Saturday, March 31, 2012

A Story About A Black Cloud

In the world of emergency medical services, there is a phenomenon called a black cloud. An EMT or Paramedic is said to have it when they get a bunch of really bad calls. When they are not around everything is fine. When they show up, the poop hits the fan.
I have been lucky enough to have a white cloud over me thus far. As you can guess, a white cloud is opposite of a black cloud.
That is up until about a month ago. If you have been reading my blogs or following on Facebook, you probably can tell I haven't had the greatest of luck lately when it comes to my health. It may not be EMS related, but the black cloud continued to hover overhead.
Last night I sat down on the couch for 30 minutes or so. I sat with my leg underneath me. When I got up, my knee gave out and I couldn't put any weight on it. "No problem" I thought. It will pass after a minute.
I hobbled around on it all night. This morning I woke up and tried to walk and it was excruciating! "c'mon..., really!?". Luckily I'm already on light duty here at work because of my abdomen, but I am still relegated to hiking the lower trails with my law enforcement pack.
On goes an old knee brace that I had and off I go to work. I am hobbling like a penguin, trying to curtail some of the pain. I cannot take any pain meds because of my surgery in a few days. Ugh...
For those of you that are superstitious, (I'm too cynical to be superstitious) lets hope that bad things come in threes. That would mean its all uphill from here.

Wednesday, March 28, 2012

A Story of Children, Pain, and the Never Ending Cough

After my appendix removal at the beginning of March, I was placed on some antibiotics. During the two weeks following, my family ran through a little cold, each of the boys and Kari were affected. They were all better when I took my last antibiotic pill. As soon as it wore off I could feel my throat swelling and my nose running.
Crap, I thought. Three days of a cold were in the cards. Not a big deal. I've had quite a good deal of colds in the past. Then, on day three of my spat with the germs, I helped work a controlled burn forest fire at the park. I spent all day in the smoke. And the cough began...
For the last 8or9 days, I have had a ferocious cough. Bad enough at night that I have had to sleep in the other room while Kari sleeps in our room with the boys. A sleeping arrangement that we will have to utilize for a while after my surgery next week.
I went to our doc yesterday and she said I was not infected with anything still, but that the cough was just lingering from the irritation. She prescribed some major cough medicine/knock you out at night syrup. It doesn't even touch the cough, and if it indicates it's "knock you outness", it is 10pm and I took it 3 hours ago and I am typing this blog at about 300 miles an hour.
Earlier tonight, when I laid River down in our bed so he could go to sleep I laid down beside him for a minute. He wanted some kisses, then, as he pulled up his covers and made himself comfortable, he reached over and grabbed two of my fingers with his little three year old hand. He whispered "hand", and proceeded to not let go. He laid like that until he started to fall asleep and couldn't keep his grip.
Moments like that are more than special. They are precious and fleeting. We have to enjoy them completely while we have them and keep them tucked away in our memories for when we don't.
I have surgery again next week. I hope to be rid of this cough, and I hope to be rid of the abdominal pain and precancerous cells soon. I hope to be back to normal ASAP! I know there are a lot of people out there much more sick than I am, but only one month in and I am sick of being the sick guy. I can't sleep in bed with my family, I can't throw my kids around or wrestle with them. I'm not supposed to even be picking them up, but I do it anyway. I have been over doing it at home and at work the last week or so in a desperate attempt for some normalcy before next week. The cost has been more pain than I expected. But it is all worth it for moments like tonight with River.

Saturday, March 17, 2012

Out of the Woodwork - A Quaint Story About Irregular Cellular Division

Let me begin this short (long) story by saying that it is not over yet. Only just recently did Kari and I actually have some answers that we were someone satisfied with. And yes, this is a non-fiction story. I have been on and off pain meds while writing this, so I apologize in advance for any jumping around or dry paragraphs. It is hard to be creative while on pain meds!

In the end of February I began having some light abdomen pain. It wasn't in any particular spot, just all around, although it did spend a majority of it's time down the middle of my stomach. At first I suspected gas pain. I saw a doctor a couple of days in, and he said it was food related and to call if it gets any worse. After 5 days or so I was worried it was something else, but I kept it to myself. My Mom happened to be in town during this time.
Now, my mom has never been the nagging type, and neither has Kari, but in this instance I can definitely say it was a good thing. They both pushed me to go see a doctor a second time and get a second opinion. So I did, and I am glad I did. The Urgent Care Doc noticed I was tender when he pressed on my right side. He decided to send me to get a CT Scan that night to see if anything interesting showed up. He told me that if everything was alright they would let me go about my way, but if they found anything they would meet with me.
On to the CT Scan that I was surprised to be getting that night. I sat on the table that moved in and out of the big expensive donut and then it stopped moving. I waited.....and waited, and finally a nurse came in the room. She asked me to wait in a secondary waiting room. There I waited....and waited, and a doctor walked around the corner and said "Mr. Jenkins, I have your doctor on the phone, we would like to have a conversation with you." I walked to his office and the Urgent Care Doc was on speaker phone.
He told me that I had what looked to be a mucocele of the cecum and appendix, and that I needed to have it operated on the next day. After getting off the phone, the Doc I was with tried to explain it more to me. It is an extremely rare disease process in which a growth in the beginning section of the large intestine (where the cecum and appendix is located) fills with a mucus type substance. (The appendix makes a mucus substance, which fills the area behind the growth.) This shows up in something like 0.3% of appendix cases. I've read one in a million chance. I was surprised, but not worried or scared of anything at this point.
The next morning the Urgent Care Doc's Office called and said the surgeon needed to see us in his office something like two hours ago. So Kari and Wren and I rushed to the surgeons office while my Mom took care of River. (She was supposed to have left that day, but decided to stay a couple more days.) The surgeon said he was going to remove my appendix via lapendectomy that day and sent me off to the hospital to get admitted and to receive an IV of some antibiotics before surgery.
Kari's parents ended up taking River to their house and my Mom was able to come to the hospital to hang out and help Kari. Kari rushed out to take care of some last minute things before getting back to the hospital just before a rush of tornado warnings came through the County. The nurse even had to come in and move my bed and the chairs in my room away from the window for most of the afternoon. My surgery was delayed, and then delayed some more as thunderstorm after thunderstorm passed through the area. We had a nice birds eye view from the 5th story of the hospital.

At around 7pm that night they surgeon came and got me from my room. They told us that they couldn't do surgery while there were tornado warnings going on. I politely agreed, as I wouldn't want them to be poking around inside my belly and the power to conveniently go out or the roof to happened to blow off or something. They put me to sleep shortly thereafter, and the next thing I remember is being wheeled back into my hospital room. Our friend Melanie Sams was there with Kari, Wren, and my Mom. I don't remember much, but apparently I said "Hey Mel" about 100 times or something.
Early the next morning the surgeon came to my room to update us on the surgery. He said the surgery went well, and that he was able to remove my appendix. Then he uttered the statement that started our worrying.... "I have never seen anything like this before. It is highly unusual, so I sent it to pathology to see if it is malignant or benign." In a moment, I felt a rush of feeling flow through my veins that I had never expected to feel. I thought, "What? I am 31 years old. I am not supposed to be dealing with any type of cancerous stuff. I am a completely healthy guy, and my family history is spotless. As far as I know, my family is a race of super humans because I have never been told that there were any genetic health concerns to be worried about." As the surgeon left I was in a state of disbelief. Kari showed up with Wren shortly thereafter and I had to pass along the news to her. I could see the worry show up in her eyes at that moment as well.
Later that afternoon they let me go home with some pain pills and a nice pair of grippy bottomed socks. (They are grippy topped to, so I am not sure what that is for, unless you are spiderman.) During my time at home I did a lot of research on mucoceles of the appendix and cecum. They are so rare, that the only thing I could find were scientific papers in which doctors were trying to figure out the best way to remove the growths without spreading the possibly cancerous cells into the abdominal cavity. We waited a few days before going back to the surgeon for a report update. On the way there Kari and I told each other that we hoped it was nothing, but that knowing our luck, something else was going on.
I knew when we got there that something weird was going on, because we were the only people in the waiting room and I could hear the office workers saying "Where is his path report? Have we gotten it yet? I can't find it?". We get in the exam room and the surgeon comes in and reiterates to us how unusual the growth was. He said that he does over 300 appendix removals a year and has never seen anything like this. Then the nurse comes in and hands him a phone. It was the pathology department. They were calling about my path report. It was quite interesting sitting there listening to the doctor have a conversation with someone on the other line about me. The first wave of sickness hit me when he said to the person on the other end of the phone, "I know I didn't get the entire growth, because when I cut through it, I released some of the mucus inside of it." (According to all the research papers I had read, this was mistake numero uno when it came to removing these things. Releasing any of that mucus into the abdominal cavity created an interesting type of cancer in which the mucus keeps multiplying and filling the abdomen. Mistake numero dos was cutting the growth in half, exposing the edge of the growth.)
Once the surgeon got off the phone, he proceeded to tell us that the growth was called a cystadnoma with severe dysplasia. Severe dysplasia, he continued to tell us, was a pre-cancerous type of cell multiplication. There are different levels of dysplasia, and mine was the worst kind. Basically, if there is a line drawn in the sand between not cancerous and cancerous, the growth was sticking it's tip toes over the edge of the line. He said that due to the size of the tools he had available to him at the time, he was unable to remove all of the growth. He said either a cecotomy (removal of cecum) or complete right hemicolectomy (removal of right colon) would be needed to have clear margins and to make sure all of the growth was out of me before it turned cancerous. In order to see how involved my colon was he needed to schedule a colonoscopy.
So, at 31 years old I was preparing to do a colonoscopy. I had to watch a video instructing me on how to prepare, and it started with, "Now that you are 50 years old..." When colonoscopy-eve arrived, I began the prep. It was lovely, and that's all I will say. When I woke up from the procedure I had a horrible headache. The doc sat down and told us that a right hemicolectomy was definitely needed, and that it was probably needed sometime very soon. Prior to this procedure I had already began the process of getting an appointment with a GI surgeon at Vanderbilt Medical Center.

The next day, my headache had grown into a full blown migraine and was causing me to vomit. I took some pain meds left over from my appendectomy and we headed to the specialist at Vandy. Boy, was I glad we were urged to see a specialist. (When my boss first heard about what was happening, he strongly suggested that we see someone who only does colon surgery because any messing around with your colon affects your entire body system. He said that you do not want a general surgeon messing around with surgery in your colon.) We sat down with the specialist, handed him my remaining records and pictures from my colonoscopy, and he calmly described exactly how the next phase of the process would go. When I asked him if he had ever seen anything like this, he said that it was rare, but that yes, he had seen this before. He calmed some of our fears about the previous surgeon releasing mucus into my abdominal cavity by saying that while he was doing surgery, he would check to see if he saw any evidence of remaining mucus. He described my next surgery in detail. He will put me to sleep and then give me an "on the table" colonoscopy. He will get an inside view of the growth, then proceed with a laproscopic surgery using 4 incisions, each one for a special tool and a camera. Once he can figure out how much of my colon is involved he will either do a cecotomy or a full right hemicolectomy. All of this will take place on April 3rd. He was very confident that this will take care of the issue, and that the only follow up I needed was to get a CT scan in one year to make sure there was nothing else growing in my abdomen.
Now, such a long story all leads me to the title of this blog post. People have come out of the woodwork to help in any way from meals, to babysitting, to mowing our lawn, to movies to watch while I am laid up in bed. People that I didn't even think knew who I was have offered the statement "If you guys need anything, just let me know". We have been in so many people's prayers and thoughts that it blows my mind! My only worries are related to the mucus cell release in my abdomen, but in all reality I should be well on the way to recovery by May and this adventure will pass like so many others. But I want all of you to know that your kindness will not be forgotten. I want to say "thank you" to all of you from the deepest part of my heart. I do love all of you.
A photo from earlier in the day that my Mom and Kari pressed me to go get a second opinion and the CT scan found the growth in my cecum. I had been on a hike at work and took a photo of this tree inside the park. It is a landmark for those of us that hike the trails regularly. It is a tree that at some point in it's growing history, it was damaged or got some sort of disease, and instead of dying, the tree has developed a massive growth around the damaged section.