Tubular, as in How I Get Fed, or Not

Another day, another medical crisis. Monday’s crisis was that my feeding tube had become blocked and I wasn’t getting the food I needed to keep my microbiome necessary. They didn’t want me to be receiving my nutrition intravenously, in a drip of saline with sugars and electrolytes and nutrition, because that just isn’t enough.

After some consulting, the floor doc decided to send me down to what they call interventional radiology. The super-sensivitity of CCDs like the ones on your phone that make low-light photography as bright as day also allow radiologists to do real-time video of your insides with incredibly low doses of ionizing radiation (the dangerous kind that causes cancer if you get enough of it).

They laid me out on the table and then, with the projector only a few inches from my neck and chest. I had a technician and an attending physician, and together they threaded what looked like a knitted cable of narrow steel up into the tube (which tickled the hell out of my sinuses, and I have been sneezing and snotty ever since, and my throat is killing me). We talked about medical stuff (“Are you in healthcare?” “No, I just have ADHD and insane levels of curiousity.”) and music and then, once they were set up, turned on the machine just just roto-rootered my feeding tube. It was just slightly kinked but mostly just clogged with the feeding liquid.

And while this is going on, I’m making all sorts of gurgly, cartoony noises. “Are you sure you’re okay?” the doctor asks.

“I told you, I have ADHD. You told me to keep my hands under my butt so I wouldn’t flinch and interrupt. I’m trying. Making Bugs Bunny noises is how I self-regulate under these conditions. Is it interfering with what you’re doing? I’ll try to stop.”

“No, I just wanted to make sure you’re comfortable.”

“Are you sure you’re okay?”

“I’m fine. I make cartoon sounds instead of cursing. If I feel any serious pain, I’ll let you know in clear English.”

“As comfortable as possible. I’ll let you know in clear English if anything feels wrong. I just make cartoon sounds instead of cursing.” And she smiled like, “Okay,” and got along well after that. She got me unclogged and flushed. She also told me to remind the nurses that if I was going to be unhooked for any period of time, for like a procedure or something, to make sure the line was flushed with water (plain tap water was fine, just like I was drinking it, it was going into my digestive system anyway) so that the goo wouldn’t turn to concrete.

Darn, I should have taught her the word “lalochezia: the emotional release gained by uttering indecent or filthly language.”

Now I miss food.

Omaha had reached the room after the procedure and I gave her the whatfor on what happened. She was lovely, but we are both very online, both through the Twitter machine and through SMS, especially now that I have SMS connected to Google Message, so I can type at her instead of using my thumbs, so we don’t have a whole lot to chat about. She brings out her laptop and I bring out mine, and we sorta work on our own stuff until I hit that two-hour or so mark where I can’t keep my eyes open anymore and lie down. She gives me a hug and a kiss on the cheek, and heads out.

That’s kinda our day now. It’s our routine. I don’t want it to be routine, but it is what it is. Ah, well.

Meditation, Prayer, Self-Discipline: It Is What It Is.

This morning, I awoke to bad news. I discovered that my stomach pump’s resevoir had filled up completely over the previous 12 hours; the “you’re making less and processing more” was either an illusion or a fluke, maybe related to the feeding tube being restricted. I was feeling profoundly disappointed, even depressed. I spoke with the doctor and she said that was the most likely cause: with the feeding tube blocked, my insides weren't being stimulated to create digestive fluids, so it gave the illusion that I was processing the bile when really I just wasn't making as much.

I decided to try the Stoic Meditation of the Sage, using Marcus Aurelius’ formula for his morning journal, and as I did, I found myself speaking out loud:

For today, I have awoken into this world to be cared for by professionals, to listen carefully to their advice and to probe with the questions that are meaningful to me.

• When can I return to my family?


• When can I return to work?


• When can I return to my athletics?


• When can I return to sex?


• When can I return to my diet?


• What will change in any of these?


• If I take the options you give me, option A, option B, option C, I will listen attentively and carefully, and we will come to an agreement about what the next steps will be, and I will have a clear understanding of what the consequences of those steps will be in the coming days. We will not repeat the shoulder fiasco.


• In the meantime, I will embrace my condition with fortitude, courage, and even industry. I will, to the best of my ability, do what was in my control, and if I cannot control my body’s need for rest or distraction, I will understand and forgive.


• And now, with those decisions made, I will step into the day with my fears and my concerns and my plans for addressing them in the back pocket of the pants I cannot wear, and I will spend the rest of the day in relative good cheer. Caveat only, that my short-term responses may be shortened, modified, dictated by the pains caused by my throat and my sinuses and all the damn equipment in my head, to which I still must express gratitude for it is keeping me alive. For I am the sage, and this is what the sage brings into the world.

I felt better afterward. Still emotional and weak, but at least I have a plan, a bulwark, against the shocks of the day.

There were two consequences of this: the first was that after doing it out loud, I felt so profoundly better that I heard Girl Scout say, “Welcome to The Council, Sage.” Which is bloody obviously now that I think about it.

The other is that I must have said it loudly enough that my nurse stopped by. “Are you okay?” she asked.

“Fine,” I said.

“I thought I heard voices.”

“Oh. Just praying.”

“Oh.” She looked puzzled.

I remembered I had put “no specific religious practices” on my patient chart. “It’s complicated. And personal,” I told her, while listening to the integration going on inside my head. (I think they’re debating whether or not having Sage means we still also need Ritual Master.)

“Okay,” she said, and closed the door again.

Rant: Americexit

All right, conservatives, let’s say you get your wish and Democrats find it evermore impossible to get anyone from their party elected anywhere in the United States. Aside from a few “blue” holdouts, the country is completely controlled by conservatives.

Then what?

Do you have a plan to reduce healthcare costs? Trump didn’t. Bush didn’t. Reagan didn’t. Do you have a plan that will actually reduce crime? That will actually save trans kids from thoughts of depression and suicide? That will reduce the price of gasoline, of groceries? Do you have a plan to preserve America’s great national parks? To make our air more breathable, our water more drinkable, our food safer? Do you have any ideas about making our country smarter and healthier? Do you know how to manage our aging electrical grid? Rebuild or restore our roads and canals and rail lines? Do you have any plans for preventing corporations for controlling all our lives?

If you get your way, it will be because you cheated; you gerrymandered the states, you exploited loopholes in the Constitution that gave a patch of dirt in South Dakota more votes than a Spanish-speaking family of four in Los Angeles, and you elected election officials who disqualified Democratic votes at impossibly higher rates than Republican votes.

Over on the other side of the ocean, “Brexit” appears to be in the final throes of collapsing the United Kingdom. Twenty years of unbroken English-speaking conservative rule has led to this moment: their healthcare is collapsing. Their energy grid is collapsing. Their water quality is plummeting. This winter, it is expected that the current conservative reign will lead to people starving to death, freezing to death, dying of dysentery. Or, just in general, die from a lack of healthcare.

I mean, you’re already doing it to yourselves. Thanks to your politicization of COVID and vaccination, COVID is killing conservatives at much higher rates than liberals. You want to claim that’s all fake, but you can’t hide obituaries. You can’t hide the funerals. And you all die at 1.76 times the rate we do because of it.

Prove you have imagination, compassion, and a sense of self-preservation. Go on. Because otherwise I’m just betting that you don’t have those things, you just want to win, and you’re willing to stack human bodies a mile high if you must to claim some sort of “victory.”

And if those bodies happen to be your own, your mothers, your fathers, your childrens’, well, you’re perfectly happy to let that happen.

Prove us wrong.

Sage: Day One

I have a new alter. Looking back, this new integration should have been obvious, but it’s nice to have him now. He is Sage.

Sage’s first day on the Council has been funny. He manifested because I needed the courage and fortitude to start talking to my doctors more directly, to ask better questions and get better answers. So, this evening, the Council kinda got together. Critic sat next to him and Girl Scout asked, “Well, you’re the keeper of ‘What should we do next,’ right?”

Sage said, “Look, the point of me is not to pick our projects, this practice can’t do that. It’s to help us do those projects in a way that supports our collective vision of a good life, caveat the ADHD and other challenges. And today, we did very well. The surgeon came in. We asked the question we said we would ask. We got the answer we didn’t necessarily want to hear, but he did describe the next steps, the courses of action. And it is the next step, not the step three or four steps down the line.”

And then he paused for a moment and said, “And my goodness, you were not kidding. That Omaha woman is fierce, isn’t she?”

Girl Scout rolled her eyes and said, “We know.”

Sage leans back against the sofa and tents his hands in his lap. “The only question now is simple: how permanent am I? Will you all support my invocation tomorrow?”

Girl Scout said, “We’ll try.”

“I suppose that’s all I can ask.”

Health Update

Today has been a mixed day. I woke up this morning to the disappointing news that the apparent reduction in bile reflux had been an illusion. The blocked feeding tube had reduced the amount of processing my GI tract was doing, and my liver had backed off on the production of digestive fluids; that had created the illusion that I was actually processing the bile rather than having it drained by the stomach pump. With the resumption of inter-intestinal feeding, my bile output went back to approximately two liters per day. So the duodenum, the first few centimeters of my intestine, had not opened up as we had hoped.

On the other paw, the surgeon today confirmed firmly, and to Omaha’s satisfaction, that the CT scans indicated that the blood mass from the hemorrhaging had retreated signifcantly, and that the fluid buildup around the duodenum that was crushing it and causing the blockage had likewise reduced quite a bit.

The question of whether or not the duodenum is irrevocably damaged– scarred or necrotic or just incapable of the hydraulic pressure needed to stay open– has not been established. So the course of action remains the current course of action. I’m still here, stuck in the hospital, barely able to stay awake for three or four hours before I run out of brain and must nap. They’re gonna wait until next Saturday for the next CT scan, and if there are no behavioral changes in my digestion by then, we’re gonna talk about sending me home with a cart for the stomach pump and feeding tube, and a in-home nurse who’ll visit three times a day to change out my filters and feeding and watering and such. Dunno if I’ll be able to work under those conditions; I’ll be unable to even leave the first floor of the house, and I’ll be tethered to these stupid pumps until… well…

They’re talking about waiting another two weeks after that to see if there’s any resolution. After that, we’re discussing endoscopic procedures, either a straight-up stent or maybe just a balloon to inflate the duodenum back to its natural geometry, then remove the ballon to see if it holds. If any of this works, I get to start a bland diet, slowly adding more mass and more solids over weeks and months.

If not, we move on to the question of laproscopic resectioning. But they’re saying they won’t even consider that until three months after my initial intake on October 9th.

Something has to give, and I hope it’s in a good way. This is so dreary, and I feel so useless just lying here.

Omaha did come by today, and she helped me walk around the floor twice, and I felt very good doing that, and then she chaperoned my shower, so I’m clean again. She’s been wonderful. I love her so much.