Sunday setback

On Saturday, late afternoon, another milestone. Even though I was a little apprehensive about it, the NG tube was removed. This is the tube that sucks any accumulated bile, fluids, etc out of my stomach so the gut doesn't distend and swell up. It's only supposed to be removed when the bowels are functioning adequately to move the fluid through (ultimately winding up in the toilet). I'm always a bit cautious to want the tube removed too soon mainly because their insertion is about the most unpleasant and uncomfortable experience a patient might endure without anesthetic. Despite the progress I was making and how well I was feeling, I wasn't fully on board with pulling the tube without being absolutely completely sure I wouldn't need it again (foreshadowing much?).

Anyway, the tube was pulled and I felt fantastic. I was able to wash my face. I cleaned myself up nicely. Really started to feel human. Even organized my room a little bit. I now looked like most other patients...just a single IV in my arm. I had more freedom to move around than I'd had in a week. I went to bed (after another poop, thank you very much) and slept even better than the night before.

Early Sunday morning the docs came in and told me I was to start eating clear liquids that day. WOOHOO! Bring on the Jello! I went to the bathroom and had the best poop to date! My bowels were working! I'm good to go! I really thought I was nearing the home stretch.

They brought me a food tray that contained 2 4-oz cups of apple juice and one 4-oz container of orange jello. (Also coffee, but I thought that was a bad idea.) I couldn't help but enjoy every drop of it. The AJ was cold and refreshing. The jello was slimy and playful in my mouth. All of it, mmmmmmmmmm. I was happy. And I felt happy for about a half hour or so. Then I started to feel just a little bit nauseous. Not too badly, and I didn't worry too much about it. But a little queasy nonetheless. I told the nurses and they ordered me a prescription of an anti-nauseau drug to settle things a little bit.

Early in the afternoon my Uncle Steve, Aunt Cindy and cousin Katie stopped by, after driving all the way from Tolland, CT. They claimed to be the Gregson representatives to report back to my folks how well I'm being cared for. I think in reality, they wanted to see and play with Lucy. Of course Erin brought her by and everybody had a great time. It was a wonderful visit and it was so great of them to make the long trip. Unfortunately, during the course of their visit my nauseau got progressively worse and worse. After a couple of hours, I was curled up in bed doing whatever I could to avoid vomiting. So, to my Gregson relatives, sorry for my antisocial behavior toward the end of your visit. It meant a lot to see you and to know that you were willing to make such a long trip just to see me. I know my folks also appreciated it. I just started to feel horrible and wish I was in a better condition to spend more time with you.

Not long after they left, I started to puke. A lot. We (me, docs, nurses) decided that my gut wasn't quite ready to tolerate clear liquids just yet. As the doc explained to me, the bowel is extremely sensitive. It goes into shutdown mode at the slightest disturbance. Which is why it was shutdown for 4+ days after surgeons cut it, prod it, moved it around and patched it back together. I guess the instant any kind of food hit the bowel, the same thing happened. A minor little shock that it couldn't quite tolerate, so it decided to play opossum for a short (hopefully?) period of time. I was puking because all my gut fluids were backing up again and my stomach was getting full. Time for the NG tube.

During hospitalizations past, whenever I was ready to try clear liquids, after being on NG suction for a long period of time, the docs would simply clamp off the tube and disconnect it from suction. Leave the tube in just in case it's needed again. Going back to the beginning of this post, that's essentially why I wasn't too keen on pulling the tube so eagerly. I felt it could be left in and I could eat with it in. Now, I needed a new tube. Bad enough when I first got it in the ER almost a week ago. At least I was expecting it and knew I needed it. Hell, I wanted it back then. But now I was so pissed off and anxious and apprehensive and worked up about the whole situation that I was a nervous wreck. On her first attempt, the nurse couldn't get it in. Mostly my fault, because I was so tensed up, I didn't make it easy for her. So we took a break for a bit while she consulted with the doc. About an hour later the doc came in and we discussed everything. Thankfully, a different doc than the one who ordered the original tube removed, who I think I'm going to ask be removed from my service. This guy was NOT condescending, very respectful and fully understood my reservations. He put me at ease and made sure we'd make it go as smoothly as possible. Plus, he ordered me a decent dose of Ativan to soothe my nerves a bit. It was actually the doctor himself who placed the NG tube. A lot of people questions doctors' abilities to do such mundane procedures. It's usually the nurses who are best at such things. But this doc is kind of the "closer." He's called in when others have trouble. And he was good. Very confident and firm, yet respectful. For anyone who's never had one, placing an NG in a conscious patient requires teamwork (or else a lot of brute force and blood). The doc and patient work together to get it in. I've had tons of tubes, so I know my role. But a lot of docs and nurses have different techniques. This doc read my cues and I knew what he was doing at all times. One of the smoothest NG placements I've ever had. Kudos to him for a great job.

As soon as the tube hit my stomach, it was like striking an oil field. The pressure was so great that it geysered out of the tube and splattered all over the bed, etc. I've never seen such pressure buildup with any of the tubes I've had before. But he got it hooked up to a suction canister quickly and the relief for me was immediate. In fact, within 15 minutes, the canister was completely full (1500 mL!!!) and I called in the nurses to change it out. Within another 5 minutes, it filled up another 400 mL. Plus the 400 mL I puked up beforehand and there was over 2300 mL fluid built up in my stomach that was unable to work its way south. No wonder I was so nauseous. That's some potent jello!

So, with these setbacks, Sunday ended with me more depressed than I'd been. I was looking forward to eating and moving forward with my recovery. Instead, I'm now setback at least a day or two, until my bowels can recover from this latest "trauma." Hopefully they'll wake up soon, 'cause I really liked that jello!