Map of life expectancy at birth from Global Education Project.

Tuesday, August 31, 2010

Next Episode of As the Colon Churns

This post is not going to be particularly meaningful, but I have to advance the narrative. So what happened after I suffered that horrific bout of paralytic ileus?

I couldn't have any narcotics, because they sedate the bowels, and of course that was the opposite of what we wanted to happen. And I couldn't have any aspirin, or tylenol, or ibuprofen. Those all supress fever. The doctors had to keep track of my fever so they could tell if something disastrous was happening. So I could have no pain relievers at all.

Peter told me to ask for atavan, a tranquilizer, which might help me sleep. He told me I could put a pill under my tongue and dissolve it. Dr. Huang agreed to my request, but things didn't work out the way I expected. Nurse Huang came in a few minutes later with a big, ugly syringe, and gave me a very painful shot in the ass. It might have done some good, but I didn't sleep that night.

I wasn't idle, however. I had developed diarrhea. My nurse -- Nance now, there was a shift change at 4:00 -- gave me a plastic device she called a "hat" that would hook over the sides of the toilet to catch a stool sample. But I didn't produce anything that could arguably be called stool for many days. Instead, I would stagger into the lavatory every half hour to expel a pint or two of pale yellow fluid.

I had to report every one of these episodes to my nurse, and I had somehow to try to catch my urine too so it could be measured. It was a real challenge. I had to urinate standing up so I could use the blue jug with the cubic centimeter markings, but it was far too dangerous to try to urinate before I had relieved my bowels. At the same time, it was a feat of hatha yoga to hold back my urine while my bowels were gushing.

That was not my only problem. Every time I went into the lavatory, I had to push the IV pole in ahead of me and get it positioned correctly so I could wrestle the knee-length smock out of the way and get my pants untied. Then I had to reverse the process on the way out. Every time, the IV got yanked around inside my vein.
In the next two days, I went through four or five IVs. They would stop running completely, or the arm downstream from the needle would get painful and swollen. Now I was more dehydrated than ever. Just because I couldn't stand the thought of drinking anything didn't mean I couldn't, at the same time, feel just as thirsty as a dying man in the desert.

There was never an IV nurse after 5:00 in the afternoon. Once the IV stopped running at night and I lay there desiccating for five hours before someone came to put a new one in. She didn't know what she was doing. First she blew a vein in my left hand, then she tried to put the needle in the crook of my left elbow, in the big vein they take blood samples from, and she blew that one as well. She finally gave up. During business hours, I was considered a windfall instructional resource. The IV nurses would bring students around to jab at me, until I insisted that the butchery stop.

Once, while I was lying in bed, I looked down to see the line full of blood and then I saw that it had somehow come apart. I pushed the call button. When Nance came in, she gasped and said to me, "don't look at the floor." A man came in with a mop a few minutes later and he just said, "Oh man." I didn't look, but from the way the man worked the mop, I figured the puddle of blood must have been at least five feet in diameter.

I said to Nance, "Look, the reason this is happening is the way I have to manipulate my clothing every time I go to the toilet. I have to get this damn nightie out of the way so I can get my pants down, and it keeps getting tangled in the IV line. Can't you give me a regular short pajama shirt?" Well, they didn't have any. The long johnnie was the only upper garment in stock. But she improvised. She got me a surgeon's scrub top. Not only did that put a stop to the repeated torture of blown IVs, but it immediately gave me back a measure of dignity I hadn't had since the night I walked in. I was now the only patient in unit 7B who was not humiliated by his clothing. The scrub top had a flattering cut and was an attractive blue with tan piping; it was closed in the back; it ended appropriately at the waist. I was now dressed like an adult instead of an infant.

That was definitely a win, but I had other problems. Remember I still had the diarrhea. And the fever. And the cramps. The day after the episode of the intubation and vomiting, not having slept for 36 hours, I determined to put an end to the cramping which I thought was doing permanent damage to my guts. I closed my eyes and concentrated on the deranged bit of flesh below my navel. I tried to communicate with it. Every time a spasm began, I would talk to it softly in my mind. "Relax, relax, don't fight your fellow intestines. Go with the flow. Accept the contractions as they come your way. Accept them and let them pass through you." Between attacks, I would visualize the waves of peristalsis flowing smoothly down through my bowels. With astonishing quickness, I gained voluntary control over the spasms and, within 20 minutes, they had stopped.

That was not the whole cure for what ailed me, however. I had gas pains worse than ever, and something new: an occasional sharp stab near the incision that would make me gasp. Whenever I walked, as I did often now, I would feel at least a little pain in that same place, and once in a while it would flare up and stop me in my tracks. The doctors could feel a hard lump there, and I could feel that lump inside me without even touching it. Another development which did not improve my mood was that my right testicle was sore all the time. You tell me why. Having to measure and describe every secretion of my body for my nurses was humiliating. I still could not sleep through all the pain, the diarrhea, the tornados of bells, the stench of burned popcorn, Mr. Karakov talking in his sleep ...


robin andrea said...

This is such a nightmare of an experience, I am seriously blown away by the incompetence. I almost can't believe that there's more to be told, and it sounds like it's about to get even worse. Oy.

I like your meditative response to the pain. Excellent.

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