Sunday, July 4, 2010

Dealing with Diverticulitis Part 1

My husband came home June 16th in the morning from work feeling kinda punk.  He went to the bathroom and when he came out he was doubled over in pain.  I wanted to take him to the emergency room but he didn't want to go.  He went to bed and after three hours took a pain pill left over from a previous illness.  He slept a bit but had a rough night.  In the morning he decided to call the doctor to see if he could get in to be seen.  I got him a quick appointment.

When Don walked into the doctor's office the nurse looked at me and whispered, "He's going to the emergency room!"  The doctor took one look at him and ordered a CT scan and CBC blood draw.  He sent Don to the emergency room.  The CT scan showed a very infected colon caused by diverticulitis, pouches that form in or around the colon that fill with material that eventually abscesses.  The doctor did a laproscope on June 18 and irrigated out the infected offending section of colon and inserted two drains.  The surgery went well and the next day Don felt better. 

Unfortunately his white count began to rise and he was sporting a low grade fever.  The surgeon figured it was from the recovering colon.  He ordered antibiotics to be delivered via IV.  Don was also on a normal saline drip IV.  This saline was causing his fluids to build up and he was packing on pounds every day and not voiding as much as he should for the amount of fluid he was taking in.  He was drinking lots of water too. 

They gave Don shots in the abdomen with a blood thinner.  This made his side very bruised.  He also became allergic to the antibiotic that was given him and he broke out in a vicious rash that started on his back and moved to the front and then out to the extremities.  He was having a hard time breathing because of the swelling of his body from fluids.  He had to sleep sitting up in a wheelchair propped against a wall with pillows situated to hold his head in position. His color was grayish and he looked like he had been in a bad accident.

On Saturday a week after the surgery Don and I decided that he needed to get off all medications and drips for at least 24 hours. Sunday the Doctor decided to let us go home.  Once there we were able to give him food (later we found out that this was a huge mistake.)  The  first night he urinated out about 10 pounds of fluid.  Over the next several days Don lost about 18 pounds of fluid alone.  He didn't eat very much.  He had good breakfasts that were bland because the doctor said we didn't want to stress the bowels until they were more healed.

Don began to decline again after two days.  Though he could breath better he was beginning to get a fever again. Tuesday we went to the hospital for a CBC blood draw which indicated that his white count was still up.  The doctor said this concerned him and also that his stools were still liquid.  "If he is like this by next week I want to do another CT scan."

But by evening Don was really bad and he didn't sleep well.  The next day after talking to family I decided to get a second opinion.  I called the Doctor again and informed him that Don was worse and we needed to do something.  He ordered another antibiotic and a infection fighter drug.  I also made a few phone calls and found out the name of a good gastroenterologist in Denver.  I tried to speak with the specialist but soon found out that was impossible.  I call our family GP and though he was out of town I spoke with Diane, the PA.  She informed me that I had the right to ask our surgeon to consult with the GI specialist.  So I called them and left a message that I wanted a second opinion.  I left the name and number of the GI Doctor.

The following day I received a call from our surgeon and told Don to go in for another CT scan and CBC.  I immediately took him in.  The surgeon found two abscesses.  One the size of a coconut and the other the size of a lemon.  They were in another area not close to the laproscopic site. The treatment for this was not available in our hospital so he called the Doctor who I suggested and they did an ER to ER transfer.  We checked Don in to the SLV Regional Medical Center ER and then I drove him up to Swedish Medical Center and from the ER he was taken into the hospital and given a room.  It was the Fourth of July weekend so we couldn't get Don's medical records until after the weekend.  However, they did send paperwork and a DVD of the CT scan. 

When he went home and began to eat we didn't realize that doing this would stress the damaged colon.  Because of this his colon may have leaked and thus the development of abscesses.  They are definitive about this but that could have contributed to Don's declining health during those few days.

After looking at the material we brought up from SLV Regional Medical Center it was decided by the head of trauma surgery and Don's surgeon to go ahead with the treatment which included putting Don into a CT scan with a grid on his abdomen.  They marked the spots and slid him out of the machine and inserted a wire right there on the table.  They put a tube over the wire and began draining out the abscesses.  They drained out 800 ccs of fluid from the coconut and 40 cc or so out of the lemon.  The drains are still in.  The lemon is doing fine but the coconut is still draining.  The technicians and physicians were amazed at how much they were able to drain out.

Because Don hasn't eaten anything for nearly three weeks he has lost over 30 pounds.  The physicians decided to put him on a PPN.  This is an IV diet that supplies protein, vitamins, and minerals.  They don't want him taking anything by mouth as it will stress the colon, leak out and cause other abscesses or even peritonitis which is extremely dangerous and can be fatal.

So that is the plan.  We wait until his bowel is healed and the tissue can withstand surgery.  When Don is well enough we can go home but we have to continue with the antibiotics and PPN so that means home health nurse. Then we go back in for what is called a re-section.  This is taking out the badly damaged colon and putting the two good ends together.  Worse case scenario is that they would have to take out the bad section, put in a colostomy bag until it heals and then go back in another surgery and sew the two healed ends together and remove the colostomy bag.  They are hoping that they will only have to do one surgery and not the colostomy.  This will happen in about three to six weeks. 

As I understand it recoveyr from these things is long but once it is healed there is no longer a problem and life can get back to normal.  Surgery can take much out of a person and getting stamina back is lengthy.  We are going to follow Doctor's orders and do what it takes to get well.  In the mean time we are grateful to friends, family, and medical staff for all their help, prayers, and support during this time.  It has been valuable to us.  Will keep you updated either here or at my daughter's site,

No comments:

Post a Comment