Sunday, June 22, 2008

Flat on My Back

The day after I checked in to hospital, test results were all back:  I did have partial obstruction of the small intestine, and my chemo had stopped working.  My oncologist was shocked at the rate at which disease had seeded all over my intestines.  One measurable mass had also grown up in the lower abdomen, but he wasn't nearly as concerned about that as he was about what was happening to my gut.

I declined his offer of surgery for immediate relief of the obstruction.  If my bowel had been kinked or hooked around a mechanical obstacle like scar tissue from previous surgeries, I might have considered the option, and I guess I would have if my current situation were immediately life-threatening.  But, he said, we could try managing the blockage conservatively--which is not generally a word in his lexicon, he being a truly gentle soul with the surgical aggression of a tiger.  I wasn't surprised to learn, then, that what he meant by "conservative" wasn't quite what others did.

The usual treatment involves something elegantly called "drip and suck".  You'll have seen patients walking around hospitals with band-aid colored sticking plaster over one nostril, holding a tube that goes from the nose, past the throat and into the stomach.  That's the suck part--well named.  It's designed to drain fluids that are accumulating in the gut and causing pain and nausea. They also have a bag of IV fluid dripping saline solution to restore hydration and prevent the misery of things like hypoglycemia.

Instead of opting for that (and for reasons I am sure are particular to just what was happening to me in its own particular way), my doc opted to give the gut a total rest.  Nothing was to come in by mouth except sips of water needed for medication.  I was put on total feeding intravenously, with carefully calibrated orange bags of lipids, the kind of food one nurse told me they give babies in intensive care.  I was put on steroids for inflammation, and a hideously expensive drug called Octreotide, injected subcutaneously 3 times a day.  Using only the logic available to hospital personnel, one of those times was about two in the morning.

So for almost 2 weeks, I propelled myself all over the hospital with this hook up.  The only part of the process I could control was to walk as much as possible to stimulate the gut to produce gas, letting us know that normal functioning was returning.  Every fart became precious, and I walked in 30 minute bouts as often as I could, getting up to a total of more than 2 hours a day. 

That's about 1 hour and 45 minutes more than I ever did at home.

The object of all this was to produce poop--and the first time something with two ends came out, I wanted to throw a party.  From there, it was all downhill--or is uphill the good direction?At any rate, the treatment was working, I hadn't starved to death--not that I lacked sufficient stores of reserved fat or anything) and I would live to have some more adventures.

It was all good in the strange Alice-in-Wonderland world of cancer survival, where you become grateful for mercies that come in the strangest disguises.

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