Sunday, October 24, 2004

Not your ordinary stomach ache, part II

Be warned, gentle readers, more medical experience described, reader discretion is advised.

Hello Kari:

WebMD.com is a very popular destination for those looking for health information. What I recently had was an intestinal obstruction.

Picking up the story where I left it, the ER didn't look too busy. It certainly was not the beehive of activity you see in the long running NBC show ER. I filled out the forms and described my symptoms and took a seat. It was about 10 minutes later they did a quick blood pressure, temperature and medical history. I returned to my seat after that.

Between the stomach pains and the post-midnight hour, my recollection of the sequence of events and timing is foggy. I think it was around 2 to 2:30 AM that I got called into the ER exam room to be seen by the MD on duty.

They asked for a urine sample and the nurse drew some blood samples. The doctor asked a bunch of questions and then examined my abdomen and said: well, given what we have so far, I'm thinking, appendicitis.

I think at this point, an IV was plugged into my right arm for fluids and to give me medications. I drifted in and out of sleep as I awaited the next phase.

The ER doc showed up and said, well, an elevated white blood cell count usually goes with appendicitis and we didn't see that. We are going to order up an abdominal CT scan. I was carted off to the imagining unit and I was able to slide myself off my ER bed onto the CT bed. That bed slid me into the doughnut for a variety of imaging including one involving contrast material. I leave it to your imagination to figure out how contrast material is introduced into a patient in a gurney who is being checked out for an intestinal blockage. Suffice to say, dignity and comfort take a backseat (and rightly so!) to figuring out what is wrong.

Eventually, I was back in the ER and drifting in and out of consciousness. This time the ER doc was joined by another doc. He said he was a surgeon and he said that the CT scan revealed an intestinal obstruction. He said the blockage could be due to a solid object such as a tumor or scar tissue. He said the intestine could be kinked like a water hose for various reasons. In any case, he suggested surgery for that afternoon. I scrawled my signature on various consent forms.

To prepare for the surgery, I had a nasal-gastric tube inserted. The guy prepping me was very good to explain what he was doing. He said, one can be inserted very rapidly in an emergency situation but since I was awake, he wanted to explain what was going to happen. He injected some surface anesthetics into my throat and into my nose. He then started to thread the tube through my left nostril. Even with the anesthetic, I could feel it work its way through my nasal cavity and then go down the back of my throat. He then explained the last phase is to get it into the stomach and voila, it was in. He then explained I'll vacuum out the remaining contents of your stomach in prep for the surgery and for the post-operative phase.

The next thing he needed to do to prep me was the attachment of a Foley bag. Since I'll was going to be in post-operative care for several days and not very mobile, it is difficult to relieve my bladder on my own. Thus, a bag with a tube is inserted to facilitate this bodily function. I'll leave it to your imagination how that is done!

As I waited for surgery, I had a brief window of time to make some phone calls to family, friends and co-workers to explain my situation.

Since the surgery suite wouldn't be available until 1pm, I had to wait. I was given some pain medication to tide me over and as such, I drifted in and out of awareness. I couldn't help but think of those war movies where someone shouts, "Medic!" And the medic gives the wounded soldier a little injection of morphine and the injured man calms down. I had no energy to be thrashing around but the pain was quite the constant companion and when the injection would go in... I could feel my whole body lighten and my mind go foggy and the pain would be reduced substantially.

Eventually, I was wheeled to pre-op and it was a beehive of activity. It was Grand Central Station for patients being processed for surgery. As I was wheeled in, I saw two other patients wheeled out to their respective surgeries. As I was wheeled out, I looked over at the guy who was next in line and we gave each other the thumbs up.

The surgery suite looks just like in the movies though it wasn't as brightly lit as I thought it would be. Would there be music playing like in the television shows? Indeed, a little rock music was playing quietly. The anesthesiologist noticing I was Chinese said something in Mandarin. I responded in Cantonese saying I spoke very little Cantonese. She said okay, I guess we will stick to English and the staff laughed. She put the mask over my face and in about 3 seconds the world went away...

To be continued...

Take care and be well,
Rene

Part I

Part II

Part III

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