REX ROUND TWO

Just when I thought it was safe to go back out into the real world...

WEDNESDAY.MARCH.2.2011: Woke up as usual. While standing in the bathroom, I felt really dizzy. My vision went dark and my hearing dimmed for a few seconds. I sat down on the bed and called for Josh. I thought maybe it could be low blood sugar so I asked for some orange juice. After resting for a minute I felt a little better.

Throughout the morning all I wanted to do was sleep. Our new cleaning lady had come for the first time (God love her!) and I could barely keep my eyes open. She was at the house all morning but once she left in the early afternoon I decided I'd try to take a shower. Bad move. I could feel myself feeling faint again while I was in the shower. I sat down on the shower step and the next thing I knew I was on the floor. Thankfully, Josh had just walked into the bedroom to check on me when he heard the thud. I must've only lost consciousness for about a second or two but it's a miracle I wasn't injured. He helped me dry off and get back into bed.

After that episode it seemed obvious that I should call the doctor. I knew the nurse would say, "Go to the emergency room," and of course, she did. Next I called my primary care physician trying to get someone to see me instead of going to the ER. I couldn't bear another three hour wait at Rex. Their reply was that I needed to get to the ER and implied that I'd best stop messing around. So we made arrangements for the kids (thanks MA, Gma, And Gpa) and headed for the beltline.

Fortunately the wait was much shorter that evening. I don't know if I could have handled it otherwise. After an exam, the doctor determined that I was probably just a little dehydrated so they gave me one unit of fluids and sent me back home. The ER doctor did note that my platelet count was exceptionally high and suggested that I follow up with a hematologist within a few days.

When I got home, I had the exact same dizzy feeling. I knew something else was wrong but in a way, I think I was too exhausted to deal with it.

THURSDAY.MARCH.3.2011: Woke up exhausted. Slept most of the day. The only new development was (TMI WARNING) sticky, tarry looking poop. I'm no doctor but I've read enough about baby poop that I knew that couldn't be good. I prayed it would go away by tomorrow and went back to sleep.

FRIDAY.MARCH.4.2011: It didn't. And I was still tired. I seemed to feel a little better, getting up to get a drink of water and ate a little. But I promised my Mom the night before that if my symptoms didn't go away by this morning I'd call the doctor.

I called mid-morning and it took until almost 4:00 for the PA to get back to me. She ordered a CBC and the nurse scrambled to find a lab close to me to have it done STAT. The closest one is in Clayton so we quickly called MA to watch the kids and we got there as fast as we could. Arriving at 4:45 apparently was not good enough to have a CBC done. Never mind that they only take ten minutes to do...

So on to the JoCo ER. Now, let me take a moment to say that I have been really impressed with this ER. It is very small and is affiliated with the hospital in Smithfield. Josh, myself, and our daughter have all been there for different emergencies over the last year and a half and we have gotten great care. I didn't have to go to the ER side of the hospital; just was taken straight to the lab. We went in immediately, they drew my blood, and then we headed back home.

Within an hour my doctor (surgeon) called me himself. He said that my hemoglobin had dropped to 5 and should be around 12. He was surprised I was still walking around. For some reason it didn't register with me that hemoglobin is your iron level. I've had low iron before, dropping all the way into the 9's while I was pregnant with one of my kids.

My doctor made arrangements for me to be directly admitted into Rex (THANK YOU, DR. E!!) instead of going through the emergency room. He said to hang tight and somebody from Rex would call me when my room was ready. We called Gma and Gpa to come stay with the kids once again. (Not sure what we'd do without them.) I sat and finished my dinner because I knew I wasn't going to be allowed to eat anything for awhile. That's the drill when I end up at Rex.

By 11:00 that night I was hooked up to an IV getting three units of blood and some fluids. I had a visit from the IV team because my arms were still black and blue from my first hospital stay. They used a tiny ultrasound paddle to find my veins and even numbed me a little before they put the needle in. They're really good at what the do...and I'm not a newcomer to needing their services. I'm a "tough stick" so they say. I was also warned not to get out of bed without help. That startled me a bit.

SATURDAY.MARCH.5.2011: For some reason I thought I was just going to be in the hospital for the night...When my doctor's PA came in that morning, he certainly set me straight. "Don't expect to be out of here before Monday," he said. He explained that the most common cause of such a low hemoglobin level after surgery was internal bleeding. Now they just had to figure out where it was coming from.

PLAN A: The first thing they did was an endoscopy. I was stressed because I didn't want to be sleepy for the rest of the day but I actually woke up really easily and didn't really feel any more effects. My GI doctor was out of town so his partner performed the endoscopy. He cracked me up. He found a small ulcer in my stomach but he wasn't certain that there had been much bleeding coming from that. So...

PLAN B: He wanted me to swallow one of those tiny pill cameras to see what was going on in my intestinal tract. You can read more about them here: http://www.popsci.com/node/19963. Even though it sounds really cool, I had a bad feeling about this from the beginning. If you have a kink or a stricture somewhere in your intestines, it can get caught and then you have to have another surgery to remove it. So...

PLAN C: In order to check for issues, I had an Upper GI with small bowel follow through. If you are not a fluoro lab regular, what that means is that I swallowed some barium (a LOT of it actually) and the radiology tech kept taking xrays every 15 minutes to an hour until the barium had reached my large intestines. Well, that can take up to several hours. In this case, I had xrays from 1:30pm to 7:30pm that night and it still wasn't where it needed to be so they called it a night.

The good news: My hemoglobin had held steady in the 9's throughout the day. They decided to give me two more units of blood overnight to see if it would go higher.

SUNDAY.MARCH.6.2011: One more xray at 7:00am. The barium had reached its goal. However, the verdict was that my system was moving far to slowly to try the pill camera. That was really a relief. At the same time, that meant nobody was 100% sure where the bleeding was coming from.

My PA came in that afternoon and reiterated what my doctor had explained on Friday night. After any kind of surgery, especially on organs, blood can slowly ooze from the surgery site. It can be a little or a lot. He compared it to when you get a really bad burn on your skin. It doesn't bleed nor does fluid just flow out of it. It literally oozes. And like an oozing burn, all internal bleeding eventually stops. If it doesn't, obviously you would die. So, the plan was to wait at least another day, check my hemoglobin levels every six hours to see if my body could keep them up on my own. My crelbows certainly appreciated being assaulted every six hours. Not.

MONDAY.MARCH.7.2011: My GI doctor stopped by early and asked, "What are you still doing here?" He announced that I looked way better and that he expected Dr. E to release me. And...he did...at like 4:00 that afternoon. He had been in surgery all day and didn't get up to do rounds until then. Ugh. My hemoglobin had risen to the 10's and I was keeping it there on my own. Goodbye Rex!

Since then I have been eating myself out of house and home. I had lost 18 lbs. from the day of my surgery in February but now I've gained back about four. For once I'm not too worried about gaining weight. In fact, I'm kind of happy about it. From the day I came home from my surgery in February, I lost a total of 66 lbs. - mostly fluid that they pumped into me from the first hospital stay. I was happy to find that I weighed exactly the same on Monday as I had the Friday that I was admitted. I hope and pray I never have to go through that again!

As I write this, I have about a week left of medical leave before I return to work. I am working on building stamina and getting my strength back. I think it may be a couple more months before I really am myself again. I have to stop and be thankful though. I am alive...and that's a big deal! :)

I have to give a shout out to the nurses on 7 East at Rex. I have now been in their care four times. They are wonderful but I hope next time I see them it's at the mall or something!