Friday, November 23, 2007

When The Bell Tolls - Ya Better Listen

I have spent the last six months slowly and daily living with graduating pain levels. That was until the last month.

One morning I rolled over to shut off the alarm clock and got the wakeup call of my life. Feeling a huge and very painful pop in my lower back and an instantaneous back muscle spasm, I began a new chapter of my life. One that deals daily with getting my health back.

Fortunately for me, my better half was there to haul me out of the bed that morning and take me to the urgent care center. I was unable to stand up straight, was dragging my right leg, and unable to tolerate lying down (my spine was locked up in perpetual spasm causing my pelvis to tilt at a painful angle in which I could pass my hand easily underneath my back while lying down). The initial round of pain killers and muscle relaxants did nothing to help my back spasms and two days later after sleeping fitfully in a chair we were able to get in to my regular doctor. After x-rays, the doctor prescribed a stepped up medication therapy and a visit to the chiropractor in four days once the medication had a chance to kick in. For those four days I remained sleeping in the chair and hoping the medication would work.

Going to the chiropractor helped tremendously. He had me lie down on his exam table and said, "Please remove whatever you have in your back pockets." When I told him I didn't have anything in my pockets he said, "Boy, you are messed up." Fortunately for me he was able to make a single adjustment (he tried for two but couldn't because my back was still spasmed too much) and I spent my first night in bed that night after 6 nights in a recliner. What a blessed relief that was!

So after missing 10 days of work, I returned with a lumbar support cushion for my chair feeling a hundred times better than I had for months. It seems that since I took a desk job after having been so physically active that slowly my back had decided to go into mutiny on me. What I did find out was that I actually had had a herniated disc at the L5-S1 region, which I re-tore when rolling over. The doctor said that the first time I injured it I probably just thought I had strained my back and was able to go on with my work, but the second injury created enough of the "cushion" to be gone between the discs that it created the pain I felt which was aggravated by the muscle spasms. I also found out I have a bulging disc at the L3 region and levoscoliosis which causes a curve to the left of the spine at the bottom of the thoracic region where it meets the lumbar region of the spine. The levoscoliosis affects the nerves that feed the abdomen and groin area causing pain to that region.

This is where my health story becomes more interesting. Now as a nearly 50 year old, I was experiencing painful menstruation for the same six month time frame and had undergone a complete physical with ultrasound that found nothing conclusive to explain the monthly agony I was having. Having ruled out (prior to my back going out) any organic reason for the pain it was with some relief to believe that the source of the pain was my back caused by the levoscoliosis. This revelation I could live with it. At least I wouldn't be having to endure a hysterectomy.

So I worked for a week with minor back and abdomen discomfort helped by medication that I only took at night. I invested in a Sealy mattress set (for a fraction of the cost) that was comparable to a Cadillac of the Tempur-Pedic mattresses and was sleeping like a baby. I actually felt pretty darn good compared to what I had a couple of weeks prior to the morning my back seized up on me. I was able to catch up on my backlog at work and was feeling pretty good about things when I returned to work the following Monday morning. That is when, hell began again for me - but with a very surprising twist.

By Monday afternoon my abdomen and right side was hurting some. No problem, pop some pills, sit in my new zero gravity recliner with the heat massager on full blast and I thought I was good to go the next morning. But by Tuesday afternoon the pain was so bad that I medicated myself at work which I had not had to do since I had returned. My office mate noticed my discomfort and I told her I had probably thrown my back out once more.

Tuesday night the pain was radiating from my belly button to my right groin with pain on my right flank (side). I couldn't stand upright, couldn't sleep, and the medication was not helping. I began to suspect that I had the cursed luck to be having an appendicitis attack on top of everything with my back. I finally took my temperature and with a sinking feeling confirmed to myself I couldn't ignore the symptoms I was having. So I called in to work once more and took myself off to the urgent care center again, having sent my better half off to work earlier that morning with the stubborn notion that "this too would pass".

I dismally failed the exam. The urgent care doctor wanted to call for me a ride, but the hospital was only a couple of miles off so I drove myself. After I hit the ER, things began to move pretty quickly. Lab work was done and I had an elevated white blood count (showing an infection). A CT was done and although they couldn't visualize my appendix, the doctor said that I definitely had "something going on" as there was a thickening in the abdominal wall in the region that I had pain in. A surgeon was called in, the anesthesiologist made his appearance and before I knew it off I went to surgery.

It wasn't my appendix. The surgeon began a laparoscopic surgery and found as he put it a "perfect" appendix. What gave me my trouble turned out to be a diverticula - not to be confused with diverticulitis - but rather a congenital birth defect, which usually is seen on the left side and discovered at a young age (before adulthood) where a single spot of the intestine causes a weakening in the intestinal wall which causes a pocket to form that finally becomes necrotic over time. In my case, the diverticula had burst causing the thickening of the abdominal wall as peritonitis set in. Fortunately for me, the hole closed off quickly (encapsulated) or I would have been in much more serious condition. As it was, the surgeon ended up removing the diverticula (which the anesthesiologist described as "massive") and about 6 inches of my large intestine. He also found a cyst on one of my ovaries and removed it, leaving the ovary intact. All were sent off to the lab for testing before they closed me up and thank God came back negative for cancer. I figure the diverticula was probably the size of a small tangerine, based on the size of the incision they made to remove it.

That was Wednesday. By Saturday I was released from the hospital. Let's just say it wasn't a pleasant experience. I found only one nurse to be working at a "gold standard" level during that time, while the other nurses (and aides) not only were substandard with their care, but indifferent to boot. On Friday I demanded to see the doctor as the pain wasn't being covered by the medication he had me on. The problem I had with all the staff was trying to make them understand that I was having back spasms that was right up there with the pain I had had a month prior, while my incisional pain was inconsequential (one of those if you don't touch it, it doesn't hurt things). He finally prescribed a muscle relaxant after my insistence and low and behold, my pain began to go away.

I also told the doctor that I was disappointed with the lack of proper and adequate basic personal protection the nurses had taken (no gloves, etc. while giving injections, changing IV sites and IV bags) and that I could take care of myself better at home. I had finally told one of the nurses, that I had worked in a long-term acute care facility taking care of MRSA, VRE, and flesh eating disease patients and asked her to use gloves for her own protection (forget mine at that point). I had felt a sudden wetness (which I discovered was blood) coming from down below earlier in the morning and I had called this same nurse to check it out. She asked, instead of LOOKING to see exactly where I was bleeding from (having had surgery on two different regions, either which I could have been bleeding from), if I had brought "personal hygiene protection" with me! It wasn't time for my period, it was 10 days early I told her and no, I didn't have any "personal hygiene products" with me. So off she goes and comes back a few minutes later with a package of napkins, tosses them on the furthest side of the bedside table away from me and waltz's back out the door. I thought my better half was gonna kill her. He got "that look". That was when I called her back to the room and we both demanded to see the doctor. (Why I began bleeding was probably due to trauma to the ovary and tube as it was nothing akin to menstruation, which the doctor allowed after examining me and resolved itself late Saturday).

I was still running a temp and insisted on another round of antibiotics from the doctor. I had been forced to take my own temp under my armpit and adding a degree as is customary in this case, as the aides had a problem understanding that drinking cold water (as I had been constantly due to the temp) would affect the outcome of the reading. (Case-in-point, I took it with my personal digital and had a 102. 4 temp, the aide came in within a half hour and shoved it in my mouth, even though I told her that I had just taken a drink of ice water and announced my temp was 97 degrees. I told her to try again and this time took it from her, put it under my arm and to her surprise it came back 101.3 (add the degree and there you go...). Can you say pissed off? (Always, ALWAYS - I am sorry to say as a nurse - look out for your loved ones in the hospital, take notes, question the staff and try to learn as much as possible about their health situation and appropriate care they should be receiving and then DEMAND it). Temperatures under 101 are not normally treated with Tylenol, but a consistently higher than normal temperature is indicative that something other than a normal healing process may be going on. Meaning, another set of lab work and more antibiotics if necessary, is not an uncommon way to deal with it.

Well no one was happier to walk out of a hospital than I was Saturday morning. I am now doing very well. I saw my personal doctor on Tuesday and he was amazed (the look on his face was worth a million bucks) that I had come in - not because of my surgery - but because I wanted to make sure that I didn't run out my medications for my back and to get my annual flu shot while I was off work. I don't think the poor man really believed I had had surgery until he got me up on the exam table and saw the incisions for himself. He was taken aback when I told him that I wanted the low dose of pain medications renewed for my back, as I didn't need the stronger and addictive pain medication the surgeon had put me on. He allowed that I would always have back problems and promptly re-wrote the medication prescriptions for my back, all the while muttering that he had never seen anyone come in that soon after surgery and not make a "big deal" about it.

To me it wasn't a "big deal" having had surgery. My back is a "big deal" and was the real culprit as I laid in that hospital bed in pain. Now that I know how to deal with it, I find myself celebrating my new found health, even if I do have to live with back problems. I am still having the up's and down's of surgery with a good day followed by a bone aching tiredness the next, but hey - everyday it gets better and it's nothing compared to what I had lived with for such a long time before that morning the alarm clock rang and woke me up once and for all about my health.

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posted by Is It Just Me? at 7:13 AM