It seems like my medical problems are causing additional medical problems. Or something. Whatever the cause, new medical problems are piling up like cord wood.
At about 2AM last Friday I was, once again, unable to breathe. This time there was chest pain to go with it, something new. I had been short of breath and my chest felt like an elephant was sitting on it since early that afternoon. I figured it was related to the failed mitral valve in my heart.
Karen called 911 because that’s what the book says to do. She told them we were specifically not requesting an ambulance, we just wanted information. They’re not able to give information, for obvious reasons in hindsight, and—of course—sent the ambulance. She waved it away, trotting after it hollering that we weren’t going to be paying for this. That’s my wife and one of the reasons I love her abundantly.
So, off to Saint Paul’s United Hospital, two weeks after my last visit. The triage nurse remembered me and shuffled me right off to one of the emergency department doctors. He thought it was probably gall stones, and I was admitted. Being admitted is important, believe it or not, because with most health insurance plans you pay a hell of a lot more for emergency services if you’re not admitted than if you are.
After realizing that the pain had been constant and showed no signs of subsiding, the emergency room doctor ordered morphine. No, no, I protested; morphine does nothing for my pain, I don’t get the euphoria benefits, and it seals my butt with cement. All I get is a little warm—morphine takes the edge off my constant chill. Besides it’s contraindicated in renal failure. Well, maybe it will work this time, I thought, and in went 12 mg—a pretty healthy intravenous dose.
It should have taken me out into the painless, euphoric bliss for which the opiates are known, but of course this is me so it didn’t. I got a little warm and may have nodded off once or twice but the pain was still there in full force. My thought is that if you can only get one effect from morphine, go for the euphoria. Not a chance in my case.
Sure enough, within hours my butt had sealed itself off from the rest of the world and wasn’t interested in letting anything go. Ever again. Even after dialysis—where 50-100 percent of the morphine is supposedly removed, nothing was coming out. Not now; not ever.
Through the day Friday, various doctors ordered a battery of tests. Blood tests to make sure it wasn’t my heart acting up even more; ultrasound of all my abdominal organs; dialysis; chest x-rays; and a computerized tomography (CT) scan of my chest.
The CT scan was especially fun because it involves the use of contrast dye that is toxic to the kidneys. Could the doctors, oh, I don’t know—maybe actually talked to each other—to schedule the CT scan for immediately before dialysis instead of immediately after? Not in this lifetime. Oh, and could the doctors have communicated with the dialysis folks to order additional blood draws? Of course not.
By midnight on Saturday, the pain had subsided and I was breathing easily without oxygen. At 5PM on Saturday I was released. There was a lot of hand-waving by all the good doctors—and they are good doctors—but no diagnosis. “Come back if it happens again,” were they’re parting words. And I swear to God, at least two of them waved goodbye like Vanna White. Then the real fun started. My butt was still hermetically sealed shut, seemingly for the duration.
Sunday morning I roused my friend and traditional Chinese medicine practitioner. As I’ve said many times, western medicine keeps me alive; he keeps me well. He’d know what to do as he’d done it before. I went in for the decidedly non-traditional Chinese medicine treatment known as the colonic. A colonic isn’t really a best practice with end-stage renal disease patients because it can cause a severe drop in electrolytes. But, what’s the alternative? It worked and I returned home and chugged a quart of Gatoraid to restore the electrolytes.
The traditional Chinese medicine practitioner explained clearly what was happening with my non-happy morphine dance. Because of my misspent youth (not abusing opiates; I was partial to hallucinogens), it takes a good bit of morphine to even move my needle. The drug has an affinity for inhibiting peristalsis and, in my case, it’s neurological and much worse. The only solution is to get out the blasting tube and buckets of water, keeping a safe distance.
By 1PM today I was back to almost human. Just in time for more dialysis. Sigh.
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