Galling

On Saturday, April 16, I went to sleep back on the sixth floor of the hospital. Someone had written "Welcome back!" on the whiteboard. Thanks, I guess. I do appreciate the welcome and, if I have to be in the hospital, I'm glad it's with familiar and highly competent staff.

On Sunday, we learn that I have c diff — very common among hospital patients and others taking heavy antibiotics — and I start some new antibiotic. A sharp pain under my right lung suggested that I might also have a gall bladder problem, which could also explain at least some of the recurring nausea and vomiting. During Saturday and Sunday night, the pain was constant and caused me to ask for relief. During the day, it only hurt when I breathed deeply.

My attending physician tells me I have an ultrasound scheduled for some time on Monday, and I should not eat for six hours before the exam. What time is the exam? Can't say, so don't eat after midnight, to play it safe. Well, I'm not usually eating after 8:00 pm, so this should be fine.

Sunday night into Monday is a second straight bad night of sleep. They're pumping me full of saline solution, even though I am no longer dehydrated, so I have to get up every 1 to 2 hours to pee and/or have vitals checked and/or have blood drawn. "Welcome back!" (The Thursday night before I got readmitted to the hospital was the very first post-hospital night that I had slept all the way through.)

Monday morning comes. No breakfast, because eating or drinking would interfere with the ultrasound. Which is when, again? They can't say. Late in the morning I learn that my exam is scheduled for 2:00, which means I am going to go from 7:00 p.m. Sunday to 3:00 p.m. Monday (if I'm lucky) — 20 hours — without eating or drinking, because they couldn't give me any idea of when my exam would be. I express my unhappiness, but what can they do? There are 15 people ahead of me. The cable guy and the appliance repair guy can at least pin it down to morning or afternoon, which allows a little planning. And you can eat while you're waiting.

Transport shows up to take me to the ultrasound exam (early!), and my mom and I head down. I get rolled into one of two outpatient ultrasound rooms, as the other outpatient room and an inpatient room seem to be occupied. The exam takes about 15 minutes. At the end, the tech tells us she called Transport about 10 minutes ago, because they've been running late today and she wanted to get a head start on the waiting. (They're running late today?)

Forty minutes later, my mom wanders back to where the tech headed when she was done with the exam. Several techs are sitting there, at least a couple of them waiting for Transport to clear patients out of their rooms so that they can get another patient down for an exam. It is clear that they, like the other techs and the nurses, are consistently frustrated by how long it takes Transport to get patients where they belong. In this case, transportation may explain why it takes so long to get through 15 patients — the exams are quick, but it takes a long time to get the patients out of the exam rooms.

Back in my room, I finally get to eat and drink. A little later, the report: I do have something going on with my gallbladder, though I'm not clear what — stones, infection, maybe both. Another drug, and a followup appointment on Thursday. Then we're on the way home.

Back up on Thursday. Blood work. The phlebotomist is excellent — a painless stick, pride in her work. A meeting with a surgeon, whose initial inclination upon hearing my symptoms was, "This is a no brainer." (Take out the gallbladder.) Now, examining me, he rethinks. The pain went away after two days, and I'm having no other symptoms. I do have gallstones, and they could bring the pain and illness back at any time, but there's no rush. With yet another new medication, and some dietary adjustments, I might be able to shrink the stones and avoid surgery, at least for now when I have a lot of other things going on medically. A dye scan will provide more information.

Every morning, I take these pills, plus a multivitamin. Same
in the evening, minus the multivitamin and the four small
pills on the right. The number of medications doubled in the
past week.

I ask the resident (the surgeon is gone) whether the gallstones are related to rest of the recent assault on my body. He doesn't think so, which makes them just a cruel coincidence, like my medical plate isn't already full enough. How galling!

At my next appointment on Thursday, with a transplant nurse practitioner, I learn that my blood counts are really good. My platelets are higher than they have been since before I was diagnosed with aplastic anemia, six-plus years ago, and are now fully in the normal range. Hemoglobin is also better than it has been since chemo started in January. I ask about the gallstones. Her experience, contrary to the opinion of the resident, is that stem cell transplant patients have more gallbladder issues than the average patient. There's chemo, immunosuppression, changes in diet, rapid weight loss — a lot of reasons for the body to get out of balance. This makes me feel slightly less aggrieved.

Since Monday, I've been feeling pretty good. I've been adding short jogs (about a minute for every four minutes of walking) to my morning outings, and my appetite has been good. I have been enjoying the birds and flowers, both while out on my jog/walks and through our windows.

I head back up to meet with my doctor this Monday (April 25), and I have a radioactive dye scan scheduled locally later this week to have a closer look at my gallbladder, to make a more informed surgery decision. If there's no surgery, I'll be able to have the Hickman Triple Lumen removed from my chest, which would be a nice treat. No more line flushing, no more plastic-bag-and-tape jobs before every shower — it would be another step toward normal.

(Thanks to Jan for the title.)