Out of the hospital but not the woods
This is some journey I’ve started, which I detail with my previous posts on my first visit to an emergency room and my surgery and subsequent discharge from the hospital. I didn’t choose to have pancreatitis, and yet at the same time I did. The instigating factors like diet, excess weight, not getting sufficient and regular exercise, not keeping myself sufficiently hydrated — I made choices over the years with all of these.
Well, pain has a way of changing your perspective on things. I’ve become serious about those instigating factors I just named in a way I never was before. I thought I was serious before, but the truth is I wasn’t. I never attacked those issues with the same type of determined action as I have the past several days.
I started by doing some research on pancreatitis and the diet that promotes recovery. I was right to suspect that the advice I received to eat smaller meals of non-fatty foods wasn’t quite complete. Apparently this is not something that resolves itself in a day or two. It often takes months and sometimes years for the pancreas to heal completely. There is no magic drug or procedure to heal the pancreas. The pancreas must heal itself.
To help the pancreas do that, I have to reduce the demand for the normal function of the pancreas as much as possible. The pancreas provides two things for the body. First, the pancreas provides digestive enzymes to aid digestion. When the stomach can’t handle the job of digestion, which it typically can’t when high amounts of fat are present, the pancreas steps in to lend a hand by providing digestive enzymes. The passage of those enzymes through an inflamed pancreas causes pain, so I can avoid pain by avoiding high-fat foods.
This is also the reason for eating smaller meals. Too much food at once means the stomach can’t handle the job, and so the pancreas steps up to help. The pancreas can heal itself, but it must be left alone to do so.
In addition to digestive enzymes, the pancreas provides insulin, so anything that will spike blood sugar is out. I’ve actually weened myself off a lot of sweets over the years, so this is not much of a problem for me (though I’m not certain how I will celebrate my upcoming birthday, but that’s a different story). My bigger problem is the high-fat foods. My absolute favorite food to eat is sausage biscuits and gravy. I could eat that all day every day and not get tired of it. And then there’s all the things you can do with cheese. I absolutely love cheese.
But now, there’s no more pizza, no more lasagna, no more cheddar sausages, no more bacon cheeseburgers — and I just said bacon. There’s so much you can do with bacon, including eating it by itself. Now that’s all out. I’m reminded of something my grandfather once said. He said, “The only thing better than butter is more butter.” I agree completely, but I also accept the need to refrain while I’m in recovery. And I don’t know how long it will take.
It’s not all bad, though. When I look at my new low-fat, low-sugar diet, what I see is roughly 80% of the diet I’ve been moving myself towards before pancreatitis took center stage. I’ve been moving in slow increments mostly because I didn’t want to give up the foods that now are completely off limits because now my body will not tolerate incrementalism. Now I have to be all the way there and nowhere else. That wouldn’t be agreeable if I had to be this way forever. But I won’t be, or at least that is my intention. Yes, this recovery period will be slow and long. But it will also end. And when it does, I will keep the diet I’ve developed because of it and slowly add an occasional delight, like biscuits and gravy or pizza or a bacon cheeseburger or butter on homemade white bread.
But for now, the time is to hunker down and devote myself to healing. And it’s more than my pancreas that needs a long recovery to heal. My pulmonary embolism will not heal any time soon. That’s going to take months of blood thinners and more movement every day during those months to increase circulation in my blood vessels.
And who knows what else may be lurking inside of me? This past week I’ve been tracking my weight and noticed I’ve been losing 1-3 pounds a day. In fact, I’ve lost around 25 pounds since my first visit to the ER a little more than two weeks ago. At present, I’m not greatly concerned about the weight loss because I’ve been trying to lose weight for a long time, and now it’s going. Granted this isn’t my preferred method of weight loss, but it’s going all the same, and I’ve got plenty left in store for this to continue over the next couple of weeks. That said, a part of me does wonder whether this weight loss is a leading indicator of some other health issue that I’ll need to add to the mix.
We will have to wait and see. One thing I have quickly learned from pancreatitis is the need to take one day at a time. One moment you could feel you’re doing fine, as I did earlier this week, and then the next you have another pain episode followed by fasting for a day or two and then starting over again on a liquid diet. It’s hard to see what or even if anything is coming over the horizon. So you have to focus on what you can do with what is right in front of you today and trust that all will somehow work out for the best. And so I follow the advice of Rocky Balboa at the end of Rocky III — “Just keep punching.”
Out and yet not
I cannot begin to tell you how happy I am to be out of the hospital. On the one hand, I’m very grateful for the care I received, but on the other hand, it started to feel more and more like a prison, especially after the surgery.
The surgery itself went well, or so I am told. I don’t remember a thing about it. And yes, there was just one surgery, not two, as originally planned. Monday morning I’m half starved with diarrhea getting prepped to go, and the surgeon decided to have another MRI scan. Apparently, he had a second look at the first image and thought the stone might have passed through me over the weekend. So I had a second MRI and kept starving in case it showed the stone was still there.
While I waited for the results, I couldn’t help but notice something humorous. I’ve been having different nurses rotate through each day in taking care of me, but I noticed that today, which is Halloween, one of my nurses is named Chucky! You can’t make this stuff up! I had to take a picture because I knew that otherwise no one would believe me.
By evening, the MRI results came back negative, which meant I was then rushed the second surgery on the following day. Seeing as I how I had just been starved through diarrhea to prep me for a surgery that was not going to happen, I wanted to wait a day to give my body a chance to recover. But the surgeon refused to wait. He wanted in the very next day. I had just a small bowl of broth that night and then not allowed anything as part of my surgery prep.
Personally, I’m glad I don’t remember anything about the procedure itself. I remember being placed on the surgery table surrounded by several individuals who each then began prepping individual parts of the body for the procedure. The anesthesiologist really did his job well, because I lost consciousness while they were prepping me and did not regain it until sometime after I had been placed in the outpatient area.
As I awoke, I noticed a feeling of cleanliness in my abdomen, a really good feeling from that part of my body that I had not felt in many years. Then the anesthesia wore off completely, and I felt pain from the incisions. The doctor had made four small incisions just large enough to insert his tools and remove the gallbladder without cutting me wide open. And they hurt like the dickens.
The staff didn’t know what to do with me being in so much pain that they just put me to bed to let me sleep it off. But there were two problems with that approach. First, as I would discover later, getting up and moving around as much as possible after the surgery helps keep the area from getting stiff. And was I ever super stiff the next morning! Second, I was already malnourished not having eaten anything since the night before, and that was just a small bowl of broth, the only thing I had to eat that entire day. How anyone can expect the body to recover without proper nutrition is beyond me. But hey, I never went to med school, so what do I know?
I soon learned that wasn’t to be my only challenge. The incisions in my abdomen made it painful for me to move my diaphragm, so in order to breathe without pain, I had to focus on using my chest for each breath. The result was a very sleepless night. I could close me eyes and try to rest, but even two shots of morphine (oh, do I love morphine!) Wasn’t enough to take all the pain away. I did manage to snooze some, but I was never really out.
The doctor who came to follow up with me the next morning became very angry when he learned about my condition. I was supposed to have been moving around after surgery not to mention fed. If that were the extent of my problems, I would have been a much happier man, not least of which because I would have been discharged that day.
But such was not to be. I found myself with severe breathing problems. Simply standing up out of a chair or taking a few steps would leave me out of breath as though I had just run a mile. I know I have exercised-induced asthma for years, but this was something else entirely. And the doctor treating me had no answers. By later that evening, there still weren’t any. While the doctor and nurses assembled to discuss how to proceed, my dinner was sat in front of me out of reach across from the bed where I was confined. Here I was hungry after my ordeal waiting on the staff to figure things out.
Eventually the doctor came in with no answers and began interrogating me. She seemed to think my difficulty breathing was related to COVID vaccines. I had been tested twice for COVID while in the hospital, and neither test came out positive, so what would that have to do with any of this? Hungered, I became more irritable as the doctor’s dead-end conversation with me continued. At length, she suggested I take a Xanax, which only irritated me even more.
After the doctor left, I had to admit to myself I really was anxious. It was all understandable. I just wanted to know what was happening to me and no one had answers. Plus I was hungry. So my first step in calming down was to eat my dinner, which one of the nurses was kind enough to warm back up for me. Then I played some relaxing music on my phone, meditated for a while, and then did some writing in my journal. A nurse came in to take my vitals and administer the Xanax, but I stared her down and intimidated her into keeping that away from me. My drug-free approach was sufficient for me to calm me down.
The next day I began one test after another, and in the end the results were conclusive. I have deep vein thrombosis (DVT) from a blood clot in my left leg. At least a portion of that blood clot broke away and traveled to my lungs, covering both of them with a pulmonary embolism (PE). Apparently pancreatitis wasn’t enough for me. My theory is that the stress of the events before, during, and after surgery dislodged the blood clot in my leg to travel up to my lungs. The doctor of course takes a different view, one that absolves the hospital of any wrongdoing.
Whatever the mechanism, the treatment plan is the same. I’ll be on blood thinners for 3-6 months for the PE, which totally freaks me out considering I could die from a simple cut or a knock to the head. I also need more movement, since spending so much time sitting in front of screens promoted the DVT to begin with. The idea is that over time with thinned blood and sufficient movement the clots will dissolve.
Treatment for the pancreatitis is different. All I was told is to eat smaller meals and avoid greasy food. That’s not a lot to go on, so I’ll be doing my own research to get more specifics. But it’s not like they ever gave me much to go on. Here’s another laugh. The morning of my last day in the hospital I finally got a menu. All my meals had been chosen for me previously. Only now when I am about to leave do I actually get to pick my meals. I selected some nice herb-crusted chicken and vegetables for lunch. Why I didn’t get to pick any of my other meals during my stay I’m not sure.
One thing is definitely for sure. As I followed the nurse out of the hospital and breathed clean air outside the building, I felt an immense freedom. But now the longer road of recovery can begin, and I started by driving myself home.
My first hospital stay
Life just hit me a hard one. A couple of days ago I began having an incredible abdominal pain like I had never before experienced. I wasn’t sure where it came from. It seemed to die down towards evening, so I thought that perhaps I could sleep it off.
I had no idea what I was thinking or dealing with. I awoke in the early morning with the pain just as strong as ever. It was a debilitating pain, but it was certainly more than a mere annoyance or irritant. I looked at the clock and wondered if I could stand it for another 3-4 hours until the clinic opened, because that would certainly cost less than the emergency room. But it didn’t take long for me to choose the emergency room. Accordingly, I got dressed and drove myself to the nearest hospital.
My first visit to the emergency room taught me, among other things, that no one working in the emergency room has any sense of emergency. Unless you’re bleeding profusely or crying out in agonizing pain, they’ll “give you a number” which they don’t tell you and then get to you when they get to you. I have to say, not ever witnessing anything like this for myself, I was a little taken aback.
The benefit of the early morning hour is that there weren’t that many others waiting to be seen, so it didn’t take long for a doctor to assess me. I did have to wait for blood work and a urine sample, but all the doctor needed after that was some answers to some very brief questions, which I happily answered. The resulting diagnosis was pancreatitis caused by gallstones. My gallbladder would need removal.
I spent the rest of yesterday in the ER being moved between two different rooms until I could get the admitted into the upstairs room I now occupy. I’m not sure how this is going to pan out. And I certainly never gave much thought to my pancreas before any of this came upon me. But apparently it’s quite the essential organ. The pancreas produces digestive enzymes to help with digestion in the stomach and intestines. It also produces insulin to help manage blood sugar levels. But if it becomes inflamed, that inflammation results in the abdominal pain I experienced earlier for the first time.
The leading cause of inflammation in the pancreas is excessive drinking. Alcohol causes a narrowing of the bile duct in the pancreas, which limits the amount of digestive enzymes that leave the pancreas at one time. Those that get held back end up eating the pancreas, leading to inflammation and pain. I’ve never had a drop of liquor in my life, so my pain, the doctor theorized, likely comes from gallstones. Gallstones blocking the bile duct can block the flow of digestive enzymes, which then leads to inflammation and pain.
Obviously the gallbladder needs removal. As if that isn’t enough, an MRI image taken yesterday appears to show a gallstone in the bile duct itself somewhere between the gallbladder and the pancreas. Thus, I will need two surgeries: the first to remove the gallstone, and the second to remove the gallbladder. The gallstone will be removed with a procedure called ERCP. A doctor will insert an endoscope down my throat, into my stomach, and from there travel up the bile duct to remove the gallstone. Then I can have the gallbladder removed.
Removing the gallbladder will be an important step toward preventing future pain, but for the present there isn’t a magic solution. The pancreas can heal itself, but it must be given time and space to do so. That means lowering the demand on the pancreas as much as possible. I’ve been on a liquid diet so far and uneasy with the antibiotic the doctor gave me to prep for surgery. It has nausea as a side effect, which the doctor says affects only 2% of people. I guess I’m part of that 2% because I’m super queasy inside.
I’m also uncertain about the future. But I intend to take everything one at a time and deal with each as best I can, working in the hope that all will be well in the end.
Here you can find news and announcements I want to share. In between I'll include reviews of the books I read. Find me on Goodreads.com for more book reviews.