Injuries/Illnesses

I count myself fortunate that the most serious physical injury I've suffered in the course of my life has been a hairline fracture of the right wrist requiring only a soft cast. Masturbation jokes aside, it was little more than an inconvenience that I wasn't able to participate in little league for that summer.

Where I have fared less fortunate is in disease. Now, I was born an asthmatic with severe allergic hyper-sensitivities. My parents tell me that I spent the first few years of my life in and out of hospitalization, but to this date I have very little recollection of those times. What I do remember is having to spend 15 minute periods with a nebulizer three to four times each day. That simply became a matter of routine, and I didn't really mind the time sitting still during my childhood. I did mind the twice-weekly allergy injections, but that is expected of any little kid who has to face needles. At some point--I cannot precisely remember--I hammered down and simply accepted the injections without complaint. They, too, became a matter of routine and little bother to me. Ultimately, I don't consider my disease of asthma and allergies to be serious burden on my life. It is what happened a little more than four years ago that I consider something worth mentioning.

It was the day after a friends birthday celebration at a local microbrewery that featured live music, decent beer, and filling pub food. I was stricken with what I thought was the typical reaction to a night of knocking back beer after beer on a stomach full of a southwestern jalapeño burger. After a day of the runs, I began to notice spotting of blood. I phoned my doctor thinking it was a case of food poisoning, and he scheduled me for an office visit the next day. Things only got worse as my abdomen began to cramp painfully. The doctor took my vitals, and agreed that most likely I had a mild case of food poisoning. He wrote me a scrip for antibiotics, and requested that I drop off a stool sample to the local lab for culturing. I was on the antibiotics for three days when the culture came back clear. The diarrhea was now supplemented with nausea, and the bleeding was much worse. The doctor insisted that I come in the next day for a sigmoidoscopy--not a procedure I recommend anybody do in an office environment. After finding no signs of trauma to the colon, he sent me home with another scrip for a strong anti-diarrheal and instructions to take of work and rest. A few days passed, and I began to suffer high fevers with terrible night-sweats. I went to stay at my parents as I had degenerated to the point where I could no longer tolerate anything on my stomach, not even liquids. A last call to the doctor was made, and he insisted that my parents take me to the emergency room immediately, as undoubtedly I was becoming dangerously dehydrated.

After three hours waiting to be admitted, I was taken into a preliminary examination room. It was when they took my body weight that I discovered that in the two weeks I had been ill, I had lost close to thirty pounds in mass. They put me on a gurney, and tried to get an IV started for fluids. The dehydration made the task difficult, and after several failed attempts a veteran nurse was called over. I spent three days in the hospital while doctors ran more tests: cultures, bleeding scans, CT scans. Finally, a young specialist came to my hospital room and told me the final diagnosis. I had Ulcerative Colitis. My own immune system was methodically destroying my large intestine. It explained the diarrhea, the bleeding, the nausea, and the fevers. There is no cure, he told me, save for removal of the large bowel, but there were a wide array of medicines that would put--and keep--the colitis into remission.

So, I began trials of different treatments during which I was kept on a high dosage of corticosteroids. When the Asacol didn't work, i was put on Imuran. When the Imuran didn't work, I was put on a local-acting steroid. When that didn't work, and after the fourth visit through the ER, I was told that I would be put on a new drug called Remicade. I was also told that if I were to experience another flare, it was highly likely that surgery to remove my bowel would be required as the damaged would be too great to recover from. No feeling enthusiastic to the prospects of wearing a colostomy bag all day, I opted for the Remicade without hesitation. Yes, there were risks. Its a specific immunosuppressant, and you can get tuberculosis. You can have a life-threatening reaction that causes respiratory arrest. At this point, I was tired of the flares and I was tired of the hospital. I just wanted a treatment that worked.

The Remicade was a godsend. Within a week, I was well on my way to full remission. My specialist--the same who initially diagnosed me with Colitis--was very pleased and I became a sort of poster child for him. He would cite me as a success story for future patients suffering from the disease. For a year there was no diarrhea, no nausea, no fever, and no bleeding. I was gaining my lost weight back, and my lost strength. The Remicade intervals were at eight weeks, and it seemed like this would become just another matter of routine much like my asthma. Unfortunately, that would not be the case.

My large intestine had suffered quite an ordeal. I had experienced four severe flares requiring hospitalizations in only six short months. This rapid cycle of flaring followed by calming inflicted significant damage on my sigmoid colon. As a result, the tissue was filled with polyps and weakened. One morning, the tissue failed and several sites in the lining of the intestinal wall split open. There was no pain, but lots of bleeding. Every forty-five minutes I was forced to the bathroom to let go of accumulated blood. After a few hours I started to get dizzy spells and I knew that the situation wasn't going to get better. I called my brother and he drove me down to the hospital. This time, I was admitted immediately as a bleeding patient; they don't fuck around when you say you've been bleeding profusely for hours and feel like you are going to pass out. A doctor on call took one look at me and cleared me for a unit of blood. With the IV in my arm, I was still forced to seek the bathroom every 45 minutes. I tried as hard as I could to hold back the blood with the slim hope that maybe that would give enough time for clots to form. I had no such luck, and I was scheduled for a scoping the next day.

When morning came, a nurse told me that since I had not improved and my blood counts were still falling, I was authorized for two more units of blood. It took about two hours for the first unit to infuse, and the nurse brought me materials to prep for the scoping: A cup of crushed ice and a bottle of Citrus-flavored Magnesium Citrate. The mag citrate went down pretty easily--it tastes just like sprite--and the nurse began prepping a second IV site for a saline drip. The doctors wanted me fully hydrated during the colonoscopy. What happened next, however, was totally unexpected.

I vividly remember what happened the moment that nurse pushed the butterfly needle into my arm. As a bleeding patient, I was attached to equipment that automatically measured my blood pressure and heart rate at regular intervals. If any of those values fall below a threshold, alarms are sounded to alert the on-call staff of a potential emergency. When that narrow steel point penetrated my skin I felt an intense wave of heat over me followed quickly by severe nausea and disorientation. I gasped, "I don't feel so good. Please tilt my head back..." and saw that the readout on the blood pressure monitor dropped from 130/60 to 50/60. I heard alarms sound and as nurses began to pour into my room I felt like a large weight was coming down on my whole body. I was crashing. There was no pain, just a quiet pressure that squeezed all other sensations out. As everything in my vision blurred together, a nurse slipped an oxygen feed over my face and asked, "where is that other unit of blood? How far can we open up this feed?". The response came, "all the way!", and I felt the push of blood being forced into my left arm.

The infusion of fresh blood coupled with oxygen brought me back to lucidity. I rolled my head over to the nurse with the butterfly needle and slurred, "I didn't mean to scare you like that..." She chuckled nervously and said that I could have at least waited until she had her morning cup of coffee. After the third unit of blood was fully infused, I was moved for my colonoscopy procedure. I had some niiiiiiiice drugs for that. I vaguely remember shitting on a nurses hand, and thinking to myself: "I really don't care. Just fix me." When I came to, my specialist told me that he found three bleeding sites that he had to staple shut, and that I shouldn't have any more problems with them. I just rolled my head in acknowledgement and went back to sleep. I was discharged two days later.

Since then, I haven't had any serious trouble with my colitis. Doctors say that the disease hasn't killed anyone, but I know that if I hadn't gone to the ER the night that I started to bleed profusely, I wouldn't be writing this now. But, I made the right call. I'm still on my Remicade. Apart from the occasional spotty minor flare-up, everything is just going routine for me.

Jam it back in, in the dark.