Wednesday, March 28, 2007

The Dreadful Listeria: Part 6

When the Soldier got home he met with Dr. PJ and discussed what had happened while he was in Germany. He too felt it was worth looking into more to see if it was actually ulcerative colitis and not chron's. A colonoscopy was scheduled and preformed. The biopsies would confirm that it was indeed ulcerative colitis. Dr. PJ and the Soldier decided it was time to try an IV treatment drug. This drug was very expensive but to most people who received it, the ulcerative colitis went immediately into remission. It was given in a four stage program. After the first treatment you would receive a second treatment 2 weeks later. Then every 8 weeks after. Even with the insurance paying a substantial portion it was going to cost the Soldier about $500 a treatment.

There was several risks to the IV treatment that had to do with how badly the drug lowered the immune system. The Soldier wouldn't understand how bad the risks were until after the second treatment. When he went in for the second treatment the nurse took his temperature and noticed it was a little high. But it was only 99 degrees so with the doctors permission the Soldier was given the second dose. That night he began to get the chills in bed and got up and checked his temperature. It was up to 102. He took some Tylenol and went back to bed. He woke up that morning really not feeling well. He called in sick and took a bath. He had developed a head ache but thought it was probably the flu. He made an appointment with his doctor and was seen right away.

Dr. H was his primary care physician. The Soldier and him became very close. This doctor truly cared about his well being and did everything he could to help. He thought it was just a viral infection and told the Soldier to get some rest and drink fluids.

That night was the Soldiers first night back to college. He couldn't not go, so off he went. As he sat in class he was shaking uncontrollably. His temperature had raised to 103 before he went to class. Half way through he went to the professor and told him what was happening, the professor told him he looked like hell and to go home.

He got home about the same time as The Misses. She took one look at him and new he was bad. She was a nurse and had sneaked a IV bag home from work and wanted to give it to him. She had given him an IV before so he was confident that she could do it. It took her four tries to get the IV in a vein. He was so dehydrated. He laid on the couch and fell asleep.

When he woke up a few minutes later there was something wrong. He sat up and told The Misses it was time to go to bed. Before he could stand up he got nauseous. She ran and got him a bucket and he began to throw-up. Usually this makes a person feel better, but not him. He looked at The Misses and she told him she thought they should go to the hospital. He looked at her and in his mind he was saying "no, I was just there it is viral." What came out was complete gibberish. A worried look came to The Misses face. She started to say she couldn't understand him. This made him more angry so he again said "I WAS JUST THERE. THEY DIDN'T KNOW WHAT WAS WRONG!" Again all that came out was complete gibberish. She stood up and grabbed her cell phone. If he didn't agree to go with her she was calling 911. At that point he nodded his head and she got his shoes and went to the truck.

His head was pounding and when he went to sit down in the passenger seat he slammed his head into the top of the truck. The pain was horrible. All he could do was cover his eyes as she drove as fast as she could to the hospital. He remembered getting out of the truck and her saying "do you need a wheelchair?" He motioned no, and stumbled into the emergency room. Right inside the emergency room door was a wheel chair. He walked over and sat down in it. This is the last thing he remembered for 4 days. He vaguely remembers opening his eyes for a second and seeing his mom standing over him wearing a mask. The next thing he knew he woke up with his dad in a chair next to him. He didn't know what happened or where he was.

Friday, March 23, 2007

The Surgeries Continue: Part 5

When the Soldier came to he was numb from the waist down. He had been given a spinal block so he wouldn't feel any pain. This block seemed to last longer then the last one. He had been given an IV to stay hydrated. Enough time had passed and it was time to use the restroom. The problem was because of the spinal block he didn't know he had to go. The nurse came in and asked him to start moving his legs. He started to move them and when he pulled his right leg to his chest he felt a warm sensation. He looked down and his gown was wet. He looked at The Misses and told her what he was feeling. She told him to do it again and when he did he started to pee. He probably really had to go and when he pulled his leg up the pressure released his bladder. "I think I just pissed on myself", he said to The Misses. She just started to laugh. He really didn't think it was so funny. Luckily she was the only one in the room at that time.

Dr. Airforce came in soon after and announced that the Soldiers "porn career was over" (not that it ever started). Instead of making and incision he had cut a chunk out of his bottom in attempt to get ride of the fistula canal. Not only was this operation much harder to take care of it also left a lovely scar. He was released that same day and was given two weeks off. He would have to take a bath after every time he went to the bathroom. Then The Misses would have to pack gauze into the wound to help the healing process. The Soldier really learned at that time just how close him and The Misses were. You can imagine how close you would have to be to someone to get that close to that area.

The next day was a big weekend for them. They had already booked a flight to Mallorca, Spain to spend the weekend laying on the beach and playing in the water. They had thought about canceling the trip but it was nonrefundable. So off they went. Unfortunately the Soldier wouldn't remember much of the trip because of all the happy pills he was on. Now that he thinks back, he vaguely remembers bits and pieces. He wasn't able to get in the water at all for fear of an infection. He wasn't supposed to but had a few drinks which is probably a main reason he only remembers bits and pieces. As you can tell by the picture. He really wishes he remembered more.

When they got home The Misses had to go away for two weeks. He was still recovering and needed to have his wound packed still. He shared an apartment with Airborne and The Mormon. Both of these guys were nurses and could take care of the wound. You can imagine how awkward it was asking them to perform these duties.

One morning before Airborne went to the hospital, the Soldier asked if he would "pack his ass". He was a good friend and said of course. The Soldier was laying on his stomach spreading his butt cheeks. Airborne was kneeling next to the bed with gloves on when The Mormon walked in. He had been away and didn't know the Soldier had a surgery. When he walked in the room he stopped. "What the hell is going on?" he asked. Airborne started to laugh and the Soldier asked if he wanted a piece of this too? They all burst out laughing.

He would eventually have another surgery for the same thing while still in Germany. He was lucky that Dr. Airforce was able to preform the next surgery. They had discussed when the Soldier left Germany he should talk to his civilian doctors to make sure it was ulcerative colitis and not chrons. All in all while on his 14 month deployment he would have three surgeries and put on steroids twice. The year was turning out to be a bad one and when he got home it would only get worse.

Tuesday, March 20, 2007

Nothing funny about U.C. Part 4

Once the disease was found it was time for treatment. It is not known how you get Ulcerative Colitis. For some reason the immune system starts attacking the colon as if it was a foreign object. There is a cure for this disease but it involves removing the colon. The drugs that are given are just trying to put the disease into remission. Some patients can go years without a "flare-up". It was time for the soldier to figure out how to put his disease into remission.

Once he started to take the horrible steroid after about 3 months his stomach started to feel better. His biggest problem was that steroids are so bad for a person that you can't take them for long. Once he stopped taking them he would have another flare-up. Dr. PJ put him on several different drugs in hopes that something would start working, but the only thing that worked was the steroids.

Another two years had passed and the army came calling. His reserve unit was being called up in support of Operation Iraqi Freedom. They learned that instead of going to Iraq they would be going to Landstuhl Germany to take care of the wounded soldiers. He talked to his doctors and it was decided it would be okay for him to deploy since he was going to a hospital where he could continue to get care.

It was back to the scene of the crime, if you can call a misdiagnosis a crime. Upon arriving the Soldier started feeling a small bump on his bum. He went to sick call and was scene by a doctor that told him it was probably a bruise and it would just take time to go away. At this point he had been on steroids twice already that year and was starting to have another flare-up.

A couple months went by and the bump never went away and started to get worse. It was very uncomfortable to sit down so he decided to bring it up to the gastro doctor. Dr. Tennessee was one of those doctors that was just doing his time. He had a fairly good knowledge of Ulcerative Colitis, but wasn't used to having to deal with patients for more then three days. Soldiers that end up at Landstuhl that are injured were very rarely there for longer then three days before being shipped off to a hospital in the states. He took a look at the bump and knew right away that it wasn't a bruise. He made the Soldier an appointment with a general surgeon the next day. Because of the flare-up he also put him back on the steroids.

If the Soldier thought a civilian doctor was rough when doing an exam, he was in for a real eye opener when the general surgeon took a look. Dr. Pink walked into the exam room wearing pink scrub bottoms with a light blue flowery scrub top. You could tell he was in a hurry and had better things to do. He asked the soldier to lay on his side with his pants down. What came next was pure pain. He was everything but gentle when examining this bump. He told the soldier it was probably a fistula and need to opened up now.

The surgery was set for the next day and was very uneventful. The Soldier was given a spinal block (essentially a epidural) and Dr. Pink made a small incision. He was released from the hospital and wasn't even given time off to heal. Two weeks later he was in for a check-up and Dr. pink showed just how ungentle he was. He had the soldier lay on his side and started sticking a long cotton swab into the wound. The pain was so bad the Soldier swung back and hit Dr. Pink in the arm. Everything seemed fine and he was given another check-up appointment.

Lucky for him Dr. Pink had been sent to Kosovo, so for the next appointment he was seen by Dr. Airforce. Dr. Airforce was a young surgeon, but really cared about his soldiers care. He wasn't the typical Army doctor. The Soldier worried about getting the cotton swab again so he decided to load up on the "Happy Drugs" before he went in. Dr. Airforce walk in and just started talking to the Soldier about his life, the disease, and Dr. Pink. After about 20 min. finally he said well maybe I should take a look. Everything looked fine and it was decided that this would be the last follow-up visit. Unfortunately this wouldn't be the last time the Soldier would see Dr. Airforce.

A month went by with little change. The steroids hadn't taken control so there was still stomach pain and bleeding, by this time it was just part of life. When he started to feel another bump he got concerned. One big difference between Ulcerative Colitis and Chron's disease (another inflammatory bowl disease) is the development of fistulas. In most case but not all, fistulas are only experienced in Chron's disease. The Soldier new that chron's disease was the worse of the two. He went back to Dr. Airforce and he wanted to go in and take a look for himself. He didn't say it, but you could get the impression he wasn't impressed with Dr. Pink.

The surgery was the set up for the next day. Dr. Airforce came into the pre operation room and started to talk to the Soldier. After a few minutes the nurse came in and shut the door. She seemed to think they were getting a little to loud for the other patients. They were laughing and telling jokes. The soldier felt very comfortable with him.

The surgery was a normal fistulatomy. What came next was a series of events that were actually very funny.........

Psssst............. that picture is of Dr. Airforce an all around good guy.

Monday, March 12, 2007

Nothing Funny About U.C. Part 3


Nothing really changed for the next 2 years. The Soldier went on believing he only had IBS and just lived with the blood and the stomach pains. He hoped when he left active duty he would be able to control what he was eating and the symptoms would go away. Unfortunately for him the symptoms never went away.
It was now July 04. He had been dealing with this for 3 years now. He was no longer an active duty soldier, he was now a weekend warrior (a reservist). His symptoms were getting worse to the point he wasn't able to do much physically because of the pain and the need to use the bathroom. He needed to go see a doctor, but at the time he didn't have insurance.
His mom (the worrier) finally broke down and made him an appointment to be seen. She couldn't stand to see her baby in such pain. The appointment was set, but not with his normal doctor. He was too busy at the time and couldn't get him. So the appointment was made with a doctor in the same clinic.
The day of the appointment the Soldier was so excited. Finally a real doctor, not that the Army's doctors weren't real. It was just different. The Soldier had no doubt that soldiers being wounded in battle were getting the best care anywhere. When a soldier comes in with a disease on the other hand, they are never seen by the same doctors so there is no consistency. There is always the feeling that the doctor is there doing his or her time. Waiting until they have paid back their debt to the Army for paying for their medical degree. Once the debt is paid they are gone to make the real money. The ones that stay like the fact that they never have to pay for malpractice insurance because there is a law about soldiers not being able to sue other soldiers.
The Soldier new from the beginning that the doctor he was talking to was different. She seemed to ask much better questions and had answers that made sense. The Soldier explained his situation and the doctor had a puzzled look on her face. "You have had this bleeding for 3 years now?" She asked. "Yes ma'am, they told me it was IBS and that there was probably a tear from being dehydrated." She stopped typing on her computer and said "I have many patients with IBS and none of them have bleeding with it." She went on to explain that she thought it was Ulcerative Colitis. Ulcerative colitis? He had never heard of this, fear again went down his spine.
The doctor asked if it was okay to do a rectal exam. She explained that she could go get an escort if he wasn't comfortable with having this done with just her in the room. This is just what he wanted, a total stranger in the room while this doctor stuck her finger in his poor bum. He explained that he was okay with her taking a look. He had the thought that she was a small lady so this shouldn't hurt to bad. He was wrong. For being so small she seemed to have a lot of anger when doing the exam. Most exams he had experienced were very short, this one seemed to last forever. When it was finally over she left the room. He sat there with this new term in his head. Truthfully he really didn't understand what she said so when she entered the room he asked her to write it down.
She explained she had talked to another doctor and they felt he needed a colonoscopy immediately. He went white. He was expecting them to pull out a couple of bottles and get right to it. But no, they set him up an appointment the next day and gave him a prescription to clean him out.
Early the next day he started the cleaning process. After all was said and done. This was by far the worst part of the colonoscopy experience. He followed the instructions and spent the next 4 hours in the bathroom.
His dad had taken day off so he took him to the hospital. Not much was said on the way there. His dad was probably just as worried about his son as he was. When the nurse came and got him, his dad gave him a smile and said "at least your nurse is cute." She was very cute. He told the nurse how scared he was and explained what he had went through the last time. She couldn't believe anybody would do a colonoscopy that way. She assured him they would make him very comfortable and he wouldn't remember a thing.
Dr. PJ was the gastroenterologist that was going to perform the procedure. He introduced himself and the Soldier told him his story. Dr. PJ couldn't believe he had been dealing with all the symptoms for that long and assured him he would find out what was going on.
The next thing he knew he was waking up in a room with his mom and dad. He didn't remember a thing. From what his dad said on several occasions he had asked the nurse if she could get him more of these drugs, he would make her Top Ramen every night (Top Ramen was the only thing he knew how to make). He was told he even asked her out. He was sure it wasn't the first time someone in the haziness of the drugs had asked her out. Unfortunately for him in all the excitement he missed the big rock on her wedding finger.
Dr. PJ entered the room and told him and his parents that he too thought it was Ulcerative Colitis. In fact because he saw signs of the disease throughout his whole colon he said it was actually Pan Colitis. He had taken several biopsies and the results would confirm what the good doctor had thought.
Dr. PJ gave him two prescriptions. He explained that the first one was a very common drug used to treat Ulcerative Colitis. He would need to take 4 pills 3 times a day while they tried to get it under control. The second prescription was a steroid. This would be the first dose of many the Soldier would take of this nasty drug. He was given an appointment to follow-up with the doctor in a few weeks. By then they would have the the results of the biopsy and they could discuss the strategy to keep this disease under control.
They left the hospital and on the way home his mother stopped at a pharmacy to get the prescription filled. As mentioned before he didn't have insurance so this was going to be expensive. For a one month supply the total for the two drugs was $1,100. Outrageous, but his mother wanted her baby to get better so she paid the amount. With the Colonoscopy and Drugs the total for that month was well over $5,000. It was time to find insurance and fast.

Thursday, March 8, 2007

In the Ghetto


Now don't get me wrong. I love the little house we are making into a home. It is what it is, a fixer-upper. I have painted every wall in it (sometimes twice to get the right color) and have really made it comfortable.
It's just in an interesting neighborhood, and what was interesting just got weird. Our Backyard neighbors have never been what we like to call a model tenant. There is the junky truck parked in a corner that instead of being used as a vehicle is now their own private dump. Their kids love to jump on their tramp all day and all night. God bless their high screechy voices! And you can imagine the yard could use a few drinks of water and good mowing.
I have gotten used to all this and have even found comedy that I may in fact live in the ghetto. A lovely rendition of In the Ghetto can be heard coming from my horrible singing voice every time I pull into our driveway. The Miss's tries to make excuses and reassures me we don't live in the ghetto, but due to recent events she may end up agreeing with me.
Lately I have been noticing a lot of beer cans piled up just off the side of the deck of our neighbors home. You may contribute this to an out of control BBQ or the occasional garbage can getting pushed over by the screeching children running around the backyard. But this is Utah and it is January. No one has BBQ's at this time of year and the kids never go to this area for fear of the dogs (oh yes, forgot to mention the two pit bulls that never leave their dog run).
A couple of weeks ago as I was working on the new patio door I am installing. I jumped when I heard a loud clink from my neighbors yard. As I turned and looked, the husband was walking back into his dinning room and closing the door. I didn't think much of it until and hour later I heard the door opening and out he came. He finished what was left in the Budweiser can and threw it on the ground hitting the 15 or 20 other cans laying in the snow.
I wouldn't understand that what was happening was weird until a few days later. I couldn't believe my eyes when I saw his lovely wife come out in her Sunday dress and start picking up the cans and putting them in the garbage.
I really think its time to build a big fence!
P.S. Yes, that white line across the bottom of the picture is a hammock. Although most people use these for relaxing our neighbors screeching kids use it for a swing. Just one more verse to add to In the Ghetto.

Friday, March 2, 2007

Nothing Funny About U.C. Part 2

After about 3 months of getting nowhere with Doc Bunch. The Soldier finally got what he had asked for. Although later he would wish he had never suggested it.
One Monday the Soldier went in for a follow-up and Doc Bunch suggested it was time to send him to the "big boys," luckily he was recommending him to go see a gastroenterologist and not someone that was bigger then him. Lord knows his little bum couldn't take a bigger finger.
Later that week the Soldier asked a really good friend to give him a ride to Landstuhl which was about 45 minutes away. His friend agreed to give him a ride and on the way, the Soldier was thinking that this would be a quick visit.
At the time Landstuhl was not the hospital it is now. The second Iraq war had not begun and the hospital was mostly filled with pregnant wives of Soldiers and the occasional retired Soldier that decided to stay in Germany. Now days the hospital is full of Soldiers that have been wounded in either Iraq or Afghanistan.
When walking into the gastro wing at Landstuhl the Soldier for some reason didn't have a good feeling. It wasn't that he thought he had cancer. Doc Bunch had done all the blood work to rule that out. He just didn't know what was going to happen. Sitting in the waiting room he noticed it was full of very old people. He was by far the youngest in the lobby. He felt like he didn't belong there, but wanted to know what this "specialist" had to say.
A few moments passed and a nurse came in the room and called his name. His friend wished him luck with huge grin on his face. He thought it was very funny that his friend was there to be seen and eventually get a colonoscopy. The Soldier followed the nurse down the hall and was placed in an exam room. The room had a huge chair in the middle. The chair was larger then most he had seen and was in a very weird position. As he was trying to figure out how the thing worked the doctor walked in. He introduced himself as Major So And So. He started reading over the Soldier's chart. He too explained it wasn't cancer. At that point he asked the Soldier to come over to the weird chair and lower his pants and kneel on the footrest. At that point he realized it wasn't a chair at all, it was a mid evil torture devise. He asked the doctor why he had to do this. Couldn't he just read what the other doctors had wrote. He explained that he was the "specialist" and need to take a look for himself.
After the finger the doctor opened up a drawer in a cabinet and handed him a gown and two bottles of fleet enema solutions. The Soldier looked at him in puzzlement. Then asked if he was going to do the procedure now. The doctor gave a small grin and said yes.
The doctor led him out of the exam room to a bathroom. He told him to follow the instruction on the box and he would see him in about 30 minutes. As the doctor was about to leave, he turned around and said to make sure the slit in the gown goes in the back. I guess Soldiers are just stupid and always put the gown on the wrong way.
The Soldier followed the instructions on the back of the box and got changed. The instructions don't say this, but you should know (in case you are ever in the situation) to get all the air out of the bottle prior to inserting the end in your bottom. The bottle is only half filled with solution and the other half is air. You can imagine the gas pains that followed after blowing all that air in your bum.
Once he was finished the Soldier left the bathroom. Once again he was walking down the hall in a hospital gown, black socks pulled up to his knees and his black combat boots were clunking untied down the hall. A nurse led him into another exam room.
The exam room was very plain. It had a table in the middle with a monitor placed next to it and not much else. The nurse told him to get on the table and lay on his left side. When Major So And So entered the room, he began to laugh and told him he must be in the Infantry. The Soldier asked why and the doctor said only an Infantryman would get on his table with his combat boots still on.
As he explained what was about to happen the Soldier asked if they were going to give him some medicine to relax. The doctor explain he was very fast and wouldn't feel a thing. This was complete BULL S*%T!
As the procedure started the amount of pressure that he felt was unbearable. It was like the worse gas and diarrhea pain he had every experienced. He yelled out a few choice expletives as the nurse was telling him to breath. "Breath?" he replied as he told the nurse where he could stick this tube. During the procedure the Soldier watched on the monitor everything that was happening. As the Major came to a place of interest he would press the tube into the sides of his colon and the pain would get worse as blood would pool where he had pressed. The Major explained there must be a small tear somewhere which is consistent with IBS.
After about 15 minutes (fast my ass) the procedure was finished. About half way through the procedure the nurse had to close the door because of the words coming out the Soldiers mouth. Sweat dripped down his forehead and he was very light headed from the lack of breathing. Because he had not been given a local anesthetic they were not able to take any biopsy, which in the end would be a major mistake. The Major explained a little about IBS and sent him limping down the hall with the squishy stuff between his cheeks.
His Friend was asleep in the waiting room. When the Soldier woke him and explained what he went through. His friend gave out a Simpson's "AAAAHHHH HHHAAA".
On the way home the pressure in his gut was unbearable. Germany is not like the U.S. We are spoiled when it comes to the distance between gas stations and rest areas. Between Baumholder and Landstuhl there are exactly zero places to stop. Usually in the company of friends the Soldier would have no problem releasing any pent up gas. But in this case he was so afraid something else would come out he had to hold it. He already knew his good friend would be announcing to the whole company the experience he went through. He didn't want to add fuel to the fire. For some reason with every moan he made the laughter from his friend got worse.
Eventually he was in the comforts of his own porcelain and everything was back to normal. For the time being he was comforted in the fact it was just IBS and with the proper diet everything would be fine. The biggest mistake the Soldier would make was listening to this "Specialist." Little did he know there was a much greater problem taking place in his poor colon.......
And the moral to this story is never have a colonoscopy without any drugs. If the doctors says he's fast, tell him to go to hell and find another "specialist".