Last Week

by Bernard Brandt

the invalid

The Invalid wakes up in terror
To feel his toes becoming numb,
The doctor’s made another error--
What unknown symptoms are to come?

From The Fatal Lozenge, by Edward Gorey

The whole wretched mess began last Thursday, at about 12:30 noon, when I had a sudden need to go to the bathroom. When I wiped, I found that the toilet tissue was soaked in bright red blood.  “That’s odd,” I thought to myself: “That hasn’t happened before.”

At 2 p.m., I had a sudden need to go again to the bathroom, but this time, it was the toilet bowl which was filled with bright red blood.

I dressed soon after, and had a friend drive me over to the local ER. While speaking with the triage nurse, twenty minutes later, at 2:40, I needed to go again to the bathroom. I had the forethought to refrain from flushing until I had the nurse take a look at the contents of the toilet bowl. Soon after, they had found an ER bed for me.

From then until 6 pm, I had these little ‘episodes’ every 40 minutes or so. I would estimate that between 8 and 12 ounces of ‘fluid’ passed with each episode. Around 4:30, about an hour and a half after I had been on the ER bed, they got around to hooking me up to telemetry, found that my pulse was 96, and my blood pressure at 169/96 (normally, those numbers are 60 and 120/80, respectively). By 5 pm, they had hooked me up to an IV and a liter bag of saline, which took less than an hour to drain.

At around 6 pm, they had moved me over to the nearby hospital, and gave me my own room. At the hospital, they affixed the toilet with a plastic bedpan which allowed me to find that, yes, I was losing 8 to 12 ounces of fluid per episode, all of it mostly red. But now the episodes were happening every half hour or so. They had put me on another IV drip of a liter of saline, but the machine was now metering it out at 75 ml/hr. The telemetry indicated that my blood pressure and pulse remained quite high. Fortunately, though, pulse oxymetry remained high at 96 percent.

At 7 pm, the evening nurse informed me that they had scheduled me for a colonoscopy for 9 am the next morning. I was also told that I would be given a gallon of Golightly to drink between then and the procedure, but until I was given that, I was to have nothing by mouth.

So I waited for the Golightly. And waited. And waited. I was pretty much left alone by the evening nurse. Every thirty minutes, I would unplug the IV, roll it over to the loo, do my business, and find that I had lost another 8 to 12 ounces of my ‘precious bodily fluids’, I wondered how long it would be until I either lost consciousness or exsanguinated, but since I had a phone that could only call people up, I couldn’t use teh Interwebz to find the relevant data. I did, however, use it to call my brother and my choir director, to let my family and my priest know what was up.

At about 10 pm the night nurse arrived, a smart, helpful guy named Kurt. He quickly figured out what was going on (or not), apologized for the delay in getting the Golightly, and razzed the hospital supply staff until, at 11:30, I finally got the plastic gallon jug of the nasty stuff. He said I would have to stay up until 5 or so to drink it all down. While he offered a packet of artificial lemon flavorant to mix with it, I refused, as I have had serious problems with artificial colors and flavors. That was a big mistake: unflavored, it’s rather like drinking a gallon of lukewarm spittle.

So, from 11:30 pm through 6 am the next morning, I worked my way through that gallon jug. I thought an awful lot about the question of why they had waited so long to give me the damned stuff, since had they done so, I might have been able to get the process over with sooner, and maybe even some sleep as well. But I kept these thoughts to myself: Kurt had not caused those problems, and had done all he could to take care of them.

For the next couple of hours, I noted that the quantity of red in each episode grew less and less, until by 2:30 the color of each ‘issue’ was a transparent yellow. I suspected that the mixture of blood and, er, other stuff in my bowel had irritated whatever internal wound was there, and kept the wound open and the blood flowing. I wondered whether, had the Golightly been administered rather earlier, the bleeding might have stopped earlier. But again, I kept my thoughts to myself. Again, Kurt had done nothing to cause this, and everything he could to stop it.

Indeed, Kurt was nothing but the most intelligent, considerate, and helpful of nurses. We soon got into a pattern where I would ring him up, he would come soon after, disconnect me from the IV unit, let me go about my business, then help me back into bed and reconnect me with my saline drip. He’d pour out a half liter into a large cup, and I would work my way through it, until the next half hour ‘call of duty’.  At 2:30, when he saw that the bleeding had stopped, and that the gallon had become a half-gallon, Kurt even left me alone to sleep for an hour or so, before he had me back on my scheduled dollop of liquid spit.

By 6 that morning, I had drunk all but a cup of the nasty stuff, and could drink no more. Kurt, thankfully, did not press the point, but allowed me to rest until they wheeled me over for the procedure. It was a very small room, filled with the telemetry equipment, physicians, staff, and bed upon which I was lying. The treating physician, a bright young Muslima, answered my questions completely. I asked the anesthesiologist whether anything besides Propopol would be used for the sedation. He said no. At 9:30, they connected my little IV unit to the anesthesia. I found that the expression ‘the lights went out’ to be, not a cliche, but an accurate statement of what then happened.

When the lights went back on, a little after 10 a.m., the physician in charge of the procedure told me that the technician had removed four polyps: three quite small ones, but the fourth was the size of a walnut, had become ulcerated, and was attached to the bowel wall. She told me that the polyps would be sent for biopsy, and that I would need to schedule a follow-up colonoscopy in three months, since a part of the polyp remained affixed to the bowel wall.

I was a bit dazed after the procedure, whether from the loss of blood, the lack of sleep, or from what the doctor had told me, and so I lay in the hospital bed until 2:30, when I was discharged. The friend who had given me a ride to the emergency room had been kind enough to give me a ride back, with a stop at the local grocery store in between to stock up on food and other supplies.

While I was waiting for discharge, I gave some thought to what I would need when I got home. I figured that protein, iron and water were the order of the day (for the blood loss), and so I got the fixings for beef stock, pickled beets, cheese and crackers, flour tortillas, and several gallons of bottled water.

When I got home that Friday, as I had very little strength, I drank a lot of ice water, and ate cheese & crackers and quesadillas. On Saturday, I brewed a gallon of beef stock from the water, four pounds of beef shanks and rough chopped celery, carrot and onion that I first browned for an hour in the oven at 400 degrees. And on Sunday, I made three quarts of pickled beets, first roasting the beets in the oven for the same temperature and time as for the beef stock, slicing the beets and a red onion, putting them in the quart jars, and covering with a pickling fluid of half apple cider vinegar, half water, some sea salt, and some pickling spices, brought to a boil and allowed to cool until hot but no longer boiling. Then I ate and drank my fill.

But even that small amount of work exhausted me. Making a rough calculation as to the amount of fluids that I lost from 2 through 12 pm that Thursday, and looking at the medical literature about my symptoms during that time, I estimate that I lost about thirty percent of my blood in all. For the next week after, I was constantly exhausted, and lay on my couch dazed for most of that time. I still don’t think that I have recovered yet.

During all of that time, I tried my best not to be like the poor chap depicted in the picture and quatrain which begins this present silly little essay of mine. I’m afraid I wasn’t entirely successful. And so, I tried to content myself by making a physician’s algorithm of the stages of colo-rectal cancer. I also made a mantra of Sherlock Holmes’ maxim: ‘Do not hypothesize in the absence of data.’

Ultimately, I came to the conclusion that much depended on the outcome of the biopsy. As I would not have the results of that until at least Wednesday, I tried to busy myself with other things. My studies, for example.

But I was so tired from all that had happened to me that it took me more than twice as long to do my studies with Duolingo. I could barely do anything with Khan Academy. And just forget any attempt to work with music or theology. So I did what I could, and spent the rest of the time on the couch, either asleep or exhausted.

On Wednesday, while I looked at the Mychart web page several times a day, and tried, with what little strength I had, to call the hospital, the treating physician, or the clinics I was scheduled to visit in the coming weeks. It was like circum-ambulating the Labyrinth of the Minotaur, and with much the same result. My only consolation is that I did not meet up with any bovine beastie in the process.

On top of everything else was the fact that that Wednesday, May 3, 2017, was the twenty-fourth anniversary of the falling asleep in the Lord of my first late wife, Carolyn, who had died (horribly) of lung cancer. At the recommendation of a dear friend of mine, who suggested that I have a long talk with her, I did so. The two things I got from it, other than the loving connection that I have long had with her after her death, was her recommendation that I have a large bottle of Guinness on the day of her feast, and the cryptic statement that I would be ‘surprised’ by the diagnosis.

So I took her advice, had a 25 ounce bottle of the black and delicious (my first drink since my little contretemps), and waited until I finally got the news, near noon today.

The biopsy was negative. The polyp was benign.

Of course, I can no longer simply go back to my old ways. I believe that I was given a warning. I’ll try to follow it. Rather less of the lamb, ham, and beef, thank you. Rather more in the way of veg, both green and leafy, Christian (or if you prefer, cruciferous), and red and iron laden. Ix-nay ith-way ee-thay andy-bray, and such like. And a reduction in the amount and times of drinking beer and wine. I recall reading in the Philokalia the advice that one should fast on Mondays, Wednesdays, and Fridays, and eat a moderate diet, and no more than three drinks on the other days. That seems doable.

As with my studies, my prayer, and my almsgiving, this change in way of life would appear to be a work in progress. Let’s see where the work leads.