Please pray for me

[birchswing]

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I know I have been a thorn in sides and abused this forum and individuals, and I am sorry.

A long time ago I made a post worried about a day that I thought might come. If you're enough a hypochondriac, you'll eventually sound prescient:

http://forums.studentdoctor.net/thr...a-in-benzodiazepine-tolerant-patients.966311/

I have appendicitis. I've been awake for 24 hours and have been NPO and waiting surgery which has been delayed a couple times.

My parents didn't believe my stomach pain was that bad, so in one win, I left the house on my own in an ambulance. Many hours later, a CT scan, and blood test confirms that I do in fact have appendicitis.

Healthwise I am known to my family as the boy who cries wolf.

They are here with me now.

I'm kind of terrified but also know that there is no other way forward. I am terrified to die. But I know that I would without intervention.

I don't pray often. I do sometimes.

I want to apologize to sunlionness because I remember I made a rude remark to her and TexasPhysician a while back. I apologize to you both.

I don't have the mindset for lifechanging revelations at the moment, but I at least wanted to say that. Thank you.

 

[OldPsychDoc]

Be well, Friend.

 

[sunlioness]

No hard feelings, best wishes, and prayers.

Let us know how it goes.


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[Mad Jack]

I know I have been a thorn in sides and abused this forum and individuals, and I am sorry.

A long time ago I made a post worried about a day that I thought might come. If you're enough a hypochondriac, you'll eventually sound prescient:

http://forums.studentdoctor.net/thr...a-in-benzodiazepine-tolerant-patients.966311/

I have appendicitis. I've been awake for 24 hours and have been NPO and waiting surgery which has been delayed a couple times.

My parents didn't believe my stomach pain was that bad, so in one win, I left the house on my own in an ambulance. Many hours later, a CT scan, and blood test confirms that I do in fact have appendicitis.

Healthwise I am known to my family as the boy who cries wolf.

They are here with me now.

I'm kind of terrified but also know that there is no other way forward. I am terrified to die. But I know that I would without intervention.

I don't pray often. I do sometimes.

I want to apologize to sunlionness because I remember I made a rude remark to her and TexasPhysician a while back. I apologize to you both.

I don't have the mindset for lifechanging revelations at the moment, but I at least wanted to say that. Thank you.

Good luck. You're gonna make it bro, it's just a little slice and snip and you're good. Being opened up is scary as hell though, and I know no matter what I say there's no way you won't be terrified (I can't even get a CT scan without panicking myself), so just know in the back of your mind that things'll most likely be okay.

 

[sosoreal]

You will be fine . It's a simple procedure. You will be home in no time



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[doctorpilgrim]

Best wishes and good luck.


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[PikminOC]

...

 

[Ceke2002]

Sending you good thoughts from across the seas my friend. Please let us know how it all goes for you. And don't worry, you've got this. 👍

 

[wolfvgang22]

Best wishes for a speedy recovery, I know you will be back here to opine again soon!

 

[birchswing]

Thank you everyone! I guess everyone is religious in a foxhole.

 

[Shikima]

No anesthetists in prison or foxholes. (autocorrect error on purpose)

 

[DuskPhilosophy]

Hope you're doing alright Birchswing

 

[Renzio]

Your a beautiful spirit. I will pray for you. You teach the physicians how to heal the mind and body.

 

[birchswing]

Hey, thanks very much everyone!

I wasn't sure if I would update this or not because I felt kind of strange about having posted here after the fact.

I have a lot of friends who post on Facebook when they're at the ER, even for somewhat minor issues, and I didn't want to do that. I honestly am not sure what made me decided to post here, but I want to tell you all I appreciate your thoughts very much.

So, it was an interesting experience. They are really, really good at anesthesia and surgery. Western medicine excels there very well. Everything else in the hospital was fairly stressful, but I think I had an unusual experience.

It was Tuesday night that I had abdominal pain. It came on very quickly. Textbook. Started in the center then localized to the lower right. Hurt to stand up. Felt like I needed to have a bowel movement or pass gas to feel better but couldn't. Was fairly certain by the fact that I was in a fetal position and could barely stand that it was appendicitis.

I have a complicated relationship with healthcare, as does the rest of my family. My mom won't even have blood drawn--not for religious reasons but out of fear. She won't get a colonoscopy. She's just afraid. I'm the opposite where I want every test, and my parents see me as a hypochondriac. I also know I sense changes in my body very sensitively. My dad's parents are Christian Science, and I'm not sure if that's why, but to him, the ER is like kryptonite. To this day, he still thinks I could have waited a few days before going to the ER. So while I have an unhealthy relationship with health, my parents so as well in a fairly opposite way.

So when I told my parents (who I live with) that I had appendicitis, their response was not surprising (it's just gas). I eventually called 911 because I can't drive and I didn't know what else to do. I went in thinking I was absolutely crazy. I'm not very independent in that I don't drive so I don't ever really leave the house on my own, and since I first had OCD I've been looking to my dad for reassurance and advice on what I should do about things. So this was like I was "breaking bad."

They wanted to do a CT scan and I could just hear my dad's voice in my head telling me I'm going to get cancer because of my neuroses. It was very scary being there by myself.

My biggest concern was getting a ride home because I assumed that I would be told it was all in my head and that I would be discharged from the ER.

When the ER doc told me it was appendicitis I kind of broke down, and my pulse went up to 154, and the ER doc was not sympathetic. I was in the bargaining stage of acceptance, and she was very blunt and told me I would die without surgery. I think it was actually effective in getting me to the point I could get my parents on board faster. She called my dad and told him he needed to come and both my parents did take off and stayed with me, which was a huge relief.

My biggest concern was in talking with the anesthesiologist before the surgery to explain how weird my brain is. I wasn't able to but I was able to talk with another one who talked with him. She was wonderful. And she was able to be there when I went in for the surgery. She caught him up to speed on my situation.

I did look up my surgeon and found a case where a patient died from an abdominal surgery and he admitted fault. I knew there was no way I couldn't ask about it. At first I asked the nurses and they all said he was very good. I finally asked him. I couched it very, very well. I know most people would never say anything about something like that. But I know myself. I had to ask if it was related to something happening in my surgery.

The anesthesia worked great and suddenly. The last thing I remember was them telling me to breathe into a mask of oxygen deeply. I think they tricked me (don't think it was 02). It burned my lungs a bit and that was the last thing I remember.

Waking up from anesthesia was bad though. I don't remember it, but for a half hour I was flailing my arms and legs. They called my dad back eventually. Apparently they were trying to talk to me to get me to calm down, but I am sure it was in vain because I don't know that I was coherent or even "there."

There were four nurses holding me down, and they were concerned I would fall off the bed or pull out my IV and that they couldn't measure my BP.

I (unknowingly) punched one nurse in the face who got a bloody nose.

At the point I began remembering, I remember a ton of people standing around me who seemed to want something from me but I couldn't tell what they wanted. Like I didn't know what I was doing (or that I had been flailing) or what I was supposed to do. I tried talking but I don't think I was actually talking. My vision was blurry and things were coming in and out.

Eventually things became more normal. My dad said both the surgeon and anesthesiologist had been standing far back and the anesthesiologist yelled to give me 2 mg more Versed at two different points and it was only after the second dose that I stopped flailing. At the point I didn't know any of this. I was only aware of waking up at the point that I could see them asking something of me.

I don't remember it, but apparently I asked the nurses to ask me who the president was. I was instructing them to give me a mental status exam, hehe. I kept saying I wasn't supposed to survive and kept asking it if was real. And I told them that I could now finally do the endoscopy I had put off for so many years. Apparently I said that non-stop. I then said I wanted an Apple Watch and a 4K TV as a present for having done it.

Staying in the hospital until discharge was hell. Before surgery (2 PM Wednesday), I had been awake since 1 PM Tuesday (day-night reversed sleep schedule). I never fell asleep in the hospital after surgery, and didn't sleep until I got home Thursday at 11 AM. So almost 48 hours no sleep except for the surgery.

I learned that at this huge hospital there are no doctors working overnight except for one in the ED, who is also the hospitalist. The nurses have no power to make decisions that depart from what is in the system. For example, I wanted IV tylenol instead of IV Norco (which is hydrocodone and tylenol). They weren't allowed to. They could give me Norco or nothing. ButI kept pointing out how everytime they gave me Norco my 02 dropped into the 80s. Didn't matter.
The first nurse I saw tried entering my normal medicines into the computer but did in a really weird convoluted way where they were out of order and the doses were wrong. Everyone in the hospital regardless of reason for being there is a Fall Risk. They had a sign saying "4 Days Since Last Fall--Goal 32." So I had to use a urinal in bed. And I just couldn't sleep. I felt huge withdrawal. There were machines on my legs that inflated and deflated every other second and the bed moved constantly to avoid blood clots. I kept asking to see a doctor. I asked to see a patient advocate. I eventually called my PCP after hours who spoke to the only doctor in the hospital (the single ED doctor) who let them give me 1 mg Ativan which took away the shakes. The nurses spoke poor English and looked like they had just finished a bad shift in the DMV. I was connected to devices constantly beeping because of my low 02 and high pulse. And it measured my BP regularly. I noticed each time it measured my BP my pulse pressure increased (to a high of 95). I paged the nurse who responded over the intercom that a "pulse" of 95 was fine. I tried telling her that my pulse was 125 and it was my pulse pressure that was 125. She came in and was sighing. She said your blood pressure's not 95! And I then tried to explain what pulse pressure was.

She then just ripped the BP cuff off and said "You don't need this anymore."

She was taking off the device out of punishment. When I kept trying to explain how they messed up my medicine schedule, they eventually threw a pencil and pad at me and told me to write it down and they'd give the note to the doctor the next day at 10 AM (this was at midnight).

By the time I left my 02 was 83% and I was starting to hallucinate from not sleeping (I have never hallucinated before in my life--I was seeing stars). The doctor said the most important thing was for me to sleep so they discharged me knowing I could sleep at home but probably could never tolerate the hospital environment.

As soon as I got home I fell asleep (after having some of the world's largest hypnic jerks--each one causing me to involuntarily yell and causing searing pain in my abdomen).

The first couple of days I could barely stand. They think it's from the massive muscle movements I made coming out of surgery. I was in such excruciating pain. I didn't take the Norco they gave me because every time they gave it to me in the hospital my Sp02 dropped really low. It was 83% when I got home from the hospital. I kept trying to breathe deep and eventually not taking the Norco it got back to usual. I've only taken Tylenol since I got home and didn't even take that after the first two days. At first to get up I had to grab my sheets and pull myself little by little. I would try to stand up and fall back down. My thigh muscles were too weak. I used a cane.

It was if I had done a thousand squats and bicep curls. I don't have any other explanation than it being my flailing for the cause of the all over body wastage (my term for it--I don't know what else it could have been). Now I just have lower left abdominal pain (that was the incision where it was taken out--all the way across from where the appendix was). Two other incisions that don't hurt.

Apparently I called the surgeon's office too many times with my complaints and he called me (and text-messaged me) and told me I was the worst patient he ever had and that if everyone were like me he would quit. He said there was no reason to call because if I had actual problems I should have gone back to the ED.

My parents are embarrassed that our neighbors saw the ambulance in our driveway. There's no way I can get back to the ED without an ambulance, unless I were really brave and took a taxi.

So, I've been figuring things out on my own. And I'm finally feeling better. Knock on wood.

EDIT:
This sound so negative.

I need to write the great things:
—The anesthesiologist who came to talk to me who wasn't on my case was amazing. She spent a huge amount of time with me and really "got" me. Extremely intelligent on long-term benzo use.
—My parents are amazing. They have been helping me out (they already were) a huge amount. My mom took off work to stay home with me last Friday. They went out and bought me lots of soft foods and hard candies for my sore throat. I know I sound like I'm vilifying them in my account, but it's more that I find the dynamics interesting and like to explain them and understand them.
—One of the nurses who wasn't mine was wonderful. I unfortunately didn't get to talk to her much, but she was very sweet.
—The ED nurse was also very reassuring and kind.
—Even though the surgeon blew up at me, and I then blew up at him, I think it's been good. I am trying to feel things as other people feel them. And instead of cutting things off with me, we're still planning to meet for my follow up. He's a little emotionally volatile. And I'm . . . demanding. And he wasn't used to someone like me coming through. And maybe it's been good for both of us.
—I got a lot of love and support from family and friends far and near.
—I left the house by myself!

 

[smalltownpsych]

The physically focused docs and almost all nurses just don't find our patients nearly as interesting as we do. 😀 Glad that you came out alright and took some positives from the experience.

 

[milesed]

Sounds like there is a lot to be learned from this. Maybe it will help your mom get routine care she needs.

 

[birchswing]

Another adventure late last night . . . I was browsing the medical info on the hospital's portal site and found that the CT scan said I had "Musculoskeletal: No suspicious lytic or blastic lesion of bone. Suspect metastases involving the right ischial tuberosity and proximal right femur at, both measuring less than 1 cm."

My parents actually freaked out at that more than I did. So I called them today and left a message. And unfortunately my phone didn't ring when they called back and I only got a voicemail where the nurse said the word metasteses was a mistake and should have said enostoses. Just by Googling I can see that's better obviously. But I still have to wait till tomorrow morning now to talk to someone (as the nurse left a voicemail right after closing) to find out more. I'm worried they're just telling me it's this so I won't worry/bother them. Totally not looking for medical advice here. Just relaying a new part of the narrative that is terrifying from the patient's perspective, and at this point seems to be the result of a mistake. I don't know how a mistake like that gets made. I will find out.

 

[Mad Jack]

Another adventure late last night . . . I was browsing the medical info on the hospital's portal site and found that the CT scan said I had "Musculoskeletal: No suspicious lytic or blastic lesion of bone. Suspect metastases involving the right ischial tuberosity and proximal right femur at, both measuring less than 1 cm."

My parents actually freaked out at that more than I did. So I called them today and left a message. And unfortunately my phone didn't ring when they called back and I only got a voicemail where the nurse said the word metasteses was a mistake and should have said enostoses. Just by Googling I can see that's better obviously. But I still have to wait till tomorrow morning now to talk to someone (as the nurse left a voicemail right after closing) to find out more. I'm worried they're just telling me it's this so I won't worry/bother them. Totally not looking for medical advice here. Just relaying a new part of the narrative that is terrifying from the patient's perspective, and at this point seems to be the result of a mistake. I don't know how a mistake like that gets made. I will find out.

Radiology reports are dictated via software and frequently have mistakes in them. I wouldn't freak out too much while you wait.

 

[birchswing]

Radiology reports are dictated via software and frequently have mistakes in them. I wouldn't freak out too much while you wait.

I just talked to my PCP. He is a saint.

He said he was timing my recovery by how long it would take me to find the radiology report and find metasteses listed in it.

He actually found it on Friday when I was discharged, called the hospital, they went back and listened to the recording and found it was a mistake, and that's when they added the addendum (which doesn't show up on the hospital portal site). I am very very lucky to have my PCP. He just called and talked to me for a half hour. And out of the four people who saw the report in the hospital (two radiologists and the ED doctor and the surgeon signed it), none noticed the mistake. But my PCP did in the discharge papers.

Two other things I forgot to mention that were amazing about the experience:
-Before the surgery, my cardiologist visited me in the hospital. Walked in like a knight in shining armor. I sighed a huge amount of relief. I had called him to tell him I was going into surgery and wanted him to talk to the anesthesiologist to tell them about my dilated aorta and my POTS, and he not only did that but came to visit me.
-After the surgery, my PCP (who I also texted to tell I was going into surgery) came to visit me.

They are both amazing people. I told the PCP how the surgeon told me I was the worst patient he ever had and he couldn't stop laughing. I'm very lucky there are some people who "get" me.