For the majority of August 9th, I was laying in bed, attempting to get comfortable. My stomach had been acting up for the past six months and August 9 was the day when I woke up and knew something wasn't right. First I feel a slight pain around the solar plexus area, then gradually it got worse to the point where the pain level jumped to an 8 or 9.
When this first started happening, I thought it was some bad salad. Then I thought it was the flu, then something I cooked and the last two times, the culprit seemed to have been peanut butter. I have never went to see a doctor about this because I just thought it was food poisoning or something I ate didn't agree with my stomach.
On one of the occasions I vomited like never before in my life. Painful, hard core puking that laid me out onto the bathroom floor. Beau, my wife had to help me up off the floor and guide me back into bed. The vomiting episode took something out of me. So far, what it took from me never came back and ever since then I have felt different.
Beau always stays cool and collected when I am ill. Most of the time she'll say, "Don't worry, you'll be better in a little while." When she saw how I was puking and sweating and how difficult it was for me to stand, it was one of the few times I could see the concern in her eyes. She wanted me to go to the hospital, I refused simply because I wanted to lay in bed. Two days later, I was up and around and doing much better.
One thing strange coinciding with these episodes is a strong urge for ice cream. I love ice cream and always have, but the majority of the time I have the discipline to only eat it once in a while and when I do, I eat relatively small portions (a scoop or two, maybe three). The pit of my stomach would start to get warm, then hot, and in my mind, the only option was ice cream. Ice cream cooled off my stomach and made me feel better.
This morning was slightly different in that the slight pain in the solar plexus quickly got much more painful much more quickly. So I grudgingly threw on some shorts and a shirt, walked outside and hailed a motorcycle taxi. "Take me to the nearest pharmacy, I don't care which one," I said. We went to the end of the block and the pharmacy had yet to open. Every bump and jiggle affected me and I was dripping in sweat. A few minutes later we reached a pharmacy and I told the pharmacist what I needed, "Pepcid or Zantac." He gave me a generic brand to squelch the acid in my stomach and then recommended Domperidone for the stomach pain. I took both tablets and figured I would feel better in 30 minutes.
Thirty minutes passed, I gave the medicine another 30 minutes and the pain only grew worse. So I decided to go to the hospital. Maybe I'm having a heart attack, I thought. Again I jumped on a motorcycle taxi and this time I had the driver take me to Vejthani Hospital. The doctor took a look at me and diagnosed me with food poisoning and acute pancreatitis. He made an appointment for me with a specialist and I went home. Okay, I thought, I'll be better in a few days. Two days later, the pain began again. By the evening I was in severe pain and knew I needed to go to the hospital. I am not one to run to the hospital at the slightest ache or pain—I am always thinking about the associated cost and what can actually be done—but I knew it was imperative I get in. I am very lucky I went in when I did. My gall bladder was inflamed and infected and ready to burst. This would have been catastrophic and at the very least would have meant cutting my wide open so the doctors could attempt to stave off sepsis.
Within a few hours I was in the operating room having laparoscopic surgery. The doctor cut three small holes in my abdominal region, extracted my gall bladder and pulled out a dozen or so stones. In my case, I had something known as Mirizzi Syndrome, which (1) is defined a common hepatic duct obstruction caused by an extrinsic compression from an impacted stone in the cystic duct or Hartmann's pouch of the gallbladder. Unfortunately, my right lung suffered some damage when the doctor pulled out my breathing tube and fluid began leaking into my lung. That meant a drainage tube had to be inserted in my lung and instead of going back to my room and then home, my next stop would be the intensive care unit. I woke up for a few seconds, saw my wife and kids, nodded off and woke up eleven hours later.
The procedure caused a fair amount of pain but a couple of days later, I was eating solid food and was discharged. No strenuous activities were allowed and I was to report back in a week. Everything seemed fine so I went to Myanmar to photograph a fight. The original plan was to journey through the country for two weeks, but that was out. Even if I couldn't photograph the fight, I figured I could at least watch it. Once I arrived at the arena though, the adrenaline kicked in and I decided to go ahead and start shooting. It was hot and extremely humid and I was drained, but I chalked it up to the surgery and my weakened state.
I returned home and I went in for my follow-up on the 22nd. All of my wounds had healed and the doctor was pleased with my progress. Yes, Mallon is unstoppable! Although I was far from 100%, I felt pretty good, all things considered. I was still weak, but had started walking and building my stamina and thought I would be back to normal in a month or two.
On Sunday, August 26, my wife flew off for a five-day business trip. Everything seemed normal, although my stomach was a little upset. I chalked it up to the surgery and had a bowl of ramen noodles for lunch. They were good, but something about my hunger struck me as odd. Although I was hungry, I did not want to be eating. An hour later I walked with Alex to his guitar practice. Even then, although I felt queasy and unwell, I put it down to the surgery. The discomfort was tolerable. Monday morning came and by late afternoon the pain grew intense. I dreaded going back to the hospital, but knew I had to do so.
This time when I went in, a group of seven or eight nurses gathered around me performing a variety of tasks. They quickly ruled out a heart attack and then sent me in for an MRI. By this time, the pain was unbearable. The wheeled me back into the emergency room and told me I was being admitted. A doctor came in and told me my bile duct was inflamed and no bile was being allowed through. Unbeknownst to me, my eyes and skin were bright yellow. I was suffering from jaundice. My pee went from clear in the morning to dark brown by the evening. I thought this was strange, but thought I would give a little time to see if it went clear again.
Shortly thereafter, I was sent upstairs to the room where I would stay for another four nights. A doctor came in and informed me my bile duct was so inflamed it was shut and no bile or stones were able to pass. Hence looking like Homer Simpson. In the morning various specialists came in and gave their assessments. I needed to have an ERCP done, or endoscopic retrograde cholangiopancreatography. An anesthesiologist would put me under, then a gastroenterologist would insert the endoscopic tube down my esophagus and work it into my bile duct. Once there, a stent would be inserted, opening the bile duct and allowing any backed up stones and biles to pass. Breathing had become extremely difficult, supposedly because of the gas built up in my stomach and inflamed bile duct. A nose tube was inserted and taped in place to help with my breathing. It did help a little, but a nose tube is about as uncomfortable as a catheter in your penis (if you've never had this done, pray you never do.)
The hours preceding the surgery were among the worst in my life and the pain was like nothing I have experienced. My stomach felt like someone had inserted a spiked ball into my stomach and was continually twisting and kicking it. Just when the pain seemed to stop, my stomach would begin cramping, forcing me to keel me over. At the same time, the nurses were giving me shots of Fentanyl and Morphine every 30 minutes. At first the Fentanyl worked for 10-15 minutes, eventually both drugs stopped having any affect. I had six hours or so until surgery and all I could think of was getting into surgery and having the problem fixed. Time passed slowly, but eventually it was 8:45pm, time to be wheeled into the operating room. No one came in to get me. At 9:00pm, I was still waiting. By this time I was in agony.
"The doctor is stuck in traffic. He will be here shortly," said a nurse. Great, by the time he gets here I'll be dead.
Fifteen minutes later, a gurney arrived and I was on my way. I looked forward to being put to sleep. A few nurses asked questions of me, I responded, and with the nose tube still in place, a mask was placed on my face. "Breath deeply," said the nurse. When I was knocked out for my gallbladder surgery, it took one breath and I was out. This time it too twelve. once I hit twelve though, I was no longer in pain. I awoke with nurses around me, happily chattering amongst themselves. No pain. None. Absolutely none. The bile and stones had passed, the duct was open and I felt like Superman.
By the morning the pain had returned. The meds had worn off. Fortunately, morphine was just a click away. It curbed the pain but I was still uncomfortable and miserable. I craved sleep. With the nurses and doctors constantly coming in and out of my room, I was lucky to get three or four hours at a stretch. Time passed slowly and my discomfort failed to disappear. I still had not eaten anything or drank an fluids for over four days.
Finally, the doctor allowed me to start on a liquid diet. Breakfast was apple juice, chrysanthemum juice and and a bowl of water tinged with chicken broth. It was hardly fulfilling, but the liquid quenched my thirst and helped rehydrate me. I had absolutely no appetite though. When I finally got the go ahead to eat solid food, I ate because my body needed the nutrients, not because I was hungry. My first meal was ground pork, carrots, green beans, boiled pumpkin, watermelon and Kiwi juice. Sounds good, but my taste buds were unimpressed. To this day, the only foods with any taste are ice cream and apple juice. Everything else tastes like cardboard and food is no longer enjoyable. Maybe this is a bonus and will make losing weight easier.
This second ordeal took a huge chunk out of me and weakened me. For now, I'm going to rest and recuperate and work on my health.
(1) Mirizzi Syndrome: www.uptodate.com/contents/mirizzi-syndrome
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