It’s Always Something

Gilda Radner wrote a wonderful and wacky memoir of her time with ovarian cancer. When we consider that just getting diagnosed for her was a journey in and of itself, we see how lucky we’ve been in getting answers in a rather timely basis although it hasn’t always felt that way.

At one point in her treatment, she had an intestinal blockage and the course of action, her gynecologist determined, was to insert a bag of mercury down her throat via her nose. This heavy metal would push past the blockage opening her intestine at which time, the bag, which was basically a condom, would be pulled back out up and through her nose.

When the time came to pull the bag back out, the end of the string was empty. Now she had to wait for the bag to be expelled from the other end. And, for anyone who has dropped an old fashioned thermometer knows, mercury is not easy to pick up. As children, I remember we would take copper pennies and put them in the mercury and pretend we turned them into dimes. The problem Gilda had was that the mercury was in the toilet. And being a heavy metal, would not flush. The slightest fart and little balls of mercury would pop out. There is no way to do this story justice without direct quotes but, if you are familiar with this talented woman’s work, you can imagine how crazy it all became. As she said, “it was quintessential Roseanne Roseannadanna.”

At the end of the hilarious account of all this, was her admonition learned from a wise nurse… “Don’t let a gynecologist put anything in your nose”

Wise words, we’re finding out.

As everyone is well aware, the meds always seem to have an effect and generally not what you’re expecting. We’ve certainly had quite an experience with poop in all its forms. This time, Rich worked his way into a full blown blockage, beyond constipated, his bowels were now impacted. Again, not a new experience, but this time, we’re in the hospital. It’s not up to us to dispense medications. Our notes show that even from ten years ago, the protocol was to megadose on Senekot and Colace. Similar to a pre-colonoscopy cleanse, this would do the trick.

With our “too many cooks spoil the broth” array of doctors, no two were of like mindedness. The overriding opinion came from hematology…. Over the counter doses of meds. Let’s take this slow and easy.

To paraphrase Gilda and her mercury bag, don’t let a hematologist determine the course of action for your bowels.

It’s not gonna end well.

Days went by. Pressure built. Rich looked ready to give birth. And the analogy was not too far fetched. The labor pains were awful! When the pulmonary doctor took pity and advised hourly doses of miralax, there was relief. Partial, but relief. And the next day, when vitals were taken, Rich had lost fourteen pounds in twenty four hours. Unfortunately, it was a little too early to celebrate. Although his comfort was much improved, there still existed a small blockage that would enable, throughout the day, the buildup once more of gas and pressure. No room for food in his stomach and the pain of the bloating is back.

At one of the rounds in the recent past, we were offered some advice by the hematology doctor. To take a look around and see the situations that others on this floor are in. To understand that we had dodged a fatal pneumonia. Impacted bowels were nothing to worry about.

In many ways, good advice. But when your pain is on a ten on the universal pain scale and you are writhing on the bed, at this point for days, it’s hard to have empathy for what basically boils down to the starving-children-in-China-syndrome. Those kids aren’t benefitting by me cleaning my plate and those patients on 7Monti aren’t going to all rise up and walk because Rich eschews a better treatment. Perspective is one thing, nonsense is another.

Morning rounds Rich took a stand. No longer was he a complacent patient. He stood his ground that not enough has been done over the last five days. A plan is devised with coordination of the various departments overseeing Rich’s hospitalization. An enema which will be followed, if needed, by a manual manipulation of the blockage… an attempt to break up the fossilized poop that just refuses to make a move. Unfortunately, plan B had to go into effect. Softening that blow, there is a karmic moment of giddiness, the hematology doctor was the one who, because of a lack of urgency in setting up the right treatment, has to be the mechanic going in under the hood. Sadly, it is once more unsuccessful.

The GI team is brought in and they recommend a CT scan to get a better look at the blockage. Apparently everything below the blockage got cleaned out with the pulmonary doctor’s cleanse protocol. Now it’s time to work on the cause of all of this and clear it once and for all.

Dr. GI decides to start a medication that we tried before. But, like Dr. Pulmonary, he goes for hourly doses and not Dr. Hematology’s wimpy OTC dosage suggestions. We start that while waiting for the CT scan is being set up. If these don’t work, the next step is a colonoscopy that will include an effort to remove the blockage.

Luckily, the new protocol begins to have an effect and, in twenty minute intervals for hours on end, Rich is using his new walking skills to and from the bathroom. Physical therapy by poo.

Throughout this hospitalization where we are on the general floor, we’ve seen how the stem cell unit is really an ideal situation for patients with a two for one patient to nurse ratio of care. There is a sense of urgency when consults or tests are needed. Most importantly of all, whatever your concerns are, they are taken seriously. Your belly pain is not any less of a concern than the PCP that brought you there in the first place. The rest of the hospital would do well to follow suit.

That’s not to say that the staff on the general floor is less caring, less involved in the care of their patients, but more that they are stretched thin… too thin… and have less immediate resources than their counterparts behind the double doors in the little hall of little rooms. It makes us appreciate where we have been. And all the more anxious to get back home.

There is still a long road to heal from this latest bout of pneumonia. We’re reminded time and again that we can expect another few weeks at home of medications and care to recover from this most insidious of illnesses. And we’re also reminded how lucky we’ve been, once again, to have gotten where we needed to be before we knew we even needed to. That some symptoms that seemed totally unrelated brought us immediate care which removed the word “fatal” from our diagnosis.

But it is true… as Roseanne Rosannadanna said, “It’s always something”