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I'll Be Prone For Christmas
Note: I combined two posts into this one for easier reading.
I had a very traditional Christmas this year, spent in a warm, quiet environment, shared only with those closest to me: The Queen, and the on-call staff of the Virginia Mason Hospital's Emergency Room.
Actually, the holidays came a little early this year. On the morning of December 23rd I woke to discover that Santa had brought a little something down my gastrointestinal chimney. But at first I thought I was just suffereing from a routine backache. The pain was in my left flank, just under the ribcage, so I assumed I had pulled a muscle in my sleep or something. Anyhow, I was experiencing only mild discomfort, so I headed off to work. I figured eight hours in my ergonomically-correct chair ought to fix me right up.
Instead, I wound up declaring it a sick day around noon, when I could no longer focus on anything beyond the fact that I had apparently been shot in the back with a crossbow. By this time I was sweating, perhaps feverish, and a little concerned about throwing up. I hobbled down to the bus station and took the first coach home. I'm not too proud to admit that there may have been some whimpering involved in this endeavor. Possibly even some moaning. Yes, I had become The Guy No One Wants To Sit Next To On The Bus.
When I got home I did a little Googling, and zeroed in on this page about the wonder of kidney stones. Here are some Fun Facts that are not even remotely fun:
The next day the pain had moved to my front, consistent with the "kidney stone" hypothesis. It also felt much better -- so much so that I was able to so some last-minute Christmas shopping (by which I of course mean "all my Christmas shopping"). If anything, the moderate pain in my abdomen distracted me from the excruciating pain of being at the mall.
And so, to the night before Christmas -- Christmas morning, really, since The Queen and I didn't hit the sack until 12:30 or so. Mamma in her 'kerchief and I in my cap had just settled down for a long winter's nap, when what to my wondering gut should appear but an sharp stabbing pain that just filled me with fear!
See, now the pain was my back ... again. Which meant that either (a) the kidney stone was going back up my ureter, like a kid at the playground clawing his way up a slide, or (b) I was afflicted with Something Else. Judging (b) the more likely of the two possibilities, we figured we better go to the ER to make sure it wasn't appendicitis.
(In telling this story a few days later to my friend J., a.k.a. "The Human Encyclopedia," I got to this point and he said, "Well, it couldn't be appendicitis, because your pain was in your left side and your appendix is in your right." Hey, thanks a ton for that timely information!!)
And that is the True Story how I wound up in the Emergency Room on Christmas day.
* * * * * * * * *
We arrived at the Virginia Mason Hospital around 2:30 AM.
Those of you familiar with the Seattle will recognize that while 9th avenue on Capitol Hill is not exactly the shadiest part of town, it would still not be your #1 pick for "Places I'd Like My Pregnant Wife To Be Wandering Around Alone In During The Witching Hour." So when we got to the hospital I accompanied The Queen to the parking lot two blocks downhill rather than being dropped off at the ER entrance.
The walk back up the hill was a real treat, let me tell you. I say "walk," even though, in truth, I was using the gait popularized by the sleestaks on Land Of The Lost. And even though The Queen was kindly trudging at a glacial speed, I lagged behind hissing "not so fast!"
(Later The Queen and I had a good laugh over my macho insistence in staying with her, imaging what would have happened if we'd actually been accosted. I'd yell "You rapscallions stay away from my wife!" in a quavering voice, hunched over and shaking a single fist, while she kicked the crap out of our assailants in defence of her hubby with the tummyache.)
I was apparently the only person in the city fool enough to have stabbing abdominal pains on Christmas, because, once we got inside, we had the joint to ourselves. So here's a tip, kids: if you plan your medical emergencies for December 25th you won't have to stand in line at the ER.
I filled out some paperwork was interviewed by the receiving nurse. I described my symptoms, telling her that I'd thought it to be a kidney stone, but that the pain kept migrating from my front to my back. At this she looked puzzled and said "That's weird." I was almost cranky enough to snap "I know it's weird ... that's why I came to the Emergency Room." But then I felt so bad about even thinking this that I instead said, "Sorry you got stuck working on Christmas."
"That's okay, I'm Jewish," she said, and then added, "Sorry you got a kidney stone on Christmas."
"That's okay, I'm an atheist." I replied. "So maybe I had it coming."
Then she asked me to rate the pain on a scale from 1 to 10, "Ten being the worst pain you have ever experienced." I found this question hard to answer since I have never been in a lot of pain -- never broken a bone, never had a serious burn. So, by definition, this was 10: the worst pain I had ever experienced. But I doubted it qualified for the blue ribbon, and told the nurse as much. "Well," she said, "then make 10 'the worst pain you can imagine'." As embarassing as it is to admit, the first thing that popped into my head was the scene in The Empire Strikes Back where Han Solo gets tortured. I gave the pain a 6.
Here followed two hours of Guess The Ailment. I lay on a bed, gown-clad and IV'd, occasionally contributing bodily fluids to the cause. The attending nurse, who was five years younger than me and about three times as pierced, occasionally dropped in to say that my tests came back fine. This sounded like good news until I realized it was secret code for "we still don't know what in the hell is wrong with you."
At one point a second nurse came in and stuck tiny metallic tags all over my body. She then clamped wires onto them, which were connected to a cardiosomethingorother that pronounced my heart to be A-OK. After unhooking everything the nurse ripped off the little stickers one by one -- Sthip! Sthip! Sthip! It was like a community college's "Intro To S&M" course.
Finally I won this medical version of "Stump The Band" and was rewarded with a trip to CAT scanner. An hour later the doctor arrived with the report from the radiologist and a diagnosis in hand.
"Sorry it took so long, but the condition you've got is brand new," the doctor said, as if the Gastrointestinal Afflictions Council had just rolled it out as part of their 2004 line. "It was only first diagnosed a few years ago, so we didn't even have it in our database. But I found a case study that describes your symptoms perfectly, and the CAT scan confirms it."
The doctor seemed pretty giddy that I'd had the good fortune to contract a hip, 21st century condition. Or maybe I was giddy from the pain medication. Either way, it turned out I was the proud owner of primary epiploic appendagitis (PEA).
[Note: Okay, so here's the part where I start using phrases like "my colon" in conjunction with words like "torsion". So if you're squeamish, or if you're some ex-girlfriend looking me up via Google in the hopes of rekindling an old flame, this is where you'll want to stop reading.]
Apparently the colon has these useless things called "epiploic appendixes" (finger-like projections of fat) attached to it, and the EAs sometimes get twisted. Yes, you heard right: PEA is a result of "epiploic appendix torsion." A EA's blood-supply gets cut off when its twisted, and this results in inflammation. Fortunately, the swelling generally causes the EAs to become untwisted; unfortunately, it still takes a while for the inflammation to subside, and it hurts like hell all the while. It's your EA's way of saying, "I may have no known anatomical function BUT DON'T FUCK WITH ME MAN!"
[Note: Dude, I totally warned you not to read that.]
This was pretty much the best of all possible diagnosis. PEA is not a chronic or preventable condition -- it's just one of those things that happens from time to time. And I don't mean "one of those things that happens to me, Matthew Baldwin, from time to time" -- there's no reason to believe that I'm any more likely to get PEA again in the future than, say, you.
"But I dunno," I hear you saying, "An painful, unpreventable condition that could strike at anytime doesn't sound so great to me!" Yeah, but consider the alternative. If PEA was preventable, I would then be charged with the task of actually trying to prevent it, and this would inevitably involve cutting back on my alcohol consumption, or eating less Italian sausage, or, let's not even think about it, exercising. More importantly, PEA can strike at any age: the case studies I read on the Internet involve people ranging from 18 to 60. So -- and this is the take-home message here, folks -- my having primary epiploic appendagitis is in no way an indication that I am getting old. Huzzah!
Anyway, since the only real medical advice they could offer was "grin and bear it," I was discharged from the ER with a pat on the back and a round of "good luck"s. On the bright side, though, I did receive the perfect gift for the modern holiday season: a vial full of Percocet! Merry Christmas indeed.
Who wants some postscripts?