I am not attractive. I am "yellow man". My eyes are a thick dull yellow. My face is a blotchy orange. The rest of my skin is bronze, more the bronze of spoiled fish than a spoiled lifeguard. The jaundice makes me itch. My nails drag the thin yellow skin over points of bone. I weigh 150 pounds. Not enough for my 6 foot frame. I expect even my breath smells yellow - I'm not sure what smell that might be, but it can't be good. I belch and fart at every opportunity, knowing every pint of gas not in my stomach is that much less pain I will experience when I eat. My eyes are a little haunted. From constant discomfort and a slight fever. Not I think from fear or hopelessness, because I am looking forward to the procedure that will change this before picture to a much better after picture.
The tube called the common duct that carries bile from my liver to my intestines has been squished shut by the tumors. The bilirubins of which the bile is largely comprised backs up in the liver and has nowhere to go. So it also backs up in the rest of my system. They will put a hard plastic tube or "stent" through the common duct to hold it open and let the bile flow naturally again. This should clear my jaundice and let me digest fats properly again. They will also hopefully put me on "Octriatide", which is also supposed to aid my digestion by shutting down the hormones put out by the tumors.
Did I mention that any surgical procedure can go horribly wrong, or at least not yield the hoped for result?
The procedure at Cleveland Clinic went smoothly enough. They didn't tell Patti how long it would be, so she was stuck waiting a worrisome long time. We had taken care of our Power of Attorney papers earlier, and also the paper work that the Michigan Family Independence Agency needed from the hospital. A short form with diagnosis and dates of service type info, and a transfer of records.
We spent the night at Becca's. A very unpleasant night, especially for me. There was pain in my belly. I expected this, I had pain every time they messed around down there. This time it got worse instead of better. I told Patti we might have to go back. She said call first. I called the Emergency number they gave us and got no help - they said it was up to me, and they could not help me decide. But they would be there if I needed them. So I called my brother. He took my heart rate, asked if I had blood in my stool, and whether I got shortness of breath walking around. All these things looked good, so he said get some medicine with Simethicone for gas. I was surprised, I expected he would play it safe and send me in.
The simethicone didn't do me a lick of good. What did help was a bit of diahrea. So I tracked down some laxative in the house. Never in my life have I taken laxative. It made me nervous. It said gentle acting - 6 to 12 hours for relief. Where is caustic and brutally fast acting when you need it?
Fast acting enough, I guess. Within an hour I was on the pot and kept returning until everything was running clear. There was no sign of blood, and my pain was reduced to a couple localized spots in my belly. I got a couple hours sleep. The worst, I thought, was over.
After lunch the next day, we headed home. Already the jaundice was starting to fade a little. I'd had a few scrambled eggs. An hour from home I got cold, and pulled a blanket on over me. Then I got the chills. The chills turned to violent shaking. Patti was frightened. At first I wanted to make it home, but it was clear that wasn't going to happen. I couldn't even hold the phone still long enough to dial 911. So Patti did, and got talked through driving to the nearest hospital. They asked her if she knew CPR. This did little for her peace of mind. She said she did but had probably forgotten it. We hadn't quite made it out of Ohio.
We ended up at the Montpelier hospital emergency room. I had mostly stopped shaking by the time I lay on their bed. It was pretty obvious I had an infection from the procedure. They drew blood for cultures, took a history, and started an IV anti-biotic. They called Cleveland Clinic and started making arrangements to ship me back there. I startled them by saying "NO!". For one thing, I remember the last ambulance bill at $10 per mile. More to the point, I figured they were just going to have me on antibiotics till the infection went away. Sturgis has antibiotics. Why go all the way back to super hospital when I could just go home?
They were not used to having doctor's directions on such things refused. I talked to the Cleveland Clinic doctor who put in my stent. First he asked if I had pain the night before, why didn't I call the number on the discharge sheet? I said I did, and they just told me they couldn't help me make a decision about comimg into emergency. I heard him curse under his breath. Anyway, that pain was unrelated to this fever. I asked him to give me one good reason I needed to go back. They were just going to take cultures and administer antibiotics as a first step, weren't they? He said he didn't know what they might have to do. He can't do medicine over the phone. They might have to adjust or remove the stent, and no one else would want to touch it. He thought it would be a very risky decision on my part to drive the last hour to Sturgis rather than take the three hour ambulance ride back to Cleveland. On my back with a fever, and listening to a panicked doctor on the phone, I gave in. Why do I only seem to give in when I'm right?
I sent Patti on home. She was bushed, and I didn't want her having an accident. Besides, she had arrangements to make at home. Between bleeding and liver problems, the doctor didn't want to give me Ibuprofen or Tylenol. But once I got in the ambulance, the gave me some fentenol, so I got a couple hours sleep. The ambulance crew was extraordinarily nice. Three hours later, we pulled up to Cleveland Clinic and I got unloaded. They started to take the oxygen off of me, but I found I got terrible heartburn without it. The crew was rather amazed at how big the place was. My room was on the M80 floor. Wasn't that the floor the intern the first time around warned me off of?
Well, my temperature is 105 degrees. I'm flat on my back in Cleveland. One more time.
Copyright 2003 by Rick Clark and heirs. Non-commercial users can link to or copy freely, so long as copies are in whole and include this copyright notice. Commercial users please contact firstname.lastname@example.org or the current address at web site rbclark.sturgis.mi.us. If you found a way to make money off this my wife and kids (or I. I might be around a while yet.) could use a piece of it.