Tuesday, October 30, 2012

Reasonable Health (part 6)

During the next few days, I received IV antibiotics every 6 hours (12am/6am/12pm/6pm) and the tube that runs out of my liver/back was regularly flushed and drained.  Each day, my fever subsided till it remained between 97 and 99 degrees.  After a few days, the doctors decided to do another CT scan to look at the abscess.  It turned out that it had only shrunk a couple of centimeters (from 6cm to 4cm).  I think I was hoping that the abscess was shrinking much faster.  Then Doc D came in to speak with me about the progress.  He was a gastrointestinal specialist (they deal with the liver) and he stated plainly that I was right on track in my progress.  He said that this was a large abscess and it could take months to completely clear up and that I just needed to be patient and allow my body to do it's thing.

Doc D also stated that these abscesses are relatively rare, but that they are very curable and I was right on schedule.  That made me feel much better.

After Doc D spoke with Doc A and Doc B, they all decided that I was actually doing quite well and that I could go home soon.  Doc A came to see me and mentioned that I might be going home, as soon as today (Thursday).  After she left, Doc B came in to see me again and this time was much more cordial.  She spoke to me while looking at me (which made me feel better) and she was kind in her tone.  She said that I could go home but that she needed to speak with the other doctors first.  After some confusion as to whether I was going home on Thursday or possibly the next day, the decision and paperwork was together for me to go home on Thursday.

I was happy and a little scared.  I knew that I was going to have to take over doing the IV antibiotics at home around the clock on the 12s and 6s.  I also knew that I was going to be sent home with a drain bag hanging off of my back.  Fortunately I was visited within a few hours of heading home by visiting nurses that helped me learn how and what to do when (with the IV antibiotics).  It is an interesting process and not one that you would want to have to do at 5:30am.  However, I was home and that was a huge victory in itself.  Be it ever so humble indeed.

Reasonable Health (part 5)

I think I would be remiss if I skipped over this important moment in my illness/recovery.  Later in the evening when the abscess was drained, I was lying in my hospital room, alone.  As I mentioned in my last post, just the initial draining made a huge difference in how I felt.  Up until this point, I had 7 straight days of unrelenting, uncontrolled high fever along with pretty severe body aches, chills, sweats, dizziness, weakness and a general feeling of crap.  After the draining, I could feel a significant lifting of those symptoms. 

So that night in my room, lying in the dark alone, I said a prayer.  As a rule, I try not to pray for things but instead I tend to say thankful prayers for those things I already possess.  But this prayer was a little different.  I thanked God for the grace that was given me on so many levels.  I thanked God for a supportive wife and prayed for her to receive continued strength to be able to deal with my illness.  I thanked God for the wonderful doctors and their knowledge that was able to help me through this trying time.  I thanked God for all the nursing support and the support of all the medical faculty.  I thanked God for the love my family shows me every single day.  And I thanked God for watching over me. 

This may sound like a simple prayer of thanks, but it had a different twist in that I thanked God for all the folks around me, those who saved my life and for Gods grace for a longer life.

Those folks who know me probably do not realize that I speak with God regularly; I tend to find such talk extremely personal.  However, this moment on that night was an important one for me.  It was a turning point in my recovery.  Not so much because of that prayer, but because of the gift of knowledge possessed by the doctors/nurses and the love of my wife, family and friends.  And that is why I felt that I needed to pray for those folks.

The next morning, Doc B (still slightly aloof), came into my room and asked how I was feeling.  I immediately thanked her for her expertise and for finding the cause of my ailment.  She did not acknowledge the thanks at all, but instead said,

"Where is your wife?"

I responded, "At home I think."

She then plainly stated, "She is very bright."

Confused, I said, "Thank you."

Then she said wryly, "She made you stay here when you wanted to leave..."

Still confused, "I don't remember wanting to..."

"Yes, you wanted to leave and she made you stay. She is very smart."

And with that, Doc B left the room.

Feeling slightly slapped down but with a smile on my face, I recognized the extremely dry humor.  Thank you Doc B, you have no idea how thankful I am for your help.

Reasonable Health (part 4)

After being wheeled into radiology, I met with the doctor who was going to drain the abscess and leave a drain there so that it could continue to drain aver the coming weeks.  Doc C was a serious yet comforting fellow.  He explained that I would be given "twilight" anesthesia (the kind you are give with a colonoscopy).  Having gone through this procedure a few times in the past, I assumed that I would be essentially asleep.

I was wheeled into the CT scan room and asked to climb up onto the CT machine gurney face down with my head toward the machine.  I was then asked to place my hands over my head, sort of like I was diving through the machine.  I was then hooked up to heart monitors and given a local anesthesia for the area he was about to drain from.  After that, I was given the "twilight" anesthesia in my IV line.

A few moments later, I noticed that, although relaxed, I was still wide awake.

They asked, "How are you feeling?". 

I responded, "Wide awake, just reading the printing on the boxes stacked against the wall in front of me".

Doc C said, "Let me know if you feel any pain."

Amazingly, I did not.  I did feel some pushing and pressure in the area of my liver, sort of like someone was holding my liver in their hand and moving is about some.  But there really was not any pain.  As I laid there face down, I could hear the doctors comment that they were removing a good bit of abscess fluid.  And in very short order, they were done removing the fluid.  In the same place that they used a large syringe to remove fluid, they places a plastic tube as a drain to allow the abscess to continue to drain.  The drain comes out of my back and connects to a longer tube that runs to a drain pouch that I hand down on my leg on my right side.

I can say that once they drained the area inside my liver, I felt immediately stronger and my fever went down dramatically.  It was really uncanny the difference.  In fact, when I called to Sara who was in the waiting area just outside the CT scan room, I could hear my voice sounded much stronger and clearer.

Once the local anesthesia wore off, the pain really began.  I found that there really is not a comfortable position, except slumped forward in a chair, that can accommodate a drain tube in your back.  Laying on your back causes spasms that make it near impossible to breathe.  Lying on your side is comfortable for very short periods of time until your back seizes up and again the spasms start.  Lying on your stomach works best but again is only good for about half and how before the spasms begin and you need to get up and stretch in a chair.

I realize that this must sound like kvetching.  After all, my life was saved by this procedure.  And to a certain extent, I am kvetching.  But I am trying to be honest about both the positive and negatives of this experience and I would not be true to the experience without relaying the overwhelming pain and spasms that are part of this recovery.  It is the one thing that I cannot get away from and it interrupts my sleeping, breathing, eating, laughing, burping, coughing and my ability to move.  Imagine that you are just breathing in and someone punches you hard in the gut knocking the breath from you; that is very close to the experience I feel.  And these spasms seemingly come and go on their own (but are generally worst after having laid down to rest for some length of time).

The first day after having the drain in, a good bit of "fluid" fulled the drain pouch.  It was sort of the consistency and color of V8 juice with a goodly amount of Worcestershire sauce added, the color of a Bloody Mary.  The nurse came in, drained the pouch, measured the fluid and flushed saline into the line that ran to my liver to keep the line clear.  As the days went on, the liquid became more and more clear and a lighter color, more like strawberry Juicy Juice.  In addition, my fever went from around 100 degrees down to normal in the next two days.  From here, it was just a matter of time till the doctors would do another CT scan of the area to determine whether the abscess had shrunk.

Monday, October 29, 2012

Reasonable Health (part 3)

Friday was an interesting day.  I was on IV fluids, so my fever steadied a bit, but the doctors were still not sure what was going on.  I was still feeling a bit fragile from a solid week of high fever and the traumatic rigors I had experienced the night before.

In fairness to the wonderful doctors that treated me, I am going to label the doctors with letters so that they will remain anonymous.

I believe the first doctor I saw was a "hospitalist".  These doctors specialize in getting you the right doctors for your particular problems.  In addition Doc A was obviously very knowledgeable and quite upbeat; something desperately needed after a week of high fever.  Doc A told me that she would be sending an infectious disease specialist over to see me (Doc B).  Doc B stopped by later and was pretty clear that she did not believe I had a virus, but instead I must have some sort of biological infection like an abscess somewhere in my lung/abdomen area.  Doc B is a brilliant doctor who came across kind of aloof and disconnected.  I noticed that she did not look at me while she spoke to me but instead stood speaking past me, looking at the wall.  She mentioned that she would be taking me off ibuprofen to see how bad my illness would get.  I told her about the rigors I had experienced the night before and asked if she could do anything for that if it happened again.  She responded that she was not concerned with the rigors, and I responded that I was and was not comfortable with any place that would allow that to happen again.  Sara said, "we are not going anywhere." and with that Doc B walked out of the room.

A short while later, the nurse told me that Doc B ordered a CT scan (Cat Scan) to check out my abdomen and that I was not going to be allowed to eat anything.  A while later, the nurse came in with the first dose of the radioactive apple juice.  An hour later came the second dose and an hour after that I was taken down to get the CT scan.

About two hours after the CT scan, Doc A came to my door looking very happy.
She exclaimed, "We found the problem, you have a 6cm abscess in the center of your liver!".

Sara and I were a bit confused with her smile since it did not sound like great news to us.

I said, "What does that mean?".

Doc A responded, "We can drain the abscess and put you on antibiotics to shrink it."

My response was, "When do we 'drain' the abscess?"

The doctor stepped to the side of the doorway and I could see a gurney there with a nurse ready to take me to have the procedure done.

I said, "Do I have time to pee?"

Doc A said, "Sure"

So I did and then we were off to radiology to have the abscess drained while the doctors looked at my insides using the CT scan machine.

Tuesday, October 23, 2012

Reasonable Health (part 2)

After receiving the go ahead to go to the hospital from my doctor on Thursday afternoon, Sara drove me over to Chester County Hospital at about dinner time.  At this point I was so weak that I really could not stand or even sit upright for very long without becoming extremely dizzy and weak.  When we got to the emergency area of the hospital, they brought a wheelchair right up to the car since I did not really have the strength to walk very far.

I am not sure if it was my condition or the fact that they were not very busy, but they took me in for triage immediately.  After getting a quick look at my condition, they took me back to the emergency area and started to work on me.

What happened during the next few hours is a bit of a blur to me now.  I do remember that they took me to get chest xrays to check for pneumonia.  They also hooked me up immediately with an IV drip because I was dehydrated from excessive sweating.  I also remember that I was wearing a heart monitor.  Other than that, those hours were dotted with various doctors coming to assess what was wrong with me and visits from nurses.  After a few hours of receiving liquid via the IV drip, my fever seemed to lower a bit and level off.

It was now close to midnight and the attending doctor made the decision that I was more stable and could go home.  I was elated.  At that point, the doctors thought that I had a non-specific virus that had gotten a bit out of control and that bed rest with lots of fluids would be the answer.  They removed the IV from my left arm and had Sara sign the release waver.  I began to put on my street clothes when it happened.

In a matter of moments, rigors set in.  For those of you not familiar with the term, rigors refers to the shaky chills one feels when your body sets a new set point for body temperature in the hypothalamus.  The feeling is very similar to when you are exposed to extreme cold and cannot get warm.  Your body shivers and shakes in an attempt to generate enough heat to keep you warm.  But this was much more dramatic.  I began shaking in my legs and alternately in my upper body and arms.  I immediately asked for blankets from the nurses, but they were unwilling as they exclaimed that covering me would only cause my fever to rise too much.  Sara grabbed both my jacket and her jacket to give me some warmth, but it was a little too little too late.  By this time I was shaking uncontrollably.  In fact the shaking was to terrific that I could no longer breathe easily or steadily.  The best I could muster was occasional gasps.  The nurse asked if I wanted a Motrin, but I could not respond as I could not get enough air into my lungs to form even a simple yes or no.  Sara noted that it was at this point my lips were blue from lack of oxygen.

In addition to the inability to breathe, I could feel muscles all over my body getting pulled too tight.  My ribcage muscles ached from over tension, as did my thigh muscles, arm muscled, back muscles and neck muscles. About 15 minutes into this minor drama terror, the doctor showed up and obviously did not like what he saw.  He immediately rescinded the release waver and a new IV was installed in the bend of my right arm as the rigors slowly subsided.  The whole episode lasted about 20 minutes, but the fear of the event and the pain from pulled muscled lasted for the next few days.

In the next hour and a half, the hospital found me a room and I was taken there.  It was now around 1:30 in the morning on Friday morning and I sent Sara home.  It had been a full night for both Sara and I.

Monday, October 22, 2012

Reasonable Health? (part 1)

Let me start off by saying that this one blog, may be the most personal I have or will ever post (time will tell).  If you find yourself getting skweemish from the writing, please understand you are always free to stop (even now) and look no further.  What I am writing about is a pretty serious health issue that happened just this last week and is still happening. Obviously, this is of serious importance to me but also many of you reading this might find some information that could possibly save your life sometime down the road.  Just to allay your possible fears, whatever you think happened is definitely wrong.

Last Saturday morning, I was working around our house getting ready for a gathering we were hosting later that afternoon.  Sara, James and I had the house pretty much together by noon, so I went to work putting together some food for the social.  You see, the gathering was a group of new faculty that had joined the school where my wife and I work and the folks from the meeting were we are members.  Who these great folks are is actually of very little import to the story so that will be left out.  They know who they are.  :-)

By 1pm, I started to feel a bit feverish and a little dizzy.  Since we were 98% ready, I adjourned to my bedroom to rest.  At that point I checked my temp and found it to be a mere 99.5 (all degrees in Fahrenheit, sorry rest of the world ).  Still, I was beginning to feel weak, so I laid down.

About an hour later, I awoke and checked my temp again, 100.5.  Now I was getting concerned.  I called Sara upstairs and told her the news.  She and I agreed that it was too late to send everyone away, but that I would stay in bed away from the gathering, while she hosted.

From the quiet of the bed, it sounded like folks had a great time meeting each other.  They stayed the 3 hours scheduled for the pot luck meet and greet and headed home at about 7pm.  A few very helpful folks stayed for another hour to help my wife clean up and left.  At that point, my fever was about 102.

In addition to the fever and the dizziness and the weakness, I was beginning to feel very achy all over my body (read the joke about the guy who hurts all over) and I was definitely starting to feel nauseous.  This day was not going well for me, and I was beginning to feel like I may have picked up the flu somewhere.  That night, I met a fever of 103.5 which convinced me to take a dose of aspirin and go back to sleep.

The next morning was the beginning of a roller coaster of fever; up to 103 and back down to 99.5, over and over again.  My appetite completely disappeared and there was not a spot on my body that did not hurt.  Even my teeth hurt!

I began drinking lots of clear liquids; water, apple juice and ginger ale.  I even worked very hard at eating some apple sauce and the very occasional banana.  There were times where I thought I might be turning the corner, and there were lots of times where it was obvious that I might be getting worse.  I was so sure that I had a flu, that I did not bother to contact my doctor will Tuesday that week. 

After examining me, he was not so sure it was the flu (smart doctor).  But I was so sure that I convinced him with a true story that 2 of my students the previous week had come to their lessons immediately after recovering from flu viruses.  He let me go home with the caveat that I would contact him on Thursday if the fever did not drop to below 102.  On Thursday, I recorded a fever of 102.5 and contacted my doctor.  He sent me immediately to the hospital.