Hospital - June 26 to June 27, 2023

I want to refer to the time when I am not in hospital as the time between blockages. That time is rich, full of activity, friendship, love, good food, physical fitness, whimsy. I love it.  Hospital time is, well you know. It’s difficult. Pain, combined with lots of waiting and being around others who are in pain and not always able to handle it well. The staff and supply shortages caused by the Conservative provincial government mean that wait times are longer, staff is exhausted and patients and their families are at times very angry. There is a higher presence of security guards everywhere. Despite all this hospital staff remain as caring as ever. I find kindness and humour somehow.

On Monday afternoon, I start to have a stomach ache. Since I have no colon and I had a bowel resection, I have severe adhesions, so my stomach aches are usually an indication of a bowel obstruction. This feels like a minor ache to me, so I don’t pay it any attention. After a dinner of chicken and salad, it worsens. The pain is extreme. Clenching and spasming pain that goes from a 3 to an 8 on the pain scale. I vomit. That’s when I know I have to go to hospital.

The last time I was there was mid-July, 2022. The time before that was in March 2021. Before that it was three times in 2018 and once in 2012. As the staff like to say, “this is not your first rodeo.”

In the cab, I hold tightly to my vomit bag. I hope I don’t throw up. I worry that the cab driver, a woman who is speaking to someone on the phone, might kick me out. Charles is careful to explain that while I am sick, what I have is not contagious. We hit every traffic light. We drive through Old Ottawa South and I think of a dear friend who used to live there.

I always know it’s going to take a long time when I go to ER at the Ottawa General Hospital. I am in the life threatening but not immediate category. I hate going, but I have no choice. If the obstruction is not unblocked, I risk ischemia, which means that blood flow from my arteries into my small bowel stops. That means death.

Last time I was there, the residents looked at all my CT scans and found that the obstruction occurs in one of the joints where my small intestine is stitched together. They were excited about the possibility of surgery, but their boss told me and them that with the severe adhesions I have, it would be dangerous to open me up again. They do operate on patients like me. He gave an example of someone who came to ER every month with an obstruction. Mine is still not at that state, thank fuck.

I give my name at the front desk and show my OHIP Card. In a short while, I am called. I go to the triage nurse. She takes my vitals and asks why I am there. I give my usual explanation and she asks how this is usually treated. I explain that I normally get an NG tube and a CT scan and am admitted until the blockage clears. She types in all the information and tells me to return to the waiting room. She says it will take about six hours and apologizes for the wait.

From triage to entry into Observation Room 11, it does end up taking 6 hours. This is not at all an unusual wait time for me. I stop paying attention to time as soon as I enter the hospital, except to record the times when I vomit: once an hour from 7:30 pm to 1:30 am. I bring my own vomit bags because I can’t always get more from the front desk and staff suggests just keeping the one I vomited into. Gah. No thank you.

Charles and I sit at the chairs near the entrance to the Emergency Department. All chairs have been separated with plexiglass dividers since the pandemic began. This means you can’t really talk to each other because sound doesn’t carry through the barriers. It’s a narrow, uncomfortable space. A woman is moaning in pain and this moaning doesn’t stop. There is always someone moaning in pain.

Patients and their companions come up repeatedly to the front desk to ask a nurse why it’s taking so long and when they can expect to be seen. One woman was in a car accident while on a camping trip with her family of six children and husband. She is pushing a little round-cheeked baby in a stroller while talking to an older woman who is having kidney stone pain. I later learn the kidney stone woman’s name, but here I’ll refer to her as KSW for kidney-stone woman. Campground woman (CGW) doesn’t look like she was injured at all but perhaps she has a concussion. KSW and CGW are bonding over the baby.

After about an hour, I hear my name and the place where I am to report, which is the admitting section of Emergency. I speak to a young clerk while Charles stands in the background. I make jokes. When he puts the bracelet around my wrist that includes my name, birthdate and a QR code, I tell him this means we are now engaged.

Once I am “tagged and bagged,” as Charles refers to it, I tell him it’s ok for him to go. We both know it’s going to be a long night and he has to work in the morning. Before the pandemic, when I had a bowel obstruction, he would stay with me all night in ER, but there’s no need anymore. We know this routine far too well.

Me and another patient take turns vomiting. The sounds of vomiting are hard to take. A woman beside me who is there because she thinks she has listeria or salmonella from her food alerts the nurse at the front desk the first time she sees me vomit. She gets tissues for me. The next time, she moves away.

KSW is offering advice to CGW. Her husband is driving around with the kids, unsure what to do. They don’t know if they can go back to their campsite. There was a big storm on Monday night and they are worried their tent will be too wet to sleep in. All their clothes are wet. KSW suggests CGW call the campground and she does. Meanwhile the moaning woman keeps moaning and sometimes she cries out for help. Her caregiver, a white-haired woman wheels her in her wheelchair up to the front desk. I don’t hear the conversation.

Last year a different woman was moaning but sometimes yelling, which caused a security guard to talk to her and find out what she needed. She needed to talk to someone on the phone but didn’t have a cell phone. The guard took her over to the pay phone.

KSW suggests CGW call the campground to see if the storm affected their site. She does and the campground staff agree to check out the site for her.

An ER staff member comes out. She has a small square of paper. She calls out names. These are the folks who will be allowed to enter Emergency for treatment. They are happy. One says it’s like winning a lottery. As expected, my name is not called.

I hear my name again. I go to the nursing station to see nurse, A1. (/A1 because he is one of three nurses whose names begin with A I will be treated by tonight.) I ask him how his night is going and he says it’s terrible, but with an exaggerated emphasis on terrible, that makes me think he’s serious but also has a sense of humour. I say I’ll try to cheer him up. He laughs.

He puts in an IV shunt on the side of my left wrist, after complaining to me that I have shitty veins. I laugh and explain that I haven’t had any fluids since my first vomiting session at 7:30 pm. If you don’t drink, you won’t have enough fluids in your veins, which makes it difficult to draw the blood. He worries we’ve hit a valve, which means they won’t be able to push things through. I’m a little unclear at that point, but I joke with him some more and he says I’ve made his night.

I do not freak out. I am always calm. No matter what happens. It is extremely important to stay calm. Being angry or loud will not make this experience easy for anyone. I am lucky in that I know exactly how this is going to go for me. I think I do anyway. If I’m really lucky, the obstruction will clear on its own. I’ll get anti-nausea meds, something for the pain: morphine or Delaudid, then I’ll speak with the resident surgeon who will consult with the senior surgeon on staff and they will come up with a treatment plan.

I return to my seat in the waiting room. I now have a giant piece of transparent tape surrounding the thick pad of gauze on my left wrist with a shunt sticking out of my vein, and an admittance bracelet on my right. At least I’m balanced.

KSW has moved seats with CGW so that she can charge her phone. The baby is being very good, not crying, just smiling, eyes lighting up when KSW talks to them. The campground has called to say the camp site is fine. They didn’t have the storm as bad as it was here in Ottawa. The campground is about thirty minutes away. CGW calls her husband to let him know. He’s unsure whether he should wait there with the kids or go to the campground. She has no idea how long she’ll be and can’t reassure him. She tells KSW that he is forty but doesn’t act like it.

CGW is called in to Emergency with another group, including a young person who has explained to the nurse at the front desk that she was helping someone on Rideau who had had a seizure and was bleeding and the person bled all over her, including on her legs. She has psoriasis and her legs are scratched and itchy so the woman basically bled all over her open wound.

CGW comes out a short while later and says goodbye and thank you to KSW.

The moaning woman is in her wheel chair while her caregiver is at the front desk, asking again when they will receive treatment. KSW tries to help the moaning woman. She teaches her a way to breathe through the pain. I try it and so does the woman beside me who is worried she has listeria.

KSW has to go to the bathroom and asks the woman beside her who doesn’t seem to speak English very well to let her know if her name is called to enter Emergency.

A young resident wearing scrubs comes out and reads a bunch of names. KSW’s is on it. the woman who doesn’t speak English well doesn’t say anything, so I speak out, letting the resident know KSW is in the washroom. They have to wait until everyone is there before the group can go in. It’s like a weird kind of museum tour. I expect the patients to have a long rope attached so they don’t get lost. She returns and they go. I thank her for her kindness. I figure she should know. She’s surprised. I know that she is in a lot of pain and yet she tried to help another patient. You see that a lot in ER.

I have a really bad vomitting and pain session at 1:30 pm. So bad that I am now moaning quietly too. There’s something about showing one’s pain and suffering to others. Most people in that waiting room are in pain. I know this, but it still feels like I’m at the bottom of my own personal hell to let myself be seen this way, to be in this state. I am helpless against this pain. This last time I’ve tasted peanut butter and that’s really gross to me, but also…I hadn’t had peanut butter since breakfast, which means the obstruction must have started then or even earlier. I always blame the food I ate, but I’ve been told that it isn’t really the food, that it just happens, a bit of food gets caught and sticks. At 3 pm I ate cherries. I didn’t mix them with anything else as I usually do. I just ate them alone. If  I eat raw fruit or vegetables it sometimes seems to lead to blockages. I can’t be more certain about what I’m saying here. I know it isn’t necessarily the food that causes the blockages but these foods on their own can cause stomach aches and these sometimes indicate blockages, so I don’t eat them alone. Except when I do. So I was already feeling bad for eating the cherries when I tasted the peanut butter in my vomit. This made me feel better. Ha! I know how strange that sounds.

After this intense pain and vomit session, I start to feel better. I used to always feel better after vomiting but not this hospital visit nor the last one. Finally the pain isn’t there. Then at 2 am, someone calls my name. Just my name alone. It startles me. I am sure which direction to go in, and the person in scrubs points toward the entrance to Emergency. That entrance used to be publicly accessible but since the pandemic it now requires a badge to enter or staff to let you in. I am let in and I follow the green dots on the floor all around the long hallway and finally into the room marked Observation. My room is #11at the very back. All the rooms are really just areas of one big room, separated by blue curtains. My room is directly across from the nurses’ station. There are a lot of beeps and the lights are bright. Lots of moaning here too. Nurses voices. Buzzers. Cries.

I sit on the bed, but don’t put on the gown, since I haven’t been told to. A2 arrives and takes my vitals, feels my stomach, listens to my lungs, asks me questions. I try to listen to a podcast, but I’m distracted. The man in the bed beside me is dealing with some kind of dementia. He is angry and confused and wants to go home. Another man with MS has to be moved. He made a mess of himself. They try to take his blood but he can’t be still.

A2 asks for a urine sample because I wasn’t asked for one already. Despite not having drank anything since 7:30 pm, I actually have some sample to give. I hadn’t felt any urge to go to the bathroom before that, so this is a happy surprise.

I am cold. Nurse A3 gives me warm blankets. Eventually a resident comes to get my information. I explain that the pain seems to be mostly gone and I’m not vomiting anymore. She talks to her boss. They decide I should try drinking fluids. I get a glass of ice water and drink without vomitting. It’s around 3 am or so, I think. She comes back and says they don’t want to discharge me in the middle of the night, but will give me a lot of water to drink and if I don’t vomit or have pain, I can go home in the morning. No NG tube, no CT scan. At first I am nervous about this. I don’t want to have to return and spend another 6 hours in pain in the ER waiting room. She is understanding. The nurses bring me two glasses of water at a time. I drink about five. No vomit and no pain. I can go.

The doctor lets me know that I should be on a clear liquid diet, including Gatorade for the first and possibly the second day, then introduce some yogurt, pudding and smoothies, and gently return to solid foods. I have diabetes and am worried about the effects of sugary things, but she says I need to do this, so I do.

I’m at home now and it’s Wednesday. I’m on day 2 post obstruction. I had to forego my fitness classes for the rest of the week, and a reading I had planned to go to, so it’s quiet. Charles and I had a big sleep last night. I ate chicken broth for dinner. He ate breakfast. Today I slept in. I’m writing this. I’m reading.

Thanks to all who’ve sent good wishes and thoughts. I don’t know when the next time I have to go to the hospital will be. I am not sure how I feel about that, but I’m looking forward to the time in between. I have many plans to celebrate and savour this time.