Karen has been having increasingly more intense gas pains. We were trying to be extra careful with what she ate. We tried probiotics along with beano or lactase pills whenever either applied in the slightest. But it seemed to get worse and worse, no matter how careful we were. After reading about other peoples' experience online we figured there was a good chance it was a partial blockage in her intestines due to the new stoma. Karen knew we had a couple appointments today, so she decided to just wait it out and talk to the doctors about it.
At roughly 2 am Karen woke up in a lot of pain. She had suffered through these pains before and it always seemed to pass. So thought she'd try to ride it out one more time. However, for 3 hours there was barely any output from her stoma; nothing but a little, almost clear liquid. A few minutes past 5 am, the pain became too much. It would spike to a 9 out of 10 or so, before going back down a little. She was getting more and more nauseous, and ended up vomiting. It took some of the pressure off of her stomach, which had felt so bloated and painful, but it was only temporary relief.
We contacted the 24 hour line to reach the doctor on call, but after a few minutes of waiting for a return call, we realized that no matter what he said we were going to have to go in to emergency. He did return our call on the way in, but there wasn't much to say other than we thought there was a blockage and we were heading in. We went to the Mayo Clinic Hospital and were pleased with the short wait. There was probably no more than 5 minutes waiting, and then 5 minutes of a nurse asking questions and gathering her history. Then, a couple minutes later someone came in to take us back to a room. They apologized for the wait and said they had a lot of people come in right before us. We were surprised they apologized. It was probably the shortest wait time I've ever seen - or hear of - from the waiting room to the emergency room. So the extra time spent heading out to Mayo was certainly worth it.
While it sounded like a blockage, they wanted to make sure they knew what they were dealing with and they lined Karen up for a CT scan. They gave her Dilaudid - the one that's a derivative of the morphine family - to get the pain under control, and anti nausea medication to help with the nausea. And then to prepare for the CT scan, they gave her a fairly decent sized bottle of contrast to drink. Omnipaque to be more specific. I guess the thing has a reputation for making you go. Sure enough, out of no where, the stoma started emptying. They schedule the CT scan an hour after you drink the contrast, but she was so backed up they were still able to see that there had been a blockage. Karen said she worried for a moment they might have thought her crazy. But they said they see this happen all the time with the contrast. We asked for some contrast to go, but I guess it's a better joke than request.
We think we've narrowed the culprit down to a bagel she ate on Thursday. It's actually a pretty big no for someone with a new stoma like her's, but she really loves bagels and thought just eating half shouldn't be too bad, especially since they had encouraged her to eat more fiber at one point. Lesson learned. The reason it wasn't obvious from the start was because Thursday was also the day her Percocet prescription was officially halved and we had started to cut back on it. It was also around the time we realized Alieve was working better than Advil for her pain. So it was masked fairly well, and we didn't know what was to blame for what.
I also mentioned that Karen had two appointments this morning. But of course, we were in the ER and weren't able to make it to the building next door. The first appointment was with the doctor who did the original surgery. He - and his "entourage" - came to us for the appointment. And on top of that, they stopped in just after the CT scan had finished, so he was able to provide us the results I mentioned earlier, and then do the rest of the exam. They ended up removing most of the staples, but left several in at a couple areas where her incision had been healing the slowest.
The second appointment was to be with an ostomy and wound care nurse. She, too, came to see us. Karen asked if there had been another option for dealing with the blockage, as she had read something online about flushing stomas, but the nurse said they didn't do that for her kind of stoma. So even if she had been able to hold off for that appointment with the ostomy nurse, it doesn't sound like it would have done any good. In the end, it turns out all we could have done is reverted to a liquids diet until the partial blockage had cleared on it's own. This is certainly a learning process.
While it had slowed down a bit, with things moving, they made sure she could tolerate a liquid diet and then released her around 12:30 in the afternoon. She is feeling a lot better now as far as the pain goes. There's still some nausea cropping up from time to time, but she's still backed up a little as well. All said and done, I think we will see much fewer bad days in the mix as we figure all of this out.
