Tag Archives: Hospital

A Rolling Stone Gathers No…?

Kidney stone with a maximum dimension of 5mm.

Kidney stone with a maximum dimension of 5mm. (Photo credit: Wikipedia)

***Disclaimer: This is an absurdly long post. Read at your own risk.***

This post is officially for yesterday. I’ll be posting again this evening for today. For once, however, I actually had a pretty good reason for not writing yesterday. What is that reason, you ask? It is the simple matter of me passing a kidney stone, without any pain killers. Yep, you read that correctly. About 24 hours ago I passed a kidney stone and it was, to say the least, quite uncomfortable.

I knew something was wrong yesterday morning. When I awoke from the couple of hours I was able to sleep, I felt like someone was squeezing my lower abdomen in a vice. The pain got so bad that I began to vomit, and was unable to keep liquids down, rendering the pills I took for the nausea totally useless as twice I tried to take them and twice the just came back up again along with whatever was left of my stomach contents at that point.

But I suspected another bowel obstruction, so fortunately I decided I needed to get things checked out at the hospital. By 1pm I was at Legacy Emmanuel Hospital. I would have gone back to Legacy Meridian Park, where I was seen for the previous obstructions, but when I called, the guy at the ER admitting desk told me that the wait was over four hours long! So since all records are shared between Legacy hospitals, it made sense for me to go to Emmanuel, where the wait was only about an hour long, and where they would have all the records, lab tests, and scans from my previous visits to Meridian Park. Had I gone to Providence (where I would rather have gone, despite the fact that it is further away from my house than either of the Legacy hospitals), they would have had to start from scratch and re-do all the x-rays, CT scans, blood, urine and stool tests that were done originally at Meridian Park. And of course my experience is that sometimes two different doctors will read the same scans or the result of a blood test in two completely different ways.

So it made sense for me to go to Emmanuel rather than Providence.

I made sure I was able to drive; I had nothing left in my stomach, so vomiting wouldn’t be a problem. I was in pain, yes, but although it wasn’t getting any better, it also wasn’t getting worse. I was exhausted, yes, but I certainly was in no danger of falling asleep – there was far too much going on inside my body for me to be able to rest.

Once there, the wait seemed interminable. All I wanted was to lie down – the only position that seemed even remotely comfortable was lying on my left side with my knees curled nearly up to my chest. And there was no place in the ER waiting room for me to lie down like that. Instead I was forced to sit in a chair, hunched over so that my back wasn’t pressed against the chair. Not very comfortable in and of itself, and less comfortable for someone who has (albeit unknowingly) passed a kidney stone just an hour or two earlier.

Fortunately, the wait wasn’t much longer than an hour. By 2:30pm I was back in a room, lying on my side. The nurse placed an IV and drew blood for labs. Finally the doctor came in. He was a kind, partially balding man, probably in his mid-forties. His name was Dr. Gillette, which of course made me wonder if he was possibly related to either the family whose manual razors I have often used for shaving, or to my sister’s junior high basketball coach.

He asked me the obligatory questions, listened intently, then did his standard physical exam. Nothing was out of the ordinary, except that I nearly screamed and simultaneously jumped off the gurney when he pressed on my lower abdomen. I told him that it felt sort of similar to the way I’d felt with the bowel obstruction, but not exactly the same. And then, he asked me to lean forward and pressed on my lower back. I felt nothing when he pressed on the left side, but when he pressed on the right, I nearly vomited it was so painful.

He ordered x-rays to see if the obstruction had reoccurred, and ordered a urine test. Fortunately, I had just enough liquid in my body to be able to pee right away. He also ordered a bunch of IV fluids and some nausea medication through the IV as well. We were very clear that any sort of narcotic pain relievers were not an option.

The x-rays came back completely normal. But when he came back he told me that the urine had a lot of blood in it, which usually indicates either an infection somewhere in the urinary tract, bladder, or kidneys, or else a kidney stone, which he thought most likely. He ordered a CT scan to confirm.

Laying on my back in the CT was excruciating. But one of the great things about CT’s is that they take less than ten minutes. Before long I was back in my room, waiting. I didn’t have long to wait, however, because the doctor came back in to tell me that I had definitively passed a stone sometime in the past 12 hours. The CT scan I had taken at Meridian Park just days earlier had shown two medium sized stones in the right kidney. The scan he had just take showed only one. In addition, the scan showed significant inflammation throughout the urinary tract as well, which solidly proved his suspicion that the stone no longer appearing in the kidney had decided to take a painful tour of my ureter before exiting my body.

It was a bit of a relief, really, knowing that the stone had passed and therefore the worst was over, however, it didn’t change the fact that I was still in a substantial amount of pain. And it was at this point that the line became a bit hazy, for the doctor, if not for me. It was at this point, having satisfied himself that I was really in pain and not just there to try and scam drugs, he asked me if I wanted him to treat the pain or not. I’m not sure why I had the self-control to turn him down at that point, but I did.

I asked him if there was anything else, non-narcotic, that he could use to treat the pain. He said, actually, there was. Unfortunately, the particular drug he wanted to use was in my medical records in the list of drugs to which I am allergic. But it had been listed as an allergy since 2009 when the doctors at Serenity Lane (the first inpatient alcohol and drug treatment center I attended) in Eugene gave me an intramuscular injection of it, which caused an enormous rash, made me short of breath, as well as causing lightheadedness, dizziness, and a whopper of a migraine.

When faced with those two choices, however, I decided that perhaps taking a chance might be a good idea in this situation. I told the doctor that although the medication (a powerful anti-inflammatory called Toradol, also known as Ketorolac) was listed as an allergy, I would rather chance an allergic reaction than either have zero relief from the pain or take narcotics, which, although they may have helped in the short run, will always make me miserable later. He agreed, and ordered the Toradol, but made sure the nurse stayed with me for 10 minutes or so after she administered the medication, to make sure I didn’t have a severe reaction to it.

Fortunately, I had no negative reaction at all this time. It just goes to show you how complex our bodies are, that once I had a major issue with a medication, and several years later I had no problems with it at all. My suspicion is that the batch of medication given to me back at Serenity Lane was either old, or possibly just bad. Plus, the route of administration was different. An intramuscular (or IM) injection involves the medication being injected into muscle (usually shoulder, buttocks or thigh) and absorbing into the bloodstream from that tissue. It takes longer to be effective, and can sometimes cause a range of side effects that are unassociated with intravenous (or IV) injection. So perhaps that was the major difference. Or perhaps my body’s tolerance to the drug had just changed over the last four years. Who knows, really? The important thing is that the medication worked. I finally felt some relief, and was able to drive myself home, with the doctors instructions being to make sure I kept myself hydrated (as dehydration is the main cause of kidney stones) and to rest and take ibuprofen for the pain.

I could tell that the doctor was surprised that I didn’t accept his offer of opiate pain medication and that I didn’t ask for any to take home with me. Now, 24 hours later, I’m quite glad that I declined. If I had not, I surely would have run out of whatever medication he gave me (if I have access to a bottle of opiate medication, it is typically gone as quickly as I am capable of ingesting it) and would most likely be facing several days of misery. For most people, taking narcotics even round the clock for a day or two would not produce withdrawal effects. But for someone whose brain is still out of whack from years of opiate addiction, it can only take a day (for some people even just a few doses) and the withdrawal symptoms kick in.

Instead, although I feel sore, the pain is easing, and I don’t have to fight through three days of nausea, muscle aches and cramps, fatigue, dizziness, anxiety, insomnia and depression.

Right now, I’m just sore and tired – I didn’t sleep very well last night, because of the pain. But that is altogether preferable than the alternative.

I apologize to anyone who has kept reading this far. I know this post is immensely long compared to my usual. But it was a story I needed to tell. Not for bragging rights, but to remind myself that yes, I can make it through pain without having to take narcotics, and that I am capable or refusing them, even when they are offered by a sincerely compassionate doctor.

It is the reality that comes with being an addict – sometimes you need to chalk up the wins to remind yourself that you may be powerless over your drug of choice once you have made the decision to put that drug into your system, but that you have the power to choose not to use that drug in the first place.

Thank you all for reading, it is days like today where I am reminded how powerful it is to share your experience with others, even you may not know the majority of those with whom you share.

Peace to you,

-Nathan

Intention vs Commitment

First off, let me briefly apologize for the interlude between the last post and this one. Once again, I had a short bout with some stomach issues that have now been resolved. If you want to know the details, read the next paragraph. For those who are either uninterested in medical stuff or grossed out by what goes into (or comes out of) our bodies, just skip to paragraph three.

I went into the hospital with abdominal pain, nausea and vomiting the middle of last week. The ER took a CT Scan of my abdomen and spotted what’s called a small bowel obstruction, which was caused by an adhesion caused by scar tissue from a previous abdominal surgery. While I can’t pretend to understand that particulars, what all that medical jargon means, basically, is that when the surgeons went into my abdomen to remove my appendix back in 2009, they accidentally made a small nick in the outside wall of my intestinal tract. Over time, scar tissue formed there, making the outer wall of the bowels unstable. Then, the outer wall can collapse on itself and “adhere” to itself, which is where the name “adhesion” comes from. This can happen for a variety of reasons, and sometimes for no discernible reason at all. Once an adhesion forms, it blocks off the intestinal tract, causing an obstruction. And, apparently, once it happens in a spot once, it has a significantly higher chance of reoccurring there in the future.

So, while I was not happy to have to spend three nights in the hospital again, I ended up learning something that went a long way toward explaining what was happening to me in late October and early November of 2012, and perhaps even starting as far back as two years ago. I have had quite a few abdominal issues similar to the ones described in the above paragraph that went unexplained. The doctor told me that many of those could have been this same problem exactly, but that unless they take the CT Scan at the exact right time it is very difficult to spot the adhesion, and in fact, often when the scan is taken without contrast, it cannot be seen at all unless the doctor already knows where to look and is looking for it specifically. I asked the radiologist later about it and he said, “It is like spotting one colored line in the midst of many slightly different colored lines. You often can’t see it unless you already know it is there.”

While all that really confirms, on one hand, is that I have indeed had at least a few unexplained hospitalizations that now have a clearer cause. But, on the other hand, I recognized something else that is very useful to me.

You see, while I was living both in parents house and on my own this past fall, I maintained my vegan diet, but I often ate more processed foods and my grain/gluten consumption went way up. This was, in recent history, when my digestive issues began. Then, even more recently, from the end of my hospital stay in December, I have been back on a diet more like what I used to eat in the past, including dairy and even some meat. I didn’t particularly want to eat those things, but I had the riot act read to me by two different dieticians in the hospital because I had lost so much weight so quickly. They wanted me to bulk up and told me I really ought to consider meat and dairy again for at least a short period of time until I gained the weight back, and then just to monitor things more closely once I switched back to a vegan diet.

I also realized that I have a tendency to not eat when I get sick. That seems sort of obvious to many of you, but I often forget about it because I usually feel like I’m eating enough, even when I’m not.

Also, my exercise makes a significant difference in my appetite and in my total calorie intake. It also affects my weight directly: muscle is much heavier than fat. So when I started to get sick, I not only started to eat less, but I also stopped working out, which caused the muscle to atrophe and turn into fat, which caused me to lose weight twofold. Not a good combination.

So, as of tomorrow, I’m back on my vegan diet. That’s really what this post is about. It’s an accountability post. I just tend to be more successful in any enterprise when I tell other people what I am planning on doing. Even if I never know who or where you are as you’re reading this, I know that someone out there has read what I wrote and they will know, and what in my head would have just been an intention becomes a commitment.

I have just enough life experience to understand the difference.

While an intention is nebulous, passive, and unrealized, a commitment is structured, active, and firmly put into place – it is binding, and does not yield to varying future circumstances.

In short, an intention is something you’d like to do, a commitment is something you are doing. It is intention enacted.

So, what does that mean for me from tomorrow on? It means returning to more involvement in my food, cooking more often, and preparing ahead mentally when shopping so that I have the things I need to create dishes for myself that I enjoy. I know that if I don’t really like something, I usually won’t take the time to cook it. Instead, I will often just snack or eat something easy or quick, and it is usually something processed, with all sorts of chemicals and preservatives. It is much less healthy than planning ahead and making at least a general menu for myself so that I cook and have leftovers to eat later. I end up getting more calories and also eating better quality foods that are easier for my body to digest.

At this point, I believe that it was at least partly my vegan diet (and my generally less stressful life) that caused such a marked decrease in stomach discomfort and a lack of any complications in my GI tract that required a doctors intervention. This was something I already knew, but that I briefly discarded in the face of pressure and change. That is something I will have to think about.

Thanks for reading, and I apologize for the lapse between posts again.

Peace to you,

-Nathan

Wellness Quest 2

I was home, now back in the hospital and have been more out of it than you could believe  But I got some inspiration from my Dad and a Doctor here at Providence decided to shake off the fumes of the last couple months, regroup, and go at again.

I don’t know where that will leave me tomorrow, but I was sure how it would leave me yesterday – still in that cycle of broken dreams and empty rooms where I’ve lived the last sad years.

So now, Begin Wellness Quest 2.0. Not much will be changing except that my posts may feel like the recycle a bit as I slowly find my feet again.

Thank you so much for all the continued support of my family and friends – Even when I couldn’t be there for you, you were there for me, with the grace I aim to return the favor.

So I wanted this post to be a description of who I want to be. I’m going to look past all the obstacles, and focus on the goal, as were – the solution rather than the problem.

First, logistically (because I can see that all else disappears when I take opiate drugs, even if it is supervised in the hospital). This will have to be unwavering, through pain and struggle and, and I must be, overall, doubtless in my certainty.

Second – Also a foundation piece: I want to be honest in every single word that passes my lips, no matter the point, no matter the ears of the recipient, not harsh, undiluted, I’m gonna be brash and in your face. Because I believe each person’s walk on this earth is different, and that we each walk and make our own truth as we live it. But despite that. Blatant falsehood is wrong. No matter the reason, it has returned to me over and over again in the past few months that when I lie in order to put off the consequences of my actions, the just keep adding up till I have to serve the time  anyway. What good reason is there to lie when the people I love don’t lie to me?

Third – The overcoming of obstacles. I feel best when I am put in a situation that I am told I cannot overcome and yet I succeed. Whether the challenge is physical, mental, emotional or spiritual – I will be looking for ways to create and overcome new obstacles and bolster my foundation in other places.

Fourth – I will stop placing artificial obsticles in the way of meaninful employment, and. most importantly, stop putting limitations on my career as a writer. I realize when people ask me now about what I’m working on they get a cross between a volunteer and that’ maybe nice but well, he’s not going anywhere with his life, or even worse just a guy who’s too old to be living with his parents and freeloading. I want to effectively be doing the things that i need to do to be healthy while still being social and finding meaningful employment.

There will be more additions to this and to the other pages soon, I promise. I’m back to the post-a-day schedule.

Thanks again to all my readers who have continued to support me despite my absence the last few months!

Peace to you,

-Nathan

Takin’ Care of Business

English: Emergency room after the treatement o...

English: Emergency room Photo credit: Wikipedia)

I wish I could predict things before they happen. Well, perhaps not. But it would sure be nice to know in advance when I’m going to get sick. I know that when I listen to my body I can notice those signs that precede a major illness, but some of the smaller, more complicated problems that can be caused by my CF are harder for me to predict, and I can sometimes confuse them with normal CF symptoms I feel every day.

Anyway, I started this entry last night, so I’ll be writing you another for today later on.

But here’s the crux of yesterday for me: I had some pretty serious pain in my flank and in my lower abdomen again and when I called my doctor he was concerned and once again directed me to go to an ER asap. So I did, not having a clue what they were going to be able to do.

It’s tough for me when I am in the hospital and I am experiencing real pain to not give in when offered narcotics and if they aren’t offered, it can sometimes be really hard for me to not ask for them. Despite the fact that I know where that leads, part of my brain always tries to rationalize it: “Hey, it’s ok,” it says, “you’re sick, in the hospital, the doctors are monitoring all your medications, they know your history, they won’t give you anything too strong and they won’t send you home with anything so it’s not like you’ll have to go through withdrawal again, you’ll just be more comfortable here, right now, in the hospital, and then they’ll figure out the problem, treat it, and you can go home and the pain will be less and you can handle it.”

But all that boils down to is that the part of my brain that still wants to numb out the rest of the world wants to take drugs now, for immediate relief, and not worry about potential consequences in the future, and in fact, not even think about consequences as a possibility. My logical brain knows that consequences are inevitable for me if I even take one dose, even if it is supervised and in the hospital. And yeah, there are exceptions. If I got into a car wreck or broke my arm or had any other obvious, serious, pain causing injury that can be objectively observed, then yeah, they can give me narcotics. I’d probably need to stay an extra week in the hospital so they could supervise me tapering off of the drugs, but obviously if I have a real injury or illness that they know causes pain, the rules change. But barring that, I need to always remember that I can handle pain. I just have to commit to not letting myself go down that path again despite how much something might hurt.

It is tough though, because I feel sometimes that when I get sick I might as well have a couple doses of pain medication while in the hospital. Because it won’t be long enough to cause dependence, it would be supervised by medical professionals, and it would make being in the hospital so much easier.

But on the flip-side, even a dose or two of those medicines get my head spinning, and I always want more. Even if I tell myself and tell the doctor I only want one dose, I inevitably ask for more, and inevitably try and convince the doctor to give me something to go home with.

So I know that I really can’t do that. I made that mistake back in August, allowing myself a single dose while in the hospital, and it sure did make me want more.

Here’s where I tie in the title: my health is just one more aspect of my life where I just need to take care of business. Sometimes that means going to the ER. Sometimes it means just staying home and resting instead of going out. Sometimes it means doing an extra nebulizer treatment during the day, or changing my exercise routine based on what my body is telling me.

But the point is, I have to take care of business when it comes to my health. It really is not negotiable. There have been a couple days where I’ve let things slide, and there have been a couple days when I really didn’t feel well but I forced myself to do things anyway, which is fine, but there’s a fine line between working through something difficult and not taking care of myself.

I just have to keep in mind that I will suffer the consequences should I be lax on my meds or forget to take my digestive enzymes, or just stay up too late and get up too early. I am coming to learn that almost everything I do has an effect on my body, and it is all I can do to make sense of those many influences (both major, obvious ones and smaller, less noticeable ones) and try to respond accordingly.

What my body tells me right now is that I probably need to eat and take a quick nap before finishing my work.

I can tell my body and my brain are tired, and that is usually the perfect time for me to take a break.

Thanks for reading,

Peace to you,

-Nathan

Where I’m At, Now

I could give you all a lot of garbage reasons for why it has been (and this is ridiculous) I don’t know how long since I’ve posted. Some of those reasons might even sound rational. Hospital this, infection that, moving in, moving out, busy with work, blah, blah fucking blah.

The truth is that after finally moving into a new place, I realized quickly that it wasn’t working for me. Not enough space, nowhere to truly cook for myself, and a generally unhygienic atmosphere. I felt more unhealthy there than I have since the beginning of my wellness quest, and I have had to look at WHY I have felt that way.

Here’s what happened – I let my routine lapse. I tried to create a new one at my new place and failed. But I took just a little too long to ask for help. I left myself open (so to speak) to illness, and sure enough, illness came.

I’m not saying that I can always control my disease. Cystic Fibrosis isn’t always logical and I can’t always control when and how I do or don’t get sick. But one thing I know for sure – the chances of me getting sick are significantly increased when I don’t follow my routine: meds, exercise, diet, meditation, and writing. All of those things have helped me on a daily basis work toward optimal wellness, and I was all too quick to “modify” or “alter” or even to completely eliminate some of those elements because I was feeling well and doing well.

So it is time for a re-frame. I could kick myself while I’m down. Or I can remind myself how far I have come and how well I have done, and get myself back into gear.

So here’s where I’m at, now: I’ve moved back in with my parents till I can find a place of my own that supports my wellness goals. I am restarting my one-post-a-day rule for myself, here on The Wellness Quest. I am recommitting to stick to a plant-based, vegan diet. No “cheating”. And I am recommitting to exercising daily, including my Tai-Chi practice, cardio, and strength-building exercises. Finally, I am re-establishing my daily meditation practice, at least ten minutes a day.

Those were the things that got me here. They are the things that will continue to move me ahead. I have confidence that I can create the routine I know I need while allowing myself some new freedom at the same time.

We all have to learn to adapt. The realization for me was that I was not adapting, I was regressing. So it isn’t back to the drawing board. It’s back on the horse. (sorry for the mixed metaphors. But this isn’t a literary blog, so who gives a damn, right?)

Thank you all for staying with me. And I thank you all for your encouragement and support even when I disappeared from the blog-o-sphere for some unconscionable time period I haven’t even wanted to quantify.

Peace to you, as you move through your day. May you find your freedom within the routine, and beauty, within the mundane.

-Nathan