Pancreatitis 2: Attack of the Gallbladder

Last Thursday morning, as I was brushing my teeth after breakfast, I felt a sharp stabbing pain in my upper right side. I already had my suspicions, but hoped it would pass. By lunch, it had subsided a bit, but it came back after eating. It still wasn't great by the time I got home, so I ate some oatmeal which normally helps, but instead it was the excruciating pain of the end of June 2020. Tylenol didn't help much, so it was time to head to the hospital.

There were more people in the waiting room than the last time, but I still seemed to get in relatively quickly. After an initial assessment in one room, they moved me to a chair in the patient treatment area and hooked me up to IV fluids, and gave me some morphine, and antibiotics. The nurse who inserted my IV called the IV pole and pump "Pamela" and said she'd be my girlfriend for the night. The doctor confirmed my suspicions - I had pancreatitis again and it was probably caused by gallstones. They wanted an ultrasound, but that would have to wait until morning.

Pamela the IV pump

I had to stay the first night in that chair. It was a pretty comfortable chair - probably comparable to a hospital bed anyway - but the ER is busy and noisy, so sleep there is difficult. The morphine helped, but it was still a fretful night so I saw some people come and go. When I first sat down, the guy next to me was young and reasonably healthy looking. He had come in with chest pain, but the doctor said it wasn't a heart attack and instead suspected that he was working out too hard. He went home before I really fell asleep. When I woke up next, there was a young girl there. She was asking her mom why that man was sleeping while wearing glasses. (I had no where else to put them really.) She had some sort of stomach issues but nothing serious, the doctor recommended drinking more fluids and laxatives for now. I waved at her before she left. Then there was a patient transferred from Indian Head. She came in hooked up to an IV and the paramedics who brought her, rather than disconnecting the IV and pump from the patient, just took a different IV pump that was in the ER and took that back. That seemed smart if a possible issue for asset control.

When Friday morning rolled around, the ER was quieter and I got sent for my ultrasound. It's just a short walk away from the ER, so I strolled there with the porter who was a young woman and possibly not well suited to the task. She was a bit jumpy when we passed a guy sleeping on a stretcher and moaning. I got two ultrasound technicians for the price of one that day. The one who did the bulk of my scan was training with a more experienced tech. Because of the back and forth discussion between them, I could sometimes tell what they were looking at. At one point I asked "Are you checking out my hemangioma?" And she sort of giggled and said "We aren't allowed to say anything."

The ultrasound showed evidence of gallbladder inflammation, but no evidence of gallstones perhaps because they couldn't see the bile duct very well. So, they sent me to the Pasqua to get an endoscopy done as that can get a better view. I got back into my clothes and my parents drove me to the Pasqua so I could get checked in there (I was a patient of both hospitals at that point complete with two wristbands) and I sat in the waiting room. I think I was third to be called and moved to the prep/recovery area where I switched out of my clothes and back into a hospital robe and was lying on a bed waiting. When they were ready for me, they rolled me into the procedure room. There were four or five people there - a couple of nurses, the anesthesiologist, and the doctor. The anesthesiologist introduced himself, told me what he was going to do, asked the usual set of questions about allergies, and then sat down to wait. The doctor was busy on the phone and then dictating notes from the last case. Meanwhile they had me roll onto my left side, put an oxygen feed into my nose, and a sort of cylindrical plastic flange into my mouth with a whole in the centre of it for the scope to fit through. That was strapped to the back of my head so it wouldn't move. I think I remember the anesthesiologist getting up, but after that, I just woke up back in the recovery room with a sore throat and feeling quite confused but, after a few minutes, I was meeting back up with my mom and headed back to the General.

It was now close to five on Friday night and I was back in my chair waiting for the results and a bed to open up. The endoscopy did find gallstones, so they were going to move me to the surgical ward in preparation for emergency (or possibly urgent) gallbladder removal. While waiting on the bed, they gave me something to eat. Between pancreatitis and possible surgery, no solid foods were allowed, so I got two jellos and two apple juices. It was probably 8:30 before I got taken up to the ward. I was extremely cold at that point and asked for an extra blanket and even tucked my head under the blankets to warm myself up. Eventually I got warm enough and fell asleep for a bit. When they woke me to check my vitals, my oxygen was lower than they liked, so they put me on supplemental oxygen for a while. Between the pain in my abdomen and the sore throat and anathesia from the endoscopy, I probably wasn't breathing deeply enough. By morning I was back to normal.

Saturday morning, I signed the surgical consent and advanced care directives and then it was just waiting. I was tired from lack of sleep but my stomach was feeling better. If I had been feeling that good Thursday night, I never would have come into the hospital. My throat was still sore and scratchy from the endoscopy and my voice sounded completely different - lower and raspier. There wasn't anything I could do about it though as, while waiting for surgery, I was not allowed anything by mouth. I mostly dozed, read, and played on my phone with an occasional stroll around the ward thrown in. (Surgical ward Pamela had at least one wonky wheel so didn't like to go in a straight line which made walking with her kind of annoying.) I was told that as soon as they knew if I was going down they'd let me know or if I wasn't going down, they'd feed me. By 8:30 pm, it was a no go, so, I got a fine meal of toast with jam, jello, broth, and orange juice. At that point, I was hungry enough that no matter what it was going to be the best meal ever.

Sunday was pretty similar to Saturday until 6:30 pm rolled around and they told me I was going in in about 20 minutes. I texted my parents to let them know and they arrived before I got in. 20 minutes became two hours until around 9:30 when, just after I thought "feed me or cut me open", they came to let me know that I wouldn't get in that night. (Dinner was the same as Saturday - toast, jam, broth, orange juice.) While waiting, my dad asked if I was scared. I certainly didn't have the heart pumping, mind numbing version of fear. I was anxious and unsure of what was next, but that's a different sort of thing. When it comes to medical procedures, I tend to feel kind of detached from my body. They are something that gets done to it, not to me. That seems to help me get through them. What didn't help was having my parents sitting there looking at me nervously trying to be supportive but not actually saying anything. It just fed back into the nervousness. I wouldn't have minded so much if they had been busily chatting away about other things. As a result, I swore that whenever I finally got to go in, I'd only text them when I was just leaving the room and not in advance.

As it turns out, that wasn't a problem. Monday morning rolled around, the resident came by to check on me and told me that I was high on the priority list but they needed to get through scheduled surgeries first and it would be mid-afternoon or the evening before I got in. So, I went about the day like I had the previous couple except I was running out of things to amuse myself - there's only so many crossword puzzles I can do. Eventually my parents came over to visit and then, with no warning, the nurse came in to do a quick set of vitals because I was going down for surgery. She instructed me to take a trip to the bathroom first and then everything else gets left in the room - socks, underwear, glasses - just me and the hospital robe go down. After Sunday, I said "I'll believe it when they actually take me down" at which point the porter showed up.

The nurse detached me from Pamela and then I was ready to go. They take you down to surgery on the bed in your room, so the porter put up the sides, unlocked the brakes, and proceeded to push me down to the elevator. The operating room is on the second floor. They wheeled me through a pair of double doors and into a niche along a curved hallway. This appears to be some sort of surgical waiting area. The nurse there put a hairnet on me, verified why I was there and that the consent paper work was present and hooked me up to a bag of IV fluids. At some point the anesthesiologist came in to ask the usual allergy questions and tell me what was going to happen. Two other patients also came into this hold area - an older man with dementia and a broken hip and another person who possibly had diabetes and needed a toe removed. Both of them were taken off to an OR and then it was my turn.

They wheeled me back through the double doors I came in and through another set that were across the hall and then down a hall and around a corner before parking against a wall. The porter left and one of the OR nurses came out. She again verified who I was, why I was there, and that they had all the right information and then asked if I could walk. So, I got up, and walked into the OR carrying a bag of saline solution in my hands.

The operating room is a large room with high ceilings. I remember it as being largely white. The operating table is narrower than I would have guessed - just wide enough for my body but not really my arms. It's metal, hard, and cold but with a space designed just for your butt. They had me undo the tie at the back of my robe and lie down. Around now, my surgeon introduced himself. My legs were strapped to the table so I wouldn't fall off and they started hooking up leads to the monitors, and putting in boards to support my arms. The nurse seemed to be having some difficulty and I remember thinking that I should help (which would not have helped at all.) Then they put a mask over my face and asked me to breathe and the monitors started beeping in new more alarming ways. They hadn't asked me to count or anything but it seemed to be taking a long time for me to go out. Then I heard the anesthesiologist say they were going to put me out (so whatever the mask was for, it wasn't to put me out) and the next thing I remember I was in the recovery room.

The recovery room was swirling in every direction. If I stared at the ceiling, it was mostly just loops, but if I looked elsewhere, it was even more dizzying. Wiggling my fingers felt weird - like they were detached from my body. Somehow my toes felt more connected when I wiggled them. At some point, I asked the nurse if she had told me her name (talking was an effort and I sounded drunk because I kind of was). She had, but she told it to me again (I promptly forgot again unless it was Jean in which case some part of me remembered but I'm not going to put money on that name). She asked me to move my knees. The man with the broken hip was also in the recovery room which surprised me because I figured my surgery would be quicker than his. Eventually, the room stopped spinning quite so much and my vitals must have been good enough that they took me out of the recovery area. We went to the big elevator which is mostly reserved for trauma cases. Unexpectedly, it went down to floor 0 and there was another case waiting there. The nurse who was with me said that I was stable, so we got out and they got on and we waited for it to come back. And finally, I was back in my room.

Between pre-op, operation, and recovery, I was downstairs for about three hours. When I got back to my room, they hooked me back up to Pamela and to a machine to automatically check my vitals. As was the case following the endoscopy, my oxygen was low, so they supplemented that. I was still pretty woozy, my tongue felt fuzzy, and my mouth tasted like I had some sort of fluoride treatment at the dentist. I forced my parents to sit rather than fussing (and they mostly listened - it probably helped that the nurse scolded them for turning the vitals machine so they could see the numbers.) Eventually, I was feeling alert enough to sit up and have some water. Sitting, as it turns out, is the hardest part. Trying to sit the way I had for the entire rest of my life was too painful. Instead, I needed to roll onto my side and push up with my arm instead.

After sitting up, everything else seemed to progress quickly. I sipped some water, put my socks back on, and before I knew it I was alert enough to be taken off oxygen. Then I went to the bathroom and was permanently disconnected from Pamela. (Poor thing, but I'm sure by now she's found someone else to pump 125 ml/hour of ringer's lacatate into.) I even got to eat - orange juice, jello, and a roast beef sandwich. I asked for pain medication, then walked my parents to the elevator, and then went to bed.

Tuesday morning, the surgical resident checked my incisions, said everything looked good, and said I'd be released later in the day. Breakfast didn't initially arrive (I was somehow still on the no food by mouth list) but I eventually got toast, a muffin, milk, cheese, apple sauce, and juice. By noon, they pulled out my IV line, gave me the discharge papers, answered all my questions, and let me go. I had lunch at my parents house, then we went to Superstore to pick up pain medication and a few other things and they took me home. By that point, I was exhausted and in pain, so I took some Tylenol, said goodbye to my parents, and took a nap. I ordered a barbeque chicken rice noodle bowl for supper that night.

Recovery has progressed uneventfully since then. At this point, I'm more tired than sore and couldn't imagine working a full day yet. (Fortunately, I'm off for another week.) The incisions are healing well and I suspect they'll be fully healed before all the hair on my abdomen grows back. (I have a giant oval patch that was shaved in the OR just like when a dog gets surgery. That happened after the anesthesia took effect so I don't remember it happening.) I try to keep in mind that I'm still recovering, so I don't need to be a hive of activity. On the wall in the bathroom of the surgical room, there was a poster listing six things you should do everyday.

Six things to do everyday

While that list isn't relevant anymore, I do, sort of, have a list of things I'm trying to do everyday now:

• Shave
• Shower
• Get dressed
• Eat three meals
• Go for a walk

So far so good. I even exceeded expectations and made a loaf of bread.

Recovery Rye Bread

Next week, I'm going to get a haircut and do the monthly blood work my doctor ordered before this happened. Maybe I'll even bake twice.