WhiteCoat

Under the Knife – Part 1

“You can’t keep popping antibiotics to cure your diverticulitis,” Mrs. WhiteCoat told me.

Yeah, yeah. I know. That’s why I grudgingly went to see a surgeon.

Then I started wondering to myself. Aside from those neurologic complications and the increased incidence of tendon ruptures, why can’t I just take Cipro and Flagyl every few months?
Actually, I was more worried about long-term complications from repeated episodes of diverticulitis. Inflammation from diverticulitis can cause strictures, adhesions, fistulas, obstructions, and other badness that I didn’t want to have to deal with later in life.
So … I may as well get this diseased colon of mine removed while I’m still “healthy.”

We decided to stick with a surgeon that we’ve known for a long time. I had seen him a couple of years prior when I had to stay in the hospital for another episode of diverticulitis. He has lots of experience doing colon surgery, plus he’s a good guy. I requested a month off of work, figuring that I would hopefully be back to normal a few weeks after the surgery.

A week before surgery, I got an e-mail with preoperative instructions from the nurse. Had to make sure that I was “cleaned out” before the surgery, so the day before surgery involved drinking lots of laxatives. I decided I wanted to go even one step further. I pretty much only drank liquids for the two days prior to surgery. I didn’t want there being any chance of extra stool in my colon that could contaminate the surgical site.

We had to be at the hospital at 6:00 AM on the day of surgery. That meant getting up about 4:30 in the morning. No problem, I figured, I’ll be sleeping most of the day. I just felt bad for my wife.

While we were getting dressed, she looked at me and said “I could hardly sleep last night. Aren’t you worried?”
I really wasn’t, except for one thing that kept running through the back of my head. It was almost like a bad omen.
One of the last patients that I had seen in my last emergency department shift was a gentleman who was 50-ish and who had been in a nursing home for the prior 4 months. He suffered a relatively straightforward injury. He was shoveling snow when he slipped and fell, breaking his hip. He had a standard hip replacement performed, but that’s when his troubles began. First, his surgical wound got infected. They had to open up and debride some of the infected tissue. Then, the hip prosthesis became infected. He was on intravenous antibiotics for a month. The organisms were unfortunately resistant to most antibiotics, and the infection persisted, so the surgeons had to remove his entire hip prosthesis. Then he was on more antibiotics to try to cure the remaining infections in the tissues. Since he did not have a hip joint, he was unable to walk and was relegated to a bed. Then he began to develop bed sores. He came to the emergency department because his hip was getting more red and was draining pus … again.
When I looked at him, I felt such pity because you could tell that he was a strong, proud man who was beaten down by a bunch of superbugs and wouldn’t even have existed if it weren’t for all these patients thinking that their runny noses and coughs need antibiotics.
Yep, fate being what it is, I could just see myself getting infected by one of these multiply drug-resistant organisms that I complain about on my blog so much. If I had had a temporary colostomy bag, I could deal with it. Postoperative pain, no problem. Infections… now those worried me. And there wasn’t a damn thing I could do about it.

I packed up a couple sets of scrubs and a couple packs of gum, since I knew that I wouldn’t be able to eat for a while after surgery. I put a computer and an MP3 player in the backpack. I also took my phone and an extra battery just in case. Anything else, I figured someone could bring me later if I needed it.

With that, I gave each of the kids a kiss on the forehead while they were sleeping, then my wife and I walked out of the house hand-in-hand.
I’M driving,” she said.
“Fine, I’m sure they’ll have some nausea medicine there for me when we arrive,” I joked.

On the way to the hospital, my wife kept looking over at me with tears in her eyes while she was driving. “Cripes, it’s colon surgery,” I thought to myself, “it’s not like they’re doing a heart transplant or something.”
I just smiled back at her.

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Here are links to the other parts in case you get lost:
Part 1Part 2Part 3Part 4Part 5Part 6

 

14 Responses to “Under the Knife – Part 1”

  1. matt says:

    Antibiotic resistance is scary stuff. An economics blogger Megan Mcardle, last week did a presentation on the incentives different players have in terms of antibiotic development and use that was pretty interesting. http://bcove.me/7clj8tfa

    The neurological effects of the quinolones are not to be trifled with. I was given levoquin for a kidney infection, and from the moment I took it I felt like I was tripping on acid, seeing moving lights and feeling like the everything was fake. After 5 days it was so bad I went to the ER, I told them I felt like I was floating away, and they sent me for a psych consult. After finishing my ten days I started having panic attacks, and severe insomnia, I never had either ever before in my life, I am 40. But I didn’t think it was the antibiotic, I didn’t know what was wrong, in a 3 months I was fine.

    2 Years later I had a sinus infection and was given Avalox, I took the first pill, had a ceasure, my wife called an ambulance but I was able to stand by the time they came, and I knew it was the pill. I stopped taking them, but it wasn’t enough. 1 Week later I tore my Achilles tendon on my right-foot. Somehow taking the avalox permanently screwed me up, it was at least 4 months before my brain started feeling normal, my ankle took nearly a year to get better. Now I can’t eat meat because occasionally I get a turkey that was given quinolones and I start tripping.

    When I visit a doctor I don’t mention the neurological issues, I find they either don’t believe me or think that the drug couldn’t have caused it, but I have an scan of my ankle no one questions that.

    • tracy says:

      Matt…i like the way you spell “seizure”…scary stuff, indeed!

      Sending healing wishes your way, Dr. Whitecoat!

  2. Michelle says:

    ???!!!
    No one is writing.
    We are all in shock, WC.
    Get well soon. friend. We need you.
    And Matt, buddy, you don’t need to scare us, either, ok? It would be a far bleaker world without either of you.

  3. Scott says:

    Thanks so much for sharing. Good luck and I look forward to reading the rest of it. You truly have a gift for language and this is one of my favorite blogs. I expect to see a lot more productivity now that I know you’re not doing anything for a while ;)

  4. DefendUSA says:

    Back in the day when my job was culturing Mycobacteria, and doing antibiotic resistance measuring, I remember thinking that I would “never” take drugs unless I felt near death.

    Instead, I tried to treat the symptoms. I shudder now, when one of my kids has a cut or an injury because you never know if will become a MRSA infection.

    It’s not open mic, but I have a question. Do people with diverticulitis ever have issues with their gall bladders also? I seem to be noticing some commonalities among patients with this DX.

    And I guess it’s safe to think that if you are blogging you are well on your way to a full recovery? :) Glad to hear it!

  5. Marilyn says:

    There you are, dealing with all the post-surgery difficulties, still teaching us! I learned a new concept today, the muffin-top!

    Being on day 5 of a liquid-only diet, trying to overcome the same malady, your option is looking more and more tempting but I’m scared to death of those bad bugs…

    Glad I wasn’t one of those who contributed to the super-bug epidemic, I can count on my fingers the number of times my entire family of six has used antibiotics in the last 25 years. Not that it made a difference :-(

    Heal quickly, Dr. W!

  6. Imamontanalady says:

    Love your blog.

    My thoughts and prayers go out to you for a full and speedy recovery.

  7. I’d like to jump into the pool and let you know that much good energy and prayers are being sent your way for a great, healthy recovery as well. You were missed while you were away.
    Jim

  8. Essay says:

    Nothing good (except one of your stories) comes from a prelude like this. While I love your writing and have a suspicion your story will make me smile as much as cringe, I’m sorry you had to go through what I anticipate you’ve gone through to provide me with more education and entertainment.

  9. Angela says:

    Dear WhiteCoat,
    Good Luck!!! I hope you very well and are able to get back to blogging soon,and medicine in a few weeks.
    Again,Best of luck to you and your family.

    Sincerely,
    Angela,R.N.

    P.S. Yes,We do make the WORST pts,

  10. Rlbates says:

    Hope your recovery is smooth and easy. Feel better soon

  11. Chelsea says:

    Hoping the rest of your recovery goes smoothly and you don’t have to repeat this again. Thanks for sharing your personal.

  12. SeaSpray says:

    Hi WC – I’m sorry late getting in here to comment. You know I’ve been sending good thoughts and prayers your way.

    The idea of surgery is bad enough ..the risks ..but to have to be concerned about super bugs is disturbing =frightening. I forget the stats now, but something like 25 % or higher number of patients die in hospitals, not because of what being treated for, but because of infection. That is why they moved the Arizona congresswoman out of the hospital so quickly after her brain injury.

    Knowing physicians are concerned about debilitating infections is telling. Because it takes a lot for you to react.

    Matt, I’m also sorry to hear you went thru that.

    I’ve had Levaquin for uro infection, but that stuff never happened. Maybe some people more sensitive then others?

    And WC ..your poor pt enduring all of that. How awful.

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