Non Obstruction Obstruction
Hospital 2023, Part 2
On Monday, August 21, I had a stomachache that soon developed into the kind of pain I recognized as an obstruction, excruciating. I stopped eating, just took little sips of water. The weird thing is I was still having bowel movements, just liquid, but still. Usually with an obstruction, my digestive system stops. It’s completely still, which is a weird feeling. By 1pm I vomited. That’s when I knew I had to go to the hospital.
I put what I thought I might need for a two-night stay into the bag.
I took a Lyft over and discussed the health of my driver, who was grateful that in his twenties he had no health issues. We talked about how difficult it is to get a doctor.
I asked him to drop me off upstairs at ER, so I wouldn’t have to take the elevator. They took away the escalators at the start of Covid 19 and haven’t yet put them back. I’ll take the elevator if I have to, but with my elevator fear, I always choose another option, if possible. I was too sick to take the stairs and I’m not sure I even know where they are.
I checked in at the information table, marked with a big I. I am not sure why people don’t seem to realize that’s where they check in. Many people still go past to the plexiglass areas where the triage nurses are and interrupt their sessions with patients to ask questions. At this point, I have seen a lot of human behaviour in the ER, so I try not to get angry or annoyed by this. I try to remember how afraid people are, either because they are in need of care themselves or because a loved one is there.
The man behind the info desk was friendly as they always are. He apologized that the wait to get triaged was going to be longer than usual. I told him that I understood and I was just grateful to be there. I felt safe. I like to be as friendly as possible with medical staff. These are tough times for them as well as for patients. It does no one any good to get angry or impatient. Other than timing my vomit and pain spasms, I throw my watch away while in hospital, or rather, I stop paying attention to time.
I sat in my usual favourite area with the more comfortable chairs divided by plexiglass. The pain was severe, but I was relieved not to be vomiting like I did last time: 7 vomiting sessions in 7 hours.
A woman beside me slept and would wake up and go over to the nurses in triage when she awoke, for fear she’d missed her name being called. I always like the part where patients names are called. It feels like a lottery. I’m always amazed that some whose names are called are no longer there. Some need to go out for smoke breaks, some leave because they run out of patience.
I wore my red hoody and jeans, and had brought a scarf in my go bag, the one I prepare for the hospital. I don’t have a pre-prepared go bag, and I know I should, but I don’t have double of most of the essential items, so why bother. The hospital is always freezing so I wear warm clothes and the hoody helps if I want to doze while I wait. I put the hood on and cover my eyes from the horrid fluorescent lights. Everything about hospital colour schemes is awful – bland and neutral greys, blues, beiges.
It took an hour to get triaged. I answered the usual questions and the nurse took my vitals. The nurse told me I would be assigned to “green” for observation. There are 3 levels of triage: green for observation, and I don’t remember what yellow and blue are for, but I’m assuming one at least is for urgent attention.
I then was called shortly after for registration where I received my hospital bracelet and made sure they had Charles listed as my emergency contact. Charles would join me later after work, but we’ve been through this routine so often, there’s no need for him to come earlier.
Shortly after that I was taken to the Observation Room area by the man from the info desk. I asked him how his day was. He was tired, but otherwise upbeat.
In Observation, I was given the isolation room where they put Covid patients, not because I had Covid, but because it was the room that was available. While most of the other rooms are just areas of the floor divided by curtains, this is a full-on room with two glass doors and a private bathroom. Very weird. It was quiet, which was good, but felt strange.
This part becomes a blur for me because I was just there in June, but I went through the usual dealing with the nurse who then did my blood work, which is something that usually gets done in triage, then eventually a young resident came in to ask me the same questions I am always asked about what brought me there.
Last time, I vomited one final time and the pain went away just before I was put in the Observation area, so eventually the treatment plan was just to have me drink a little water and see if I was ok. At which point, I was discharged. I had had a “partial bowel obstruction.” This was a new term for me. Usually my obstructions are always complete, as far as I’ve been told. That’s why I am usually admitted and prescribed the NG tube.
In the past, the vomiting and pain continued until treated with pain and anti-nausea meds, and then an NG tube after a CT scan revealed the obstruction.
This time, there was a lot of uncertainty about how to treat me. I still had pain. In fact the pain was escalating from a 5 or 6 on the pain scale in the waiting room to as high as an 8. I wasn’t vomiting.
When I spoke to the first nurse, I told her that since I don’t have a colon, I have to be concerned about dehydration. I hadn’t had anything to drink since the early afternoon, about 7 hours before or so. She gave me an IV with one bag of saline, but when it was done, the next nurse on staff didn’t give me any more. She also did my blood work and used a vein in the top of my left arm rather than the crook of my arm to take the blood and put in the stent. I have never seen that before. Last time, the tech put it in the side of my left wrist.
Charles found me by checking in with the nurses at triage when he got to the ER department. You can’t just walk in to the rooms anymore, you have to get buzzed in. He was as surprised as I was about the room. The air in the room caused him to sneeze. He has seasonal allergies and he figured that since the room was for respiratory patients, the air was circulating from outside.
The porter came to take me to get the CT. He was in full protective gear, not just a mask but a face shield, a gown and gloves. Normally these days, the porters aren’t even wearing masks anymore. Given the room I was in, I could understand why he was being extra careful. I explained to him that I didn’t have Covid, it was just the room they had available. He didn’t respond to that.
I like the porters typically. They have a weird job, running through the hospital with stretchers and wheelchairs, making sure the patient is in a safe and comfortable position and then transporting us to our tests and back.
They did a CT scan, which I never mind. I always say the injection of the contrast dye is like drinking a shot of whiskey and having a small orgasm. The techs usually laugh at that. This time the tech said they offer a full service there and we both laughed.
The results of the scan showed that I had fecal matter and liquid in my small bowel but not an obstruction. This was a weird one for me. Maybe it explained why I kept on having diarrhea after the pain began and why I only vomited once.
I use the Ottawa Hospital’s MyChart.ca to check on test results, so I had the results before the resident came back. Charles had gone home to have a night’s rest at about 8pm. No point in him staying in a chair all night, especially because he has to go to work early the next day. In the early days, the first obstructions, he would stay all night with me, but as the staff says about me, “this is not your first rodeo.”
The resident returned and told me the results. She wasn’t sure what to do. An NG tube doesn’t work for partial obstructions, and I was still in pain but not vomiting. She wanted me to take pain and anti-nausea meds, but I was worried that masking the symptoms would mean they wouldn’t be able to tell what was wrong. She said something about treating the symptom and not the cause, and this didn’t make any sense to me at all, but I was in such pain, I agreed to the pain meds. She even wanted me to tell her which pain meds I could take, and I said I’d had dilaudid and morphine before. She wanted to know what dose, but I said she’d have to check the records. I had no clue. At this point, I was starting to get pretty nervous and didn’t have a lot of confidence.
She left to check with her supervisor. When they returned some time later, her supervisor wanted to discharge me, even though I was still in pain and refer me to General Surgery for an outpatient appointment. I was afraid and anxious to hear that. I was still very much in pain. I was worried about all kinds of things, such as organ failure. When I made that comment to the doctor, she dismissed it. She told me that since I lived close to the hospital I would be ok. That was not at all reassuring. We discussed the matter a bit more, and she ended up deciding that a consultation with General Surgery would be a good idea. I was relieved.
After I took the dilaudid, I felt a bit nauseous. The nurse told me that it was probably the meds. The pain gradually went away. Then two orderlies in full protective gear, just as I was getting to sleep, came to transport me to a ward. Another patient, a Covid patient, needed the room. I was totally fine with that. It felt like overkill for me to be in this single, isolated room anyway. Although I would miss the lack of hospital noise.
The porters are also very skilled at making sure that the patient’s personal belongings are properly taken care of, putting them all on the stretcher.
Did I mention that in ER, they put the patient on a stretcher with sheets the entire time. The rooms are very cold. You can get a warm heated blanket if you ask.
I still had all my clothes on until about 10pm, when I switched to the hospital gown. They no longer tell you to put on a gown, but wearing jeans with stomach pain is no picnic.
The ward where I was put was outside of ER in the hallway nearby, in a former conference room. The General, and likely many other hospitals, have to jerryrig pretty much everything these days to stretch their dollars and make more space where there is none. Last July I was in a small cupboard with two other patients and we were on reclining chairs.
The ward had 5 beds, separated by curtains. The nurse was very busy, but courteous. Soon after the doctor from General Surgery came by. His name was Dr. Lamb, which I loved. He was indeed as gentle as a lamb. He called me a professional at having obstructions and told me that since I had experienced this so much, I was the one who knew my body best and if I didn’t think I should leave the hospital yet, I didn’t have to. I worried about taking up needed bed space, and he reassured me that I needed the space too.
He came up with a treatment plan that made sense to me. I would do a small bowel challenge, an x ray where you drink a contrast liquid four hours before the x-ray. I knew that usually this stuff acts like a laxative, and in most cases, it frees my obstructions. The x-ray itself would be useless to them, most likely, but the contrast liquid would be useful to me. If the x-ray didn’t reveal the problem or it turned out to be an obstruction, I would get an NG tube. He also wanted me to drink some water, which I did, and it stayed down. At that point the pain was going away or might have already gone completely.
The nurse came with a plastic glass which had almost half a glass of liquid in it, the contrast in water. I was to drink it fairly fast, but not chug. Unfortunately I thought this meant I should drink it down in 15 minutes. The stuff tastes like sweet earwax. It’s horrible. My stomach hurt and I vomited it back up. I thought that would be that, but the nurse said I had to do it again but this time much slower, about 45 minutes. I ended up taking an hour.
I had warned the nurse that I was likely going to have diarrhea from the contrast. She told me to let her know if I needed the bathroom, but the shift change occurred when it was time for me to go, and so I asked someone at the desk where the bathroom was. It was a single bathroom that required a code. Fortunately the code was on top of the door.
And yes, my blockage was released.
There was a man in the bed across from me who had issues with his jaw. It was quite painful. An elderly woman beside me told a young doctor not to get old. Another woman who was 90 and somewhat confused was told by a doctor that she had cancer, but that there was nothing they could do. It was heartbreaking. All night she called for her daughter.
The nurse was a very personable and friendly man who seemed quite caring in his treatment, but he was also really busy with 5 patients to take care of. I didn’t need anything, so he mostly left me alone. They had been taking my vitals fairly regularly but this stopped on the 2nd day.
I wandered around a bit, near the stuff destined to go to storage and the cleaned lab coats of residents. I also came across a self-standing, full-length mirror, so I took a selfie:
A doctor came to see me and said that if the x-ray results were ok, I would be discharged right away.
The porter was supposed to come at 10 am for me, but hadn’t arrived just before 11, so the nurse called a few times and eventually the porter showed up. I had my street clothes on because for the CT scan I was allowed to wear them, but it turns out the x-ray can’t see through clothes the way a CT scan can, so I had to change quickly into a gown, then get in a wheelchair. I felt a little silly, since I’ve had plenty of x-rays in my time and I usually know to wear the gown. I think I was just a little extra tired, thanks to the whole experience.
The x-ray was fast: one standing up and one lying down. The technician said that the contrast had ended up in my bladder. I knew that the test wouldn’t reveal anything at that point.
It wasn’t until about 1pm that I finally was released. There was some confusion over the discharge. The nurse very helpfully badgered the staff of General Surgery and eventually I was let go, but I didn’t receive any discharge papers and when the nurse removed the stent that had been put in for my blood work, he told me to hold on to the gauze for a good few minutes. I didn’t hold on very long and blood went everywhere which was quite upsetting. He was busy and preoccupied and came over to give me a new gauze but didn’t clean up the blood on me or anything. It was a sloppy exit.
The Lyft driver on the way home talked to me about how Covid was over and not that serious anyway, since none of his friends or family had died from it. We talked a little, but I stopped talking and let him listen to his religious music in peace.
I am home now, taking it easy with food and enjoying being back in the routines of my life again. The hospital is an awful place to be, but there is no way I can avoid it. I will have more issues with blockages, whatever they are called. As the saying goes, “it is what it is.” I find ways to make the experience as calm and easy as I can. I take the necessary steps to treatment and I try to be as courteous, articulate and communicative as I can to the medical staff.
While I was in, I sent a few social media posts and photos out to my lovely community of friends, and you were wonderful, darlings. You sent me lots of well wishes and showed concern. It really helped.
I had also brought two poetry books with me because I am still doing the Sealey Challenge, trying to read a poetry publication daily in August. It was a wonderful idea to bring them. I read Susie Campbell’s the Sleeping Place and started Abegail Morely’s, the Unmapped Woman. Both were fascinating and helped distract me from the weird and awful experiences of the hospital and my health.
I have a plan to live joyfully when I can, be good to others always and endure the pain of my obstructions as best I can. With that in mind, I will be attending the Riverbed Reading Series tonight and I hope to see you there. If not, I’d love to hang out with you over coffee and enjoy a little sunshine and friendship, if you’re in Ottawa, or coming.
During the worst of my pain, I was thinking about how stupid it was of me to make plans. I had been planning to go to my fitness instructor’s one act monologue performance, but I was still in hospital. I had been really looking forward to it. He’s a former United Church minister and a writer. I knew it was going to be special, but I couldn’t go.
I have all kinds of plans for this fall, launching my book, Beast Body Epic, which is, somewhat ironically, I suppose, provoked by my health crisis. At this point I feel like I could write a volume 2 and 3. But I started to worry that I wouldn’t be able to enact these plans, that I wouldn’t be able to do the readings in Ottawa, Toronto and Montreal, but you know what? That might happen. But maybe I’ll be able to. And whatever happens, that’s out of my control. I will handle it. I will rejoice in this moment. I will be loving and good and that’s about all I do have control over.
Seeing the pain and discomfort and upheaval that so many people undergo in hospital is a great reminder of how good my life is, how good it is to be alive. In the moments between pain, life, my darlings, is wonderful. I am very grateful to be here, grateful for friendship and love.