Friday, November 7, 2014

Angels On My Barcalounger

I originally had about a hundred fifty titles for this post.  OK, at least six.  Or seven.  I may have a hundred fifty by the time I'm done.  More keep trampling my cranium every day.  What's wrong with me?

"Primal Tales of My Wicked Uncle Wiggley", "Knockin at the Dragon's Door", "There's Flying Monkeys in My Nightmares",  "Frankenbelly, the Absurd",  "There's Gangrene in My Soup?", "The Appendix-Why?"  But "Angels On My Barcalounger" won out because I did meet a few Angels on this particular journey, and without them my recovery would not have been what it has been.  Alex, Teresa, Kay, Delilah, Loree, Dee and Laura-I bow to you and humbly thank you.  You cared for this old wracked with pain body with such incredible kindness and compassion.  And humor.  Words cannot fully express my gratitude.

And of course, I would be wholesomely remiss if I did not mention my very own personal Angel, my lovely wife, whose undying love and support is a blessing EVERY SINGLE DAY.

I also have a new Superhero, my surgeon, Dr. William Statton. The hell with Batman.  Or Katman.  Du.  This man makes life and death decisions every single day.  As far as I'm concerned he saved my life, with skill, compassion and humor.  Thanks again Doc, words cannot express.

BTW, I have, apparently, dated myself with the "barcalounger" aspect of the title to this tale.  Barcalounger is another term for recliner.  As in furniture.  There is a Barcalounger web site and everything.  For any of you that didn't know.  And I just love saying the word, barcalounger.  It's a problem, I know.  But in the aspect of this tale, of course, it's an unorthodox metaphor for where I would be.  At any particular time and place.  And fortunately, in this particular time and space of immediate need, there happened to be some Angels.  How lucky is that?

How did I get to the point where I garnered Angels and a new superhero?  Well, let's first examine the nasty little rascal that caused all this uproar, my appendix, who I have confoundedly named Uncle Wiggley.  My very wicked Uncle Wiggley.

Extending from the inferior end of the large intestine’s cecum, the human appendix is a narrow pouch of tissue.  It is located in the right iliac region of the abdomen (in the lower right-hand abdominal area), measuring about four inches long and roughly a quarter of an inch in diameter.

The appendix is not a vital organ and medical researchers still debate its exact function in our bodies. One hypothesis suggests that it is a vestigial remnant of a once larger cecum. This larger cecum would have been used by vegetarian ancestors to digest cellulose from plants. Supporters of this hypothesis therefore conclude that the appendix no longer serves any purpose for us.

Another hypothesis suggests that the appendix acts as a storage area for beneficial bacteria during times of illness. Beneficial bacteria living in the appendix could survive being flushed out of the large intestine by diarrhea. The appendix would therefore help a person to recover more rapidly from illness by enabling the bacteria to re-colonize the intestines after the illness has passed.

Apparently it also serves an important role in fetus development.  Well, whatever Uncle Wiggley did at one point in time for me he decided not to do it anymore.  He apparently got upset me for whatever reason and decided to get all infected and stuff.  Like, what'd I ever do to him?  And let me tell ya, when an appendix decides to go south it definitely screws up your appetite.  For just about everything, including food.

My odyssey first began in the early morning hours of October 4th, when a sharp pain in my abdomen woke me from sleep.  The pain slowly gravitated towards my right side as the hours and weekend progressed.  I did my on-line duty, reading up as much as I could about appendicitis.  I was sure that was what was bothering me.  The pain was constant, but I did not have a fever, and I still had a small appetite, of sorts.

I called my doctor's office the first thing Monday morning, and that is when I discovered my GP had left the practice.  (I don't go to the doctor's office that often.  It's one of the LAST places on the planet where you'd be likely to find me.)  I was informed I could see the Physician's Assistant, or PA, at ten that morning.  Concerned that this could be appendicitis, I gladly took the appointment.

After the nurse checked me in, took my vittles and asked me why I was there, the PA finally came in.  She sat down in front of the computer and proceeded to ask me a litany of irrelevant questions about irrelevant symptoms, like leg cramps and hands swelling-when I was in there with abdominal pain.

She never even touched me once.  She never palpated the affected area, nothing.  Nada.  Zilch.  It was like I had Ebola or something.  At that keyboard she came up with the conclusion I probably had pleurisy, a lung condition, primarily because I did say it hurt more when I took a deep breath.  Which it did.  It all hurt over there.  So she prescribed Ibuprofen 800's and sent me on my way.  She also did order some blood tests, just in case.

The tests came back negative.  For what I don't know, but they were negative.  I'd be willing to guess my appendix hadn't yet exploded and my white cell count was normal.  I bought in to the pleurisy diagnosis, primarily because I didn't have a temperature and still had an appetite.  Not huge, but I was still eating.  Those two issues are apparently huge red flag warnings when trying to diagnose appendicitis.  Especially the temperature thing, and mine had been running pretty much normal.  Everything was working somewhat soundly, albeit painful, so I continued on my way.  For days.

And then over the night of October 15th I developed the chills, knowing then I had a fever.  That morning I called the doc's office again, and garnered an appointment at 2:00 that afternoon.  With the same PA.  I inquired as to whether or not a real doctor was available, and the receptionist got a little miffed, stating "Our PA works under the direct supervision of a doctor."

Well, whatever.  I just hoped they'd get the diagnosis right this time.  Pleurisy?  In my abdomen?  Really?  That entire day was spent in growing agony, and I couldn't do much except hang out on the sofa and watch Hogan's Heroes reruns.  And laugh with the pain.

I presented myself at the doctor's office with a 101.5 temperature.  After the nurse took my vittles, the PA came in soon thereafter with a mortified look on her face.  This time she immediately palpated my rock hard right side and said I needed to go to the ER.  ASAP.  She thought my gall bladder had burst.

The problem I encountered, and what also helped lead me towards buying into the pleurisy diagnosis, was that the pain seemed to be higher than where the normal appendix would be.  And it was lower than where gall bladder pain is normally associated.  Well, fuck me.

After I checked in, I got to sit and wait in the ER waiting room for two and a half hours.  Doubled up on a chair.  It was a big day in the ER.  I don't do crowds or waiting well, which is why I would rather bleed to death than go to a hospital ER.  Which was probably why I was doubled up in agony on a chair.  That and a pleurisy diagnosis two weeks ago.  I almost got up and left, but the pain was getting worse and I'd just have to start all over. 

All the rooms were full, you know, ambulatory people with goiters and sniffles.

"Oh, I'm congested and maybe have a cold.  Got an aspirin?"

I was outside in the waiting room slowly dying while some people were inside the ER simply dying to get attention.  There's a difference, I'm sure.

I was finally ushered in and led to a bed in the hallway.  Hell, I didn't care.  I just so needed to lay down.  The floor would have been fine.  The ER nurse was great, unfortunately her name escapes me.  Another  unnamed Angel to be added to my list.  She was thorough, and the ER doc was soon by my side.  We talked, and then he palpated.  Boy did he ever palpate. 

He hit the spot and that jolt sent me beyond the moon.  Just the thought of that jolt still hurts today, a couple weeks later.  That's gotta be what a bullet feels like; a white hot, searing fireball of fury tearing deep inside the pillow soft down flesh of my abdomen.  YOW.  It had already been feeling like a slew of flying monkeys had been stabbing me relentlessly Manson style.  The Doc just dropped a bowling ball into the mix.  Death sounded good. 

He then ordered a cat scan, trying to rule out appendicitis, gall bladder problems or c a n c e r.

"Oh great", I thought, I hadn't really thought about that possibility yet.  Thanks Doc.  He also reiterated the obvious ongoing dilemma, the pain location seemed to be too low for the gall bladder and too high for the appendix.  The cat scan would tell the tale.

In the meantime he also ordered a shot of dilaudid, or hydromorphone, a synthetic morphine.  Maybe I had died and gone to heaven.  After sitting in agony for hours, days really, I was lying down and soon the pain would diminish.  A little bit.  That shot took the edge off, but them dang monkeys were still there, jabbering and poking me in the side with a red hot andiron, which amazingly felt better than being stabbed with a butcher knife.  Or so it seemed. 

It turned out to be a fun deal being in the hallway.  All kinds of shit house howdy things were going on.  And everybody, doctors and nurses alike, always had a smile on their face for me as they passed by on their urgent missions.

My lovely wife was there soon after I arrived in the ER.  Besides her love and compassion, she also had her IPhone, which enabled us to keep track of the Giants-Cardinals pennant game.  I've been a Giants fan since 1962, so even though I couldn't watch the game on TV I still had to keep track.  Even in a foggy ether.

We also had a doctor that was keeping track of the score through us.  We were his score source.  At one point I was signaling the score by hand to him waaay down the hall in between his bed calls.  It was hilarious.  Or maybe that was the dilaidid.  With or without drugs, I crack myself up all the time.

Which is different than cracking up.

I think.

It took about an hour to get the cat scan, but then a scant fifteen minutes later my ER Doc was smiling and waving at me from down the hall.

"It's acute appendicitis!" he hollered through the din, gesticulating and smiling. 

I smiled, gave him two thumbs up and said, "Great!"

I think.

Actually, it was good news.  It definitely beat the Big C as far as I was concerned.  And it was something that could be taken care of with relative ease.  No uncharted territory here.  The Doc was down by my side in another couple minutes, explaining how Uncle Wiggley had kind of wrapped himself up around and in with my large intestine.  That's why his location was abdominally abnormal.

Fortunately I had not eaten that day.  I had reread a bunch of stuff about appendicitis that morning while I was down for the count, and the specter of surgery loomed.  If it truly turned out to be appendicitis, surgery was really the only option.  Get that bugger out of there, before it gets all pus-e and bursts.  I had a cup or two of coffee and maybe a glass of water that morning, but I gotta tell ya, nothing down there in that region was feeling right.  It was like something had died and the noxious vapors were filling the void, which, in a way, turned out to be kinda true.  I mean, the gangrene was festering.

 Appendicitis is a medical emergency that requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity's lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.

The most frequent complication of appendicitis is perforation. Perforation of the appendix can lead to a peri-appendiceal abscess (a collection of infected pus) or diffuse peritonitis (infection of the entire lining of the abdomen and the pelvis). The major reason for appendiceal perforation is delay in diagnosis and treatment. In general, the longer the delay between diagnosis and surgery, the more likely is perforation. The risk of perforation 36 hours after the onset of symptoms is at least 15%. Therefore, once appendicitis is diagnosed, surgery should be done without unnecessary delay.

Since I hadn't eaten, he said, they could get going with surgery right away.  And I mean, things got moving really fast at that point.  A burst appendix can be life threatening.  It was then around 7:00 PM.  An EKG was ordered, a chest x-ray.   More blood tests.  Bam.  Bam.  Bam. 

Somewhere in there, it is a little bit sketchy, I met my Super Hero and the Anesthesia Kid.  Then I was wheeled down and around quiet, dimly lit hallways, through passages and corridors until I landed at a pre-surgery party down area.  There I met two lovely surgical nurses, whose names also escape me.  More unnamed angels.  My surgeon and the Anesthesia Kid were also there.  I think it was around 9:00 to 9:30 PM at this point.

My Super Hero, the surgeon, Dr.Statton, explained the intended laparoscopic procedure, which is much less invasive than open surgery.  He would make 3 small incisions, one through the navel, and see if he could do the deed that way.  But he also stated since it had been more than a few days since the pain started and most appendix burst within 24-48 hours it would more than likely be a full blown open surgical procedure.  He even expressed concern for my bikini line, but since I am a 60 year old male and my beach roving days are way behind me, I said it was OK.  Slice away.  It'll just be another wound upon my visage.  Another tale to be told.

I kissed my lovely wife good night, and our hands touched good bye, lingering for an extra moment, perhaps a lifetime.  I remember transferring from the gurney to the operating table, wincing in pain with any movement.

They put a mask over my nose and mouth.  "Count backwards from ten!"


I awoke on a space ship.  "Innerspace, the final frontier.  These are the voyages of the Starship Dave..."

I looked around.  I was soaring high in orbit, somewhere.  The command center seemed fairly quiet and dark, but then there were all sorts of strange colored lights on all sorts of intricate contraptions.  Some blinked, some were steady.  Once in a while a contraption would make an otherworldly space ship noise, kinda like Yoko Ono singing.  If you call it that.  It appeared I was the only one in the command center, until a young lad named Alex strode in.  I liked the shuck of his jive immediately.  I was also stoned to the bejeezus.  I appeared to be on a happy journey.

Alex, the self-proclaimed navigator for this leg of my journey was a sure fire hired gun on a trajectory to the stars.  In his early twenties, he was off and running on a career in service for all us rapidly aging old poop farts.  An admirable young man with such care and concern, and he's just now on his way.  He turned out to be an adept accomplice.

He steered my spaceship through a couple galaxies, always keeping me in a constant state of conscience drool, or planetary exploration.   IV hits of Dilaudid every couple hours.  We were always trying to stay ahead of them dang flying monkeys with their freakish butcher knives.  They were chasing me.  Always after me.  I was running, and running hard.  I think we were getting close to the rings of Saturn.

Or Buick.

As dawn crept upon our side of the Milky Way, I was introduced to a new navigator, an angelic creature named Teresa.  My initial navigator had to head off rest, repast and refueling.  But the hand off went well and Teresa and I became acquainted quite intimately, her care and professional demeanor lessening much of the humiliation one can feel when their aging old poop fart body is on display.  With my once proud WWE physique now resembling a soft white belly by Truman Capote, modesty could only go out the window.  And laughter could only ensue.  Amen.

Except when she preformed one excruciating procedure which allowed a certain part of my anatomy to function properly.   Without that dicey, white knuckle intervention the weight of the world on my abdomen (and bladder) would only increase until the point where it burst.  And then a shit house howdy bunch of pain and tears would ensue.  And probably my intestines too.  Teresa was a darling, and she kept the Starship Dave in orbit throughout the day.

That morning the Galaxy Commander, my surgeon, came in and gave me the travel scoop thus far.  He did initially try laparoscopic surgery, but then had to convert to an open appendectomy.  The appendix had perforated.  Burst.  Poof.  Lucky me.  I would need to stay in orbit for 4 or 5 days while they kept my system lubricated with IV antibiotics.  And pain medication, you know, trans-dimensional rocket fuel.  

Minutes crept into hours, and hours into light years.  There were visitors.  Phone calls.  Apparently there were people out there who were interested in what I was doing.  Where I was going.  I told them I'd just passed the Milky Way, left Uncle Wiggley on Mars, and was on my way towards Pluto.  The friendly planet.  Just trying to stay ahead of the flying monkeys.  And Tom Jones.  In leopard print briefs and playing trombone.

Ya, I was experiencing some weird, wicked dreams.  I'm sure they understood. 

When the witching hour once again came upon my vessel, Teresa handed me off to Kay, my next night time navigator.  Kay and I got along quite well, sharing some of the most wonderfully silly and insipid jokes ever known to deranged lunatics or elementary school children.  But we laughed, or giggled, a lot.  It was a bit painful to laugh, but it was also another necessary form of healing.  Kay was a delight and kept my star ship on course through the night.  We laughed together in the face of those damn monkeys.

The next morning I was introduced to Delilah, another young, enchanting creature.  She was a traveling RN for hire.  13 weeks here, 13 weeks there.  What a great way to explore the country until maybe finding an ideal location to land.  Delilah preformed another quite intimate procedure for me, removing that certain item that Teresa had set in place the morning before.  The Galaxy Commander felt that certain part of my anatomy could now function properly, so Delilah was the lucky girl who got to remove it.

Sigh.  Another lovely girl to witness me in my not so perfect prime.  But what a doll, all accomplished with compassion and humor.  Which humor was probably initiated by me.  But she played along.  I mean, if ya can't laugh at yourself and the predicaments ya find yourself in from time to time, then maybe you're too darn serious.  This was a hell of a predicament.  I was pretty much helpless.  And hapless.  I had to laugh.

Sweet little Dee was one of the co-pilots, there was always a co-pilot behind the main navigator.  She was a sweetheart, I know we had several conversations.  About what I have no idea, it's possible this memory lapse could be due to the drugs.  Flight fuel.  Keeping me in orbit.  Ahead of them monkeys.

And then came Loree, one fantabulous night time navigator.  She was the mother of twins if I recall, and a son out of state that was a comedian like me.  I was flattered.  She thought I was funny.  My dear Loree was the navigator who finally got a decent oral dose of flight fuel down for me.

You see, eventually I would be going home and would not have access to IV drugs, like the Dilaudid that was slowly replacing my blood.  They had given me a couple NorCo's, or Vicodin's, to mix with the Dilaudid, but those did not even touch the pain.  It was like popping a sugar cube.  Without the acid..  Even the Dilaudid left me at a 3-4 level of pain.  But without it for too long a time, I would lose my orbit and get excruciatingly close to the sun, heading into the 8-9 pain range.  And then the monkeys would come. 

At any rate, Loree talked with the Doc and landed on a 10 mg Percocet.  I took that around 10:00 PM, think I began to feel a rush and then I woke up around 4 hours later.  It was amazing!  I had finally slept for more than an hour or two for the first time in WEEKS!   That was the first drug that actually dropped the pain level enough so that I could sleep.  For at least the four hours it was "live".    

Loree hit me again at 2:00 AM and again at 6:00 AM.  I was in full blown orbital ecstasy.  And I could sleep again!  We had finally landed on something that worked, and should work when I went home. 

And then I was handed off to Laura, another wonderful Angel of the most fabulous kind. We engaged in many heartfelt conversations throughout the day, whenever she would come a calling.  At east I'm pretty sure I think we did.  And of course, we laughed a lot too.

That evening I was visited by Loree again, it was old times!  Our bond just got stronger.  And then my final day in Jello Land I was flying with Laura again.  When I finally got my walking papers and into some reasonable street clothes, we hugged good bye.   Thank you again my dear.

I did get up the first day after surgery for a ten foot stroll to the door.  Then I had to rest.  The next day I made it into the hall, and the next day I was doing cart wheels around the football field.  Actually, I've never been coordinated enough to do cartwheels.  I think you need longer legs than I have to do cartwheels.  I would look like a penguin if I tried them today.  And then probably get dizzy.

My fine young son steered my space ship home that Monday afternoon, five days after I initially went into orbit.  I camped out on the sofa for a few days and nights, still unable to crack a full night without waking up for some pain meds.  And I did not want to be a bother for my lovely wife.

I had the drain removed four days after I had returned home and seven days after the surgery.  Apparently when Uncle Wiggley burst he spewed pus and gangrene all round my abdomen.  This is the big problem, infection, and why it's usually better to get the dang thing out before it decides to explode, or perforate.

Yeah, so I had this little drain pump thing with a tube going into my belly.  Wonderfully colored liquid would drain into this vessel which would then be drained every 8-10 hours while in the hospital.  The amount of viscous liquid gradually diminished, yet I still had to have the dang thing inside me when I went home.  Then, when I went to the Doc's office to have it removed, I discovered the tube went in about 18 inches!  18 inches!!  I was thinkin it went in about 2 inches.  Just 2.  And when he pulled the tube out...I hollered a quite explosive expletive.  He said it wouldn't hurt, only feel weird.  Well, it was both.  Fortunately it was a little after 5:00 PM and most of his offices were bereft of patients at that point.  Otherwise, my holler of "OW, FUCK!" might have made them wonder what the office and doctor were all about.

And immediately after he pulled it out and I hollered, the good doctor looked down and quite calmly said, "I'm sorry.  Did that hurt?  Much?"

I love my doctor.

Ten days after the surgery I was still in pain.  Diminishing, but there none the less.  I did note though that staple discomfort was still a heck of a lot better than burst appendix screaming pain discomfort.  A lot better as a matter of fact.  I had about seventeen staples total.  Two were in one of the lower lapiroscopic locations, three were in me naval, and twelve were along the Mason Dixon line.

I also have discovered that even though an appendix only weighs in the neighborhood of an ounce or two, depending on the volume of pus involved, having it removed under extreme circumstances is good for at least a ten pound overall weight loss.  I didn't really eat anything for the first couple days, and then it was quite minimal for the next few days after that.  The first piece of lightly buttered toast I ate was the most amazing food item I have ever eaten in my life.

Well, my sand kicking days at the beach are definitely gone.  I probably won't be hitting up very many of those egocentric weight lifting poses either.  I'm sporting a Frankenbelly now to be sure.  I kinda look like I had a 40 acre pasture barbed wire fence strand tattooed across the right side of my belly.  And that's a OK by me.  I think there's a few more miles left on this little planetary venture and I can make that all happen without Uncle Wiggley.   Good riddance.

Once again, words cannot express my gratitude enough for the angelic intervention I was fortunate enough to receive during this inter galactic journey.  I humbly bow to all the caring doctors and lovely ladies of healing, heart and light.  May peace and love always be with you.