Tag Archives for illness

Futile Emergency Room Resistance

For the first time since having surgery last August, I landed in the hospital emergency room on Sunday. I was struggling with a pain flare up all day and finally had to surrender to the fact that my pain medications were not doing all they could for me in the pain management department. After trying to be still, crying, talking myself into a space of calm, and trying desperately – but failing miserably – to sleep through the pain, I gave in. When you’re barely moving and still have intense pain in your feet, ankles, thighs, hips, pelvis; and lower back pain that feels like it has tentacles spreading up your back, it’s hard to keep assuring yourself for hours on end that the increasing waves of pain will pass. On Sunday, there was no ebb to the painful tension enveloping my body, so the dreaded emergency room became my last resort.

Before making the decision to go I contacted some of my friends who usually make themselves available to keep me company while I sit through the hours of IV medications slowly dripping into my veins. Unfortunately, on Sunday afternoon, as one would expect, most of them were locked into plans. The ER is uncomfortable enough, but having to face going in on my own always makes it worse. It’s also partly why I held off from going in for so long. Later in the afternoon when I could bear it no longer, I accepted the offer of a neighbour who had come by to drop off some items from the farmers’ market to go with me and keep me company until someone closer to me could come be with me. I’m certain I would have waited hours longer before going if he hadn’t stopped by.

Emergency rooms, especially on a weekend, tend to be populated with interesting characters. When we arrived at my local ER on Sunday, there were people from all walks of life waiting for triage to the right level of care. One woman suffering from obvious mental health issues was shouting incoherently at the top of her lungs what must have been a badly patched together montage of events from what sounded like a tragic life. As she became more animated and the flow of expletives in her ranting increased, the hospital security guards and police were called to subdue her. When I finally made it into the ER treatment area I could still hear her shouting from a distant corner, and I overheard the nursing staff assuring security they could leave because she was securely restrained. It hurt my heart to picture that woman strapped to a hospital bed against her will.

Thankfully, I didn’t need that kind of intervention. However, once the nurse recorded my vitals I knew that my body was in crisis. My blood pressure was 162/82. That’s not the highest it has ever been but it was high enough to confirm for the nurse completing my intake, that my pain was real and I wasn’t in the ER seeking drugs when I said my pain was an 11 or 12 on the pain scale. After a 90-minute wait, I was finally seen by a doctor who had me list the cocktail of pain medications I take daily so she could understand what I was coping with and what she might be able to do to help me. I could tell from how little she said that she was trying to wrap her head around someone with a body as small as mine taking such high doses of pain medications yet still feeling so much pain. I tried to get her mind moving by telling her what treatment(s) I had received in the ER for past pain flair ups, and that seemed to jumpstart things.

My friend J arrived a short while before my discussion with the doctor started. It was good to have her there because she has been through this scenario with me many times before and is sometimes faster at responding to questions about my condition than I am when I’m in that state. J’s arrival also gave my very kind neighbour a chance to slip away and head home. He had sat with me for a few hours then hung around chatting with J and me, for longer than he needed to, to make sure I got some treatment before he went home. His presence reminded me how blessed I am to have so many people in my life who care about me, even when they have no vested interest to do so.

After consulting with the ER Attending Physician on shift, the doctor returned and told me they were going to start by giving me a shot of my old faithful injectable Toradol, and that I should take the scheduled dose of my pain medications, which at this point were about 90 minutes overdue. Unfortunately, I wasn’t paying close enough attention when she said I would receive an intramuscular shot of Toradol instead of an IV drip. For anyone who’s never had a needle plunged into a muscle, unless you have masochistic tendencies, give it a pass. The pain in my arm after that shot rivaled what I was already feeling in the rest of my body. The nurse instructed me to rotate my arm to get the medication flowing through me. I flapped my arm around like a bird with a broken wing for about ten minutes. For all the good that it did because my pain was unaffected.

When the doctor returned to check on my progress, my blood pressure reading had dropped to 160/82. For the first time, the Toradol wasn’t working. She went off to get more advice. What she tried next was an IV with an added milligram of Dilaudid, which is part of my regular pain medication regimen, and Lidocaine. Lidocaine is a local anesthetic that prevents pain by blocking the signals to nerve endings in your skin. It’s usually used to numb skin before painful procedures: think about the shot to your gums before your dentist starts drilling. Within 30 minutes, after the drip was opened, I started to feel some relief, and the sure sign that things were moving in the right direction was my blood pressure began to fall.

With this positive result unfolding the Attending Physician came by my bed to talk to me. He was empathetic with my situation and concerned that I am living with this extreme pain. He wanted to know what treatment(s) aside from pain medications I have received and added a few suggestions for future treatment(s) to my list. He also made it clear that if the effects of the medications I received wore off I shouldn’t hesitate to return to the ER; and that if I did I should tell whoever treated me to try the Lidocaine, as unusual as it may sound. He even asked if I wanted to have an extra top-up of Dilaudid to make sure the positive effects I felt didn’t wear off too soon. However, because I still had a dose of Dilaudid left in my pillbox for the night, I opted instead for another dose of the Toradol.

Once the IV drip stopped and I got dressed, I became acutely aware of how hungry I was. The night’s ER adventure ended at 2:00 AM with J taking me to a nearby 24-hour diner to get a huge Chicken Parmesan sandwich with French fries, and a slice of cream cheese icing-covered carrot cake to go. More importantly, although I had resisted going, my visit to the ER gifted me with the knowledge of an alternative cocktail of medications to bring my pain back to a level where I can cope if I need extra support again in the future.

 

Chumbawamba – Tubthumping

 

Another Scan, Another Problem

My illness is starting to feel like a long meandering river that you might see photos of in National Geographic Magazine, with a caption describing how it formed over centuries under the pressure of slowly receding glaciers. I know that probably sounds overly dramatic but the curves my body can throw at me seem endless. The farther I fall into life with chronic pain the more my body changes and the more I learn about the human body – my body especially – that I never could have imagined needing to know three years ago. Each test, scan, or invasive procedure reveals another unexpected facet of what could be THE SOURCE or at least a contributing factor to what is happening within me.

I recently had a series of appointments with one of my specialists. He’s the gynecologist who has been an incredible advocate for me. He managed many of my referrals, even though he didn’t have to, when I became his patient a few years ago, to make sure that I connected to the right doctors. He’s also the doctor who removed the offending growth from my pelvis last summer when it turned out that my MRI results were misleading and I didn’t have a rare congenital condition which could have led to the removal of most of my rectum. I suspect that as long as my pain continues, I’ll be in and out of his office a lot in the coming years.

The first appointment with him was at the beginning of April for my bi-annual check-up. After I detailed how things were progressing – or had not shifted at all – in the preceding six months and since the removal of my pelvic growth, he ordered some tests for me. He wanted to rule out the possibility that he missed any small growths during my surgery that could now be growing larger; or that the one removed was regrowing and causing me to have continued pain. The most dreadful of the tests he ordered was the abdominal ultrasound series. This ultrasound consists of two parts: an abdominal scan that starts near the diaphragm in the area just below my rib cage and works down to the lowest point of my pelvis; and a transvaginal scan, which requires the insertion of a condom-covered probe into the vagina. I dare anyone to guess which of the two scans is my least favourite – and probably so for most women. Just saying the word “transvaginal” makes my skin crawl, and having to endure the procedure with my existing pelvic pain feels indescribably cruel.

After having to reschedule the appointment for my scans because my body refused to cooperate long enough for me to make it to the hospital to have it completed, I was finally back in the gynecologist’s office at the beginning of June for my results. It was the same day I ran into the Doppelgänger of a former friend while trying to cope with some difficult feelings. Of course, the scan results added an extra layer of angst to that day. The best news was that there were no new growths clinging to the walls of my pelvis to cause concern, but images of my uterus told another story: the report detailed two objects in my uterus. The first is a small fibroid, a noncancerous growth found in the uterus that often appears during childbearing years, which my gynecologist said is so small it doesn’t merit much concern. Of course, my body being my body, there is another growth about an inch in size I do have to worry about, a uterine polyp. Uterine polyps “are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps).”

This polyp could explain some symptoms I have in addition to my chronic pain that originated in my pelvis: my unpredictable and excessively heavy periods, and severe period cramps. My gynecologist believes that removing it can help to relieve these symptoms, which are probably my body’s way of trying to expel the foreign body in my uterus. So what are my options to deal with this inch-long polyp? I could continue to have it monitored at 6-month intervals to make sure it doesn’t grow or change in any other way or I can have it removed now. That’s right, more surgery. Because, although “[m]ost uterine polyps are noncancerous (benign)… some precancerous changes of the uterus (endometrial hyperplasia) or uterine cancers (endometrial carcinomas) appear as uterine polyps.” The procedure to pluck the polyp from my uterine wall can take place during day/ambulatory surgery, which means I shouldn’t have to stay in the hospital overnight. However, if my ongoing negative responses to physical stimuli and my body’s alarming reactions immediately after my surgery last summer are any indication I will most likely need to stay in the hospital at least one night for observation.

I have an appointment later this week to schedule the polyp removal and discuss the possible outcomes of the procedure. After the surgery, the polyp will be biopsied to make sure it’s benign. Then I’ll probably have a series of uncomfortable transvaginal ultrasounds scheduled to monitor whether the polyp makes a comeback or any others spring up. Plucking it out might not mean it goes away forever – there’s a rare chance it can recur –, but at least the physical symptoms, and the pressure and anxiety I feel while thinking about it taking up space in my uterus should lift – until the next thing shows up…

 

Billy Joel – Pressure

 

Gratitude and Creativity: A Blade Of Grass

It appears that the Penny Dreadful television series had an unexpected impact on me: the darkness, the fear, the gore, and the intensity that held it all together.

One episode in particular, Episode 4 of Season 3, ‘A Blade of Grass’, where the character played by Eva Green, Vanessa Ives, relives the trauma of her forgotten institutionalization really moved me. The loneliness, pain, and terror she experiences in her padded cell are raw. Watching her live through every moment was frightening and made me cry at times.

However, a few words from that episode clung to my mind: “not even a blade of grass.” The context in which they are said is meant to convey hopelessness, but I felt inspiration from them.

It took a bit of turning the words over, in my head and in type, but I was finally able to weave them into poetry.

A Blade of Grass