Hospital. Take 3.
After three days, after taking a total of three low dose (81mg) enteric coated aspirins, I was having another GI bleed, much more aggressive than the first. I was losing more blood, more rapidly, than I had previously. Knowing what was in store for me in the coming days — no food, no shower — I took a shower before driving to the emergency room to begin the process all over again. (I found I averaged about 30 minutes between bleeds. Helps to know how much time you’ve got when planning.)
While waiting for the ambulance, I left a sample of blood in the rest room toilet for the emergency room staff to examine. I managed to remain sitting upright while waiting for the emergency crew. Once on the floor was enough. Also stayed conscious while traveling to the hospital and carried on a conversation with the third ambulance crew I had gotten to know. As much as I enjoy Bill Murray in Groundhog Day, I was beginning to tire of doing the same thing over and over.
The hospital was busy which meant I and my wife, who had followed the ambulance, were put in a large room that usually functions as one of the hospital’s labs.
I could feel my large intestine filling again with blood and asked if I could use the commode. And asked again. And asked again. My wife asked. Finally, a commode was wheeled over.
Once I was seated, the blood came out of me in a torrent. I have no idea how much. I started to get lightheaded. Going into shock is not unusual. Rapidly weakening, I put my head down against my wife’s side and told her the most important truth I know: “I love you, I love you, I love you, I love you.” I couldn’t say it enough.
My bowel finally drained of blood, I watched as one of the nurses took the nearly overflowing chamber pot and struggled to carry it to the sink. Word came that a room had opened up in a different ICU than the one I was in just days ago and off we went.
In the ICU upstairs, I was told I would not be getting out of bed. I was too weak to do something as complex and delicate as navigating to a commode, sitting down, and expelling my half hour’s worth of no longer coagulating precious bodily fluid. Instead, I would be using a bed pan. The bleeding this time showed no signs of slowing. As the male nurse, a gentle black giant with the nickname Coca-Cola, said to me, it was as if the blood was going out of the bag and into the bed pan without stopping inside me. I would eventually go through seven units of blood during my second GI bleed. Between my first and second episodes, all of my blood and more would be replaced.
(Sometimes the blood, which is refrigerated prior to use, didn’t have time to warm up. The nurses apologized for it being cold as it flowed in. I appreciated the apology. I also appreciated the apologies that came with the efforts to find new places to put needles. With two hospital stays so close together, the nurses were running out of sites to put needles for blood and saline. I wound up with needles in both arms lined up from the crook of my elbows to the back of my hands.)
As midnight approached, I was told I would be going to nuclear medicine to see if, by injecting me with radioactive red blood cells, they could pinpoint the source of the bleeding. Radioactive blood brought visions of Peter Parker, though I was probably just hallucinating. The nuclear session, which lasted 90 minutes, revealed nothing. Time for some exhausted, endlessly interrupted sleep.
The next morning they suggested trying the nuclear test again. I asked Coca-Cola if it would help if I moved as much blood through my intestine as possible. Every time my intestine filled up, I would let it discharge. It would mean I would wind up in a large pool of my own blood, but this was hardly a time to be squeamish, right? Coke agreed. Let it rip.
I let it rip. When I was wheeled back to my space in the ICU, I looked like a crime scene. Everything below my butt was dripping blood. A striking contrast with the white sheets. A team of nurses took on the challenge of cleaning me up before rolling me onto the clean white sheets of my more permanent bed. This was not the groping of lurid naughty nurse fantasies. It was more like being slowly rolled through a car wash in a wheelbarrow. The only question was whether all that bleeding would yield anything of value.
It looked like it was worth it. The results from the nuclear lab were spectacular. The flow of blood draining onto the gurney pulled the luminescent radioactive red blood cells with it. With a clear picture of where I was bleeding, it should be possible to patch me up.
Should be.
Wasn’t.
By the time I was ready for surgery — angioplasty this time; back again through the femoral artery in my crotch — the bleeding had stopped. A fair amount of time had been taken up before the surgery securing a plastic bag to my butt so I could defecate blood without making a mess in the operating room. Bag secured, we waited. The nurses, doctors, and yours truly. Waited. And waited. Waited, as it turned out, too long. Once the surgical team was assembled, there wasn’t much for them to do. For ninety minutes the team attempted to locate an internal wound that had already closed itself. Bag still attached, I was wheeled back to my room and confronted with an array of long faces.
There was nothing else to be done. No other tests, no other procedures, no other drugs. So much for Modern Medical Magic. No point in hoping that Dr. Gregory House would show up with some stunning insight because, for the moment, my body had healed itself and there was nothing more to do.
Except spend another day and a half in the hospital.
The concern was my hemoglobin. It was low. Thanks to the bleeding and the infusion of saline, I had fewer red blood cells on a per-volume basis than a healthy person, which meant the percentage of hemoglobin present in my body had fallen. I had, in a phrase from the early days of television (my childhood), “iron-poor tired blood.”
Super.
I awakened that night having no idea what time it was. I wanted to go home. I tore off my butt bag and tossed it in the trash. I told one of the nurses I was no longer bleeding and wanted to leave. Seems I couldn’t. If I were not officially discharged, my insurance company would have no obligation to pay. However, it might be possible to move me out of ICU since, as was established earlier in the day, there was nothing more to be done for me.
The next day, my wife and I each made the case for expediting my discharge to the various doctors and nurses who came through on what appeared to be a random rotation. In the quiet times, my wife would hold the back of my hand against her cheek. Later, she asked me if I noticed. I noticed. It was my anchor to this world.
Finally, a room was found and the move out of ICU took place late in the afternoon. I was to spend yet another night and then, depending upon my condition, I might be discharged.
The next day I was informed my hemoglobin still wasn’t where they wanted it. Hemoglobin is the body’s oxygen transport system. And it’s the iron in hemoglobin that makes blood red. Rather than keep me until my hemoglobin rebounded, it was decided that I would take a non-prescription iron supplement for a while to get my blood back to spec. Aspirin had likely put me in the hospital and now Geritol of “iron-poor tired blood” renown was getting me out. I agreed to take anything they wanted if it meant I could leave. (I later learned that proton pump inhibitors, such as Protonix, keep the body from properly absorbing iron. I could take all the iron supplements I wanted and, as long as I was taking Protonix, my body couldn’t make use of them.)
Ask your doctor… Take 2.
Discharged for the third time in less than a month, I made the obligatory appointment with my primary physician.
He was initially speechless. Then, collecting his thoughts, he said he was going to talk about drugs that he had no intention of ever asking me to try (they all work more or less like aspirin), and wrapped up our meeting by noting in my chart that under no circumstances was I to be prescribed aspirin, or anything like aspirin, in any form, by anyone, for any reason.
This is a major departure from what is known as the standard of care. Prescribing aspirin is just something that’s done — the standard — for people who have heart problems. Aspirin’s mild anticoagulant effects keep blood from forming potentially lethal clots. For about 1.5 to 2.5 per cent of patients, though, aspirin reveals its darker side — it’s an acid after all — producing the kind of effects I experienced. Just a few low dose (81 mg) enteric coated tablets had given me a taste of the world without me in it.
Well, I did not notice this box but the one down below so I posted a response down there and goodness knows where it went. I am a dufus.
In summary, amazing story Mrlipid. I’ve not been at this site lately but I have time on my hands of late so thought I’d poke around and your story caught me off guard.
Sounds like you have a wonderful woman at your side! I was amazed at the amount of blood you lost. In game turns I am giving you +20 end, +15 str and I am tossing in +5 spell power for your consumption of a twilight drug. 🙂
Hope you continue to do well.
Gah!!!!!!!!!!!!!!!!!!!!!!! That was scary but infectious reading!! Glad it has a happy end but really, every time I get reminded about the health insurance American-style I get shivers.
Amazing experience, Mr. Lipid and one that, hopefully, being as challenging as it was, really made the taste of living ON for you better.
@Auditrix: I do have a wonderful woman at my side. Thanks for the good wishes.
@Meho: Every day’s a win. And everything tastes great.
Jesus, Mary and Joseph! Your whole story just reinforces my thought that “modern” doctors are simply casting chicken bones and hoping for the best.
So glad you lived to tell the tale, MrLipid.
@Toger: Thanks. I’m grateful I’ve got a place to tell it. And long-time friends who are willing to listen.
I felt a bit jelly-like reading chunks of that, absolutely terrifying but wonderfully written. I’m so glad you’re feeling well now mrlipid and I hope it continues, I don’t think you can go wrong with daily scrambled eggs for breakfast though. Eggs benediction indeed!
I’ll echo Meho’s thoughts on American healthcare. 100,000/60,000USD is just a staggering amount, and let me get this straight: the insurance company pays that? How much does healthcare/insurance usually cost from month to month then?
And thanks for the How Doctors Die link, that was a real eye-opener.
@Gregg B: Thanks.
Here’s a breakdown on the costs. The total bill for the heart attack and two GI bleeds came to $ 100,000. The bill for the heart attack care came to about $ 35,000 and the bill for the bleeds about $ 65,000.
I pay roughly $ 625/month for insurance with a $ 2000 deductible. I’m on the hook for the deductible plus a percentage of total bill after that. Which means the out-of-pocket cost to me was about $ 3000 and the insurance picked up $ 97,000.
If at all possible, I plan to die like a doctor.
Lipid also pointed me to the How Doctors Die link. Eye-opening is right. It’s something that’ll always be in my mind from now on when there are medical emergencies.
We could have a long, long talk about American healthcare, but it wouldn’t make anyone happy. My mother was in the hospital a couple weeks ago – one week, $55,000. The battles with Medicare are as epic as the battles with private insurance, which will actively look through your entire health history for a reason to refuse you when possible. “You were hospitalized with a minor stroke? Well I see here that you were treated for a concussion 35 years ago. Preexisting condition. No coverage, sorry (we’re not sorry).” What’s most baffling is why so many Americans vehemently oppose reform.
I’ve given MrLipid very strict instructions (a) not to have another heart attack and (b) not to go through any of that again. Assuming he follows my orders he”ll be with us for a good long time! 🙂
One of the advantages of being in a high risk pool is that the high risk pool, by definition, assumes preexisting conditions…and has no choice other than to ignore them. It’s the insurer of last resort and can’t be fussy about old concussions. Or hang nails.
I pay tax of around £600 per month and earn around £1,500 after tax. The tax I pay covers all my health care and local services such as council tax and the amenities they provide, bin collection, police, fire services; basically everything that’s public sector my taxes go towards.
I would consider £500 a month for all this (considering 99% of services I don’t use) rather a lot of money, but I’m incredibly grateful for the NHS. I’ve been nothing but ill all year and have had dozens of trips to the doctors. I also dread to think how much removing my tonsils would have cost privately.
Lipid, I shall finish reading your article (tonight, promise)
As trivia, Lewis, I did some Googling and in the States an uninsured tonsillectomy would set you back about $6000 for the procedure. There’d be added costs for any blood or lab work, anaesthesiologists, and of course if you have to stay in the hospital overnight that’d be a large addition. I’d say it could be managed for around $8500 all-in.
What’s so maddening about MrLipid’s experience, beyond just the scare, is that 75% of it was caused by doctors. Well-meaning doctors, sure, but aside from the initial issue it was, as he put it, a “disease caused by treatment.”
I made the shocking mistake to read this when I was hungry and a little tired. TWICE. Both times I wound up feeling a bit dizzy. It reminded me of my own (nowhere near lethal!) agonising visits to the hospital a couple of years ago, all bottoms and colonoscopy. I hate that feeling of being so vulnerable and fragile, that there are things inside of us that might just go pop and bust; and that’s what MrLipid’s incredibly matter-of-fact monologue brought home. Even though it was the treatment that was life-threatening that the original problem.
Glad you made it through MrLipid, despite the better efforts of your doctors =)
@Harbour Master: Thanks. Glad to be here.
I take it as a huge compliment that you read it TWICE.
Ah, I wish I could say I read the whole thing twice! I just got queasy and had to stop until I had got some food inside of me. But I did read the passages about your first bout of “diarrhoea” twice, once to make just to work myself into queasiness, second time to prove I was good to continue.
@Harbour Master: Then I take it as a huge compliment that you got through it. 😉
That was extremely brave bit of writing mrlipid. I commend and thank you deeply for it. Admitting vulnerability and owning it like that is against the big book of macho rules (and more manly than not crying or remaining stoically silent).
Having had my share of brushes with the American medical miasma, I could really relate to much of the what you revealed. Your use of wit and humour through the piece helped soften the ugly truths spilling out of the experience. Out of compassion, and simply to relieve a bit of misanthropic disdain for industrialized health “care”, I took a Rango break about half way through. If the writing was of less quality I surely would not have returned; but, you have a gift for storytelling.
Here’s to hoping that you find more beauty in your future than in your past, and more joy in your present than in paths not taken!
Bravo.
@Brown Fang: Wow. I’m humbled. Thanks.
De nada. 😉
I apologize for all the typos in my post (wrote quick without editing).
Bloody hell, mrlipid. Bloody hell. Glad you are still with us. I’m 61 and so far haven’t had the pleasure of any long hospital stays. You always think you’ll be different, that the docs and tubes and machines won’t get to you but it always does. And yes, first rule, ALWAYS be nice to the nurses.
Wow mrlipid, I don’t even know what to say. Horrendous experience, fantastic bit of writing. Glad you are still with us and hopefully you will never have to go through that again.
Thank you for sharing your experience with us. It was eye opening and has given me plenty to think about and be thankful for. You tend to forget how quickly your life can be turned upside down and what we take for granted on an everyday basis.
Much health to you my friend and to all fellow Tappers.
@Scout: Bloody hell, indeed, Scout. Bloody hell, indeed.
For what it’s worth, I’m 61, too.
@tanis38: Thanks. Life is fleeting. Don’t miss it.
Mr Lipid, that was very scary to read but so marvelously written. In the beginning, it sounded like what I experienced about a year ago when my husband had a quadruple bypass. He had been suffering pain while playing tennis for quite a while and never told me. Finally he went to the doctor. We were lucky that he came through it with flying colors, thanks to a wonderful cardiac surgeon. But your story quickly descends into horror. It makes me angry that the medical profession didn’t do better by you. I am so glad that you survived your ordeal. Take care of yourself and enjoy your eggs.
MrLipid, first let me say I’m happy to hear that you FINALLY got through that horrible ordeal. I also admit I had to cut your story up in separate parts to read, because I get queasy and faint easy when it comes to blood and needles and the ilk. I can’t imagine confronting one’s mortality to that extent. The worst I went through was having my appendix removed (which wasn’t great). Health is very fragile, thinking of how complex our bodies are and what all can go wrong. It’s also scary how much we still have to learn about how to properly diagnose and treat various ills. Depending on our medical system to be the knower of all is … well … probably a tad misguided. Still, it is amazing the talents that the doctors and nurses and specialized surgeons all possess and the benefit to humanity that they bring. It also brings to mind how much faith the world puts in all these prescriptions. While true that many are life savers, it’s scary to realize how dangerous side effects they can bring when combined with others. All in all, we just put our faith in the system I guess and keep our fingers crossed. My personal mentality is to not take drugs unless I absolutely have to. Other than a daily vitamin, that’s about it.
I wish you well and hope you now have many healthy years in front of you to focus 100% of your energies on Tap Repeatedly again. 🙂
@Pokey: Thanks. Glad to hear your hubby is doing fine. As for the medical profession not doing better by me, I think they did their best. The nurses were great. As far as my ordeal, I’ll paraphrase the pilot’s line about landings: any hospital visit you can walk away from is a good one.
@lakerz1: Thanks. Didn’t realize I was writing a serial. 😉 I tend to forget that it’s a big advantage to have no issues with blood or needles. If you want to read a book that may tell you more than you want to know, read Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch. Yipes! And now, your kind wishes in hand, back to the games!