![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Abdominal Pain Cause Unknown Male
Saturday, 19 September 2015 15:33So, we've finished two weeks of classes for Fall 2015 -- the first full week, since Labor Day got in the way of the first week. And I'm tired. Not unreasonable given that since late December I've been trying to stay off my foot to let it heal. And by the end of the day, I hurt. No, not the foot, which has no working nerves. But the shoulders. It's all the walking with canes and walker, and standing in front of the blackboard.
My last class of the week I had a lot of equations to write. But, I had the two parts of the lecture online -- calculation of the electric field at a point P perpendicular to a line of charge and a review of 2D and 3D integration -- and so I punted and printed them out, then sat next to the document projector. I'm no dummy.
Wednesday
This second week of classes was also the next round of doctor's visits. I haven't reported all of them this summer. Mostly the results have been very positive, with the hole in my foot slowly closing in. Yay. But I've also had a couple of incidents (December, May, July) where I'd spike a low fever for a day or two and the swelling in my left leg would swell up some -- and like gas price hikes, take much longer to go down than build up.
So I see my foot surgeon about every ten weeks or so. She debrides the wound area and trims the toe nails. I don't need any local anesthetic for this scalpel work -- no feeling there. The trimmed area bleeds some, which is considered good. There's a new small pressure wound on the instep, caused probably by the combination of the new AFO (which has never quite been right) and the newer pair of shoes (which are stiffer, tighter and a slightly different design from the other shoes, despite both being New Balance 10½ 6E). The guy who made my first AFO left Spectrum Health and now it turns out the outfit which made the second AFO has been cut loose by Spectrum for problems. Huh.
Also, Spectrum keeps rearranging the deck chairs and so the foot surgeon is now in the third location after two years in the same complex. Like the new location of the Wound Clinic downtown, it's a longer walk/roll than it used to be. Sigh.
Thursday
The next day was the monthly visit to the Wound Clinic. I schedule these after the foot surgeon when they both show up together, so the surgeon does the debridement. The wound area is definitely smaller and in the last month dropped from the little central hole being 1.9 cm deep to 1.2 cm. Yay. Healing.
Neither doctor's office has the same bandaging supplies we have, so, no surprise, the bleeding on Wednesday had leaked out a bit and soaked into the offloading foam pads of the AFO. No problem. One of the staff is expert at "arts and crafts" and replaced the pads. We'll now use a bit of the calcium algenate with silver on the pressure wound as on the main wound.
We finally bit the bullet and Mrs. Dr. Phil went and cut some of the stitching in the newer left shoe's upper, to relieve some of the pressure, essentially extending the tongue. Also I finally have a line on a place which might be able to make shoes wider than 6E to accommodate the AFO. One size fits all my ass...
Friday
With those two doctor appointments out of the way, I stopped by the Campustowne Labs in Allendale to get another set of blood work for Infection Diseases. I had planned on calling them this week to see if we were ready to end the antibiotics I've been on for over a year.
Saturday
But then... around midnight to 1am, I felt very tired and my stomach hurt. Not my stomach, actually, but on the other side. Since 2013, I've sometimes had issues with gas, so I took a couple of Gas-X. That didn't help. Well, maybe it was more heartburn. A couple of Tums didn't help.
The pain was getting stronger, sometimes feeling like it went straight through me to the back. I tried to go to bed around 3, which is usually a little early for me on the weekend, but it wasn't like I was getting any writing done. But I couldn't get comfortable. Lying on my left side, as usual, I had no good way of placing my arms that didn't cross the sore area. 3:38 I got back up and went back out to the living room chair.
Around 4am I began to get concerned. Several times I had gotten heaves, but hadn't actually vomited anything. I checked my temperature -- no fever at 97.1°F. But I also got out the tablet and began to look at WebMD to see symptoms for things like appendicitis. A little while later I got Mrs. Dr. Phil up. Of course the librarian used her search-fu and felt maybe it was more like gallstones or a gallbladder attack. Or maybe pancreatitis.
At this point I figured I was probably going to go to the ER, so I called my doctor's office and got the emergency service. A few minutes later the on-call doctor got back. She was liking pancreatitis better than appendicitis, but agreed I should go in. Now, given my size, history, mobility issues and the nausea, I asked about the difference between our driving the half hour plus to Butterworth from Allendale versus calling the EMTs. She figured it was pretty 50-50, but felt it was good to err on the side of caution and get some data from the EMTs.
So I called 9-1-1 and requested an ambulance. Actually, Allendale Fire showed up first. They were very nice -- one of the tall young guys remembered when they came in May 2013 when I first got sick and had to carry me out of the house. The men from LIFE ambulance were next. The pain, which had peaked in the 8 to 9 out of 10 range (I figure a 10 would be incapacitating/passing out) was down to a 3 to 4. Everyone agreed I needed to go in. At least this time I was able to slowly walk out of the house on my canes, rather than be hauled out on a canvas sheet.
It was odd getting on the gurney out front. With the lights from the garage behind me, the sky above was pitch black until they raised the gurney up and I could finally make out the outlines of the trees. The rains had paused. They loaded me in, took vitals and then we finally left with Mrs. Dr. Phil to follow in a few minutes. The guy riding in the back of the bus was a 31-year veteran EMT. He did a great job of setting an IV line while on the move. Also did a glucose check. Yes, I am not diabetic -- something I took great care to remind everyone after our 2013 hospitalization experiences. But I guess if your pancreas is shutting down then your insulin level goes, too. Glucose was perfectly fine.
I wasn't quite sure which way we went, except when I sat up a bit and saw through the light rain on the back window the McDonald's sign to my left -- we must've been on I-196 and taken the College Avenue exit onto Michigan. I've been in the ambulance ER bay at Butterworth before...
Wheeled into a room -- reminded the two EMTs of my weight, but other than grabbing someone from the nursing station to keep track of my feet, they lifted the sheet and got me on the hospital's gurney no problem. Now I would be in Room 43 for a while. The first nurse who came in said she'd be my nurse for the next half hour. By now it was 6:30am and at 7 the shift changes. One of the things I knew from previous hospital stays was how you have to repeat (a) your particulars and (b) a brief version of systems and history many times. Mrs. Dr. Phil showed up with a number 43 name badge stuck on her shirt.
They wanted to give me two injections. One was for Zofran, an anti-nausea drug. Fine. It works differently than OTC Dramamine, directly on the neural receptors, and I didn't find it to have any side effects I could tell. They also want to give me morphine for the pain. But by now the pain level was way down -- isn't that always how it is when you go in for medical treatment? Also, I have managed to go through all my previous hospitalizations without pain meds beyond Tylenol and didn't feel I needed to go there... yet. So I refused that.
My vitals were relatively normal, if not a little elevated. B.P. 141/37, versus my usual baseline of 120/60. Pulse was 66, versus usual resting of 59-60. I told everyone that I had blood work done from Friday afternoon and they drew blood to do a repeat 15 hours later. The area in question continued to be sensitive to being poked at, but not nearly as painful as a few hours before.
We'd brought a Ziplock with all my currents meds, plus I'd packed a little bag with my Kindles, USB cord and charger. Just in case. If they were going to admit me, I'd need that Kindle to stay sane. (grin) Mrs. Dr. Phil was amused that the hospital/Spectrum WiFi recognized her Kindle Fire HDX. Really don't know what else was going on in the ER. It seemed quiet -- Room 43 opened onto one of the nursing stations -- and I never saw anyone rushing around.
The two blood works -- Friday afternoon and early Saturday morning -- were fairly parallel. I talk about serendipity a lot in my life, and not only was it conveniently Saturday morning rather than a class day, having the Friday blood work as a baseline was just bonus. The white blood cell count was 0.40 and 0.41 respectively in the right units, for example. The liver enzymes were higher, but still in the normal range. If the gallbladder was acting up, it might not be delivering bile to the liver, so that might explain the readings. And at one point I passed 440mL of urine into a hand urinal -- I'm an old pro at this stuff. It was darker than usual, possibly because one of the websites had suggested not drinking water, I guess in case I needed surgery.
Then it was time to go and get an ultrasound of my abdomen. Poking it hard with the probe, especially while holding a deep breath, wasn't easy. But still, the pain level was way down from the 8-9 range. But they couldn't see any gallstones or much in the way of enlargements. The next level would be to do a CAT scan, but given my size that could physically be problematic. With the immediate thought of something like appendicitis ruled out, the best part of valor was to call it a day. I was sent home with a couple of prescriptions, just in case it returns -- whatever "it" is. It's interesting that the oral version of Zofran is a dissolveable, which makes a lot of sense if you're vomiting. (evil-grin) We'll monitor things and repeat the blood work in a week or so and re-evaluate.
Well, you can see from the blog entry title that they technically didn't find anything. If this is an ongoing thing and not a one-off, then we'll probably see more another time. Someone else might be disappointed or mad that they didn't find anything. But we know enough to know that sometimes it's just not possible to figure this out -- or it's too early if this is going to develop into something more definite. Bottom line, I didn't need to be admitted today or rushed to surgery. Which is pretty much a bonus. No one thought we were being overcautious or stupid about doing the whole EMT/ER thing, especially given my history of the past two years. Being on meds for that long, it's always hard to tell what stresses those put on the body, and besides, people get gallbladder and pancreas crap all the time.
I ended up driving the Bravada home. It's easier for me to get in on the driver's side than the passenger side, and having not been given any drugs past the anti-nausea, I felt pretty fine -- by now the clouds were beginning to break up, though there were some spectacular cloudscapes -- and the pain which had gone down to 1-2, was in the 0-1 range. I'd not gotten any real sleep overnight, but had dozed on and off several times. We had breakfast at 11:24 at home -- about an hour later than our usual Saturday morning. Then I went to bed for a two hour nap. This time the bed was cool and soft and comfortable -- no problems.
We were going to go see The Scorch Trials at Celebration North this afternoon, on the way to our monthly Game Night. But I passed on that, of course. Another time.
Oh, and I got a prize. Since I'd been gurneyed into the ER, I had neither canes nor walker, so I had them wheelchair me to the waiting room while Mrs. Dr. Phil went across the street to Lot 7 (she's an old hand at this, I'm afraid). Only one person there, but a few came in as I sat and read my Kindle book. A hospital cop asked a boy traveling with perhaps his grandmother if he wanted a sticker. And another kid. Then she smiled and asked if I wanted a sticker. I asked what kind. Turns out it was a Spectrum Health Security Police Junior Officer. Well, yeah.
I'm Dr. Phil. I carry a badge. *** (Click on photo for larger.)
©2015 Dr. Philip Edward Kaldon (All Rights Reserved)
Not shown: the awesome Hulk Smash bandaid I got from the blood draw.
And so, life goes on. You never know what will happen...
(Damn, I forgot it was Talk Like A Pirate Day in the ER. Guess I was more worried about that nasty pain thing, after all...)
Dr. Phil
*** One thing I'm jealous of with Mrs. Dr. Phil's newer Kindle Fire HDX is that it came with a photo editor. I've looked before at photo editors in the Kindle App Store, but mostly they're either crap or filled with pre-packaged Instagram-type filters. Yuck. But today I went looking again and found a Photo Editor by Macgyver. (grin) It's not perfect, none of the apps had more than a 4 of 5 star aggregate rating -- the big dings here included it no longer working in horizontal screen orientations. I can live with that. Anyway, I took this picture with the Kindle Fire HD, illuminated only by a 300W halogen torch lamp fifteen feet away, then adjusted the Gamma/contrast a little bit and resized the imaged. Then emailed them to myself. I can live with these results.
My last class of the week I had a lot of equations to write. But, I had the two parts of the lecture online -- calculation of the electric field at a point P perpendicular to a line of charge and a review of 2D and 3D integration -- and so I punted and printed them out, then sat next to the document projector. I'm no dummy.
Wednesday
This second week of classes was also the next round of doctor's visits. I haven't reported all of them this summer. Mostly the results have been very positive, with the hole in my foot slowly closing in. Yay. But I've also had a couple of incidents (December, May, July) where I'd spike a low fever for a day or two and the swelling in my left leg would swell up some -- and like gas price hikes, take much longer to go down than build up.
So I see my foot surgeon about every ten weeks or so. She debrides the wound area and trims the toe nails. I don't need any local anesthetic for this scalpel work -- no feeling there. The trimmed area bleeds some, which is considered good. There's a new small pressure wound on the instep, caused probably by the combination of the new AFO (which has never quite been right) and the newer pair of shoes (which are stiffer, tighter and a slightly different design from the other shoes, despite both being New Balance 10½ 6E). The guy who made my first AFO left Spectrum Health and now it turns out the outfit which made the second AFO has been cut loose by Spectrum for problems. Huh.
Also, Spectrum keeps rearranging the deck chairs and so the foot surgeon is now in the third location after two years in the same complex. Like the new location of the Wound Clinic downtown, it's a longer walk/roll than it used to be. Sigh.
Thursday
The next day was the monthly visit to the Wound Clinic. I schedule these after the foot surgeon when they both show up together, so the surgeon does the debridement. The wound area is definitely smaller and in the last month dropped from the little central hole being 1.9 cm deep to 1.2 cm. Yay. Healing.
Neither doctor's office has the same bandaging supplies we have, so, no surprise, the bleeding on Wednesday had leaked out a bit and soaked into the offloading foam pads of the AFO. No problem. One of the staff is expert at "arts and crafts" and replaced the pads. We'll now use a bit of the calcium algenate with silver on the pressure wound as on the main wound.
We finally bit the bullet and Mrs. Dr. Phil went and cut some of the stitching in the newer left shoe's upper, to relieve some of the pressure, essentially extending the tongue. Also I finally have a line on a place which might be able to make shoes wider than 6E to accommodate the AFO. One size fits all my ass...
Friday
With those two doctor appointments out of the way, I stopped by the Campustowne Labs in Allendale to get another set of blood work for Infection Diseases. I had planned on calling them this week to see if we were ready to end the antibiotics I've been on for over a year.
Saturday
But then... around midnight to 1am, I felt very tired and my stomach hurt. Not my stomach, actually, but on the other side. Since 2013, I've sometimes had issues with gas, so I took a couple of Gas-X. That didn't help. Well, maybe it was more heartburn. A couple of Tums didn't help.
The pain was getting stronger, sometimes feeling like it went straight through me to the back. I tried to go to bed around 3, which is usually a little early for me on the weekend, but it wasn't like I was getting any writing done. But I couldn't get comfortable. Lying on my left side, as usual, I had no good way of placing my arms that didn't cross the sore area. 3:38 I got back up and went back out to the living room chair.
Around 4am I began to get concerned. Several times I had gotten heaves, but hadn't actually vomited anything. I checked my temperature -- no fever at 97.1°F. But I also got out the tablet and began to look at WebMD to see symptoms for things like appendicitis. A little while later I got Mrs. Dr. Phil up. Of course the librarian used her search-fu and felt maybe it was more like gallstones or a gallbladder attack. Or maybe pancreatitis.
At this point I figured I was probably going to go to the ER, so I called my doctor's office and got the emergency service. A few minutes later the on-call doctor got back. She was liking pancreatitis better than appendicitis, but agreed I should go in. Now, given my size, history, mobility issues and the nausea, I asked about the difference between our driving the half hour plus to Butterworth from Allendale versus calling the EMTs. She figured it was pretty 50-50, but felt it was good to err on the side of caution and get some data from the EMTs.
So I called 9-1-1 and requested an ambulance. Actually, Allendale Fire showed up first. They were very nice -- one of the tall young guys remembered when they came in May 2013 when I first got sick and had to carry me out of the house. The men from LIFE ambulance were next. The pain, which had peaked in the 8 to 9 out of 10 range (I figure a 10 would be incapacitating/passing out) was down to a 3 to 4. Everyone agreed I needed to go in. At least this time I was able to slowly walk out of the house on my canes, rather than be hauled out on a canvas sheet.
It was odd getting on the gurney out front. With the lights from the garage behind me, the sky above was pitch black until they raised the gurney up and I could finally make out the outlines of the trees. The rains had paused. They loaded me in, took vitals and then we finally left with Mrs. Dr. Phil to follow in a few minutes. The guy riding in the back of the bus was a 31-year veteran EMT. He did a great job of setting an IV line while on the move. Also did a glucose check. Yes, I am not diabetic -- something I took great care to remind everyone after our 2013 hospitalization experiences. But I guess if your pancreas is shutting down then your insulin level goes, too. Glucose was perfectly fine.
I wasn't quite sure which way we went, except when I sat up a bit and saw through the light rain on the back window the McDonald's sign to my left -- we must've been on I-196 and taken the College Avenue exit onto Michigan. I've been in the ambulance ER bay at Butterworth before...
Wheeled into a room -- reminded the two EMTs of my weight, but other than grabbing someone from the nursing station to keep track of my feet, they lifted the sheet and got me on the hospital's gurney no problem. Now I would be in Room 43 for a while. The first nurse who came in said she'd be my nurse for the next half hour. By now it was 6:30am and at 7 the shift changes. One of the things I knew from previous hospital stays was how you have to repeat (a) your particulars and (b) a brief version of systems and history many times. Mrs. Dr. Phil showed up with a number 43 name badge stuck on her shirt.
They wanted to give me two injections. One was for Zofran, an anti-nausea drug. Fine. It works differently than OTC Dramamine, directly on the neural receptors, and I didn't find it to have any side effects I could tell. They also want to give me morphine for the pain. But by now the pain level was way down -- isn't that always how it is when you go in for medical treatment? Also, I have managed to go through all my previous hospitalizations without pain meds beyond Tylenol and didn't feel I needed to go there... yet. So I refused that.
My vitals were relatively normal, if not a little elevated. B.P. 141/37, versus my usual baseline of 120/60. Pulse was 66, versus usual resting of 59-60. I told everyone that I had blood work done from Friday afternoon and they drew blood to do a repeat 15 hours later. The area in question continued to be sensitive to being poked at, but not nearly as painful as a few hours before.
We'd brought a Ziplock with all my currents meds, plus I'd packed a little bag with my Kindles, USB cord and charger. Just in case. If they were going to admit me, I'd need that Kindle to stay sane. (grin) Mrs. Dr. Phil was amused that the hospital/Spectrum WiFi recognized her Kindle Fire HDX. Really don't know what else was going on in the ER. It seemed quiet -- Room 43 opened onto one of the nursing stations -- and I never saw anyone rushing around.
The two blood works -- Friday afternoon and early Saturday morning -- were fairly parallel. I talk about serendipity a lot in my life, and not only was it conveniently Saturday morning rather than a class day, having the Friday blood work as a baseline was just bonus. The white blood cell count was 0.40 and 0.41 respectively in the right units, for example. The liver enzymes were higher, but still in the normal range. If the gallbladder was acting up, it might not be delivering bile to the liver, so that might explain the readings. And at one point I passed 440mL of urine into a hand urinal -- I'm an old pro at this stuff. It was darker than usual, possibly because one of the websites had suggested not drinking water, I guess in case I needed surgery.
Then it was time to go and get an ultrasound of my abdomen. Poking it hard with the probe, especially while holding a deep breath, wasn't easy. But still, the pain level was way down from the 8-9 range. But they couldn't see any gallstones or much in the way of enlargements. The next level would be to do a CAT scan, but given my size that could physically be problematic. With the immediate thought of something like appendicitis ruled out, the best part of valor was to call it a day. I was sent home with a couple of prescriptions, just in case it returns -- whatever "it" is. It's interesting that the oral version of Zofran is a dissolveable, which makes a lot of sense if you're vomiting. (evil-grin) We'll monitor things and repeat the blood work in a week or so and re-evaluate.
Well, you can see from the blog entry title that they technically didn't find anything. If this is an ongoing thing and not a one-off, then we'll probably see more another time. Someone else might be disappointed or mad that they didn't find anything. But we know enough to know that sometimes it's just not possible to figure this out -- or it's too early if this is going to develop into something more definite. Bottom line, I didn't need to be admitted today or rushed to surgery. Which is pretty much a bonus. No one thought we were being overcautious or stupid about doing the whole EMT/ER thing, especially given my history of the past two years. Being on meds for that long, it's always hard to tell what stresses those put on the body, and besides, people get gallbladder and pancreas crap all the time.
I ended up driving the Bravada home. It's easier for me to get in on the driver's side than the passenger side, and having not been given any drugs past the anti-nausea, I felt pretty fine -- by now the clouds were beginning to break up, though there were some spectacular cloudscapes -- and the pain which had gone down to 1-2, was in the 0-1 range. I'd not gotten any real sleep overnight, but had dozed on and off several times. We had breakfast at 11:24 at home -- about an hour later than our usual Saturday morning. Then I went to bed for a two hour nap. This time the bed was cool and soft and comfortable -- no problems.
We were going to go see The Scorch Trials at Celebration North this afternoon, on the way to our monthly Game Night. But I passed on that, of course. Another time.
Oh, and I got a prize. Since I'd been gurneyed into the ER, I had neither canes nor walker, so I had them wheelchair me to the waiting room while Mrs. Dr. Phil went across the street to Lot 7 (she's an old hand at this, I'm afraid). Only one person there, but a few came in as I sat and read my Kindle book. A hospital cop asked a boy traveling with perhaps his grandmother if he wanted a sticker. And another kid. Then she smiled and asked if I wanted a sticker. I asked what kind. Turns out it was a Spectrum Health Security Police Junior Officer. Well, yeah.
I'm Dr. Phil. I carry a badge. *** (Click on photo for larger.)
©2015 Dr. Philip Edward Kaldon (All Rights Reserved)
Not shown: the awesome Hulk Smash bandaid I got from the blood draw.
And so, life goes on. You never know what will happen...
(Damn, I forgot it was Talk Like A Pirate Day in the ER. Guess I was more worried about that nasty pain thing, after all...)
Dr. Phil
*** One thing I'm jealous of with Mrs. Dr. Phil's newer Kindle Fire HDX is that it came with a photo editor. I've looked before at photo editors in the Kindle App Store, but mostly they're either crap or filled with pre-packaged Instagram-type filters. Yuck. But today I went looking again and found a Photo Editor by Macgyver. (grin) It's not perfect, none of the apps had more than a 4 of 5 star aggregate rating -- the big dings here included it no longer working in horizontal screen orientations. I can live with that. Anyway, I took this picture with the Kindle Fire HD, illuminated only by a 300W halogen torch lamp fifteen feet away, then adjusted the Gamma/contrast a little bit and resized the imaged. Then emailed them to myself. I can live with these results.
Posted on Dreamwidth Crossposted on LiveJournal
