Initially appeared on vox.com on 3/13/2010.
(I'm never quite sure what other people's sensibilities are in terms of publicity - not that my blog is widely publicized - but for the sake of privacy I've eliminated other names and faces from this post.)
At the end of this week i was diagnosed with acute diverticulitis with a micro-perforation. As i am still in semi-patient mode and don't really want to go through pathophysiology etc., the interested reader can find information about the condition here.
I first started feeling some hypogastric pressure on Tuesday, but i thought it was just bad gas. Wednesday morning was more uncomfortable, but having a few good poops seemed to make it slightly better, and i was still able to do a treadmill 10-miler and go to work. Wednesday night was when it started getting really bad, with the sensation localizing to the left lower abdominal quadrant, bad enough to keep me from getting a good night's sleep. It was mostly a feeling of wanting to have a major poop, but now completely unrelieved by going to the bathroom.
On Thursday morning i already had the sinking feeling that something bad was happening. Flexing my left hip produced abdominal discomfort, my appetite was shot, and i generally felt feverish - although my temperature was only 37.1 Celsius. In what is perhaps an excellent example of very bad judgment, i massaged the tender area and strained more than usual while sitting on the toilet - as if trying to squeeze a large chunk of fecal matter through.
Still, with the Filipino worker mindset in place (i.e. keep working unless you're actively dying), i went in to the hospital to do my 2-10 shift. Tentatively self-diagnosing myself with acute diverticulits, i asked one of my partners to call in some antibiotics for me - fully expecting to finish my day, start them as soon as i got home, and wake up feeling much better the next morning. I even spoke to one of my GI partners and scheduled myself for a colonoscopy in the upcoming weeks.
Alas, it just kept getting worse. Four hours into the eight-hour shift, i felt like i got run over by a truck. I had to stop and take frequent rest breaks, people kept pointing out how terrible i looked (which is always good for the ego), one co-worker accused me of walking "crooked," and another said i was just "grunting" instead of conversing. So i finally called one of the ER docs, filled him in on my suspicions, and asked to be evaluated.
The ER folks were nice enough to let me go about my business (people don't stop getting sick when their doctors are ill, of course) in between lab draws and getting prepped for an abdominal CT, but eventually when Gianina came to the hospital i just laid in an ER bed and became docile. Soon after the CT scan, the ER doc came in and gave me the bad news - acute diverticulitis with micro-perforation: bowel rest, IV antibiotics, and possible surgery.
Thankfully the colorectal surgeons felt that conservative treatment would be best; after a night of NPO, a day of liquid diet, a few bags of normal saline, and several doses of IV antibiotics i was eventually allowed to go home. So here i sit, typing on the keyboard - hungry, a little uncomfortable, but happy to be home.
Commentary to follow.
Showing posts with label diverticulitis. Show all posts
Showing posts with label diverticulitis. Show all posts
Welcome to 6-South Dr. Chong, Part II - Thoughts
Initially appeared on vox.com on 3/16/2010.
In my haste to bang out the previous post, i completely forgot to put up my reason for choosing that particular title.
From the get-go, i'd like to state in no uncertain terms that the care i received on this floor was SUPERB. Part of me would like to think that the fact that i'm staff and am on good terms with everybody on the floor was the reason i got such excellent care. While i do think that *may* have been a contributory factor, i have no doubt (just based on working on that floor often) that they provide the same quality of care to everyone. Which makes me feel bad because i wasn't the one VIP on the floor, but on the other hand it means that EVERYONE is a VIP. Kudos and sincere thanks to the 6-South staff from me and my family.
Despite giving me a new perspective on things - the view of the room from the bed is decidedly different from the SIDE of the bed - there were no earth-shaking epiphanies; nothing to make me want to change the way i practice medicine or the way i treat my patients, no realization that OMIGOD THIS IS HOW PATIENTS REALLY FEEL I'VE BEEN WRONG ALL THIS TIME. I now appreciate why patients who feel even slightly better beg to be sent home day after day (as one of my surgeons put so aptly: "It's like trying to sleep in the middle of Meijer."); furthermore, i now fully understand how bad a restricted diet (even the full liquid "ice cream" diet) can make one feel. But will it make me discharge my patients or advance their diets prematurely? No.
If anything, it made me realize how smoothly everything goes when patients are informed and cooperative. Granted, having been in this field since 1997 (counting medical school) gives me a deeper understanding of everything that goes on, so i just smiled politely when they wanted to do any little thing. I wanted so badly to go home on Friday afternoon, but when my surgeon indicated that he wanted my abdomen to be less tender, i understood his point and relented.
Contrast to some who unfortunately know just enough to be dangerously uninformed - questioning the need for every simple diagnostic and contesting every suggested therapy - which doesn't necessarily provide better care.
Sometimes the cure can be almost as bad as the disease. Anyone who's seen me eat can appreciate the personal torment limiting my diet creates. I'm hoping that by next week i'll be able to return to my favorite Chinese buffet and feel like my regular gluttonous self. I've also had some worsening nausea and dizziness over the past few days, which i suspected was from one of the antibiotics. So i've had my meds changed and my symptoms have gradually improved.
I did get a kick from the shock value of walking around the floor and coming up to co-workers i see daily clad in a gown (note that i did have pants on underneath) with an IV stand in tow. I know i always feel sympathetic to people in the field who get sick; sometimes we get so wrapped up in making other people better that it's jarring to get reminded of our own fragility.
Another thing that i'm having trouble dealing with is my surgeon's advice to "take it easy" for the next two weeks, i.e. no weights and NO RUNNING. Thinking about this rationally, a two-week layoff shouldn't really make a big difference in the grand scheme of things, but of course it doesn't make me feel any better. I was planning to do the Eagle 10k again this year; i suppose i still could, but my dreams of running a PR (which, to be honest, is only a moderate pace to "real runners" anyway) have just gone up in smoke. As everyone keeps telling me though, my focus right now should be on getting better. It'll be even worse if i push too hard, rupture, and end up with a colostomy.
In my haste to bang out the previous post, i completely forgot to put up my reason for choosing that particular title.
From the get-go, i'd like to state in no uncertain terms that the care i received on this floor was SUPERB. Part of me would like to think that the fact that i'm staff and am on good terms with everybody on the floor was the reason i got such excellent care. While i do think that *may* have been a contributory factor, i have no doubt (just based on working on that floor often) that they provide the same quality of care to everyone. Which makes me feel bad because i wasn't the one VIP on the floor, but on the other hand it means that EVERYONE is a VIP. Kudos and sincere thanks to the 6-South staff from me and my family.
Despite giving me a new perspective on things - the view of the room from the bed is decidedly different from the SIDE of the bed - there were no earth-shaking epiphanies; nothing to make me want to change the way i practice medicine or the way i treat my patients, no realization that OMIGOD THIS IS HOW PATIENTS REALLY FEEL I'VE BEEN WRONG ALL THIS TIME. I now appreciate why patients who feel even slightly better beg to be sent home day after day (as one of my surgeons put so aptly: "It's like trying to sleep in the middle of Meijer."); furthermore, i now fully understand how bad a restricted diet (even the full liquid "ice cream" diet) can make one feel. But will it make me discharge my patients or advance their diets prematurely? No.
If anything, it made me realize how smoothly everything goes when patients are informed and cooperative. Granted, having been in this field since 1997 (counting medical school) gives me a deeper understanding of everything that goes on, so i just smiled politely when they wanted to do any little thing. I wanted so badly to go home on Friday afternoon, but when my surgeon indicated that he wanted my abdomen to be less tender, i understood his point and relented.
Contrast to some who unfortunately know just enough to be dangerously uninformed - questioning the need for every simple diagnostic and contesting every suggested therapy - which doesn't necessarily provide better care.
Sometimes the cure can be almost as bad as the disease. Anyone who's seen me eat can appreciate the personal torment limiting my diet creates. I'm hoping that by next week i'll be able to return to my favorite Chinese buffet and feel like my regular gluttonous self. I've also had some worsening nausea and dizziness over the past few days, which i suspected was from one of the antibiotics. So i've had my meds changed and my symptoms have gradually improved.
I did get a kick from the shock value of walking around the floor and coming up to co-workers i see daily clad in a gown (note that i did have pants on underneath) with an IV stand in tow. I know i always feel sympathetic to people in the field who get sick; sometimes we get so wrapped up in making other people better that it's jarring to get reminded of our own fragility.
Another thing that i'm having trouble dealing with is my surgeon's advice to "take it easy" for the next two weeks, i.e. no weights and NO RUNNING. Thinking about this rationally, a two-week layoff shouldn't really make a big difference in the grand scheme of things, but of course it doesn't make me feel any better. I was planning to do the Eagle 10k again this year; i suppose i still could, but my dreams of running a PR (which, to be honest, is only a moderate pace to "real runners" anyway) have just gone up in smoke. As everyone keeps telling me though, my focus right now should be on getting better. It'll be even worse if i push too hard, rupture, and end up with a colostomy.
C-Day
Initially appeared on vox.com on 6/3/2010.
So after weeks of anticipation (well, not really - since i was in the Philippines enjoying myself for most of May), i finally had my colonoscopy today.
The main indication was my recent episode of diverticulitis (see my two most recent blog posts), although given a strong family history of colon cancer, the screening angle is also most welcome.
I agree with what most patients say - the prep is indeed the worst part. Clear liquids only on the day prior to the procedure, four tablets of Dulcolax at 3pm followed by 119g of MiraLax two hours later, and another 119g of Miralax the next morning for good measure - the whole "colon cleanse" is not pleasant. By the end of the whole process - nothing but clear liquid is coming out of your behind.
HOWEVER, i must admit that it wasn't as bad as i thought it would be. I guess the whole point to having you take the Dulcolax and MiraLax in the afternoon is so that you can expel most of your bowel contents early in the evening. The timing of the meds was just right, as my last BM was around 11pm; contrary to my fears, i was not up "pooping all night." True, you do have be in the immediate vicinity of a vacant bathroom within the next few hours after taking the meds, but there's really no pain - just inconvenience.
Nor was hunger was not as much of an issue, as the copious amounts of fluid i drank up to four hours prior to the procedure kept me full - if not satisfied. After all, it's hard to be satisfied even with 2 liters worth of Gatorade in your belly when you're watching Man versus Food. My bad.
The procedure itself was a breeze. We walked into the doctor's office at around 2pm and got whisked into the waiting area at around 2:15. At 3pm they wheeled me into the endoscopy room and gave me some Versed. The next thing i know, it's half and hour later and Gianina is with me in recovery. Once i'm awake, i go home and have a Baconator.
So for anyone who's been told they need a colonoscopy but have been putting it off because of apprehensions - stop delaying and get yourself scheduled. There's really nothing to it.
P.S. Results? Aside from diverticulosis, nothing to report.
So after weeks of anticipation (well, not really - since i was in the Philippines enjoying myself for most of May), i finally had my colonoscopy today.
The main indication was my recent episode of diverticulitis (see my two most recent blog posts), although given a strong family history of colon cancer, the screening angle is also most welcome.
I agree with what most patients say - the prep is indeed the worst part. Clear liquids only on the day prior to the procedure, four tablets of Dulcolax at 3pm followed by 119g of MiraLax two hours later, and another 119g of Miralax the next morning for good measure - the whole "colon cleanse" is not pleasant. By the end of the whole process - nothing but clear liquid is coming out of your behind.
HOWEVER, i must admit that it wasn't as bad as i thought it would be. I guess the whole point to having you take the Dulcolax and MiraLax in the afternoon is so that you can expel most of your bowel contents early in the evening. The timing of the meds was just right, as my last BM was around 11pm; contrary to my fears, i was not up "pooping all night." True, you do have be in the immediate vicinity of a vacant bathroom within the next few hours after taking the meds, but there's really no pain - just inconvenience.
Nor was hunger was not as much of an issue, as the copious amounts of fluid i drank up to four hours prior to the procedure kept me full - if not satisfied. After all, it's hard to be satisfied even with 2 liters worth of Gatorade in your belly when you're watching Man versus Food. My bad.
The procedure itself was a breeze. We walked into the doctor's office at around 2pm and got whisked into the waiting area at around 2:15. At 3pm they wheeled me into the endoscopy room and gave me some Versed. The next thing i know, it's half and hour later and Gianina is with me in recovery. Once i'm awake, i go home and have a Baconator.
So for anyone who's been told they need a colonoscopy but have been putting it off because of apprehensions - stop delaying and get yourself scheduled. There's really nothing to it.
P.S. Results? Aside from diverticulosis, nothing to report.
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