[note that dates are probably wrong. I have no sense of date/time at my best, and I haven't been my best in a while]
On Monday, I was pretty low energy, but figured a few nights' sleep would put me right. When I woke up on Tuesday, I felt thoroughly wretched. Stomach ached something fierce, no appetite, no energy. Finally had fizzygeek haul me off to see the doctor. My regular MD was out that day, so I saw one of the other people in the practice. He poked and prodded and came up with no clear cause. His best guess was just constipation, so he ordered abdominal X rays and suggested taking a laxative. We hied directly off to the imagery center and got the X rays, hoping he'd call back later with more information.
No call that day, still felt horrible the next day, so fizzygeek called the office again, and got an appointment with my regular doctor. He said the X rays didn't show anything out of the ordinary, and did the usual poking and prodding. He also came a cropper, but his best guess was appendicitis (even though there was no fever or nausea), and told us to go to the emergency room.
The emergency room protocol had changed a bit, you fill out a slip and come answer questions when they call you. So I sat down while the clerk took down information. She wanted to know why I was there. I told her my doctor had sent me, suspecting appendicitis. This confused her, as I didn't have any fever or nausea, but they admitted me anyway. Eventually the persom came by to draw some blood, and fizzygeek made sure to point out that I was needle-phobic. She poked and prodded both arms and hands, and decided to call in the professionals. I really appreciate when people do this for me instead of just hoping they'll manage okay. A little while later, another woman came in, and said she was quite equal to the task. As she had the same first name as fizzygeek's mom (who is a top-notch phlebotomist), we took this as a good sign. Sure enough, she did a combo blood draw and IV insertion that didn't ache when it was in! I was so impressed and relieved.
They gave me a dose of Demerol for the pain, and some other medicine to counteract the nausea that Demerol can cause. I had my usual reaction to Demerol, which is like losing the vertical hold in my eyes. The world just flips by vertically. But it did take the edge off the pain. The doctor wanted a helical CT scan, explaining that it and the blood work would yield a definitive diagnosis. So I drank the oral contrast dye (sort of like metallic-flavoured ginger ale), doing my best to follow the directions ("drink an inch every 10 minutes") without the benefit of a clock. There was quite a wait for the CT machine (the ER was swamped by then, and I later found out that 28 of the 30 people there at that point got CT scans). I got hooked to the other dye injector (125cc of dye in about 15 seconds, yeesh) and the machine did its bit, then they wheeled me back to ER.
They needed the exam room, so I got parked in the corridor while they waited for the radiologists to slog through the backlog and send a report. After a while, the pain got to bothering me, so they gave me a dose of Torodol. This didn't have the immediate effects of Demerol, but over the next hour or so, the pain dwindled down to a dull ache, and it didn't make me feel loopy. The corridors were filling up with excess ER patients, and the people there had their hands full, so I just tried to stay out of the way and not be a nuisance. One woman flew off the handle and stormed off with her daughter when they couldn't get an ER room RIGHT THEN. Poor form.
Eventually the doctor came by and announced I was her diagnostic nightmare. The CT clearly showed an inflamed pancreas, but the pancreatic enzymes were all normal. But some of the liver enzymes were awry. White count was up, but no fever. Nothing made any sense. They decided they didn't want to send me home that way, so admitted me to the hospital. As the hospital was also full, this basically meant that I stayed on a gurney in the hallway. By then the pain meds had come into full force and there was basically zero pain. Powerful stuff. I eventually got a couple of little containers of apple juice to sip, as my mouth was getting dry. Poor fizzygeek was slowly dying of boredom. After a while, they brought me some ice chips to sip. I asked why I was down to ice chips when I'd been having juice earlier, and the nurse explained that my timing had been good, the orders had arrived right afterward.
After a while, it was time for more blood work. I was dreading another stick by a person of unknown skill, but I could tell that behind her youthful looks (deceiving, she has a husband and 2 kids) and teasing ("This is my third blood draw ever!"), she was on the ball. Did such a good job I didn't even have to pause in whatever monologue I was engaged in at the moment. Should have caught her name. They were going to culture the blood and see if they could find any evidence of microbes to perhaps explain the high white count.
Eventually fizzygeek reluctantly admitted she simply had to go get some rest (she'd had a couple of rough weeks). I assured her I would be fine, but asked her to let the nursing station know my IV was about to run dry (they were fresh out of the fancy IV pumps, so it was a simple gravity drip). About an hour later, it did run dry. As I didn't want to get air in my lines, I used the valve to pinch it off. The staff was still swamped. I watched the shifts turn over and the night crew arrive. At one point, an orderly wandered by looking for someone. I hadn't seen her, but asked him to let them know that my IV had run dry. Quite a while later, when things had slightly calmed down, the head nurse dropped by and apologised for not getting to me yet. She got a new IV hooked up, brought me my bedtime meds (with some bonus apple juice to wash it down). At one point, I had screaming babies in full stereo, but managed to get several quick naps anyway (I suspect the painkillers helped).
Quite some time later, she came by and said I could wash off if I liked. That sounded like a nice thing to do, so she disconnected me from the tubing, and set me up in a little-used bathroom in another wing with warm wipes and toiletries. I also got one of the nice jumbo wrap-around gowns, which is much nicer than the ones that gap in the back. That sure was a pleasant change. When I wandered back to the ER, they had stripped the gurney I had been in (for what? 11 hours?), and she said they'd found me a room. Said room turned out to be a storage closet off the main corridor but it was still a little darker and quieter. They've finally rounded up one of the computerized IV pumps and get it hooked up. But it's extremely finicky, and keeps beeping over this or that parameter it doesn't like. The nurse is getting frustrated, and I suggest that they gave her the bitchiest pump in the entire hospital. She agrees. I also got a third dose of painkillers, yet a third kind (dilantin?). This stuff felt rather like demerol, but with lesser visual effects and it made me feel warm all over. I managed to get a few half-decent spells of sleep, except when they were taking histories next door (just a curtain away). Some people get loud when they're nervous or in pain. After several hours of this, I felt like I could start taking histories. I tried to get more sleep, but the bed was angled, and I don't easily sleep on my back. I eventually snagged a nurse and she flattened the gurney, and I got a little fitful sleep. They said they'd probably be able to get me a real bed soon. I asked if the culture had shown anything, and they explained that it would be 72 hours before there would be any results.
Sure enough, they had finally cleared out an ER exam room and put a bed in it for me. So I got a little sleep under better conditions. Then it was time for the next day's blood work. Happily, I recognized the fellow who came in in the half-light. One of the phlebotomists had told me about him last time I was in, he was generally regarded as the best there is. He seemed pleased I recognized him and knew his name, and did a superlative job. Maybe needle sticks were not a big deal, maybe I could finally be shut of this wretched phobia one day.
A couple of hours later, they found a semi-real room for me. It was in an odd little "short stay" corridor on the first floor, but I had walls on three sides, a curtain at the front, one of those fancy beds that adjusts itself to equalize pressure, a TV, all that stuff. fizzygeek came to visit, and brought along a bunch of light reading, as well as my electric razor (the hospital had supplied a blade razor, but I've never used one, and decided this was not the time to learn). At some point, another doctor (Dr. Gill) had dropped by, explained that he was as perplexed as everyone else, but had a theory that perhaps something from the bile duct was turning to gunk or sand in the gall bladder and clogging up the opening it shared with the pancreatic duct into the intestine. So he wanted to run an MRI to get a closer look. I had never had an MRI before, but was familiar with the concept and not worried about it (hey, the upshot of a phobia is that anything that doesn't involve it improves by comparison). So no food, no drink because it would complicate the MRI. Hours go by, and a whole bunch of nothing happens. I start to get uncomfortable again, so they give me a little dose of dilantin, which took the edge off enough that I wasn't flopping around trying to get comfortable all the time. Eventually poor fizzygeek has to run off to work. I reassure her that I'll be fine. At one point, a patient advocate wanders by to see if I have any issues. I don't want to be a complainer, but I'm curious as to the long unexplained MRI delay. She says she'll loop by radiology and see what the holdup is. 20 seconds after she leaves, an orderly arrives to take me to the MRI. She comes back a few seconds later and I thank her for the instantaneous service. She looks sheepish and admits she had nothing to do with it. I thanked her anyway.
I figured they'd have me change gowns for the MRI, as the one I'm wearing has metal snaps. They explain that it's not a problem, don't worry about it. My gold crown also is out of the strong field area and will be fine. It takes the guy quite some time trying to jockey me onto the table in the correct alignment. After I scoot down about a dozen times, my legs are sticking off the end almost to my knees. Finally another tech shows up and explains how to arrange patients of my length and proportions. Finally everything is in place, the strap the locating sensor to my chest, slide me into the giant donut, and put headphones on me. The headphones bring me two things. One is LOUD DISTORTED Christmas music, courtesy of some radio station that spends more time broadcasting EVEN MORE LOUD AND DISTORTED ADS than music. The other is the instructions, which are pretty repetitive. Unlike the cool recorded voice prompts from the CT machine (built by the same company), the operator tells you what to do. And he sounds annoyed. "Take your breath. Release it. Take another breath. Hold." Then the machine operates for a few seconds, and, in a truly annoyed tone, he announces, "Okay, BREATHE." Repeat several dozen times. The machine itself was interesting. Given the healthy voltage fields I could feel, I'm guessing this is not one of the superconducting magnet variety. The sound was the distinctive raspy buzz of sawtooth waveforms at various rates. Toward the end of the scan, when they were running a heavy duty cycle, I did start to feel somewhat warm. No surprise, as I suspect the machine was dissipating a huge amount of energy in its magnets. I remember thinking "this isn't as claustrophobic as I'd heard about, but nosebeepbear still probably wouldn't enjoy it." I was later to find out that she'd been having an MRI the same day. Then I went back to the wheelchair in the waiting room and watched them get the next person set up. Eventually, someone came to get me, but swapped patients with someone else halfway there, leaving me with someone who didn't know where I was headed. Luckily, I knew which room I was in.
It turns out that the MRI wasn't the only reason I wasn't allowed any food. Apparently eating can trigger pancreatic action, and they wanted to avoid that. Not feeling up to much, I made an early night of it. Sleeping is difficult, as the bed is optimized for patients lying on their backs, and I'm no longer doped up enough to sleep that way. Finding a comfortable position on my side takes a fair amount of effort, and the sheets aren't quite wide enough (neither is the bed), and I'm bent in the middle, which is especially annoying as my pancreas is still larger than usual. I finally find a barely acceptable position and BEEP BEEP BEEP! It turns out that the tubing on my IV gets kinked if I bend my arm, and the IV pump (they finally found one) complains. If I don't satisfy it in FIVE SECONDS, it beeps continuously until the nurse comes to reset it. I finally find another, more awkward position where I can sort of sleep. I awake to a stern discussion. Someone has come around to take the 6AM blood draws. But it's 3AM. The ward nurse doesn't like it. The needle chick says she has a lot to do, normally starts at 3:30 anyway, and what's the big deal. The warn nurse stomps off to call a supervisor, and needle chick strides in. I figure, I'll be good, I'll just lie here, it's just a little stick, I'll get through this.
The needle feels like an ice knife being plunged right through my elbow joint. It HURTS. I shriek and start hyperventilating unevenly. Needle chick totally loses her composure and keeps stammering "over soon, over soon, calm down, over soon". Reality has a nasty habit of punishing complacency quickly and cruelly, eh? I have a brief thought that it would serve her right if the samples clotted (this often happens when I get a bad stick), but realize that it would just mean I'd get stuck again. I should have found out her name too. Dammit, there should be a minimum competency requirement, at least for people sticking us needlephobes. As there's zero chance of getting back to sleep anytime soon, I sit up and chat with the night assistant for a while.
The next day, my orkney drop by, and we have a lovely chat. Dr. Gill shows up and explains that the MRI doesn't show much of anything out of the ordinary, other than a slightly pinched opening, which is easily explained by the adjacent inflamed pancreas. He's still sticking to the theory that the gall bladder is producing particles (invisible to X rays, CT scans with and without dye, ultrasound, and MRI) that are clogging the duct and causing the inflammation. He even found a word for that form of pancreatitis (I truly wish I'd written it down). He suggests I consider getting my gall bladder removed, in an effort to avoid any more recurrences. It was nice that orkney got to meet him, he's a good guy, very friendly and forthright, and willing to explain anything we liked. I'm allowed a clear liquid diet, so I get jell-o, broth, and fruit juice. The doctor said he'd step up the diet, and if I tolerated it, I would probably be out on Sunday. The night brought more of the same protracted battle to get any sort of decent sleep. I was sorely tempted to ask for more painkillers just for their sleep inducing effects, but decided that was just not a good idea for a lot of reasons.
Saturday morning, I was still on the clear liquid diet. The doctor dropped by later and said my blood work had zipped back to normal already, and he'd try a full lunch and if that worked out, he'd recommend I go home that day. Lunch was a chicken breast sandwich, roll, and bean soup. Seemed to go okay. Finally got unhooked from that accursed IV, put on street clothes, and fizzygeek drove me home. Orders were pretty simple. Low fat, low residue diet. The low fat is obvious, but the low residue confuses me. I don't know how long these are to last, either. There's also a referral for a surgeon to get my gall bladder removed. When I got home, I had a really nice hot shower, and then mostly slept the rest of the weekend. Sweet, sweet sleep.
I have a call in to the doctor, because I'm still curious as to the diet (why the low residue, and how long should I follow it). I also want to know if they managed to culture anything. And I'd like to know the lovely word he'd found for what he thought was going on. As always, I'm tempted to ask my friends in the medical fields about some of this, but I'm aware doctors grow to resent the constant requests for free advice, so I'm not going to add to their troubles.