Tuesday, February 26, 2008

Paging Dr. Smith

If you are as old as dirt, like me, you might remember this guy. This is Johnathan Harris, who played the infamous Dr. Zachary Smith in the TV series "Lost in Space" which aired in the early 1970's.

In the series, Dr. Smith was always devious and unreliable. You never could count on him. He would put on a brave face, but at the last minute, he would chicken out.

I ran into a Dr. Smith of my own during my October 12-14, 2007 hospital stay.

I had been admitted to the hospital with acute diverticulitis, combined with an abscess on my bowel that was pressing down on my bladder. After they discovered my situation following a CT scan, they asked me who my surgeon was.

What? I didn't have a surgeon! I didn't know I needed one until now! So the hospital contacted the surgeon on call, which turned out to be my Dr. Smith.

Dr. Smith seemed nice enough. He explained what was happening with me. He even drew a picture of my bowel, bladder, and where the abscess was that was causing all the trouble. He said that I would need surgery to remove the part of my bowel that contains the diverticular pockets.

When I was discharged from the hospital, on a Sunday night, he told me to contact his office the next day (Monday) to schedule an appointment, where we would further discuss the surgery. We had arranged for me to be on oral antibiotics (Augmentin) and then have a follow-up CT scan in two weeks.

The next day, I dutifully called Dr. Smith's office, and arranged for an appointment with him on the following Friday.

The IV antibiotics in the hospital had worked well. I had received some relief from the intense pain I had experienced the week before.

In fact, the next day, Monday, I returned again to work again, as if nothing had happened. (I was somewhat weakened, and I still had some pain.) It was dawning on me that I was going to need surgery, and I felt myself resigned to that fact. I confided in a couple of my co-workers and my boss that I had spent my weekend in the hospital. However, most people didn't know that I had even been in the hospital again.

Things progressed along nicely through the week, until Thursday, when I got a call from Dr. Smith's office. I was informed that Dr. Smith was retiring, and that he was no longer taking new patients. My Friday appointment was canceled out from under me, and I was summarily dumped! My Dr. Smith was as unreliable as the one on the old TV show!

I was dumbfounded! What was I to do now? I decided to call my internist. But they were really hesitant to even schedule and appointment for me. They told me to contact a surgeon. However, I needed some recommendations for a good surgeon -- and that was part of what I wanted to discuss with my internist, who after all, is supposed to be my primary care physician.

Reluctantly, my internist agreed to meet with me the next day, on Friday. When I got there, it was like I was radioactive. She didn't want to touch me with a 10-foot pole. She didn't want to counsel with me, or have much at all to do with me.

My wife came with me to that appointment, and we were appalled at her attitude, and her unwillingness to be of much help. Finally, I got a list of recommended surgeons from her, and we left.

We haven't been back ever since, either.

I have one doctor, my rheumatologist, who is my most trusted doctor. I called his office, and asked him to give me a call, with some recommendations for a colon surgeon.

My rheumatologist called me back, and we discussed several doctors, and he told me which one he go to if he were having similar trouble. This doctor is the go-to doctor for complicated bowel surgeries. The doctor he recommended is often times consulted by other doctors when they have difficult cases.

I decided to go with the surgeon recommended by my rheumatologist. He also happened to be on the list that I wrenched away from my internist. This turned out to be a very good decision.

In the long run, I feel grateful that I had the surgeon I ended up with. Maybe it was a blessing in disguise that Dr. Smith wimped out on me, after all.

Saturday, February 23, 2008

A Full Plate

I believe it all started on the night of September 1, 2007. We had decided as a family to get up at 3:00 am to watch a meteor shower. After Dawn Ann’s diagnosis of cancer, I decided to try and do as many fun things we could as a family, and together as a couple as we could before the mastectomy. Viewing the meteor shower was one of these activities. (Another was going to the State Fair as a family. And thirdly, we celebrated our wedding anniversary early by going to Johnson’s Mill bed and breakfast in Midway, Utah.)

We took some treats with us to nibble on as we watched the meteor shower. I remember getting some Red Vines, and a bag of caramel popcorn.

The popcorn, although it tasted pretty good, had a lot of unpopped kernels in it. I didn’t think a lot of it at the time, but that bag of caramel popcorn might have been my downfall. I believe that one of those popcorn kernels may have been the cause of another bout of diverticulitis.

A few days after the meteor shower, I felt some pain in my lower abdomen. I didn’t think much of it at the time, although I always worried that I might be having bowel trouble again. I have a history of diverticulitis, and I worried some that I may be having another problem. I had some mild abdominal pain that lasted a few days, and then went away, so I shrugged it off. I had more important things to worry about, with Dawn Ann’s breast cancer, and I needed to support her in the face if this monumental challenge.

A month went by, and I remember being in Dawn Ann’s hospital room (October 2-4th, 2007). She had made it through the surgery alright. I was focused on seeing to her needs, and comforting and supporting her in this ordeal. As I sat in her hospital room, I again felt a return of the abdominal pain. It was a little more intense than it was before, a month earlier. But I blocked it out of my mind as I focused on Dawn Ann. Now I believe that the pain I felt that first week of October was the manifestation of an abscess forming on my bowel.

We got Dawn Ann home from the hospital, and I stayed home with her for about a week and a half. I helped her though things that first week home from the hospital. I drove her to her doctor appointments, cooked meals, did laundry, took care of the house, drove the kids around to their appointments and classes and picked up the load of both parents, as best I could

On Monday, October 8th, I went to the Insta-care clinic. The abdominal pain was now manifesting itself with symptoms in my urinary tract. I had painful, burning urinations, and began to be convinced that I might have a urinary tract infection. I gave a urine sample, and the quick test did not reveal a urinary tract infection. They were to culture the urine specimen for three days to check for an infection. They did not give me any antibiotics at that time.

On Wednesday, October 10th, I returned to work for the first time since the surgery. The next day (Thursday) I again went to work, but the abdominal pain returned with a vengeance. I couldn’t make it through the work day because of pain. I felt like my prostate might be infected, because I had some pain and tenderness in that area.

I again returned to the Insta-care, complaining of a possible prostate infection. The doctor examined me, and after a digital exam decided that I might, indeed have a prostate infection, and gave me a prescription for Cipro. (Which has been successful in treating prostate infections in me before).

Thursday night was a nightmare! I couldn’t sleep all night because of pain. I found myself curled up into a fetal position in bed trying to get comfortable. Ibuprofen and Tylenol couldn’t touch the pain, and I could not sleep.

Friday morning, October 12th, I called my Internist, and told them of my situation. They told me to go to the Emergency Room. Dawn Ann had already determined that we were going to the ER anyway, regardless of what the doctor might have said.

At the ER, I told them of the pain I was experiencing, and also that I had a history of diverticulitis. They hooked me up to an IV, and had me start drinking my “favorite” cocktail – that wonderful mixture of raspberry crystal light, and Iodine. Mmm Mmm Mmm. A cup full every 15 minutes. It takes about an hour and a half to drink it all. This iodine drink is used to provide contrast in preparation for a CT scan.

I drank the whole liter of the iodine cocktail. They wanted me to urinate before they did the CT scan, but I couldn’t. I tried and tried, but it just wouldn’t come. Then came my worst nightmare – a catheter.

In all my life, this was something that I dreaded. When I was a little boy, about 6 or 7 years old, I had my tonsils out at the old Primary Children’s hospital. In the same room with me was a little boy who had prostate problems. They had a catheter in him – and he was in agony. I remember when I was young, that I had nightmares of having a catheter put in, and being in sheer agony -- like that little boy at the hospital.

Well, you might say that I had another dream (nightmare in this case) come true. They came into my little curtained-off cubicle at the ER, and put in the catheter. Without going into details, it was one of the most uncomfortable things I have ever experienced. My nightmares as a child were not misplaced! Not only was the catheter uncomfortable going in, but It continued to be uncomfortable for as long as it remained in place.

Finally, they did the CT scan. And the CT scan revealed that once again I had diverticulitis, with an abscess – just like before nearly two years previously. The abscess was in a different location this time, and was pressing on the bladder. This accounted for the painful urinary tract symptoms I had been experiencing, which had masked the real problem.

Unlike last time, they didn’t insert a percutaneous drain tube in me. They said the abscess was too close to the bladder, and as a result would be too risky to insert.

After the CT scan, I was admitted to the hospital. They put me on IV antibiotics, and left the catheter in for a couple of days.

I was in a great deal of pain physically, but the greatest pain of all was psychological. I was supposed to be taking care of my dear wife, who just had a mastectomy the week before. Now she was having to take care of me! This was a heavy burden for me to carry. I had been prepared to serve Dawn Ann in any way possible, and give my all to serve her. And now I could not do that. It was the first time in my life when there was a great need for me to fill, but I could not do it. And that hurt worst of all!

Half A Plate full

Well, I haven’t blogged for awhile. What readers I may have once had, have surely gone away by now. Frankly I haven’t felt much like blogging lately. By the time you read the next series of posts, you may understand why.

Last September, when I posted last, we were facing a monumental challenge in our lives. My wife Dawn Ann and just been diagnosed with breast cancer. On October 2, 2007, Dawn Ann underwent a mastectomy. She was in the hospital for 3 days and 2 nights. I took that week off from work to take care of her. I have written about our experiences with breast cancer at one of my other blogs: DCIS Husband.

The mastectomy was a struggle for Dawn Ann, but she did very well. After the surgery, she was all bandaged up, and had two JP drains coming out of her. The drains were the most uncomfortable thing for her.

The surgery was a complete success! They got all of the cancer with surgery alone. Going into the surgery, we knew that there were two spots of cancer on her right breast. The final pathology report showed not only the two expected locations with cancer – but a third location that was previously undetected! The 3rd spot was not found by mammograms nor by MRI. The third spot also proved to be a more aggressive form of cancer.

The revelation of the 3rd cancer spot only served to confirm our decision to have the mastectomy. There was no doubt now that this was the correct course of action. Even if it would have been possible to do lumpectomies on the two other spots, the third more virulent spot would have remained, and could have done who knows what untold damage -- even pose a threat to her life.

Fortunately the surgery was able to get all the cancer. It was caught early enough that no other treatment, besides the mastectomy, was necessary. No chemotherapy and no radiation. This was a great relief to Dawn Ann.

Dawn Ann decided before the operation, to have concurrent reconstruction done on her breast. After the breast tissue was removed, a tissue expander was placed under her chest-wall muscle. Later, the tissue expander would be inflated with saline to create a space under the muscles, where a silicone implant eventually will be implanted.

Frankly, Dawn Ann’s breast cancer would have been plenty on our plate all by itself. But that was just the beginning of our health related troubles – which I will discuss in my next post.