Referred Pain

Tuesday was the day it dawned on me that something I thought of as referred pain from my back was a whole new problem.  For awhile now my friend up the street has been telling me I didn't look good.  She'd say things like, "You don't look like yourself." And yes, I did have deep bruised looking circles under my eyes; back pain can wear you out.  But Tuesday the back pain turned into gut pain.  Every step hurt my gut.  I found myself holding my breath or breathing like a woman in labor.  I had a doctor appointment scheduled for Thursday, and I thought I should just take it easy and wait for my appointment with her, but by 5 PM I was in a whole new kind of agony and feeling like I had a fever as well as unbearable gut pain. I have gall stones that have never hurt me, but I thought maybe it was the gall stones finally come to really do me harm.  Since I'd spent the day on twitter I threw the question out there and several people chimed in with questions and suggestions but eventually all the advise was saying "Get thee to an ER, STAT!"

I'm one of those cold blooded people with an abnormally low body temperature. 98.6 is a fever for me.  I took my temperature and it was 99.7.  I waited a half an hour and it was 100.1.  Just before I called my neighbor to ask her what she thought I should do, my gut started to hurt so bad I was doubled over with agonizing pain.  She heard the panic in my voice and said, "grab you purse; I'm coming to get you."  I'd been taking 800mgs of Ibuprofen to deal with the pain but forgot that it should have lowered my temperature as well.  When we got to the closest ER, which is the old St Marks Hospital where my grandfather had been Chief of Staff and is now the new Salt Lake Regional Hospital, the pain had started to localize to the lower part of my gut on the right side.  My friend said, "That's where your appendix is" so when we got inside the ER I was sure that was going to be the diagnosis.  On the way to the ER in her car I was gripping my hands together and holding my breath trying to cope with the pain.  When we got inside my friend noticed that I'd burst a blood vessel in the middle finger of my left hand; the finger was a deep blue/purple and the bruise was spreading.

Fortunately as I was getting ready to leave home with my neighbor I grabbed all my prescription drugs because I knew I wouldn't be able to remember them all.  I'm on a lot of prescription drugs.  Don't do it. Do not lecture me on the horrors of pharmaceuticals.  I'm bipolar. Without those drugs I'd be dead, a suicide. It is the leading cause of death among those of us with bipolar disorder.  Then there is the atrial fibrillation.  That's another three drugs including the Warfarin.  There is a blood pressure drug, a baby aspirin, and a double dose of a statin drug for my high cholesterol which is genetic and can't be controlled with diet.  Let me think, is there anything else?  Well, yes, yes there is. There is the diazepam I take for the occasional panic attack or chronic anxiety. I take three 800mg Ibuprofen a day, I take one of either of two drugs for the kind of headaches I get.  Then there is the Triazolam I take when I can't get to sleep.  I know it 's a lot of drugs, but all my seven doctors have my list of RXs and the pharmacy checks for drug interactions whenever anything gets called in, so get off my back about it.  Are you a doctor?  Well then do not lecture me.  In the olden days I'd have died in my teens or twenties.  I think I'm a fucking medical miracle, and I do not abuse any of these drugs.  My doctors would know very fast.  I never exceed dosage and I don't use the diazepam every day.  In fact some months I don't use it at all. I'm a very compliant patient.  I know my life depends on it.

We waited in the empty ER waiting room for fifteen minutes before they came and got me (very fast by any ER standards).  By now I'm moaning and doubled over.  They took my vital signs and my fever was starting to come down.  But it sure didn't feel like it to me.  They drew blood and took a urine sample.  It was only minutes when the ER doc on call came in and told me they needed to do a CT scan of my gut.  I thought "groovy" until they brought in the quart of lime green liquid I was supposed to guzzle.  I have no idea what it is because by now I'm delirious with pain and unable to actually track a conversation.  I do know it was vile tasting and as I was drinking it I thought I might vomit.  Once in the CT room they inject a dye in the IV line taped to my arm.  I don't even remember when they inserted the IV line I was in such pain.  But it was in the crook of my left arm, the only half way decent vein I have (I've been told a million times by lab techs who have to draw blood from me that I have terrible veins; they are tiny and they roll).  I've had lab techs try over and over to insert a needle into one of my veins and fail over and over.  That I don't remember the nurse in the ER inserting an IV port in my arm amazes me; it's usually such a trauma. Not for me so much as it is for the frustrated lab tech.

When they come with the results of the CT scan, I'm fully expecting them to say it's either my gallbladder or my appendix.  But no, it's my colon.  I have an abscess and diverticulitis or diverticulosis.  I'm still not sure what's the difference, but I do know that the pain is killing me.  The pain is unbearable.

While we wait for the surgeon to arrive and decide if they're going to drain the abscess or take nine inches off my colon, they ask me if I'm allergic to anything.  I tell them I'm allergic to two things: Celebrex and all narcotics. They ask me what happens if I'm given a narcotic.  I say I start vomiting and don't stop until the drug is out of my system.  (This has probably saved me from heroin addiction). I tell them that the only way I can take a narcotic is if I'm given an anti-nausea drug first and that the anti-nausea drug has to last as long as the narcotic.  So they inject an anti-nausea drug into the IV port; then they inject Dilaudid.  Even with the anti-nausea drug on board I still get nauseated, my mouth fills with saliva like it does just before you puke, but I do not start vomiting.

At this point it's clear they're going to admit me to the hospital.  The surgeon says they'll treat me with Levaquin, Flagyl and IV fluids since I am severely dehydrated, and then depending on how that goes, they will or will not either drain it or remove it.  (Honestly, I've never been big on water since it doesn't have caffein in it).  Juices and soft drinks are okay, but really they're mostly too sweet.  So I drink coffee in the morning and tea the rest of the day.  Some of you may judge me, but I drink really good coffee and very good tea.  What I lack in variety, I make up for in quality.  At least I think so.  Interestingly no one's giving me a lecture on my dehydration except my neighbor who always asks me if I've had any water whenever she sees me.  So what water I drink is mainly to placate her or take my handfull of pills with. If I were outside working in the yard I'd get thirsty for water.  There are plenty of things I could do that would make me sweat and crave water.  But during the winter and being so reclusive and all, it just slips my mind most of the time.

At this point, while we're waiting to find out what room they're putting me in, I ask if I can go outside and have a smoke.  The Dilaudid has taken the edge off the pain and that reminds me that my nicotine level is low.  A nurse volunteers to take me out to the smoking area.  Turns out she was jonesing for a smoke too.  See, there are very many medical professionals who smoke cigarettes.  I know this in part because Ms M works in the University Hospital ER. A lot of EMTs smoke too.  It's stressful work.

When we go back inside they've decided where to put me.  I'm going to "overflow" which turns out to be a section of the maternity ward that is no longer needed.  It's called the Postpartum Ward.

(to be continued)