Tuesday, April 8, 2014

One Foot in the Grave with the Other Slipping? Not Exactly.

If you are still reading, I have to assume you are at least marginally interested in my health status. When we last met together at The Eye nearly a year ago, I was still in very bad shape from undergoing surgery on my colon the previous October. My recovery had been stagnant from October to January when I had a feeding tube put in and went through a stint in HealthSouth. I entered Health South weighing a mere 68lbs and dependent on a walker to get around what little ways I could. Discouraged? You bet.

The period between February and May saw me at home struggling with a recovery that had advanced from stagnate to a mere crawl. I gained only six lbs in spite of four tube feedings on top of whatever real food I could get down, which was admittedly not much. I barely weaned myself of the walker. I was still wobbly as a newborn calf. It is a wonder I never fell. In fact, the home healthcare nurse advised me to carry my cellphone in my pocket when I had to go to another room in case of such an eventuality. We never covered what might happen if I fell on the cellphone and broke. How would I get help? Boo is a good cat, but Lassie she ain’t. I chalked the possibility up to pessimism and kept the concern to myself.

I went to the emergency room in early May with an abscess near my surgical i8ncision. The abscess was drained in the emergency room by the same surgeon who had operated on me the previous October. He slapped a bandage on the now half open incision and said the abscess was the result of a bacterial infection. Keep it clean, take some antibiotics, and everything will be fine aside from fumbling around half bent over like I have a hernia for a while.

Guess what? The surgeon misdiagnosed badly. I am going to have to be a bit disturbing here, but you need to appreciate how the following felt. I woke up on May 25 covered in bowel movement. I assumed my colostomy bag had leaked. Such is not as rare an occurrence as I would like. I felt very weak and was shaking no matter how warm it was, so the assumption was I was sick anyway and I always have bowel problems when sick. I took the bag off and showered. Again, I could not get the water hot enough to keep me warm. When I got out of the shower, my sister, Denise, helped put a new bag on like she always does. I cannot see well enough to replace the bag myself. She also changed the bandage on my incision. We both worried about bowel movement having gotten inside it.

I laid back down because I still was not feeling well. A few minutes late, I had another bowel movement that went everywhere. It is impossible. We just put a new bag on! Doubly impossible, the bag was perfectly fine. Bowel movement was coming from the incision. The only way that would be possible is if there was a hole in my colon. October had seen me suffer a burst diverticula. A warning shot, perhaps? Here I was seven months later with what looked like a full fledged, potentially fatal rupture. On Memorial Day weekend, just to make things interesting.

The surgeon who had been working on my all this time--and blew diagnosing the true condition of my colon days before--told me not to go to my hometown hospital, Carolina Pines. Go to McLeod Regional Medical Center in Florence instead. So a few minutes later, I am riding in the car, holding a large towel to my abdomen and wondering--literally--if this is the end. I was not in the slightest bit of pain, but still felt odd. Was I feeling the effects of peritonitis? Neither Denise nor I knew or even talked about it. I had another bowel movement into the towel on the way to McLeod, so there was something else to think about.

The emergency room experience was quite a shock. The attending physician was appalled at my condition. I was considered dehydrated, malnourished, anemic, and suffering from a sepsis infection in my open incision before a surgeon was ever consulted. After a CT scan, it was determined by said surgeon when he was consulted I did not suffer a colon rupture, but a fissure instead. A rupture is a tear caused by a variety of things; a fissure is a crack caused by malnutrition. He was relieved there was no rupture because he would have had to ethically refuse to operate in the shape I was in.

Which was not to say a fissure was a good thing. They are treated by a patient going on a liquid diet for six to eight weeks to give the colon time to heal itself. A patient typically loses thirty or more pounds on such a diet. I weighed 74lbs. You do not have to be a math whiz to figure out I could not treat the fissure without keeling over dead in about a month. So we did the next best thing. I became that rarest of birds--a guy with two colostomy bags at once. Because oddly enough, I could still go to the bathroom regularly, too.

I am going to stop the narrative here. My health status quickly became a secondary problem, if you caqn believe that, which is a whole other post or ten for the near future. Suffice to say, I spent a long time in the hospital and an even longer time in McLeod-Darlington for rehab. This is the beginning of my falling off the grid, not to mention wandering about trying to figure out what to do next. I was not able to let much of anyone even know I was still alive until February. I hate to leave the situation so cryptic, but explanations do not belong in a post exclusively about my health status. Sit tight. More answers, such as they are, will be forthcoming.

But the here and the now. The incision closed up after a month. I no longer had to wear a bag over it, but I now must take medication to keep the fissure from draining. Blood transfusions and supplements have eliminated the anemia. Antibioticsw cleared up the sepsis infection. I have gotten a nightly, slow drip tube feeding. The drip is the equivalent of ten Ensure drinks or 2500 calories. This is on top of three square meals and snacking. I now weigh 102lbs. That is 34 lbs heavier than last January when I sunk to my lowest weight ever and seven lbs heavier than I have ever weighed in my life previously. Months of daily physical and occupational therapy have ended my dependence on a walker and rebuilt muscles I thought were gone forever. It has take eighteen months, but I have recovered from the burst diverticula and its aftermath. Physically, at any rate.

There you have the lowdown, healthwise. I still have and use the feeding tube. I still have the fissure. I do not foresee any circumstances in which risking the loss of thirty lbs will make treating it worthwhile. I still have diverticulitis, but the medication I mentioned above to control drainage has made it unlikely I will face bowel obstructions as I have in recent years. My healthcare is more diligent these days. As I mentioned above, there are many other new circumstances, but those will keep for a more appropriate later post.

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