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Do No Harm

Another week, another hospitalization.  It had been a somewhat bumpy week after my discharge from the hospital mid-month, and after struggling with what felt like a partial obstruction this past Monday night, I woke severely nauseous on Tuesday morning, and was in the car driving myself back to the ER by 10am that morning while my husband was at work.  It says something that I felt comfortable enough to do this, as a hospital is supposed to be a place of respite and recovery.  Vomiting twice on the 15 minute trip over, I shuffled back into the ER, grateful that I would soon be relieved of my horrible abdominal pain and nausea by the staff there.  So as not to worry my husband, I waited until I was hooked up to IV fluids and had received some anti-nausea meds and happy juice before I called him to let him know I was back in and doing just marvelous.  Everything is marvelous on morphine.  I told him I was fine on my own for a while and not to rush, and was perfectly comfortable dealing one on one with the staff.  I knew what I needed to do.

Once the ER doc came into my room, I spoke with him about a test I needed to have done, something my surgeon had requested the next time I should suffer from a bowel obstruction so that he could get a clearer idea of where things have been going wrong this last couple of years.  A small bowel series isn’t a fun test on a good day – you refrain from eating and drinking all morning only to be asked to chug about 32 ounces of tasteless, chalky liquid down in one fell swoop and then hang around the Radiology unit for a few hours while they take x-rays of your abdomen every 15-30 minutes.  It’s a time consuming test, and having one done during the course of a bowel obstruction necessitates having an NG tube inserted since it’s almost impossible to keep anything down when you’re obstructed.  Having this done was about the last thing I wanted to do, but I knew the information we would gain was crucial, and the ER doc told me that since I was going to be admitted to the hospital, I should discuss the matter with the Hospitalist on staff that day.  In walked the same Hospitalist I had the rather lackluster experience with last week, and I took a deep breath, knowing that my day was about to get a lot more frustrating.

The first words out of his mouth were basically “I told you so” after having discharged me the previous week earlier than he had planned on.  Strong words, coming from someone that didn’t even know I was missing a colon until I reminded him.  As clearly as I could, I informed him of the test I needed to have done ASAP, and that my husband was on the way.  He told me he wanted to get me stabilized first, and said that once I was admitted upstairs we could take the next step.  My husband showed up a short time later and stayed with me until I was settled in my room upstairs before he left for a bit to tend to the dogs at home.  As the nurse came in the room, I asked her when the doctor would be returning to discuss the test I had asked for, and she said she would contact him.  I probably don’t need to tell you that he never returned that day.  I spent a rather sleepless night tossing and turning among the hourly visits from the nurse for pain meds, nausea meds, antibiotic and steroid doses, along with IV fluids.  Shortly after the blood draw at 5am, the obstruction passed and I fell asleep for a few hours.

Wakening again around 7am, I let the nurses know that the obstruction had passed and asked that they reach out to the doctor to let him know so that the NPO order could be lifted and I could try some clear fluids.  No food or drink is hard enough, but when you’re being funneled with 80mg of prednisone at the same time, it’s like taking a fat kid to Ben & Jerry’s and then forcing her to watch everyone else eat pints of ice cream.  I could swear I smelled ice chips.  So I waited.  And waited.  About four hours later, I checked again, and he still hadn’t responded.  Another hour after that I was done.  I decided to take the bull by the horns and lift my own NPO order, knowing full well that clear fluids were what I needed.  I texted my husband who was planning to visit shortly and told him to pick up some water ice and conceal it in a brown paper bag.  He arrived about 45 minutes later and I dug in, only allowing myself to have about a half cup of it, to see if I could tolerate it without any nausea or pain.  As I was putting the rest away, the nurse came in and spazzed out, telling me I was “violating doctor’s orders”.

I’m sorry…orders?  Do you know what it’s called when you do something against “doctor’s orders”???  It’s called “Against Medical Advice” (AMA).  Advice, not orders.  Next time I want some medical advice, I’ll write to Dear Fucking Abby and probably get a quicker response time than I did from this prick.  The essence of my reply in a nutshell?  You’re not the boss of me.

Later that day, the doctor stopped in, all up in arms because I stuck his orders where the sun doesn’t shine.  He told me he wanted to run the small bowel series then, which made no sense to me because the obstruction had already passed.  I tried to convey this to him, and he told me he would speak with my GI to get his okay.  About 20 minutes later, he returned, telling me that Radiology would be up soon to collect me and begin the test, which my GI had allegedly agreed to.  Since I trust the GI, I relented, though I waited another three hours in my room (still technically NPO) before Radiology showed up to take me down for the test.  Let’s just say that chugging 32 ounces of barium on an empty stomach was as hideous as it sounds, and lo and behold, the test revealed that there was no current obstruction.  No shit.

We had one halfway decent exchange, the doctor and I, before he discharged me from the hospital.  He had stopped in to see if I was tolerating the solid food I had been allowed to have, and he made some overtures toward actual, non-clinical conversation.  I had mentioned missing a few days of work, and he asked what it is that I do for a living.  I told him about my years in the hotel industry and how I had left last year for part-time work elsewhere due to the effects it was having on my illness.  “I could see that”, he said, when I told him I was an Operations Director for larger hotels.  I glanced at him with one eye, knowing full well he meant that now he understood why I was such a pain in the ass and always had to be in charge of everything, even during my hospital stays.

“Maybe it’s time to stop working altogether”, he said, and I shook my head and smiled.  “Why not?” he asked.  I told him it was because I had no interest in being a full-time patient, and that, in and of itself, is really the entire basis of this blog.  The fine line between patient and person, living and existing, progressing and deteriorating.  It may be denial, it may be pride, and it may be the rather large streak of stubbornness I carry like a shield, but I refuse to let the increasing number of “bad days” define me.  I still have my moments, and had one that final night in the hospital when I broke down from a combination of exhaustion, hunger, pain, frustration and anger.  It was over relatively quickly, and then things snapped back into place.  That day I may have been a patient, but tomorrow I would not be.  That day I may have been deteriorating, but tomorrow would be different.  In the end, all you can do is hope that you’re as strong as you will need to be to get through the next day.

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