Immediately following my procedure, Larisa and I hiked through the hospital (think several city blocks…for real) to visit a friend who was recovering from surgery. My first solid recollection after my procedure is sitting in the room sharing the success stories of our respective experiences. I have no memory of getting to her room. After this visit, Larisa and I headed down for some lunch.
The doctor who performed my procedure said to expect some bleeding the next couple times I used the restroom, but that things should clear up shortly. Having no colon, I am pretty regular, and I had to use the toilet immediately following my procedure and once again, an hour later, right before lunch. This is when the trouble started.
As I exited the restroom and headed to the restaurant (still in the hospital), I started to feel weird; similar to the sensation you get sometimes when you’re sitting or lying down and stand up too quickly. As I grabbed a tray and started doling out soup, things got progressively worse: ladling was more complicated than usual. There was a restaurant employee cleaning up beside the soup tureens, and I had a hard time figuring out if I should stop and move. Then I started to feel weak, and I handed my tray to Larisa so I could go take a seat. Unfortunately, I only made it about three steps until I slumped back against a counter as my head swam. The last thing I remember is my vision narrowing, and Larisa standing in front of me asking what she should do.
I came to sitting in a chair in the restaurant, weak, sweating, and totally muzzy headed. After the fact, Larisa told me that she had been forced to put down our tray, put her arms around me, and help me walk from the food area to the seating area; probably over 60 feet. There we sat, panicked as to what to do next. I tried to call my doctor, but through the fuzzy-headed fog was unable to navigate the phone hurdles set in place. Larisa asked a doctor sitting close by what to do and he said to call 911. She did, and was informed that since we were actually in the hospital, they could not respond. Fortunately, the doctor who Larisa spoke with saw my state and called the Hospital’s emergency and cardiac response teams, who were on the scene in about 3 minutes.
When the response team was able to ascertain that I wasn’t having a cardiac episode, they turned me over to the paramedics who had just arrived. The paramedics got me onto a gurney, wheeled me to an ambulance, started an IV, and drove me several blocks around to the ER.
In the ER, they immediately drew blood work and did an EKG. Not surprisingly, I was very dehydrated as a result of prepping for my procedure and the ER doc order IV fluids. We explained our situation and our concern that my intestine had been perforated as a result of my procedure; pretty quickly, I was sent for X-rays to see if anything was leaking on the inside.
As we waited for the test results, I continued to need to use the bathroom every 30-90 minutes, all with the same bloody result. As the test results rolled in, the news was all good: blood counts were very healthy, nothing on the X-ray, and as a result of the IV fluid all my vitals were back in line. The ER declared victory, writing the episode off as a result of dehydration and sending me home. We discussed several times doing a GI consult, but I don’t think that ever happened.
In retrospect, I should have either demanded a GI consult or refused to leave until the bleeding stopped. Although the ER folks asked if I was still bleeding, they neither checked the results in the bowl or had me go into a container for inspection. I should have forced this issue. Neither Larisa or I was comfortable with the discharge, but home we went. Going home from the ER was a very bad decision.
Friday night was rough. I maintained my bloody pattern with no relief. Larisa and I kept asking what exactly a “couple” bloody movements meant. While I slept OK, Larisa was gripped by fear and had a very hard time sleeping.
Saturday morning we resolved to call the GI fellow on-call if things hadn’t improved by noon. About 8, things started to improve a little. During the course of the morning we took a long walk and I noticed that I was more winded than I should be for a leisurely stroll up and down the street. It’s not as if I’m a 26.2 guy, but I do walk/jog 3-5 times per week and push myself fairly hard for 20 minutes. Strolling for half an hour should be no problem.
During devotions, I took a long time praying and asking for two things: first, that God would speak to me. Chastisement, direction, comfort or encouragement…I just needed to hear from my Father. Second, I prayed that He would help me to make a good decision. Paying another $250 ER visit co-pay wasn’t high on my list, but neither was getting critically ill. I opened the Bible to Acts 13 where Paul is addressing the synagogue in Antioch of Pisidia. As Paul recounted God’s faithfulness to His children and his delight in His servant David, an inexpressible peace flowed through me: it was going to be OK. I was going to be OK. (For the record, I realize that I am not David, king of Israel. However, I suspect that most of us with Biblical names take special note when we pray to God for guidance and then see our names in the passage we read).
Shortly after 11, I passed a lot of blood once again and called the GI fellow. The doctor responded immediately, was very sweet, was able to access my records, but after about 10 minutes indicated that my only options were to wait it out or go to the ER (she also indicated that the pictures I took wouldn’t be helpful…yeah, yeah I did). Larisa immediately made me pack an overnight bag, but I thought we should still wait. About noon I noticed some dizziness when standing up or using the bathroom, and that was the final straw. We called my parents to watch the boys and, after praying with my boys and playing one last game with them, Larisa and I headed back to the ER.
It turns out that there are two areas in the ER: the “this guy ain’t so bad and we’re gonna send him home” area and the “uh-oh, this is serious” area. On Friday I had been to the former area and after clearing intake on Saturday I was once again channeled to the “give him some IV fluids and send him home” side of the house. While waiting for the doc to see me, a paramedic came in and started an IV. Gentlemen, let me just say that you never want a male to start an IV or draw blood; they always turn it into some sort of macho-pain competition. Guys: pick the female phlebotomist. Every. Single. Time.
I headed off to potty break #1 in the ER, and my nurse had the wherewithal to put a hat down. This keen little device looks like, well, an upside down hat, and it sits inside the lip of the toilet bowl to collect…stuff. Upon completion of my duty, the hat contained ample evidence that I was, in fact, passing a lot of blood. Back in the room, a resident and med student came to see me. Interesting aside for the folks at work -- the resident was a Podiatrist. Anyway, they studiously avoided the full hat in the corner and ordered some IV fluids.
Next up: nurse shift change and potty break #2. Larisa and I sat. And sat. While nobody was actually coming into the room, Larisa was shamelessly eavesdropping on the conversation at the nurses’ station. Apparently my hemoglobin had dropped from 14.7 the day before to 11.7 when I was admitted to the ER on Saturday; this, finally, caught the attending physician’s eye.
Things started getting really exciting as I headed off to potty break #3&4 (I was only planning on one as I headed out). The frequency of my potty breaks, as well as the amount of blood that I was losing, had picked up markedly since I got to the ER. #3 was a mess and as I rose to wash my hands, I felt a little woozy and contemplated pulling the nurse string in the bathroom. However, before I could finish washing my hands, #4 announced it’s presence with a great deal of urgency, and I sat back down. You’d think that the 90 second interim would lessen the amount I was passing, but not so (note here, this is not exactly uncommon for folks with no colon and strictures… things don’t always play nice).
Standing at the door to the bathroom after washing up, definitely feeling light-headed, I had a decision to make: pull the cord for the nurse or walk the 25 feet past the nursing station and back to my room. I did what all self-respecting males would do and staggered down the hall. I even had another chance to make the right choice at the nursing station immediately across from my room. However, rather than just asking for help I bolted toward my bed.
I only made it as far as the door. As I slumped against the door-frame, I called Larisa’s name in desperation as the blackness swam up to meet me (this is real folks.) Just like in the restaurant the day before, the last thing I could see was my wife, panicked, coming to my side. However, unlike in the restaurant, my legs didn’t hold out. We made it five steps when I went completely out, slammed against the bed, and hit the floor.
In answer to my prayer earlier in the morning, we had made the right choice by going into the ER. Any earlier and we’d probably have been sent home after receiving IV fluids. I shudder to think about what would have happened if we had tried to wait this out. We were in the ER. We even had everyone’s attention. Finally.