What a revoltin’ development this is!
Six days after my first trip to the hospital, I was sitting on the toilet performing what I thought was a solid waste disposal. The velocity of it made it feel more like diarrhea. I looked in the toilet bowl. There was some solid waste, but most of it was blood.
My first reaction was annoyance. Blood? Really? Seriously? What’s going on here? Well, back to work and see if it happens again.
It took another thirty minutes for my large intestine to fill and it happened again. And then again.
Channeling the methodical calm of my late father, a glider pilot who built the glider he flew, I realized I was running out of time to make a decision. If I waited much longer and lost any more blood, I could lose consciousness and be of no use to anyone. I would keep bleeding and would eventually — another new word for me — exsanquinate (bleed out) and then it would be “Game Over!”
The first item on my pilot’s checklist was: return to the emergency room.
Fortunately, it was almost empty. I was shown to an examining room and told to wait. The same physician’s assistant and his assistant showed up and asked me what the trouble was. I said was losing blood through my large intestine and was concerned. By now my blood pressure had been taken and it was dropping while my heart was racing. Basic fluid mechanics. My heart was trying to maintain my blood pressure with a lot lower volume of blood. Not possible. Or good.
I was asked if I wanted to get off the examining table and sit in a chair. I thought it seemed possible though I was beginning to feel lightheaded. Halfway through the transition from the table to the chair, I realized I was not going to make it. I pointed my left shoulder at the floor, turned as I fell, and sprawled on my back on the cool tile.
The emergency transport guys showed up and got to work. I was conscious and both aware of and distant from the activity around me. The tiny room was filling up with folks whose job it was to keep me from becoming a carcass. As they continued to pile in, I thought about the stateroom scene in the Marx Brothers’ A Night at the Opera. My blood pressure was continuing to drop with my diastolic (the lower number in the usual 120/80 format) now at 50, and sliding.
As one of the emergency guys stepped over me, I looked up and wondered why it couldn’t be the 1959 vintage Shirley Eaton from Carry On, Nurse doing the stepping. What a waste of an angle. Then again, I remembered the reason they put curtains in a hearse: you have to quit looking sometime. Why was I thinking of hearses?
Rejoining the scene, I found my ability to respond to questions and shift my weight as needed made the job of the emergency crew a bit easier. They hooked me up to saline and red blood cell (RBC) drips, hoisted me onto a gurney and took me back to the hospital I had left less than a week before.
Here’s the oddest thing about this. During it all, even during the shoulder roll onto the tile floor, I felt quite good. The gastrointestinal (GI) bleed I was experiencing was not painful (the inside of the body is blessedly free of nerve endings which is why one can go poking around the arteries without the patient feeling anything) and I had no other symptoms. Other than bleeding a lot, I felt fine.
This puzzled the emergency medical team and just about everyone else I interacted with from this point on. Over and over, I answered their questions in ways that didn’t point to an obvious cause. I wasn’t in pain, I had no tenderness in my abdomen, I wasn’t vomiting, I wasn’t taking a blood thinner (other than aspirin), I hadn’t sustained a blow to the stomach, and so on. I was just bleeding.
Hospital. Take 2.
Once at the hospital, I called my wife to let her know where I was and what was happening. Told her not to hurry over because I was feeling fine. As fine as one could feel while experiencing repeated uncontrolled bleeds. While I waited for the medical team to cycle through, I requested a rolling commode. For those not familiar with them, a commode looks like a flimsy plastic lawn chair with a hole in the seat that leads to a removable chamber pot. And I thought chamber pots were only found in antique stores.
I filled the pot several times with gradually darkening blood. The flow seemed to be slowing.
One of the intake nurses, a phlebotomist (someone trained to draw blood – one of the first of the more than two dozen such folks who would draw blood during what would turn out to be a four day stay), mentioned this happened a lot. People would go to the cardiac wing, like I had less than a week ago, and then come back within a week, like I had, with a GI bleed. Perhaps the heparin? Perhaps the heparin and the aspirin taken less than twelve hours apart?
I was taken to the ICU (Intensive Care Unit) and told what would be happening. I would get an endoscopy and a colonoscopy. The endoscopy would look at my gastrointestinal tract from the top (through my mouth) and the colonoscopy would look at my gastrointestinal tract from the bottom (through, well, you can probably guess).
Meanwhile, I continued to bleed. By the time I was done, I needed six units of red blood cells to replace what I lost through my bowel. (A unit — U — is just less than a pint. A normal human contains anywhere from ten to twelve units of blood.)
The endoscopy was performed in my room in the ICU. All the gear was wheeled in and the procedure was done without me leaving the rolling bed that would be my home until I was sent downstairs for observation. The endoscopy was the most discomfort I had felt during a procedure because a not terribly flexible tube was being pushed down my throat. Unlike the inside of the body, which is nerveless, the mouth and throat take umbrage at having things pushed hard against them. The only finding was a modest bit of damage from acid reflux (stomach acid flowing back into the throat).
Endoscopy done, it was time to get ready for the colonoscopy which was scheduled for the next day.
This involved drinking something like 14 glasses of a fairly disagreeable gritty liquid. And then expelling it the same way I had been losing blood. What came out was neither pleasant to look at nor pleasant to smell. I started dreaming of hot showers. And hot food. I had been restricted from eating or drinking from the time of my admission and was getting a mite peckish and thirsty. Not to mention more than a mite ripe.
Once I had drunk all the gritty cleaning solution, I was ready for my enemas. Three of them. When they were over, I felt I could eat off the floor of my colon.
Next day. Time for my body to host its own amateur production of Fantastic Voyage. Or, if you’ve played System Shock 2, time to visit the Heart of The Many. (I got to see some of the imagery, via video, of the pink cave that is my colon.) This was prefaced by a bit of pharmacological magic. “Take this,” said one of the parade of nurses. “It’s called a twilight drug and it will make all this seem like a waking dream.” Did she really say that? I have no idea. All I know is that it made it all seem like a waking dream.
The colonoscopy revealed a hemorrhoid and little else. Which was good news. No cancer, no polyps, no cockroaches in hazmat suits. And no sign of why I had bled out half the blood in my body. And no sign of why I had stopped. My river of blood had apparently dried up. Time to send me downstairs for observation since, at this point, my only symptom was hunger. Turns out ice chips are not a food group.
In my new room, I got a visit from the hospital dietitian. I was told it was recommended that I eat a virtually fiber-free diet until my intestines recovered from my bout of treatment. All the foods I had been told to shun for years — white bread, smooth peanut butter, white rice, mashed potatoes, cream cheese — were now back on the menu. The idea was to reduce the burden on my intestines by reducing the number and volume of bowel movements. No kidding. I vowed to take the advice seriously and imagined buying my first twenty pound bag of potatoes. (I make a mean mashed potato with cream cheese and butter. We’ll talk later.)
Then my gastroenterologist came around to give me a prescription for pantoprazole which was to help my esophagus heal. (Pantoprazole’s sold under the name Protonix, which sounds like the name of the quiet Transformer.) With the bleeding over for the moment, all that was left to do was remain in the hospital under observation until I was approved for discharge.
After a bit of negotiating with the nurses and my gastroenterologist (my attending physician was not available), I was signed out and decided, rather than being wheeled out, I would walk out with my beloved wife. She, and I, had had enough of hospitals for, oh, ever.
Word of advice. Should you find yourself in a similar situation, dependent on others for all your needs, be as nice as you know how to be to them. Especially the nurses. Nursing is a tough job and it is amazing what a nurse can do for you if you haven’t been a jerk. I am convinced my rapid discharges were, in part, due to treating all of them with the respect and good humor they richly deserve but rarely get.
Ask your doctor…
I visited my primary physician three days later and learned that my doctor knew nothing of my emergency bleeding episode. So much for the connected world. (The physician’s assistant who treated me on my first two visits, and who offices four floors below my primary physician, had been logging in and following my progress through entries in my electronic chart.) Bleeding episode aside, my primary physician told me to restart my low dose aspirin regimen as soon as possible. His exact words, in a letter listing my most recent lab results, were: Please restart the aspirin if you have not already.
I had pointed out during our meeting that heparin is noted for lasting effects. Patients are told to alert their doctors if they have bruising or bleeding episodes up to two weeks after stopping heparin. Would going back on aspirin, also an anticoagulant, be advisable within that two week window? The answer I got was a gentler version of Ring Lardner’s classic line: “Shut up,” he explained.
I had been told at the hospital to lay off aspirin for at least a week. I thought that seemed reasonable. Once a week had passed, I started taking aspirin again.
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!