This Bowel Obstruction Sucks

I'm writing this post from St. Mark's Hospital, attached to a naso-gastric tube about the size of a garden hose (at least it feels like one). It's emptying everything it can find that wasn't able to pass beyond the bowel obstruction in my small intestine, plus any new stomach secretions. A cute 4-year-old neighbor who visited me with his parents this afternoon identified the stuff the tube is dumping into a clear plastic container as chocolate. If only.

An IV is dripping hydrating fluids and steroids into my vein to try to calm the inflammation in the tissues where the obstruction is. Sometimes, pain killer joins in the mix. And, when I'm in bed, velcro-fastened anti-embolism wraps take turns inflating to encourage blood flow and discourage blood clots in my calves. Suffice it to say that getting ready for a trip to the bathroom or a walk in the halls takes a lot of work.

After steroids calmed a preview of this in early July, cramping with intermittent watery stool returned a couple of weeks ago. Some days were worse than others, as usual. In fact, I had several good days. I even did three hikes in Zion National Park and went to three plays last week. But the bad days were hauntingly similar to the way I felt July 2. So my GI doc ordered a CT Enterography to show details of the small bowel, looking for any strictures (narrowed areas) or other problems that could cause the pain. After fighting for a couple of days with the insurance company about paying for the test, employing help from both the HR specialist at Dave's company and a high-up customer service person at Blue Cross, we set it up. 

The day before the appointment, the cramping climaxed and something broke free, gushing until I felt empty. The good part is that I was pain-free afterward. The confusing part was that I was tempted to cancel the CT because I felt better. But since the problem had recurred multiple times, including twice in the same month, I kept the appointment at St. Mark's, since it is a participating provider on our health plan. Afterward, I awaited results. The appointment was Thursday.

Enter the weekend, of course. When emergencies emerge.

Friday night was a little uncomfortable, but nothing to write home (or a blog) about, comparatively speaking. But Saturday, the cramping started kind of early. We were going to the Farmer's Market so I didn't eat breakfast. I didn't want any inconvenient bowel activity. Until we smelled the waffles at the little shop across the street. I had to have a cinnamon-peach waffle. It was glorious! And I didn't feel much different after I ate it than I did before.

So I ate a small sandwich at lunch time and kept drinking lots of water. The cramping came and went, and I still never went, if you know what I mean. We had plans to take the kids to dinner. I love Ruth's Diner in Emigration Canyon, and resolved I'd order something small and be just fine. But as we waited for our table-is-ready pager to go off, the cramping intensified. My abdomen felt distended with every swallow I'd had all day. I felt more and more unpleasant (and probably acted that way, too) as time to order neared. So I ordered a decadent chocolate malt pudding. I could limit the amount I ate; chocolate pudding is free of fiber and chunks; the chocolate and fat might just start things moving. Besides, it's yummy, and was the only thing on the menu that looked good to me. 

Man, that's weird at Ruth's Diner. I'm going to have to go back as soon as I can eat good stuff again. :-)

It was yummy, but I couldn't eat much. The cramping and distention increased. I wasn't good company. Probably not the funnest Saturday family dinner ever for everyone.

On the way home, we discussed whether to go to the hospital for help. After, I called the GI doc on call, who agreed to try to help me stay out of the hospital. He called in heftier steroids for me, along with some anti-nausea stuff and pain control liquid. But he warned that a fever or vomiting should send me to the hospital. Dave and Jeff gave me a priesthood blessing (I love having faithful Mormon Elders around). Dave rushed off to the pharmacy while Megan helped me change into comfy jammies and got me a blanket. She also encouraged, that "maybe you should just go to the hospital." When Dave returned, that's what we did.

Megan was right. This obstruction needed suction to relieve the pressure building behind it. Although, now that the distention and pressure are gone, my throat hurts most. If you've ever needed a naso-gastric tube for suction, you know what I mean. If not, I hope you never need one. The hospital doctor explained that the tube would collapse under the suctioning pressure if not so fat and stiff. Bummer.

Interesting, though, that my stomach and duodenum contents managed to obstruct even the mighty nasogastric tube this afternoon. A bunch of sticky, white granules tenaciously held together, preventing anything behind them from passing. "Have you been eating sand?" the CNA asked. It was actually a bunch of the granules that fill every Pentasa capsule I take. If they're actually glopping together and contributing to the problem instead of decreasing inflammation, they're going to be fired, just like the Cimzia if it doesn't start working soon!

I'm calling my GI doc in the morning to discuss it. Well, after a bit of telephone tag, with the medical assistant, maybe I'll get the message to him anyway. My health plan doesn't cover any of the hospitals where my GI doc, who is a participating provider, is on staff. Of course.

I'll let you know what happens.

Say well!

Beth :-)