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elfsAs always, this includes some medical details that probably constitute TMI (Too Much Information).
Yesterday, I merely endured, with the help of an extremely powerful drug, ketarolac. Ketarolac is an NSAID, a drug in the same family as ibuprofen, aspirin, and naproxen sodium, but it is so strong it has a black box warning about the risks of kidney failure and related conditions. They’re allowing me to take it because my bloodwork indicates my kidneys and liver can handle it. In less than 48 hours, I will be forbidden from taking any more. I’m genuinely terrified of when that happens, because my pain without it is quite severe.
But NSAIDs are pain relievers second. What they are first is anti-inflammatory drugs. When I spoke to my surgeon, he said that the blood mass had shrunk to something about the size of his thumb, but the location on the CT scan says to him that it might even have been in the outer lining of my duodenum (which is why there’s no bleeding inside my intestine) and its location may be causing irritation and inflammation.
As 10 Tuesday night approached, I asked the nurse for the volume of bile recovered and the interval. She said it was 300ml. “Really?” I said. “When was it last emptied?” She looked it up and said the computer recorded the last emptying at 3pm.
The human body produces approximately 100ml/hr of bile. At my highest output, I was producing a superhuman 145ml/hr as my body desperately sought to find any way to start digesting food again. Over the past 16 days, I have consistenly been producing that 100ml/hr, only to have all of it recovered by the stomach pump, and none of it getting into my actual digestive tract where it belongs.
The rate and interval the nurse gave calculates out to a recovery rate of 42ml/hour.
That is a huge drop. And it indicates that maybe, just maybe, I’m healing inside. That I’m finally clearing the blood mass and have reduced the inflammation to the point where the fluids my body produces to digest food are being reabsorbed and processed naturally by the kidneys. An indicator of that is also that I’m having to piss much more often, and in greater volumes.
I had trouble sleeping after that. My brain wouldn’t shut up, wouldn’t slow down; the day nurse I had that day was the same one who clogged my feeding tube several days prior, and my faith in her is low. Maybe she had missed recording an emptying of the recovery jar, and the data was faulty? I had hope, and I had anxiety, and then from the other end of the floor I heard shouting, an angry voice, a man not happy with where he was or how he was being treated. There was paging for security. I wanted to sleep without drugs, but I finally asked for some lorazepam, hoping it would switch my brain from “spin cycle” to “warm delicates.”
Over the nine hours since waking this morning at 6am, the rate of recovery has been 55ml/hr. That’s entirely in the wrong direction, but it does indicate that the 42ml/hr reading may not have been a fluke. I hope it’s not an indicator that once again I’ve seen a false light at the end of the tunnel. It’s still half what it’s been for the past two weeks, though! My surgeon says that he’ll consider withdrawing the stomach pump only if the recovery rate drops to 25ml/hour and stays there; that will mean I have enough passthrough that I could probably handle all of my own bile production without mechanical assistance.
Hope… hope is a fragile thing. I’ve been despondent, and now I’m terrified of losing ketarolac as my lifeline to a relatively pain-free day. The good news on that front is that my doctor says in these circumstances there’s no “rebound inflammation;” if the ketarolac is knocking the inflammation down, it’ll stay down. I don’t know what’s going to happen over the next 24 hours, but I hope the numbers start to trend in the right direction, because if they don’t, I’m gonna need a lot of lorazepam to sleep, and I’m gonna need opiods just to survive the day, and I don’t want either of those. Sleepy and stupid is not me, and it’s not for me.
I also have this maddening suspicion that if the powerful anti-inflammatory they’ve had me on for the past two days was the secret all along, we could have hurried the healing process along with a drip of prednisone after the second CT scan. I hope the surgeon comes by today; I’d like to ask him about that.
Omaha visited yesteday and today. Yesterday, she snuck– fully clothed, sadly– into my hospital bed and, despite the three sets of tubes connecting my body to life support equipment, we managed to snuggle for almost a half hour before a “low supply” warning required she get up and let me call a nurse.
I was awakened at 6am by the phlebotomy technician, who took my vitals and my blood. She was young and inexperienced, and sometimes being a Training Patient is no fun. She brought in the sampling kit they hang on a hook outside my door, put the tourniquet on my left arm, and then proceeded to set up her whole rig: collection vial, butterfly needle, bandages. My arm throbbed painfully for two minutes before she was ready. When she was done, I gently pointed out her mistake, and said, “Never forget that while you’re going through your checklist, there’s a patient here. Don’t involve the patient until you’re ready to start the procedure.” She promised she would remember.
I asked about the shouty patient. “Oh, that. He was unhappy. Now he’s not.” That’s all she said. It sounded kinda creepy, the way she said it.
Today, Omaha’s visit coincided with my mother calling, so we had a family conversation. Omaha and I walked my laps around the halls, getting me the exercise I need, and then she chaperoned my bathing so I could wash my hair. My scalp is so dry in this utterly purified air.
Yesterday, I merely endured, with the help of an extremely powerful drug, ketarolac. Ketarolac is an NSAID, a drug in the same family as ibuprofen, aspirin, and naproxen sodium, but it is so strong it has a black box warning about the risks of kidney failure and related conditions. They’re allowing me to take it because my bloodwork indicates my kidneys and liver can handle it. In less than 48 hours, I will be forbidden from taking any more. I’m genuinely terrified of when that happens, because my pain without it is quite severe.
But NSAIDs are pain relievers second. What they are first is anti-inflammatory drugs. When I spoke to my surgeon, he said that the blood mass had shrunk to something about the size of his thumb, but the location on the CT scan says to him that it might even have been in the outer lining of my duodenum (which is why there’s no bleeding inside my intestine) and its location may be causing irritation and inflammation.
As 10 Tuesday night approached, I asked the nurse for the volume of bile recovered and the interval. She said it was 300ml. “Really?” I said. “When was it last emptied?” She looked it up and said the computer recorded the last emptying at 3pm.
The human body produces approximately 100ml/hr of bile. At my highest output, I was producing a superhuman 145ml/hr as my body desperately sought to find any way to start digesting food again. Over the past 16 days, I have consistenly been producing that 100ml/hr, only to have all of it recovered by the stomach pump, and none of it getting into my actual digestive tract where it belongs.
The rate and interval the nurse gave calculates out to a recovery rate of 42ml/hour.
That is a huge drop. And it indicates that maybe, just maybe, I’m healing inside. That I’m finally clearing the blood mass and have reduced the inflammation to the point where the fluids my body produces to digest food are being reabsorbed and processed naturally by the kidneys. An indicator of that is also that I’m having to piss much more often, and in greater volumes.
I had trouble sleeping after that. My brain wouldn’t shut up, wouldn’t slow down; the day nurse I had that day was the same one who clogged my feeding tube several days prior, and my faith in her is low. Maybe she had missed recording an emptying of the recovery jar, and the data was faulty? I had hope, and I had anxiety, and then from the other end of the floor I heard shouting, an angry voice, a man not happy with where he was or how he was being treated. There was paging for security. I wanted to sleep without drugs, but I finally asked for some lorazepam, hoping it would switch my brain from “spin cycle” to “warm delicates.”
Over the nine hours since waking this morning at 6am, the rate of recovery has been 55ml/hr. That’s entirely in the wrong direction, but it does indicate that the 42ml/hr reading may not have been a fluke. I hope it’s not an indicator that once again I’ve seen a false light at the end of the tunnel. It’s still half what it’s been for the past two weeks, though! My surgeon says that he’ll consider withdrawing the stomach pump only if the recovery rate drops to 25ml/hour and stays there; that will mean I have enough passthrough that I could probably handle all of my own bile production without mechanical assistance.
Hope… hope is a fragile thing. I’ve been despondent, and now I’m terrified of losing ketarolac as my lifeline to a relatively pain-free day. The good news on that front is that my doctor says in these circumstances there’s no “rebound inflammation;” if the ketarolac is knocking the inflammation down, it’ll stay down. I don’t know what’s going to happen over the next 24 hours, but I hope the numbers start to trend in the right direction, because if they don’t, I’m gonna need a lot of lorazepam to sleep, and I’m gonna need opiods just to survive the day, and I don’t want either of those. Sleepy and stupid is not me, and it’s not for me.
I also have this maddening suspicion that if the powerful anti-inflammatory they’ve had me on for the past two days was the secret all along, we could have hurried the healing process along with a drip of prednisone after the second CT scan. I hope the surgeon comes by today; I’d like to ask him about that.
Omaha visited yesteday and today. Yesterday, she snuck– fully clothed, sadly– into my hospital bed and, despite the three sets of tubes connecting my body to life support equipment, we managed to snuggle for almost a half hour before a “low supply” warning required she get up and let me call a nurse.
I was awakened at 6am by the phlebotomy technician, who took my vitals and my blood. She was young and inexperienced, and sometimes being a Training Patient is no fun. She brought in the sampling kit they hang on a hook outside my door, put the tourniquet on my left arm, and then proceeded to set up her whole rig: collection vial, butterfly needle, bandages. My arm throbbed painfully for two minutes before she was ready. When she was done, I gently pointed out her mistake, and said, “Never forget that while you’re going through your checklist, there’s a patient here. Don’t involve the patient until you’re ready to start the procedure.” She promised she would remember.
I asked about the shouty patient. “Oh, that. He was unhappy. Now he’s not.” That’s all she said. It sounded kinda creepy, the way she said it.
Today, Omaha’s visit coincided with my mother calling, so we had a family conversation. Omaha and I walked my laps around the halls, getting me the exercise I need, and then she chaperoned my bathing so I could wash my hair. My scalp is so dry in this utterly purified air.
