Scar Tissue

So I spoke with a doctor today and here’s what I heard:

The initial hematoma was definitely COVID-induced, but the hematoma wasn’t the problem that put me back in the hospital. It was the hemorrhaging that did that. The vessels that COVID attacked are the ones that supply blood to the first few centimeters of my lower intestine, the part called the duodenum. That weakened the duodenum but didn’t cripple it. The hematoma was a bit of a red herring; instead, my duodenum was slowly collapsing due to insufficient blood flow. When it grew weak enough, it could no longer retain its shape against the hematoma and collapsed fully.

That explains the week-long delay between the initial attack by COVID and the failure of my duodenum. With the hematoma now pressing against the duodenum, I couldn’t digest food at all; I developed bile reflux disease, which is why I was throwing up on such a regular schedule. So that’s where things stand now; the connection between my stomach and my intestine is a collapsed tunnel and may not be repairable, even though the blood mass leftover from the hematoma is clearly in retreat.

My doctor “Your case is very unusual, and it may take some time to formulate a plan, because I want everyone’s opinion, this one isn’t straightforward.” Her “guess” (her word) is that I’m going to need laproscopic surgery to bypass this section. They’re going to discuss stenting the duodenum to give it an artificial structure and then giving me proangiogenics (drugs that encourage blood vessel growth) to see if we can revive it to full function, but proangiogenics are controversial because if you have the tiniest of cancers they can really encourage cancer growth as well, and if that fails, it will be laproscopic surgery anywhere. So far, none of the labs have found any cancer markers in my blood. She also said it’s possible that the duodenum did heal somewhat, but it’s like scar tissue, tough and unflexible, and may not be revivable with a stent.

I do appreciate that in some sense I’m a zebra and this is a challenge for them. I hope it means they’ll do their best. I just want to get back to my life.

I'm starting to understand the appeal of Xanax

I’m starting to understand how people get hooked on benzodiazepines.

One of the nurses told me, “You’re unusual. Usually we’re either putting stuff in or taking it out, but you have both! That’s too much.”

One thing I’ve been very candid about recently during my hospitalization is about my alters. They’re not real, they’re– grief, I really don’t want to call them “figments” because I actually hate that stupid purple dragon who promises that creativity is “easy” and “fun” when it’s nothing of the kind– they’re important to me. They give me foci for who I am in my different roles as writer, programmer, even husband and father.

The hospital is giving me a benzodiazepine for my nighttime weakness, because at night I’m alone with my fears and the pain and the unrelenting pressure of having so much medical gear shoved up my nose and down my throat. Before this incident, I could never understood why people got hooked on them. I understood perfectly well the wish to try stimulants, but aside from Adderall IR all of them make me nervous and unfocused, and that’s not what I want. I want capability, not recreation. I get satisfaction from accomplishment. My idea of recreation is spending the day on my bicycle, hiking the trails, or writing my own stories, rather than coding someone else's project for pay.

When you have only one voice in your head, benzos drops that number to zero. When you have zero voices, you have no one to be lonely with, not even yourself.

But now, I think I can understand it. People with only one voice in their heads, with no Council, no Stable, no inner friends, being lonely is hell. Being isolated is hell. And late at night, when my energy levels are near zero, and I can’t think, and I can’t regulate, I ask them for Ativan, and they bring it to me.

Ativan drops the number of voices to zero. Because when you have nothing left you can’t be lonely. You have no one to be lonely with, not even yourself.

I can’t wait to get out of here and go back to performing the Ritual of Coffee.