Sunday, May 12, 2013

Pancreatitis chapter 2

Time for an update. I know I said I was ramping down the whiny blog posts, but damnit all, this thing just came at me from the blue. Rather than go on and on to live people, those interested in my latest quest for medical contentment can read this at their leisure. I have found that like journaling, typing out my thoughts here is very helpful in putting the pieces together.

After I got out of the hospital I found that I just didn't want to eat. I would get pangs of hunger but nothing sounded appetizing. I got by with nibbles a few times a day. I made gluten free mac n cheese and other comfort food. That went down fine. After a week I went to a salad bar and had a decent meal for lunch. It was 4 weeks till I had several days of having a normal, for me, appetite for at least one meal. Overall though you could say that I am still "off my feed". Ironically since I am back to cooking all my own meals, small and infrequent as they are, I have run the dishwasher more than I have for years. I was getting tired of restaurants and prepared packaged food anyway.

A week after I left the hospital I had an appointment with one of the Drs as a follow up. This was yet another intern or resident or . . . I never have caught on to the labeling. Student Dr lets say. They should issue flowcharts. As soon as she entered the exam room she asked how I was doing with the AA meetings. "What, what are you talking about?" "Your primary care Dr has on your chart for you to go for Alcohol rehab meetings." As you know from the last post I was worried that this might happen. I protested and even though I had never seen her before in my life she argued with me because of what was in the chart. The more I protested the more I could tell that I was in one of those vicious circle things where no matter what I said it would be interpreted in such a way that they can say later "Oh yeah he's an alchy"

I had been having an attack of gout (often linked to drinking also BTW). I asked her for a refill of my prescription of colchicine. Colchicine in one form or another has been used for gout for 1200 years. I have been taking this stuff for 30 years. The old bottle said take one then one in a hour then one.  It can take several days for a flare up to subside. She wrote the Rx for 3 pills. I have never gotten less than 30 pills that often last for a year. WTF? Are alchies know for taking too many colchicine pills? These are not pills you feel in any overt way. 

Besides the involuntary anorexia my whole abdomen remains tender. Hoping it isn't my imagination I feel a number of familiar and some strange sensations in that area as well. None of them pleasant, only occasionally harsh. I know something is still not right but I have been hoping it's just a matter of recovering from the hospital stay. It was 3 weeks before I felt I could try the gym again. I did the easiest workout possible and felt kind of good when I left. By the time I got home I began to have a deep feeling of fatigue and slept for hours. This was not the usual after a first workout tiredness. I haven't been back yet. I still feel weak and it's been 7 weeks so far.

I guess I had been home for 5 or 6 weeks when my regular Drs appointment came up with my primary care Dr. Most people see the Dr once or twice a year. I see him every 3 or 4 months to check my diabetes and other blood tests. I went in a few days early to get the labs done but there was no record of him ordering labs. I left him a note asking why. He called me the next day to tell me since they took so much blood it the hospital that those tests would do. Since I was feeling not so well I did not like this idea.
When got to the clinic just a few blocks from my house I was met by a lady from my psychiatrist's office. He's the one that prescribes Adderall for ADHD. She was there to coordinate my primary Dr in writing those Rx's since I have been using Adderall for 5 years or so and am stable. After a brief visit to the parking lot for a fire drill (or bomb threat or they never told us what) she, another coordinator and me were packed eyeball to eyeball in a tiny exam room to wait for several awkward moments. Dr finally arrived with a student of his own in tow. Being the patient I sat on the exam table while they stood and talked. He balked at their request but wrote the prescription.

My primary care student Dr is an interesting character. Asian american, mid twenties perhaps, one of those hyper know it all kind of guys so he could be younger. A classic nerd that seems unaware that all the information in his head has yet to filter down to being wisdom. He has some self confidence issues over this and tends to overcompensate.  As we waited in the parking lot earlier for the fire drill I saw him in the distance with the stereotype posture of an elder asian. Wide stance, belly sticking way out, thumbs stuck in his belt loops. He seemed to be pontificating. 

After the interdepartmental coordination ladies left I asked him about the pains and concerns I had about my eating and fatigue. He dismissed them out of hand. Drs, I have observed, will often tell you what you are feeling is nothing; to either weed out whiners or as a kind of placebo to get you over what will pass anyway. However since I made such a point of shooting down his alcoholism theory he should have addressed it in some direct way. The student he had with him was a nice looking blond woman; he was in full pride & posture mode. I picture the earlier student Dr's report starting either an embarrassment for my Dr or a consensus that "well since he is in denial about being an alcoholic, fuck him" or words to the effect. It could just have to do with the Drs being overworked. Whatever the case I was not at all satisfied. The lack of resolution to this pancreatitis thing is frightening. 

The rest of the exam went as usual. Including the obligatory dramatic announcement that I need to lose weight. I asked him what I weighed when leaving the hospital then what I weighed that day. I had lost 20 pounds but he dismissed this also. "You need to lose more" I know that, Fuck him. I have been dieting and reading about dieting for over 40 years. Slow is the best way to lose weight. Before dismissing me he stopped and listened to my heart like they do. He then asked the student to listen. He asked her what she heard? They settled on skipping every 3rd beat. Fuck me. 
I am to get new labs, an EKG and be back June 3rd. 
It could have more to do with the Rx for Adderall than what he heard, but we'll see. 
This week I reapplied for the KMC health plan, fingers crossed that I get it again.

Meanwhile back at the homestead I am spending even more time by myself. The guys I play darts with haven't played since the night I went to the hospital. My other usual companions have been unavailable. My sister came for visit last week. I couldn't stop talking. For the most part I am used to this, it's been my way of life since I can remember.  Something is different about this latest medical misadventure, the need for the life affirming closeness of a woman has never seemed so necessary or so far away. Skanky, hyper neurotic, profane or otherwise undesirable women are circling like vultures. They smell blood in the water. I am Physically and financially compromised, my house always in a maintenance deficit. Even taking this into consideration I am better looking than most guys my age/size. I am also clever, funny and have all those massage skills going to waste. I should be able to do better. 

I have been spending most days flat on my back or napping. Fatigue settling in as soon as I try to do something. At least whatever the problem is with the pain in my glutes it hasn't gotten worse with all the rest.  

I like this picture of the pancreas because it
 looks like an erect penis lounging under an umbrella.
As I said I have tenderness even a bit of pain in the area of my abdomin. Other odd feelings too. I was getting back to feeling kind of normal when the pain of pancreatitis started coming back on May 2nd. 

The feeling like a tennis ball forcing it's way out just below my sternum. It was painful to lie down.  Sitting was not bad. Walking jostled things too much. I looked it up and found that many people find that leaning almost upright was most tolerable so I tried it and got some sleep. I was able to do my job. Sitting behind the wheel didn't make things worse. It was painful but didn't feel like it was getting worse. I didn't want to go to the hospital. I did what I could to repeat what they did in the hospital. No food (no appetite so that part was easy) and very little liquid. Stopped all my meds. No morphine unfortunately. It was tolerable by the 3rd day. Perhaps a coincidence but I had an episode of explosive and messy bowl movement, like had been quite often when I still ate wheat. After cleaning up I began to feel more normal. It's been a week, I had a big lunch and feel fine. Well, . . fine-ish.

Epilog May 22 2013 - Minor update not enough to warrant a whole post. 
I was nervous about filing the application to renew my County Medical plan. Last year I only had work for the last 5 months so looking poor was in the bag so to speak. This year I did the self employed newspaper distributor thing for the whole year. What with the newspaper losing popularity all the time and the cost of gas bringing my daily transportation cost alone up to between $40 and $50 a day a definitely qualify as a person in need. I got a new card and letter telling me I am covered through May of 2014. Which is good in two ways. Not only are my medical expenses covered but I will have coverage when the Affordable Care Act kicks in next year. I foresee paperwork nightmares for many people for the first few years of that at least. 
Otherwise The mystery pain like the pancreatitis hasn't been back but I still feel tired and weak most days. Could be that the heart trouble is worse than I know or just that with all that has happened recently the sleep apnea is making trouble. Or I just don't know and need to focus on what's going right till there's something I can do about it.