comfort, my rock, my reassurance.

In and out of sleep with the cacophony of musical alarms just outside my door. More medicine. More nurses...talking...SO water, no ice. Waiting for Dr. Simon... the surgeon. Too funny... Dr. Simon... so... Simon Says???? I wonder....

Card #4 Ace of Spades
Heavily sedated morning. In and out. Nurses, technicians. Jim... always Jim...where I can see him, at my bedside. Holding my hand. Touching my face. Stroking my hair. Soft words of encouragement. Calling my family. Texting friends. Waking up a bit more. Sitting up in bed....hoping against all odds that somehow all of this was a bit of an exaggeration.

Dr. Simon arrives with two of his student minions shadowing him. They smile at me, and are silent. I'm awake enough to have a discussion with him. Jim is there with me, listening as Dr. Simon informs us: 1) that I am a remarkably healthy, fit young woman (to which I snort since I'm heavily sedated off my rocker, waiting to be likely sliced up soon...not feeling too healthy actually) and I look MUCH healthier than he thought I would based on the CT Scan. 2) That I indeed have a perforation in my bowel. 3) I do NOT have air in my veins, which is VERY good news, but that the air is from my intestine (upon further cross sections of the scan) which is filling my abdomen and gave the appearance of air in the veins. This air is full of bacteria and if left untreated will form infections and abscesses on my other internal organs and I will go septic in a matter of days. 4) He recommends surgery to remove 10-12 inches of my sigmoid colon where the diverticuli develop, resulting in a temporary colostomy bag so my bowels can fully heal, with a reversal surgery in 10-12 weeks and I'll be completely back to normal. 5) He can do the surgery laparoscopically, he's one of about 25 surgeons in the country who can. 6) Recovery will be 3-4 days in the hospital. 7) Dr. Simon says we can wait a few days, pump me full of antibiotics, but I will still eventually need the surgery to address the perforation and the abscesses will likely have begun developing by then. More problems.

Simon Says: If you were my wife, I'd have you on that table in the OR I booked for you at 12:30pm.

He leaves with his minions in tow....I look at Jim and tears begin to fill my eyes. Jim holds me. Helps me think through it. Offers to get me back to California if I wanted... I think I said something like, "No way. I'm here...Let's just do this. There doesn't seem much point in waiting, It'll only increase the complications." Jim solemnly nods his head and holds me. Breathe. Close my eyes. Smell Jim's scent and just let his words of comfort sink in. Remember my blessing. Believe in the power of it. I'm going to be okay.

Pre-operative procedures and doctors begin to swarm around me...Pain begins to resurge but I know I'm about 30 minutes from going under altogether. Disbelief. Shock. HOW does this happen... NOW? I've lost 85 pounds, I'm stronger, healthier, eat better, in better shape than I've ever been... How does this happen? I was fine 24 hours ago!!!!

Jim accompanies me to the pre-operative station. He holds my hand, wipes my tears and looks at me as he says, "I will be the last thing you see before you fall asleep, and the first thing you see when you wake up! I love you." More tears...fear...and also the hope of my blessing, this wonderful man by my side, good doctors, good health...I'll be okay. I will.

Wheeled into the OR... I see my name on the board, sterile room - no more paint on the walls, no art, no carpet... I think "One Flew Over the Cuckoo's Nest". They ask me to hoist myself onto the operating table... I think I'm going to pass out as I start to cry. "Are you okay, sweetie?" asks one of the nurses. "Uhmmm....not really, I'm really pretty overwhelmed by it all...." Fade out... don't remember any "Count backwards from 100."

Woman's voice: "Shannan...wake up, sweetie. Your surgery is over. It all went really well."
Me: "Mhhhmmmm.... I want to see it."
Woman: "What?"
Me: Tap my tummy
Woman: "You sure?"
Me: Nodding.
Woman: Lifts my gown...
Me: I see the bag. Sigh. Lay my head back down...Drifting. More Voices. More pain medication.

Card #5: 3 of Hearts
Tuesday, March 27th
About 5:00pm
Wheeled into my room. Drifting. Musical alarms. Voices. Open my eyes...I see Jim at the sink in my room. Running water. Flowers. Jim's smile. Gentle touch.

Jim: "Hey, Sweetheart. Your surgery went perfectly well. Dr. Simon did everything laparoscopically. You had a sizable perforation. You're going to fully recover."

Jim sits by my side as the anesthesia wears off....texting, calling, talking to nurses. I'm in and out. He touches me, gently encourages me and talks to me.

My mom is on her way. Jim will pick her up at the airport about 10:30pm. I ask if Jim has slept at all...he hasn't.

Mom arrives about 11pm. I'm still in and out, but mostly awake at this point. Mom holds me. Has tears in her eyes. Strokes my face. Tells me she loves me. Calls me her angel. We all three talk for a while...laugh that I go to this extent to have my mom and Jim finally meet each other.

Jim is exhausted, poor man. He goes home to sleep. Promises to come back in the morning before work. Mom settles into the bench/couch/bed. Restless night...alarms, medicines, blood draws, blood pressure cuffs, etc. Who can rest in a hospital???

7am...Nurse's shift change. Two ladies come in and talk to me about financial assistance. Based on my income-to-bill ratio, I may qualify for sizeable assistance...I either pay a small portion of the bill all the way to the hospital just writing it all off. They will represent me to the doctor, anesthesiologist and radiologist re: their bills. Silver lining....BIG Silver Lining!

SO... This was my hand, not great...not what I had hoped for that day... 2-2s, 2-3s and a 6...not much to shake a stick at...until you realize that two pairs will still beat a pair of Aces. Still isn't a really strong hand, but it could be worse.

I have family who love me, friends willing to help, a boyfriend who was calm and aware enough to help direct me and get me to the right place, the right doctor and be by my side through it all. I have a surgeon who could do this laparoscopically...and this is my fate for a couple of months and then I have the great privilege of being fortunate and healthy enough to reverse this colostomy and be restored to full functioning. Many, many people live with this condition permanently...and I don't have to deal with that.

Am I thrilled about 2s and 3s? Nope...but there are less advantageous hands to have been dealt....

So, let's shuffle...and deal again.

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