Still Miles to Go

I checked back in to Chateau de MGH last night. Yup, they just couldn’t keep me away!

Over the last couple days, I had been getting increasingly worse sharp pain in my upper left abdomen. I joked to Keith that my spleen and pancreas were duking it out. But I hadn’t pooped in three weeks so it could just be constipation, right? We started pushing mag citrate through the tube. 3 bottles over 30 hours, to be exact. No success.

It hurt to move, it hurt to breathe, it hurt to sneeze and cough and burp. I laid on the couch in the fetal position all day on Tuesday with the occasional moan or whimper. Keith threatened to take me to the ER on numerous occasions. I resisted. I had just escaped; there was no way I was going back so soon. I gave in to pain medication and took 4mg dilaudid PO. I didn’t even get a slight buzz… there was something wrong with that. Four hours later, I crushed another 4mg and put it through the tube. Still no relief. No wooziness even. What was wrong? Why wasn’t my body absorbing it?

Well, still no answer on the oral dilaudid front, but I did get some answers to the pain. After only four hours of sleep, I woke on Wednesday with even worse pain – I didn’t think that was possible! – and I finally succumbed to Keith’s pestering. So we packed up our gear and headed in to Boston. The ER was a madhouse and it took a good hour just to get to screening. I curled up on two chairs in the fetal position and napped to pass the time. We finally got to see the screening doctor who felt around and guessed that my tube was out of place. So we went in for a tube study. Afterward, they got my blood and urine. We waited another 2 hours. While we waited, I vomited a few times. Oops, I thought, I forgot my afternoon Zofran! They hooked me up with IV Zofran. They stopped by to take my vitals. My heart rate, as usual, was doing the cha-cha-cha. And my temperature went up 100.2. Yep, I had a (low-grade) fever now. We waited another 30 minutes or so. My tube study was normal. And the doctor asks casually, “have you ever had gallstones?” “Uh… no. And my gallbladder is on the other side from the pain.” “Yes, but your lipase came back incredibly elevated. I think you have pancreatitis.”

Brilliant. Well, they kept the morphine coming as we waited to be taken to ultrasound to see if I had gallstones. The two main causes of pancreatitis – accounting for 80% to 90% of all cases – are excessive alcohol intake and gallstones. Considering that I’ve never even had a single sip of alcohol, we decided to pursue the gallstones theory. If it’s gallstones, they you wait for the acute pancreatitis to pass and then remove the gallbladder to prevent future episodes. And this episode would resolve as soon as I passed the current gallstone. Simple, routine, easy. Two hours later – nearly 2 am – I was taken back to have my ultrasound. The tech took forever because, she said, I was full of gas and stool. But good news: no gallstones! Also bad news: severely inflamed pancreas. And no known cause of the pancreatitis.

So the doctor sat us down with these results. First, she mentioned that I am still quite young for pancreatitis – but when do I ever follow the rules? She also said it’s unlikely that any of my particular medications are causing it and incredibly unlikely that it is caused by my diet. Unfortunately, some cases of pancreatitis are idiopathic – meaning “there’s no known cause.” But without a known cause and plan of action, they’re admitting me for at least a couple days. The hope is that they can take care of a few things while I’m in, including getting my metabolic panel under control and cleaning me out once again considering the sitz markers from over FOUR weeks ago are still in my cecum. Unfortunately, it appears that I once again have a pretty severe pseudo-obstruction in my colon which is making imaging of and treatment for my pancreas difficult.

Last night, we were stuck in the Emergency Department because there were no open beds. And the ED was packed. I got very little sleep last night. This could have simply been due to the sharp stabbing in my left side accompanied not by waves, but by tsunamis of nausea. Or it could have been due to the ED environment. The lack of solid doors, the 24-hour fluorescent lights, and the serenading beeps, bloops, and BEROOOONs. Or it could be attributed to my sick – and likely highly contagious – neighbor on the other side of way-too-thin cotton curtains who sounded as if he was gargling the air rather than breathing it and had a snore rivaling that of the Underworld-dwelling, three-headed giant Cerberus. I think my stay may be prolonged by another month due to whatever bug this caring and sharing man decided to spread throughout the ED. And his wonderful gift was accompanied by the screaming residents who determined that the solution to a Spanish-speaking patient was SPEAKING LOUDER in a language he doesn’t understand.

It would suffice to say that I’m tired. I’m hoping they can get us into a room soon because there is no rest on the horizon as long as we’re still in the ER. Twenty-one hours and counting. I pray the “open bed gods” decide to bless us with a room soon. Otherwise, I’m going to go mad from pain and sleep-deprivation. 😛

True's favorite part of the hospital: Blanket Warmers!!!