Friday, May 05, 2006

Kidney stone? No, I’m sorry. The correct answer was “Chronic Appendicitis”

I have one fewer vestigial organs today than the last time I wrote.

Since the last diagnosis that I didn't have kidney stones, but just constipation with a muscle strain, I'd bee eating a rather high fiber diet. High fiber cereals, a few servings of raw plants per day. And things kept moving, and I didn't have painful episodes.

Wednesday at work I could feel myself start to bloat a bit and begin to feel "backed up". See what one day without bran flakes will do?

I took an early ferry home, since I had plans to go out with a friend that night. But upon arrival at the ferry terminal in Marin, I realized I didn't feel up to it. I called her. She was aware of my struggle with these issues. I described the pain as always occurring in a very specific spot, on my front side, on my right lower abdomen, about 4 inches to the left of the point of my right hip bone, and one inch south.

She went online and quickly identified that the pain I was describing was consistent with appendicitis.

It just seemed odd to me that the same pain over and over again was appendicitis. Shouldn't I be dead by now? And I didn't have a fever.

Went home and IM'd with another friend, who can be either my little sister or mom, depending on what's required. Once she got wind of the situation, she chose mom:


I got out of it by electing to take my temperature. 96.8. (I'm a reptile) No fever no infection, no infection, no sepsis danger.

I ate dinner, and resolved to see if I was, as sometimes happened, better in the morning.

I woke up at 4:30, with a level of alertness and lucidty that felt wrong. My body was waking me up. The alarm went off at 5, and when I moved to get up, I found myself collapsing back onto the bed in pain from trying to move. The tender spot in my side was extra tender.

I gingerly made my way to the bathroom. If it's constipation, getting things moving should make it feel better.

Things, as was typical for 5:10 am for me, moved. But I still felt terrible. There was no way I could row like this.

And if I'm too sick to row, I'm sick enough for medical help.

I called my coach.

"Ah, it's Kenny calling to say he'll be late but he's coming"

"No, it's Kenny calling to say he thinks he has appendicitis and is going to the ER"

"I thought even numbered years were supposed to be good years for you?"

The folks at Marin General were amazing.

I was admitted, triaged and in an exam room within 7 minutes of walking through the door.

The ER nurses and docs were attentive and thorough. The ER docs were puzzled: If I walked in, just with the story of the last 48 hours, they'd say it was appendicitis. But given that this had been going on since February, they were puzzled. There was this thing called chronic appendicitis, in which the appendix becomes inflamed, and then not, on and off, but it was rare.

They forget that I am extraordinary.

I had brought my CT scan from the kidney stone study, in case it would help. They decided that the best approach was to do a CT scan. It could confirm appendicitis, if my appendix appeared abnormal, but not rule it out. Just because it looked normal on scans didn't mean it was fine.

If it wasn't the appendix, I was going to be off for a colonoscopy to see if I had polyps or colon cancer. Yay. 9 feet of tubing up the poop chute. The ER doctor said they were trying to figure out whether to send me upstairs to surgery or to send me out.

In the ER, a nurse had put in a pic line. Ironically, he missed the first vein he tried for with me, for which he apologized profusely. I accepted. We all make mistakes. He was embarrassed, since it's not as if the veins on my arms are hard to find.

He hit the second one no trouble, drew the needed blood, and administered some morphine for pain.

Morphine, I discovered, makes you queasy. So they hit me with anti-nausea drugs simultaneously.

I could feel the narcotic wrap my brain in a layer of contented fuzz. It wasn't that I couldn't feel pain, it was just that I didn't really care.

After the CT scan, I was back in the ER, awaiting news. When the nurse came in and took my vitals, again, I knew the answer. You don't start monitoring vitals of someone you intend to release.

Doctor came in.

The good news about chronic appendicitis is that, over time, your appendix looks worse and worse. Eventually, it shows up as being out of order. After several months, my appendix looked abnormal. It was coming out.

I asked about laparoscopy. I wanted to minimize scarring and recovery time.

The general surgeon showed up. She was awesome. Straight forward, no nonsense, warm, thorough. She explained that, given my situation, she'd try laparoscopy, but if, upon getting a look, the appendix wasn't operable that way, she'd have to go the old fashioned way. I'd either wake up with three holes, or two. I was hoping for three.

I then got on the phone, and called my coach. I'm having surgery, I'm not going to be able to race on Saturday. HUGE bummer for me.

I may still go up and cheer on my guys, depending on how I feel.

I then called work. Priorities.

Called my mom, and a few local friends.

I got wheeled up to surgery. As soon as I was in the room and on the table, folks went to work sticking electrodes to me. I re-assured them that, as an athlete, I could give a crap about modesty and they should just go to town and not worry. The anesthesiologist said something to me about starting some drug. And that was the last thing I recall.

Recovery room required an act of will to focus my mind long enough to open my eyes. Speech was an undertaking. I could hear someone talking, and it sounded like me, saying what I intended, but it was slurred and distant. I recall a couple kind recovery room faces. I'm sure I was as amusing as usual when coming out of anesthesia. They smiled at me as if I was a loveable idiot.

From there I got wheeled up to a nice room with a window view. I was still rather messed up, drug wise. They hit me with more morphine, and an IV and some kind of anti inflammatory.

My roommate is a garrulous 40 year old Mexican American, who was outgoing and friendly. He was slotted for back surgery. I like Mexican Spanish because it's spoken at a pace I understand. His mother was with him. He sensed my state of discombobulation, and was kind.

By the time he was about to go for surgery, I was already on the phone to friends and family, and managed a "Que tengas suerte" when he left. Back surgery. I'd not trade afflictions.

The game of the day for became "can you pee?" I sought to avoid a catheter at all costs. But as I learned, narcotics and anesthesia dull your capacity to relax the muscles you need to in order to go.

I can go, but it means I sit in the bathroom for a half hour, looking down for visual feedback as I strain to press urine out of my bladder which is being steadily filled by the IV drip. Like the brooms in the sorcerer's apprentice, the IV just keeps pumping fluids.

I manage, but it's hard. Things I am grateful for: The ability to pee freely at will. I can't wait till I can do that again.

My friend and classmate Lali came to visit me. It made me feel so much better to have company, the reassurance of some hand holding, and the attention of a little care. She didn't have to give me her evening, but she did. I'm often dumbfounded by people's kindness to me.

She and I got me up and walking around the floor. Which is an important part of recovery since my abdomen is still full of air. They literally inflate your body like a balloon for the laparoscopy. And the air needs to get out. Walking helps. This morning I strapped on the iPod and hit the floor. I started with a walker, but after a half hour ditched it, and after another hour was walking very close to normally: long srtides, no hesitation. I had a few burps. Yay for bubbles leaving. They hurt, but make me less of a puffer fish.

I'm bloated like a dead seal in the sun, and starting to get some nasty bruises.

I got to eat the lovely "clear liquid" dinner last night, featuring broth, juice, popsicles, jello (though not really jello. It was 'Gel snack'. Good branding). Normally, none of it would appeal. But the salty meaty wonderfulness of the broth was divine. I'd had no food since 8 PM dinner Wednesday.

It looks like I am to be released on Friday morning. Lali has offered to come help me get home and get settled.

My apartment is a wreck (mild wreck, but needs help). But now is not the time for pride.

The surgeon came by and told me that the cause behind all my symptoms was my appendix. It was in bad shape, though didn't seem infected, and that going forward, I shouldn't have any issues.

I'll take next week off rowing and just cox, but then I should be back to normal.

I aim to care for my scars such that I can resume my career as an underwear model.