Jigsaw 24 - Vintage Book Shop

 This past weekend I have not been well.

I have the start of Rheumatoid Arthritis and Fibromyalgia, although they are currently classing it as Palindromic rheumatism. So occasionally I get flare ups where I have pain in my ankles, wrists, knees, hips and neck. The pain comes on for no reason; nothing sets it off and it can last for 6 hours to 3 days. Pain relief and rest is usually the treatment. There is not much I can do when in a flare up, walking is painful, legs sometimes struggle to work, hands don't want to work as no strength in them and my brain just does not cope well.

So, this past weekend I have spent a lot of time sitting and completing jigsaws as it is easy to do and doesn't hurt my wrists so much. It is my first major flare up in the past 4-6 months.

This one was finished within 24 hours of the Lego one as I have had nothing else, I can do during that time.

It was easy to sort into colours, went together easily and apart from being a Holdson and being flimsy and breaking easily every time you caught a piece on your sleeve, it was nice to do. 

Jigsaw 17 - Time

 Has taken me a few days since being home from surgery to actually be able to work on a jigsaw, mainly because it involves leaning forward and that has been difficult when your abdominal muscles are not liking you.

Especially when the surgeon actually found a small umbilical hernia during surgery, so did an extra surgery at the time. That explains the tightness in my mid abdomen and reason things are so tight and painful.

Little bit by little bit I have been able to complete some of the jigsaw, have to do something to pass the time, although sleep has been a good thing in the middle of the day.

So, my first of I am sure, many jigsaws that will be completed over the next few weeks.

Day 2 - Home Time

 The extra day/night in hospital was by far the best thing to do, and now it is home time.

Whilst it will be good to be in my own surroundings, I know for certain it is not like a hotel there, everything at my fingertips and a mini fridge in the room. This room is exactly like a hotel room; in fact, I think I have stayed in hotel rooms far worse than this hospital room!

Onwards with my recovery

Day 1

 To say the past 24 hours have been rough is a definite understatement. Crap is a better word, I think. It has not been a pleasant journey and consequently, the surgeon has decided that I am not going home today, and I get the joy of staying in for another night, and believe me, I need it.

Reaction to medication, uncontrollable pain, nausea, vomiting, more pain, lots of tears and low blood pressure.

It was lovely when a colleague/friend came to see me and bought me a small gift to keep me smiling. Ok, she did make me walk up and down the corridor (for my own good) to get the blood flowing to my legs and assist with easing my tight muscles.

I told you, nurses make the worst patients!

Verdict

 The results are in, the plan is set, and we are all go

Today was the surgeon appointment and he confirmed my findings (😀) my gallbladder is coming out.

Now I just have to wait the 5-6 weeks until surgery time but at least we have a solution, although he did say it was only a 50:50 chance of it fixing the problem! A chance I am prepared to take.

We Have a Winner

 Thanks to the power of modern technology, I knew my results of the HIDA scan and what they meant before I saw the surgeon again.

Here in New Zealand, we have medical apps that allow us to link into our GP and see all medications we are taking, all test results, all letters of referral and all appointment notes. We can also message the surgery on the app and book appointments with our named doctor (although good luck with that one since covid, takes about 10 days for an appointment) and request repeat prescriptions without having to go to the surgery.

So of course, when I got the message that a new result had been uploaded then I took a quick look and bingo, found the issue:

I have an inactive gallbladder.

Your gallbladder is an organ that sits underneath your liver and assists the liver with the excretion of bile into the digestive system when you eat. The bile helps to break down fat. You can live without it; your liver and cystic duct just have to learn to divert the bile into the digestive system a slightly different route. Most people have a gallbladder that fills with bile when you eat and then excretes it out as required, usually with an ejection fraction of about 50%.

Mine is at 16%, so a little slow and useless really

Therefore, when I eat, bile is accumulating in the gallbladder as normal and then it is not emptying properly, this leads to a full gallbladder that can then go into spasm or cramp. Thus, the colicky pain I was getting as it was full of bile and not able to empty it all out.

The solution (according to Dr Google, true nurse here!) is a Cholecystectomy, which in simple terms = let's take that gallbladder out.

Guess my appointment with the surgeon in the next few weeks will be to confirm what I have already established, unless the expert has a different solution (I do trust his knowledge) and that will be some future surgery.

HIDA Scan

 Today I got my nuclear medical scan of my gallbladder.

It involved a 90-minute scan, laid on my back the whole time, with no moving (although I could hold my kindle and read) and at the 45-minute mark, I had to eat a Mars bar and drink a glass of milk, all while lying flat on the bed with a scanning machine above my abdomen.

Firstly, I am not a fan of milk. I will have it with breakfast cereal, but I am not that person that will grab a glass of milk with dinner or because I am thirsty. My baby son, well that is a different story. he will gulp it down out of the bottle stood in front of the open fridge!

Secondly, a whole Mars bar! We are not talking about a mini snack size either, we are talking the whole 50g bar, at 9.30am.

I like chocolate but am not a person who will eat a chocolate bar because I find the feeling of just chocolate in my mouth a horrible feeling and texture. So don't ever buy me a bar of chocolate or Easter egg as it will last forever and bug those around me because it is sitting there and torturing them!

I do however, like Twix and things that are a little bit of chocolate, but nowadays, I seem to manage a snack size bar and don't need a large one, plus I would rather have a jelly candy instead.

So, eating this bar was going to be a struggle. But apparently that was the point, to feed my gallbladder a whole heap of fat all in one go (full fat milk as well) and see how it coped. It was amusing having this nice gentleman stand beside me feeding me a bite of chocolate bar and then offering me the straw to drink milk through.

A HIDA scan is apparently a hepatobiliary iminodiacetic acid scan, where a radioactive tracer is injected and then you overload the digestive system with fat, and it evaluates the function of the liver, gallbladder and bile ducts by tracking the flow of bile.

Let's see what these results show, if anything, but not holding out much hope!

Procedure Day

 And just like that, 5 days passed by without incident and here we are.

Well, I have just gone through 24 hours of bowel prep and no eating, well clear liquid only so feeling a little drained but let's get this show moving.

And the immediate results when I came round......?

You guessed it, absolutely nothing!

Although he did mention one more test to me and at this point, I am open to anything, so a nuclear medical scan of my gallbladder is now planned, despite the ultrasound showing no gallstones or enlargement of the gallbladder.

Fingers crossed.

Dinner in Hospital

 With being nil by mouth for a while and then clear oral fluids and eventually allowed a soft diet, then I was excited to see what I would be getting for dinner, when they allowed me to eat.

Soup, jelly & ice cream and custard would never have been top of my list! 

It was pleasant enough but did lead to me feeling nauseous and not happy, but no pain.

Here We Go Again

 Unfortunately, on Monday, I ended up back in emergency. This time I was at work, pain hit really bad and they ended up calling an ambulance to work! Let's not talk about the way this was managed in an office of nurses 😀 to say it was comical would be an understatement, but I can definitely see the funny side of it.

This time, the doctor took things seriously and decided that maybe some more investigation was required, so referred me to all sorts of people. This led to x-rays, CT scans, blood tests (again) and so many people poking and prodding me.

The results

Absolutely nothing! Everything came back normal.

However, they did admit me and kept me in for 2 days and keep me nil by mouth for 12 hours and then clear oral fluids only for the next 24 hours, which led to only being able to have ice blocks. Which when you can have nothing else, actually taste really yummy.

The end result was that because I have my double scope procedure happening next week then they decided not to book anything in hospital, it would take too long, and to let me go home with pain relief and to wait the 5 days for my private procedures.

Private Consult

 Today I had my consult, and he has no answers!

So, a multitude of tests to be completed starting with a double procedure of gastroscopy and colonoscopy. A 2 for 1 view of my digestive track from top to bottom in 11 days' time.

The worst part of it all.... the bowel prep I have to take in the 24-36 hours beforehand! That part I am not looking forward to at all.

Oh well, if we can establish what is causing the pain, although not had any more since the last time at the end of May (2 weeks ago) so feel a little bit of a fraud really, then I will be happy.

Hospital Again

Yesterday I got hit with pain again. No explanation, just as sudden an onset as last time and no way of managing it at home.

I have been to my GP and have a referral to a private specialist to rule out some conditions, but I am now sat waiting for an appointment, although I always ask to be placed on the cancellation list, as I can usually drop everything to get to an appointment within 24 hours' notice.

With no idea on how to manage this pain, and obviously not having access to IV drugs at home, I did the next best thing...I called an ambulance.

Scared the crap out of youngest son who was away at a friend's house, as we have a doorbell camera and his phone gained a notification at 7pm that someone was on the driveway and he checked to see what we were doing, only to see an ambulance pulling up. He was quite concerned when he called to ask what was happening. Poor thing, he cares really, just doesn't like to show it too often. Bless him.

Anyway, their decision was that I needed to be checked out, again and to have some of their IV pain relief. So, back up to the hospital emergency department, a quick consult with the doctor, a silly nursing decision by me, that if I had some strong pain relief to have at home then I wouldn't need to bother them by visiting the hospital as I could manage this all myself at home, so happy to go home. She agreed and 3 hours later, home I went.

Definitely a bad nursing call but nurses are the worst patients, we know too much, self-diagnose and generally would talk our way out of any situation where we think we know better! It is also a long weekend here so nothing much is going to happen if I did stay in hospital, plus I have a private appointment in 2 weeks' time, so fingers crossed we start getting some tests.

So, I never really gave them the option of anything other than a script for some strong stuff and going home.

Mother's Day

 Today was Mother's Day in New Zealand.

With one son living away from home now and one living at home but always working on a Sunday then this is a quiet day.

However, for me, this weekend has not been pleasant. I started the day yesterday with some upper gastric pain, for no reason. It settled but was a niggle throughout the whole day. It didn't stop me sleeping last night, but food has not been my best friend at all. Leads to increase in the pain. Not uncomfortable to eat, just the colicky pain that I sustain afterwards.

Never had any issue with my gallbladder but pain is also not in the area that I would say is gallbladder related. Well, that is my clinical nursing diagnosis.

After considering all options, all theories and all ideas on how to settle this and not have to suffer any more, I went to the hospital. For some reason, no one else was there (totally unheard of in this current health crisis) and I was seen quite quickly.

A consult with a doctor, some strong IV morphine and I was sailing nicely on a sea of drugs. He diagnosed a form of gastric reflux and gave me relevant medication to assist. Whilst I was sort of happy with this diagnosis, it didn't explain some of my other symptoms but let's wait and see what happens.

Never had IV morphine before but definitely know the nursing care to be applied. Once the nurse had administered it to me, I checked my watch, Steve asked what I was doing and I explained that I needed to know what the time was, as I was pretty certain the nurse who had just given my IV meds was not coming back to check on me within the next 15 minutes!

She had completed no assessments on me prior to administering the med, so had no baseline to measure from and was going, I think, purely from the assessments completed nearly 90 mins beforehand! She did not set me up on the monitor and could have easily attached a BP cuff and a pulse ox to my finger. As I couldn't say if I had ever had this drug before, she needed to check on me within 5 mins to ensure no major reaction or breathing difficulty. She did none of this and in fact, I don't think I ever saw her again during my time in Emergency.

I survived and came home about an hour later, with instructions to follow up with my own family doctor if symptoms persisted.