Well…that’s the appendix gone. From start to finish, it was less than twenty-four hours. A blind-ending tubular structure arising from the cecum is no more, and I am reliably informed that it will not grow back.
Monday, April 23, 2018
I awaken feeling exactly like I did at Canyons 100k one year ago where I found myself lying on the ground at mile forty-three with severe abdominal pain. Thinking this was food-poisoning again, the next three hours were occupied with vomiting. However, there was something odd…only clear fluid was coming up.
Since the abdominal pain is not getting better, Debbie suggests I call Kaiser, and an appointment is made to see my primary care physician, Dr. Ferris.
After almost throwing up in – and thereby redecorating – my doctor’s office, I am given some ondansetron – often prescribed to prevent nausea and vomiting caused by cancer drug treatment and radiation therapy – nice! Since I have no fever, appendicitis cannot be diagnosed. Appendicitis is an infection, so there should be a fever. This could still be a gastrointestinal matter. I am advised to rest and monitor for temperature. If a fever develops, I should call 911 and go to emergency.
With the pain level remaining constant, I notice my temperature is up by one-degree. Is that a fever? A faulty reading? Within the tolerable error of the measuring device? It’s warm upstairs. Perhaps I should go downstairs and check it there…Nope, still one-degree. I resolve to wait and see if it goes up by two-degrees.
Email to Dr. Ferris. Is one-degree considered a temperature?
Temperature now at 100.6 degrees. That’s my line-in-the-sand. So I change into hospital ready clothes and debate taking a book along in case I am bored. The book stays, since I sense the experience will be worth remembering…
911 call is made, and I sit out front waiting for the ambulance.
Text to Debbie to let her know what is happening. Ambulance arrives one-minute later and off we go (amount billed to insurance $2,366.54)…Debbie arrives quickly in the ER.
In the ER, blood tests show dehydration with low electrolytes. Blood pressure is high. Lactated Ringers IV started which includes electrolytes – sodium chloride, potassium chloride, sodium lactate and calcium – good for an ultra marathon. Another dose of ondansetron is included, also good for an ultra marathon. At some point, I begin shaking uncontrollably, possibly because the IV is cold…so…
Bring on the morphine! This stuff works fast. I know I am in pain, but I just…don’t…give a damn…
At some point, a CT scan with contrast material is performed which confirms the diagnosis of acute appendicitis.
Zosyn, a penicillin antibiotic is started. One of the surgeons, Dr. Lehrer, introduces himself. “What do you think…should we take it out?”
Me – “seems like it will just cause problems if we leave it in. Let’s yank it.”
He explains the procedure which will be a laparoscopic appendectomy. Three incisions will be made, carbon dioxide gas will inflate the abdomen so that my insides can be viewed with a camera. The operating room will be available soon, so they expect to start around 10:30 pm. This allows Debbie to explore the Kaiser canteen, since she has not had dinner.
I am given some mouthwash, probably because I’ll be intubated due to the anaesthesia. The nurses ask whether I have had general anaesthesia in the past. Debbie leaves to get a few hours of sleep…whatever I was given for anesthesia works remarkably well. I barely remember being wheeled into the OR…just before my lights went out, I recall seeing the operating lights and thinking it looked like a film set.
Tuesday, April 24. 2018
Although I have no recollection, senator, surgery is finished.
I dreamt that someone was trying to talk to me. This confused me. Was I being asked if I knew my name, or where I was? Of course I know my name, what does it matter…can’t you see I’m trying to sleep?
I wake and look at the clock, realizing the whole appendix thing has been a dream. Turns out, I didn’t need to have it removed, and I am home. But wait…why am I in a hospital bed, and where are the cats?
Additional antibiotics are added to my IV drip – ceftriaxone and a gastrointestinal antibiotic called metronidazole, which is also used to treat vaginal infections. So I am covered under various scenarios…
Throughout the early morning hours my legs are being treated with a type of compression device that alternatively inflates around each leg. Although this is used to prevent blood clots, it is very soothing on the calves.
Ketorolac, a nonsteroidal anti-inflammatory drug, is added to the mix.
My vital signs are looking good. Blood pressure is back down at 122/71 and pulse is a respectable 51 (all that running).
Famotidine, which inhibits stomach acid production, is also introduced to the IV. Is this because I am about to be served breakfast in bed?
Dr. Lehrer visits me in the morning, and even though he said I would not remember him, I do remember his confidence and kindness from last night. His approach had just the right mixture of humor and professionalism which communicated that although any surgery has risks, this one should be just fine. There was never any moment of doubt.
I am discharged around noon, and Debbie’s bright and smiling face is there to take me home. I am prescribed hydrocodone (an opioid synthesized from codeine, one of the opioid alkaloids found in the opium poppy) for the pain. Rashly, I think I can make it through the pain without the opiates. This fallacy only lasts a few hours before I am ripping the top off the bottle…
In a few days, the pathologist will call to go over findings. There were no concerns, and the appendix was not perforated. However, the pathologist said my appendix was probably about 12-hours away from bursting. Both the surgeon and the pathologist noted that my appendix had gotten rather large.
My greatest thanks to Debbie who came to my side when I needed her. The joy of growing old together is that we get to take each other to hospital. And of course, thanks to all the doctors, nurses and paramedics. From primary care to the ambulance, from the ER to the OR, it is immensely reassuring to be surrounded by such a group of professionals.
I have pictures, but will spare the internet…hopefully back on the trails in four-weeks.