My Left Hand Comment Count

Ace May 21st, 2018 at 7:29 AM

mandatory soundtrack, support good music

I'm back to writing at unusual times (as I start this, 3:45 am) in unusual places (the basement again) about unusual things (I'm missing a non-essential internal organ!). I have no clue how to go about writing about this but it felt weird to start writing about basketball like I didn't just have a major life event so I'll attempt to start somewhere near the logical beginning.

During my first visit to my Alabama-based specialist in late February, we agreed I displayed a lot of symptoms consistent with a sick gall bladder and definitely had acid reflux problems. Both are common among ME/CFS patients. I also had a hiatal hernia discovered in a past test that could use fixing. All of these had bothered me in the past but were secondary to more pressing issues the vast majority of time and therefore went largely unaddressed. This, too, is common. I'll omit the list of others I've dealt with personally and my mother will thank me for doing so.

When I got back, the gall bladder stuff wasn't even among the high-priority health-related stuff I felt I had to address. There was the series of medication fiascos caused by pharmacies and insurance companies. I'll get on the full protocol with the correct prescriptions written out to me without relying on sample packets or filling gaps with saved-up old prescriptions sometime next week, should no further hiccups occur. (I'm not holding my breath.)  Again, I visited this doctor in late February, and had already begun much of his protocol before seeing him. It is late May. As you'll see, a lot can happen in that period of time.

After getting a couple other things squared away, including another insurance snafu that delayed this very test, I had a CCK HIDA scan on my gall bladder on March 27th, which you (and I) may better remember as the Tuesday of Final Four Week. There was a lot going on. (Like that short-lived Final Four poster, which got most of my attention that evening if Twitter is any indication.)

So I, uh, shoved my guts to the back of my mind until finding out sometime early the following week the scan revealed my gall bladder was in a gray area; sick but not urgently in need of surgery. I wanted to get my summer going as soon as I could, though, so I called my specialist—also a damn good surgeon specializing in performing these exact procedures on chronic illness patients, Roll Tide—and booked surgery for May 16th. I'd spend the 14th-19th in Tuscaloosa with my father overseeing, and accompanying me on, the entire trip.

I thought I was giving myself a reasonable amount of time to hit my Hail to the Victors deadline, already a lighter one than normal this year, and write a few outgoing player retrospectives.

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My weight has always been a bellwether for my health. I'm 5'10" on the nose. (Trust me, I've been measured a lot lately.) It's generally been between 130 to 145 pounds during my adult life. When it's up, which for me has meant 145 to 155 pounds, I'm doing well. When it's down, which for me has been as low as 115 pounds, I'm in trouble. Over the past year, I've mostly been on the doing well end of things.

For reasons beyond my understanding, my left hand has always been my easiest way to judge my weight and health. After enough years with this illness, I could pretty much tell you how my entire day would go after looking at my hand for a few seconds. One night, after I'd moved back into my parents' house for the second time since my senior year of college, I took a picture of it. I didn't quite get the compulsion but I knew I wasn't in a good place.


Taken January 13th, 2014, 8:26 pm ET, with an iPhone 4s, in my childhood bedroom.

It'd feel how it looked. In this case, it was weak and/or numb. (That's one off the list. Sorry, Mom.)

The next day I wrote a recruiting roundup and a Penn State game preview, drove to Crisler to cover an easy win, and finished the recap a tick after midnight. Nik Stauskas scored 21 points and I got unreasonably upset about a backdoor KenPom cover.

I look at that picture a lot.

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As Seth can attest, I may push deadlines a bit, but I rarely miss them, and almost never when it comes to our HTTV preview magazine, because finishing that is the unofficial start of my summer after what have lately been intense mid-August to mid-April seasons covering football and basketball. (No complaints, Mr. Beilein.)

With Seth's help, I'd already planned ahead for the surgery by cutting loose a few opponent previews for HTTV to other writers (Seth, to whom I'm indebted, included). Taking a week off writing for the site prior to leaving town felt like more than enough leeway to get six previews done. Being the procrastinator I often am, I didn't plan to write until Sunday, but a burst of unexpected productivity got me through two previews by Monday, May 7th, leaving a full week to write four on programs with which I'm much more familiar.

I'd had some mild morning nausea for the previous couple weeks, something I chalked up to stress—I broke up with my girlfriend of over a year during Final Four week, there was single-elimination basketball and hockey going on, it made sense—and adjusting to a medication regimen that now included a dose of tramadol, a relatively mild opioid that didn't always play nice with the gut-bomb of pills I take when I wake up. I felt good enough mentally and physically to set up an impromptu date for Tuesday evening, taking the usual precaution of requesting we meet at the coffee shop nearest to my place.

Within an hour of waking up the next morning, I vomited bile and some mostly disintegrated pills. I'd usually been able to ride out the wave. I weighed myself; 135 or so, not bad, not ideal. I had some discomfort in the upper right quadrant of my stomach area, where the gall bladder is located, but nothing that worried me too much. While I didn't get any writing done, I got some mandarin oranges and bread to settle in my stomach, part of an increasingly simple diet I'd taken to over the previous weeks to stay a little more comfortable. Nothing too out of the ordinary. I walked two blocks to the date, walked home six hours later—with a second date secured, I might add—and let the caffeine wear off for a few hours before going to bed content with my decision, even as I anticipated some physical blowback for the walking.

I've written one sentence for HTTV since.

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yep, still mandatory

Thankfully, Seth is a patient and understanding editor even by editor standards, so I secured an extension to join the stragglers and turned my mind to surgery prep. My parents, who both were incredible this week, took care of everything they could ahead of time: travel, hotel, a decent amount of the communication with my doctor's office, food preparation/shopping/ideas (a necessity given the esophagus procedure), and so much more. I only needed to fill out a couple pages of paperwork and make a few phone calls.

The freed-up weekend heading into the trip gave me a short-lived boost as the stress of a looming and soon-to-be-missed deadline abated. The nausea and sad diet lingered but I didn't barf again. Most any discomfort I attributed to pre-surgery stress, which felt reasonable. Despite a bumpy landing and a finicky stomach, I made it through the flight to Birmingham and drive to Tuscaloosa without incident. (Admittedly with the help of dramamine but I'd learned about BHM's turbulence-prone alignment and the small planes they take from DTW a hard way the first time around.)

The next morning, however, I vomited bile and pills again before my pre-surgery appointment. The nurse didn't say anything when my weight showed up on the scale but I've been on enough to account for shoes, a wallet, and a phone: I'd dropped below 130. I don't remember much else except the bill (large!) and a woman from anesthesia with a fine-tuned sense of which questions/answers to read out loud when my dad was also in the room.*

For my final meal before having my gall bladder removed, on my second trip to the Deep South, I ate two small pre-packaged cups of mandarin oranges.

*(Thank you, I'm sorry I don't recall your name or title. It's been a long week. This goes for almost literally everyone I encountered in Alabama. I could go on for thousands more words on how kind and exceptional all the medical professionals were at Northport Medical Center and Tuscaloosa Surgical Associates and it wouldn't be remotely adequate. I've had three vials of blood drawn by the Hand of God—I swear I wasn't even aware the needle was in my arm and I'm ALWAYS aware—and an organ removed through an opening the size of a fingernail clipping.)

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Taken May 21st, 2018, 4:12 am ET, with an iPhone 7 Plus, in my weird basement.

I went into surgery around 6:30 am CT the following day. Vague memories linger of tweeting a selfie with two words that took a very long time to spell correctly—my dad misinterpreted this as impressive typing speed—and my surgeon saying it was good we got it out when we did before informing me that smoking medical marijuana when I returned to a state where that's legal wouldn't harm my esophagus. I'm glad I had the presence of addled mind to ask that question, because my reaction to opiates is to shut down all digestive function and sweat everything out while I'm trying to sleep, which isn't very conducive to rest.

I'm now (kinda) resting, quite comfortably, at my place. My shoulders are sore, a weird quirk of the gall bladder surgery, and I'm a bit gassy, a product of my esophagus being pumped with air, but those concerns are nothing compared to those of last week; even the prospect of 2.5 more weeks on soft foods only (no meat, no bread, no carbonation for an extra two weeks) hasn't put me out. This sad diet hasn't even kept me from putting weight on. My mom is cooking up some not-sad ravioli that'll work with my current limitations. My dad is hopefully getting some hard-earned days away from stress. My brother is there if I need anything. I’ve gone 23.5 hours without ingesting an opiate and I don’t plan to turn back. My left hand feels, and looks, stronger.

It's time to knock out some previews.

Comments

M-Lemon

May 21st, 2018 at 7:42 AM ^

I am sending positive vibes your way.  Everything you contribute to this blog is appreciated, whether it's a paragraph, sentence or a word.

julesh

May 21st, 2018 at 7:47 AM ^

Two weeks ago I lost control of my bicycle and my face smashed into a wall. My teeth are the biggest casualty, so I'm right there with you on the diet. The dentist finally let me chew with my back teeth last Friday, so at least I'm off the liquid only diet! But likely a full three more weeks, at the very least, until I'm allowed to use my front teeth.

Seth

May 21st, 2018 at 7:48 AM ^

Thank you for the kind words and for giving a damn about work when you're going through all of this. My concern for your health far outweighs my interest in the state of the defense Scott Frost inherits.

blueandmaizeballs

May 21st, 2018 at 2:49 PM ^

Unsure if anyone has suggested this but you should quit diary products if not already causes I inflammation in the body and other negative health issues. Also there is a diet called Kushi that is supposed to be great people have cured cancer just by switching to this diet. Research this stuff cause I feel you I know mine isn't nowhere near how you feel but a diet can do wonders and keep you off prescription drugs. Hope you feel better !

Double Down

May 21st, 2018 at 8:03 AM ^

Thanks for sharing your story. Your perseverance is an inspiration. I will be sending good thoughts your way. Keep kicking butt at life, like you always do.

Yo_Blue

May 21st, 2018 at 8:14 AM ^

Get some rest buddy, but get back to us with frequent status updates.  We care (except for the douche who felt it necessary to downvote several comments).

1VaBlue1

May 21st, 2018 at 8:24 AM ^

Welcome back, Ace!!  Glad you made it back without further issue.  Getting ailments cleared up will only help in the long run, despite how taxing the thought of getting them fixed may be...

Blue in Paradise

May 21st, 2018 at 8:25 AM ^

Someone you have never met. But when you read someone’s writing every day (and listen to their podcasts), it feels more like you are friend than just a writer - especially when you include us on these very personal aspects of your life.

I hope you can now put these health issues behind you and fully enjoy the football, basketball and hockey National Championships that are coming to Michigan over the next 5 years.

UMgradMSUdad

May 21st, 2018 at 9:09 AM ^

Hang in there Ace.  I have an autoimmune disease as well, though it has been mostly in control until the last few years. I tend towards overweight instead of under, but when I get really sick I lose weight.  Several years ago I was in really bad shape and was getting quite thin.  Everyone kept complimenting me on how good I looked.

Know that we are all pulling for you and hope that the surgery and new medications do the trick!  

M-Dog

May 21st, 2018 at 9:09 AM ^

Ace,

It's obviously been an enormous trial, but I must say, you've covered it very well.  We would not have known that anything was amiss by the quality and quantity of your postings.

Your level of professionalism could be a detriment to your health, but the good news is you have enough to spare to dial it back some and, you know, stay around a while.

 

I'm Batman

May 21st, 2018 at 9:46 AM ^

Went in for out patient surgery. 35 minutes under, 3 hour recovery then home.

Except for they forgot to test me to see how quickly my blood was clotting, and once they cut me they couldn't stop the bleeding. So 35 minutes under became 3 hours under and over night observation. 

They left a drainage tube in my stomach hanging out to monitor the blood situation. About 3 hours after i came out of recovery i started pouring blood out of the drainage tube, so they rushed me back into 3 more hours of surgery. 

They told me i would be staying a couple days for observation, to make sure i was done bleeding. I was on a morphine drip the next couple days. As good as everyone always thinks that sounds, it was pretty much terrifying. I was having drug indiced nightmares, that i would wake up from, but hallucinate the terrifying imagery i was seeing in my dreams with my eyes wide open and awake.

Two days later, they were getting ready to release me finally. A doctor came in to remove my drainage tube and staple the area shut. Right as he touched the tube, i started flowing blood again. I was rushed into surgery for the next six hours where they sliced my from the middle of my belly all the way down my side. And thru my belly button. 

All in all i spent 10 days in the hospital, having three surgeries. Fighting everything from sleep apnea, to asthma issues. 

it took 75 staples to hold my stomach together including 9 inside my belly button. Luckily i had insurance at the time. 

The morphine, antibiotic bill alone was over $250,000. 

Ace

May 21st, 2018 at 12:52 PM ^

I hope you're in a much better place now.

When people ask why I flew down to Alabama for this when I live near Ann Arbor, it's because few things can go further in an experience like this than an unwavering trust in your surgeon, and he's performed hundreds of these operations on patients like me.

samsoccer7

May 21st, 2018 at 9:52 AM ^

Glad you're doing a bit better Ace.  I felt anxious reading this post and I can't imagine the stuff you're going through.

Nerves around the gallbladder, and the right hemidiaphragm close-by, refer generally to the right shoulder.  Patient's with acute cholecystitis (acute gallbladder inflammation/infection) will often complain of right shoulder pain/discomfort.

hfhmilkman

May 21st, 2018 at 9:58 AM ^

The sore shoulders to me implies a laparoscopic procedure. They blow up a body cavity with I believe nitrogen to have more room to work with. During the procedure the gas leaks into other areas of the body. Sore shoulders are a common symptom. This is not a big deal for a short procedure like a gall bladder removal. My wife was under for almost six hours. She had a benign mass removed from within her uterine walls and they pulled it out in tiny pieces. The consequence of that is so much nitrogen had leaked into other places like her diaphragm she was unable to breath without being in extreme pain. What was more surprising to us is that all of the doctors or nurses at UM were surprised by the symptoms and could not treat them. They could not even explain why? All the nursing staff wanted to do was drug her up on morphine and good riddance. This would have been a disaster since my wife gets nauseous on morphine. It was only upon discovery that she realized that when she was in the up right position that the pressure on her diaphragm was reduced so she could breath. This of course enraged the nursing staff in out patient even more because now she was up instead of in bed.

So moral of the story if you have severe discomfort after a laparoscopic procedure, it is the gas. If the pain is severe something as simple as changing positions may be effective enough to bring enough comfort until the gas moves out. Lots of medical staff seem to be ignorant of this symptom. The gaggle of new residents on their first rounds at least were informed as my wife told them of her trauma the night before.

And happy that evil gall bladder is out. When they start acting up they are painful. Especially when stones lodge into the ducts that connect the pancreas.

Jgruss42

May 21st, 2018 at 10:12 AM ^

This is actually a common effect of abdominal surgery. Much of the literature on the topic is from ob/gyn. I am really disappointed that the staff was so surprised by the pain!

I posted a longer explaination for the issue below (was writing at the same time you were). You are 100% correct chaning position can make the pain better - and the nerve irritation less. Usually laying down or laying on your side makes it better, but everybody is built differently, so sitting up would work for some people. After the few days changing positions is often less effective (some people do get ongoing relief from changing positions).

There was an article I read that suggested if laying on your back or side helps, the triggering issue may be the presence of the gas, but if sitting up makes it better the triggering issue might be the mechanical stress of the gas stretching the diaphragm away from the liver capsule (because sitting up, or even leaning forward a little, would reduce that stretch).  Right now they have ruled the CO2 being the ONLY cause and body fluids from surgery as being the ONLY cause.  I presume that there are multiple irritants to the phrenic nerve and if you get enough of any of them you might have shoulder pain. 

Hopefully your wife's shoulder pain improved quickly.

hfhmilkman

May 21st, 2018 at 12:58 PM ^

The shoulder pain lasted a few days and was not a big deal.  The breathing issues resolved in about a day.  Within 12-18 hours she went from being unable to breath to able to with only some discomfort.  What made things worse for her is a nurse came by and told her that if she did not start breathing better there could be complications.  So she got upset as now she has to breath and be in acute pain.  Fortunately she figured out that if she stood she was fine.

Ace

May 21st, 2018 at 1:05 PM ^

...did an evidently great job at prepping me for all this. One thing that really helped despite feeling very counterintuitive was to get up and move around. Walking, especially when I started doing some flights of stairs, really helped get everything moving. The gas pain was rough the first day back from the hospital.

Jgruss42

May 21st, 2018 at 10:02 AM ^

Glad you're feeling a little better!

Also, I wanted to drop a quick doctor note here: with abdominal surgery (especially laproscopy) something can irritate your diaphragm (the muscle at the top of the abdomen/bottom of the thoaracic cavity that controls your breathing). The exact mechanism isn't fully understood, some people think it's the CO2 used, some people think it's more of a mehanical issue from stretching your organs around from getting inflated, etc... The diaphragm is controlled by the phrenic nerve; this nerve then reads the signal as shoulder pain. The nerve confusion is because the phrenic nerve arises from the neck (C3,4,5 - mostly C4) in the same area where the nerves that control shoulder sensation arise and the signals get kinda confused by the brain. This is usually called 'referred' pain. [there are other kinds of positional shoulder pain from surgeries, but these are almost never bilateral]

If this kind of pain lasts more than a few weeks without significantly improving, it would be extremely rare. If the pain does linger for multiple weeks at a higher level, there are usually medications that can help reduce the pain. As I said - the pain almost always goes away on its own as the nerve irritation improves. This is one of those, 'more annoying than clinically significant' issues that I am certain many folks (especially ACE) are familiar with. 

Given the nature of the mgoblog audience, I thought a drop of explanation for this kind of issue would be appropriate. 

#science

[for the other clinicians in the audience, I have simplified this for mass consumption - if you want to bust out pathology slides or get into a pub-med article war, please to enjoy]

[I'm a physician in Physical Medicine and Rehabilitation. Folks come see me with 'shoulder pain' complaints regularly]

bluegoinggray

May 21st, 2018 at 10:12 AM ^

But it seems like things are on the upswing which is fantastic. Hopefully, you're on your way to much better days! Always rooting for you and love your contributions to Mgoblog!

mgobrooklyn

May 21st, 2018 at 10:20 AM ^

Thanks for "playing hurt" all these years. This blog would not be the same without you. I will be rooting for your speedy recovery and better days ahead. 

donjohn64

May 21st, 2018 at 11:04 AM ^

Praying for you Ace!

 

It's always encouraging to hear when you're doing well and I always enjoy reading your writing! Cheers to healthy living and GO BLUE!

 

ATTACK EACH DAY WITH AN ENTHUSIASM UNKNOWN TO MANKIND!