Emchap's Shit from the Internet 04/22/20 🍠
In terms of Friday night activities, I can't say that I totally endorse vomiting up everything you've eaten that evening, particularly when it's the result of a mystery illness and not, like, too many rum and cokes at your boyfriend's frat party, and especially when what you've eaten is a burger and tater tots—they are unpleasant to get back out of your soft palate. But that was what I found myself doing on Friday, as part of the ongoing and previously-addressed Mystery Wasting Illness saga.
Though unpleasant, I wasn't particularly bothered by it until I started vomiting without any reduction in stomach pain, and I became extremely scared when it got to the point that the pain hadn't stopped and I was vomiting up bile and then water that I tried to drink to calm my stomach. (Still bad, but way pleasanter than the bile.)
Because I am an adult woman who will be 30 next year, I called my dad, who did the sort of helpful physically distant parent thing of listening to me cry on my bathroom floor before suggesting that I take advantage of the doctor who lives in my phone, which I did. OneMedical does not offer telemedicine—it's all video—and since I was at that point (around 3 in the morning) naked and sweating on the bathroom floor, I sort of half-covered myself with an abandoned bath sheet and talked to some politely unfazed nurse, who said that I should go to the ER if I couldn't keep broth down. I hobbled to the kitchen, tried to drink some broth, immediately horked it into some dirty dishes, and gave up the ghost. I called an ambulance for the first time in my life (I have been very fortunate with my adult health) and hung out until I saw them outside. In the interim, I'd managed to cover myself in a caftan and shoes, which I was really counting as a victory at that point.
The EMT straight out of central casting took my temperature, and straight-up told me that I should go to urgent care in a few hours, and to the Kaiser ER if I wasn't going to, but said he would tell his sister not to go if I were her. I sort of nodded, and once he left, thought about whether I could stand the amount of pain I was in for the next three hours, and decided that no, I was sort of worried I was going to die. I called an incredibly mvp neighbor friend (subscribe to her newsletter) who put on pants and a mask and drove my ass to the Kaiser ER at 4:30 in the morning on a very-newly-Saturday, where we got to experience the deeply weird current ER flow of her driving me to the doors, the ER employees taking my temperature while I was in the car, and them taking me and telling her to skedattle.
I was expecting to have to wait, but it turns out that either they're triaging more efficiently, no one's coming in to the ER if they can help it, or Kaiser's ER is less popular than the hospital down the street, because I was the literal only patient in the waiting room and they had me into a doctor sub-10-minutes. (To their credit this may have been because I was literally doubled over in pain, which was until that moment sort of a theoretical expression for me.)
I did the normal doctor triage questions, explaining that I almost certainly had a bum gallbladder but had been trying to wait out the plague, and that I'd started puking straight bile and was worried I was going to die. They got me into a bed, and sensibly pretty immediately found a vein and poked me full of saline and dilaudid (a medication which I still had to google the name of despite it having been intimately acquainted with me all weekend, because there is some goddamn memory wipe applied to me and the not-morphine). I had at that point been awake for 22 hours, the last 5 of them unpleasantly, and immediately passed out into the most satisfying drug sleep I have ever, ever had. The sense of relief was profound.
I have complicated feelings about Kaiser as a company, but I will say that literally every single employee that I encountered during my time in their ER was absolutely, completely on their game. I was checked in on regularly, they seemed to be in communication with each other, and within a half hour of being drugged up they pulled me out to the ultrasound tech's room (which is sort of a pleasant dark cave anyway) to have my abdomen poked at. The ultrasound tech made pleasant smalltalk with me while I sort of half-mumbled sleep answers, and then asked if I might like a heated blanket, which was like asking a man in the desert if he wants water, fuck yes I wanted a heated blanket. (I got two, so I can only assume I looked pretty pathetic.) I asked her if it was in fact my gallbladder, and she said she wasn't allowed to interpret, only the doctor was, but also yeah, it was my gallbladder.
From the official doctor interpretation I learned that the more official diagnosis of what was up to me (as opposed to "probably fucked up gallbladder") was that my gallbladder was both inflamed and surrounded by sludge. Sludge is, to be clear, the technical term. Because the people dealing with me were professionals, they refused to acknowledge to me that that's funny, but c'mon. It's hysterical.
When I had originally emailed my normal doctor about this, they had told me to avoid fat in my diet and call them if I started to run a fever; when I pointed out it was getting worse, they pointed back to that advice. The Kaiser people said that they were really surprised I wasn't running a fever, so I do guess that my body didn't do me a solid on indicating how bad things had gotten, but I did absolutely send a snippy email to the practice later pointing out that I was chock full of opiates and about to have that shit melon balled out of me.
Somewhere in there I sent my boss and grandboss a Slack message that basically indicated that I was in the hospital and would be back in... later (they were lovely about it), confirmed to my family that I had found someone to make sure I didn't die, gave a very tl;dr to my boyfriend, and passed back out until a nice person from the finance office showed up because this is the US and everything is a fucking nightmare.
She pointed out that because I don't have Kaiser (this is true), they didn't want to do the surgery on me, because Aetna would not cover it. I asked her how much it would be out of pocket, since they were offering to do the surgery on me in the next hour, and she said she didn't know. Though I know she wasn't lying to me, this was the first of about 14 times during this process where I got to be very personally, opiate-hazily furious at American medical care. Kaiser arranged for me to be transferred to the hospital literally on the other end of the block from them, which does have a contract with my insurance, and I got to take the world's silliest ambulance ride. This did get me out of having to go through that hospital's ER, which the EMTs had warned me against, so that was at least good.
They settled me in, popped me back up on more of the same drugs, and I waited in the assumption a surgeon would show up. This was a mistake, because it was the weekend and also there's a plague, so instead I mostly spent Saturday chilling unattended while my roommate and the nurses ran into some distressing language barrier issues that in any normal time period would have been solved by a child or grandchild being called in to translate from Armenian.
I was told the surgeon would be coming in to meet with me that day; this ultimately turned out to be a lie. I did chat with a profoundly unreassuring internist who was not convinced that the ultrasound showed that I even needed my gallbladder out, which seemed sort of like bullshit, what with the vomiting and all; I would run into the slightly uphill battle of explaining the severity to people who had not treated me during an ongoing attack for the rest of my time in the hospital. They would ask if I was in pain and I would say no, not at that point, and they would ignore me. Periodically the nurse would ask me what the internist said. Nobody seemed to write things down.
It was in general not the A team. (I both respect the tremendous stress healthcare workers are under and also had a parent who was a nurse and so am aware that it's a job and sometimes people are not great at their jobs, whether because they're poorly suited or the weekend doctor is not the normal person or because no one is getting enough time off.) I'm a white, well-off woman who speaks English and was at that point coherent; I cannot imagine what having to self-advocate in that space would have been like without that.
I rang in the nurse every few hours to remind them that the surgeon was supposed to meet with me, and eventually got them to agree that he would be in tomorrow morning. He wasn't, but nudging at that point got them to say he'd be in that afternoon, and on Sunday afternoon I finally got to meet with the surgeon. He was a very handsome GI surgeon and I will have a crush on him forever and ever. He asked what my pain was like, and I said that at this point it was a dull discomfort but etc. etc., and he pointed out that I shouldn't have to live with constant dull discomfort anyway; he didn't, most people don't. This seemed sensible and it was at this point that I decided I'd be fine with him being the person to scoop out one of my organs.
He basically confirmed that yes, my gallbladder was full of sludge, and that though there weren't any stones, everything I'd told him suggested that if he sent me away I'd just be back with another episode and have wasted my time. He said that by showing up to the hospital I'd already gotten whatever Covid exposure I was going to get, and I might as well knock the thing out—if it was hiding the real issue (a possibility) we wouldn't know until he looked at it, and there wasn't much other treatment he could offer. He couldn't do the surgery that day because the team was at home, but could get me in for Monday. I asked how long the surgery would take and he laughed, because apparently getting your gallbladder out is 30 minutes of work for the surgeon. (For me it was about 2 hours front to back, so they spent more time getting me asleep-not-dead than they did removing an organ, which is funny to me.)
Monday came and I ran into the same issue as I had with the surgery consult in that no one could tell me a time, but after enough pestering I finally got a commitment for 12:30, which was at that point an hour away. I sent the weird sort of "I love you and let's pretend I'm not saying this just because I might die under general anesthetic!" notes to my family and friends, hid my phone, and was taken by and uncomfortably chatty patient transport worker down to the bowels of the operating building.
At that point, I was not actually in much pain besides the general muscle strain 3 days of being in bed + the occasionally unwanted medical tape arm wax, so I did have a deeply dumb and funny moment where the surgery team was trying to figure out how to slide me from my current bed to the surgery table (which is weirdly narrower than I was expecting?) before I asked if I could just, y'know, scoot. I was given scooting permissions and flopped on over before the reassuring Eastern European anesthesiologist told me that she was going to put the anesthetic in my existing IV port. I assumed there was going to be a "count down from 10" thing like I remembered from the last time I got surgery, but they've apparently updated the situation since 2000 because I remember literally nothing after that.
I woke up in the recovery room in some pain and with a sore throat (I knew they were going to intubate me, so that wasn't unexpected) and made some smalltalk with medical professionals before asking if I could have some ice chips. (Another benefit of having a mother who both worked in healthcare and spent the last two years of her life in and out of hospitals is that I am more aware of all of the not-actually-a-drink drinks you can ask for than I might otherwise be.) I was allowed ice chips and morphine before they decided I was probably stable, and got wheeled back up to my room where I sat in my bed texting everyone to tell them I hadn't died and watching Naked and Afraid.
Whereas previously the hospital had been weirdly hesitant to get me surgery, now they were trying to get me out the door, despite the fact that I was actually in significant pain. (This was less from the actual surgery and more from the being inflated with gas before they could poke around in me.) Every time I hobbled to the bathroom to undignifiedly pee in the little pee catcher they'd put in the toilet (why they were tracking my urine was never explained to me, and the nurses seemed to forget to do it unless I mentioned it to them) I nearly fell over, so I elected to stay Monday night.
Tuesday morning was mostly checks—did I do okay if I got Tylenol instead of opiates; was I able to walk a feeble, fall-risk-socked lap around the floor; did I fart. The hospital again seemed wildly unable to answer simple-to-me-seeming questions like "when should I tell my friend to pick me up" until literally the moment I was let free, and I got a last bit of bloodwork after I'd assumed everything was done. (This phlebotomist, unlike the several others I met during my stay, ignored me saying my veins were buried deep and would come slightly more to the surface with a heat pack. He was also slightly a creep about my tattoos, and gave me a bruise because he didn't listen. I hate him.)
I finally was allowed to hobble off home with an assortment of reading materials, a prescription for some heavy opiates and corresponding stool softener, and a warning not to lift anything heavy for a month. I asked what heavy meant; the nurse shrugged and said five pounds. This is literally not possible for me as someone who lives alone, so, I'm going to just hope the nurse was wrong.
I got home courtesy of truly blessed neighbor friend, realized my house was a wreck and the cat's litterbox hadn't been cleaned, and promptly burst into tears. I normally like living alone, but in the moment where I was trying to figure out how to clean my several-days-old vomit out of the bathroom sink while the cat screamed at me while also just wanting to sleep, I did not.
I got the house into an acceptable level of disorder, took a shower, and brushed my teeth (neither of which I'd done since Friday). After a brief video chat, I passed out, which allowed my cat to take advantage of his favorite activity of trying to step exactly onto my wounds, while also biting me and periodically yelling. In a dark moment, I wondered whether I could just open the back door and call it a wash. He did calm down after a time out period, and I fell back asleep only to be awoken by an earthquake, because 2020's writing is too on the nose.
It became clear when I woke up from my post-earthquake sleep that the many rounds of IV antibiotics I'd been given at the hospital had given me a yeast infection, because of course it had, so I spent most of the morning figuring out how to get CVS to bring me diflucan while eating babka hunks I tore out of the loaf my friend had given me (babka: truly great recovery gift, honestly). I tried to call the surgeon's office to figure out whether my appointment was when I had written it down as, since I was, y'know, on opiates, and had straight-up the weirdest phone call I've had in recent memory with his receptionist:
Me: Hi, I had surgery and was trying to figure out when my follow up appointment is.
Her: We only do appointments on Wednesdays between 10 and 3.
Me: Right, I think I already have an appointment, I was just trying to confirm if the date I wrote down is correct and whether I need to go to the office or do telemedicine because I think I lost the card—
Her: What time works for you?
Me: No, I just need to know if I'm already on the books, I think I found the card, it's May 6th—
Her: I can't help you with that.
Me: ... confirm?
Her: No. What's your insurance?
Me: Aetna?
Her: I'll have them respond to your message. Goodbye.
Which made me feel like I might be losing my mind. (I sent the office an email and am hoping for the best.)
But eventually (after scrubbing down the walls with Nature's Miracle and scooping the litterbox; tossing various packages in the trash; and finally figuring out how to make the CVS app work in such a way that a human would bring me antifungal drugs) I felt like I was in a decent enough stopping point. I spent the rest of the day drinking leftover soup and watching truly garbage television. (Marrying Millions, get at me.)
I'm not going to do the rest of the newsletter parts today; this one is already more than 3,000 words long and I haven't looked at a full-sized screen in four days. Everything about this process was Not Great, obviously, but I am grateful for my friends and family, for the unearned good fortune of a job with health insurance and a high-enough wage that I'm not terrified about what bills this is going to end up in (while furious that this plays into the equation, of course), and for the fact that I live in an age where I can pay someone to bring me sushi that I can eat on my couch while trying not to irritate my keyhole wounds. Eventually, I'm excited to start eating dinner not at 5pm to avoid mystery puke. I'm excited to see who goes home on Survivor tonight. Things could be worse.