Monday, June 9, 2014

The Distinct Sound of the Other Shoe Dropping

They say when it rains, it pours.  In my case monsoon season usually comes early and stays for a nightcap.   I had been cruising along for over two months health-wise after my tense encounter with Denise in early March.  I was still perilously thin, but not dropping weight like I had been.  I had little energy to go out and about, but I was not leaning on the walker any longer.  My progress was enough to avoid any hassle as the summer drew near.
  
But then I woke up on the morning of May 10th, 2013 to find an abscess to the left of my surgical incision.  I could barely stand up straight with the pain.  The abscess was similar to the bleeding under the skin I often suffer when bruised.  I could not imagine how one of those could blow up on the abdomen.  It must have been something else.  The abscess merited a trip to the emergency room.  The emergency room visit marked the first time since I took over the tube feedings that Denise took a more than marginal role in my healthcare.   She did not appear frustrated about the matter.  Her earlier attitude was still fresh in my mind, however.
  
The surgeon who had performed my operation in June came down to the emergency room to drain the abscess himself.  Before he could get there, the problem took care of itself.  The abscess swelled to the point it split the bottom part of my incision back open.  The abscess drained everywhere.  Yes, it was gross.  I ended up with heavy-duty antibiotics after a painful cleaning of the newly open wound.  I thought it peculiar for something like this abscess to suddenly develop, but the surgeon acted as though this sort of thing happened all the time.    His assurance was enough to convince Denise and I that we were not back at square one.  Okay.  Taking care of this newly open incision is not going to be a burden. 
 
 Every care was taken to the letter for two weeks.  I was forced to move about even more gingerly than before the abscess appeared, but other than the discomfort, nothing seemed amiss.  Not that I noticed, at any rate.  Seven months after surgery, I was still dragging.  Resignation set in that was how it was going to be.  But, hey--I still held onto the idea I would not be a whole lot longer myself.  On the morning of May 25th, it looked like I might get my wish.
 
 I woke up with my colostomy bag seeming to have leaked on the incision dressing.  It was not loose anywhere, but what else could have happened/  That is definitely not a good thing.  Neither was the fact I felt unusually cold.  I could not stop shivering as I took off the bandage and got in the shower.  I could not get the water hot enough to suit me, either.  When I got out of the shower, denise wanted to bandage the incision herself.  I obliged.  She took the opportunity to tell me a few thingts I needed to do while she would be down for her own surgery.  One was to keep my laundry separate because I was contagious.  The takeaway here is there was no plan to get rid of me on May 25th. 
  
I tried desperately not to shake while Denise redressed the incision.  I am cold natured, so neither one of us thought it was a big issue.  But then I settled down for a while.  All the sudden, a bowel movement happened again.  It was all over the bandage.  Once again, the colostomy bag was on tight.  I did not like the idea of pointing out the problem to Denise, but I had no choice.  She looked at  both the colostomy and the bandage for a long moment, then declared the bowel movement was coming from the incision itself.  The only way that is possible is if there is a hole in the colon.  Ah, so October was merely a dress rehearsal, I thought to myself.
  
Denise called the surgeon who performed both the October surgery and treated the abscess for advice.  He was the surgeon on call, but advised taking me to the next nearest hospital rather than my hometown hospital.  It sounded peculiar, but okay.  There was no one to watch my six year old nephew, so Denise had to take him and Kirsten along for the ride.  It was a darling sight, with the four of us on a thirty-five minute trip with me holding a towel across my belly to catch any accidents while the kids acted about as casually as could be.
  
When I got to the emergency room, I was immediately prepped for a CT scan.  A half dozen nurses tried to unsuccessfully draw blood.  There was even the possibility of going through the jugular before they actually got enough to run tests.   I laid there a gtood two hours shivering.  I had a bowel movement out the incision in the middle of it all.  I was curious why I was neither in pain, nor nauseous like I should be with a rupture, but was told that was because the contents of my colon had a place to go rather than remaining inside to poison me.  Ah, so I get to go peacefully.  It is about time that was a possibility.
  
The on call surgeon came in after viewing the CT scan.  He told me there was no rupture, but he would not operate on me even if there was.  I had a fissure in my colon, which is a crack caused by poor nutrition.  The contents of my colon was leaking through the fissure and out the incision.  This was also the case with the abscess, although no one looked any deeper at the time to find the root cause of that problem.  He looked at me and declared I was malnourished.  The blood tests showed I was also severely anemic--hence the shivering--    and suffering from a sepsis infection.  He wanted to know why I was not being treated by anyone for these problems before now.  Worse yet, when he called to consult my surgeon, he lied and denied sending to this hospital.  Presumably, he knew from the description  I had a serious problem and handed me off to someone else rather than deal with it himself.
  
Being dumped onto a surgeon unfamiliar with my case in the middle of a serious matter was unnecessary drama considering everything else that was going on.  I did not know what to say about the shape I was in.  I feared another confrontation with claims I was trying to comitt suicide.  I could not get another feeding tube this time to get everyone off my back.  Denise did not have anything to say, either.  I was due for some serious medical treatment.  I was even placed in the ICU after leaving the emergency room.  The next day is when things went completely off the rails.  

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