Thursday, February 25, 2010

Day 5 snag

In the transition to regular food and non-intravenous painkillers we've run into what I would have thought was an easily foreseeable problem of extreme constipation. Also showing up is that little nagging infection or whatever has been causing my sweats, chills and tremors every so often throughout the week.

Anyway it's been a thoroughly bad day and I'm spending another night. I am sick and tired of being sick and in pain and I am 100% old-man-grumpy about it.

02:00 in the morning Update:
To leave out a long explanation, the essential points are my bowels have been blasted back into operation, although leaving them painfully irritated. I'm again using the I.V. pain killers, but I suspect it's mostly for the convenience of the nurses as it is very strong, effective, and quickly shuts up the grumpy old bastard.

I've sorted out all that has happened and the most reasonable explanations of why (too long to post right now), and I'm fairly satisfied that I can be discharged today (It's now Friday). I'm sure the doctors will agree in the morning.

Day 5 morning Dr. Visit

Things are looking good, will be progressing to more solid food throughout today. I will need to switch to an oral pain med before being discharged. We also agreed seeing a bowel movement without complications or setbacks would be a good thing. I could possibly be discharged tonight, but more than likely tomorrow morning. All lab tests are looking fine.

No BM yet, but a successful flatulence event (and no I'm not broken hearted).

Hospital Day 5 morning

Breakfast from the cafeteria kitchens today: Herbal Lemon Tea (no thank you), Hot Broth (mix it yourself from a little packet), "Jello, Red", "Jello, Yellow", Cranberry juice cocktail cup (saving for later).

Eating is causing the bowels to try and move, but what's in there hasn't moved since Sunday and doesn't want to. Cramping pain and gas with some belching for relief. Finally got my pain med I rang for an hour ago.

The Pancreatitis pain is gone, replaced the a pain throughout the bowels. I had this sort of pain before and my internet diagnosis was "Irritable Bowel Syndrome". Not to be mixed up with Inflammatory Bowel Disease. In the few times I've had it over the last5 years I found the best treatment was mild diet, rest, and Pepto-Bismol.

The Nurse says the "Lipase" levels are back to normal. This is the primary blood test indicator of Pancreatitis.


Since the clear liquid diet is out of the nurse's station I don't have to stick to meal times. I just "Raided the Refrigerator at Midnight" by asking for some jello while my nurse was giving me a scheduled injection.

If you've never been hungry and just finished a large meal, even the most amazingly prepared dish from the world's best chef won't make any real impression. But be actually hungry, days without food, the simplest cracker becomes a taste sensation worthy of a critic's review.

Yes, the Orange flavored sugar-free Smart-Gels by "Kozy Shack" was awesome!

Wednesday, February 24, 2010

Our Daily Bread

Dinner was a styrofoam cup of thin broth. It had a slight taste of chicken and a pinch of salt and pepper. The pepper sank to the bottom. I assume it was mixed at the nurse's station because Adventist Medical Center is vegetarian cafeteria. This wonderful dinner was, surprise, followed by a dessert. A tablespoon of mint flavored malloxx.

The Joke? . . . The Punchline? . . . None here.

It really did taste good, I was grateful for it, and so far it's stayed down pain free, and for that I give my honest thanks to God.

Oh, and my I.V. is now water AND sugar not just water.

Hospital Day 4 dinner

Just had an exam and consult with a Doctor (third one so far, but I'm working with what they're calling "hospitalists"). A good chat, still no definite cause discovered but a lot of cases of pancreatitis go that way.

The good news is he thinks it's time to start a liquid diet tonight and if it doesn't increase the pain then we're on our way. Being discharged tomorrow is a narrow outside chance, more likely Friday or Saturday.

Had my usual visit from my mother-in-law and then both Sue and Barb showed up. We had a good chat for a few hours.

Hospital Day 4 noon

Still have some pain, but also some bloating and pain from the stomach acid and reflux. With the acid crawling into my throat and I'm not allowed to eat anything and only allowed to suck on ice. I'm having to deal with dual compounded problems.

Anyway in the overall view I'm slightly better than yesterday. Took a shower this morning. With the plastic sweat inducing bed I was getting a little greasy and grimy. Then took a stroll around the ward pushing the IV stand. I have a Student Nurse also this morning. A gal named Liz from Walla Walla University.

The drugs make it difficult to concentrate, so I've done very little reading. Mostly napping and staring into space. The IV's and the Pancreatitis keep me from being hungry

... more vital signs back moment

Hospital 5

Woke up at 2:00am here pretty much soaking in sweat. The cause is the plastic covered mattress and pillows. I'm trying to pad here and there with towels and blankets.

Sat up for a bit. In the hallway they had the sound system playing some very mellow harp music. It wasn't on the room speakers so I got up and went to the hall . . . No . . . it actually is a harp being played by one of the staff.

While I was up I waved to my nurse and got another pain medication shot. For some reason the pain med shot is always followed by a kind of cramping pain

Tuesday, February 23, 2010

Hospital 4

I've had plenty of visitors so don't feel bad if you haven't made it. Sunday, my mother-in-law, Patricia got to the emergency room about 9:00pm and stayed til about 1:00am. After that my memory is fuzzy. Monday Joe and Lynette, Patricia, Sue?, and Nancy. Nancy stayed the night on a pull out chair. Today (Tues) Patricia, Joe, Nancy, and then Sue. Since my remedy is just rest and things are beginning to improve somewhat, we decided it wasn't necessary to stay the night.

Joe and Lynnette drove my car back to the house Monday.

Sunday was bad for pain and I hardly slept at all. Monday was a bad day since I had not just the pancreatic pain, but then the ulcer acid reflex. I managed some naps. Tuesday was much better. The pain has decreased slightly the acid tummy is mostly under control. I've even gotten out of the room. Pushing an IV stand and going up and down the ward past the nurses stations.

Hospital 3

Almost all AMC rooms are private rooms with their own bathrooms. The bed is a funny thing. It has an air mattress with various different areas. It automatically adjusts to relieve pressure points and prevent bed sores. Although ever time you move and settle in to another position it fires up its compressor moters, which can be annoying every 10 minutes at night.

The nurse call button is also a funny thing. According to Pat it connects you with an operator in the basement who then contacts the appropriate person at the nurses station. Sometimes when I push the button it's a good 5-7 minutes before the operator responds and then there's time for all the rest of it.

Monday morning the doc reviewed the ultrasound. It showed the kidneys and gall bladder to be fine with no stones in the bladder, but where the gall duct meets up with pancreatic duct and flows to the intestine was not showed, so he scheduled a CT-scan. For contrast I had to drink a big-gulp sized contrast medium. It actually was ok, like lemonade, no grit, and after not having the slightest sip of water went down very good. Although the CT looks like an MRI, it's very quiet and was very fast.

However once the contrast emptied from my tummy, my past history of stomach ulcers led to having some acid reflux which got bad enough to make me So I request some

IV fluids with potassium (which showed low in some blood test)
Dilaudid, this is the pain killer stronger than morphine they say.. 2mg twice a day.
Protonix, an acid reducer, once a day.
Phenergan, an anti-nausea, if needed

Monday's CT-SCAN Results;
No gall stones anywhere. The pancreas is enlarged but shows no signs of damage (calcifications, absesses, etc.). Without a definitive cause the only remedy plan is to rest the pancreas by not working it, that is not feeding it, not triggering it's secretions. That meant no food, no water, not even a sip. That was changed Tuesday afternoon to allow ice.

Hospital 2

After being in the Emergency room for a little while I called my mother law Pat Turner. They took blood and did a urinalysis. The blood showed an increase in liponase indicating Pancreatitus. I had an ultrasound done looking over the gal bladders, kidneys and other things. It didn't show any gall stones.

I was moved up to the wade about 1:30am.

I keep nodding off. More later

Monday, February 22, 2010

Hospital stay

After getting up today (Tuesday), having a pain med shot, and then walking around the nurses stations and local corridor, I'm actually feeling good enough to blog.

Where to begin.

Saturday I had been feeling bloated and a little constipated, so I took a Ducolax pill. Ducolax is a very mild drug. Sunday morning I had a regular BM and was feeling fine.

Sunday morning I took Beth to the airport. She's going to a Rep' Rally at the APQS, and will be their til Thursday afternoon. I had the usual microwave burritoes for lunch ( I know what you're thinking), and felt fine after lunch.

Dinner time, around 6:30, I had some leftovers, some hamburger-noodle-cream cheese casserole that we make every now and then. I had made it Saturday night so it probably was not food poisoning.

About 7:30pm it hit me fairly sudden. Feeling just like an intestinal gas bubble. The pain was getting worse to the point of doubling over and moaning loudly over and over again. But the gas bubble didn't want to move. The pain area all across the front just below the stomach, but above the belly button. By 8:00pm the pain was really bad and showed no signs of lessening. I through some shoes on and drove to the hospital emergency room. Yeah I'm one of those people who figures it'll be faster to not call 911 and just drive.

(the pain med's have reached their peak effectiveness and I'm having trouble keeping my eyes open. . . more in a bit)

Thursday, February 4, 2010

The "Harry Potter" Bottle Puzzle.

In the first "Harry Potter" book there is a logic puzzle toward the end of the book. They are trying to get safely through a door in front of them (Forward) or they can give up and go Backwards through the door behind them. The doors are closed by fire until they choose and drink from one of the 7 bottles in a line on a table in front of them. Also on the table is a parchment with the following written statements:
Danger lies before you, while safety lies behind,
Two of us will help you, whichever you would find,
One among us seven will let you move ahead,
Another will transport the drinker back instead,
Two among our number hold only nettle wine,
Three of us are killers, waiting hidden in line.
Choose, unless you wish to stay here forevermore,
To help you in your choice, we give you these clues four:
First, however slyly the poison tries to hide
You will always find some on nettle wine’s left side;
Second, different are those who stand at either end,
But if you would move onward, neither is your friend;
Third, as you see clearly, all are different size,
Neither dwarf nor giant holds death in their insides;
Fourth, the second left and the second on the right
Are twins once you taste them, though different at first sight.
So one bottle is forward F, one is backwards B, two are nettle wine W, and three are Poison P. They are all different sizes and the sight of the liquid doesn't mean they're different.

I start with the fourth clue that positions 2 and 6 are the same. Forward and Backward have no twins so 2 and 6 must be either Wine or Poison. If wine then 1 and 5 are Poison by the first clue that to the left of Wine will always be Poison. This yields two possibilities.

Possibility "A" : P W # # P W #
Possibility "B" : # P # # # P #

Next, further develop possibility "A". By the second clue the two ends are different and neither is Forward, therefore position 7 is not Poison like position 1, and is not Forward. The only thing left is for position 7 to be is Backwards.

Possibility "A" : P W # # P W B

The two positions left are either Forward and Poison or Poison and Forward, yielding two possibilities.

Possibility "A1" : P W F P P W B
Possibility "A2" : P W P F P W B

Now back to possibility "B". By the second clue neither end is Forward leaving Forward to be in Position 3, 4, or 5.

Possibility "B1" : # P F # # P #
Possibility "B2" : # P # F # P #
Possibility "B3" : # P # # F P #

Now we fill in the remaining three positions of each possibility. The first clue says that Wine will always have a Poison to it's left. Position 1 has no left, therefore it cannot be a Wine. I start with finding which two of the three remaining positions are Wine.

Possibility "B1", Wine can't be in position 4 since that requires 3 to not be Forward. The two Wines fill positions 5 and 7. Position 4 must be a Poison to the left of Wine, leaving position 1 to be Backward.

Possibility "B1" : B P F P W P W

Possibility "B2", Wine can't be in position 5 since that requires 4 to not be Forward. The two Wines fill positions 3 and 7. Positions 1 and 5 can be either Backward or Poison, yielding two more possibilities.

Possibility "B2a" : B P W F P P W
Possibility "B2b" : P P W F B P W

Possibility "B3", Wine can't be in both position 3 and 4 because that would require 3 to be Poison (to the left of 4). If position 1 can't be Wine and only one Wine can fit in 3 and 4, then position 7 is the only place where the second Wine can fit. The first Wine can be in either 3 or 4, yielding two further possibilities.

Possibility "B3a" : # P # W F P W
Possibility "B3b" : # P W # F P W

Further developing possibility "B3a", the first Wine must have a Poison to the left, leaving position 1 to be Backwards.

Possibility "B3a" : B P P W F P W

Further developing possibility "B3b", positions 1 and 3 are either Backwards and Poison or Poison and Backwards respectively, yielding two further possibilities.

Possibility "B3b1" : B P W P F P W
Possibility "B3b2" : P P W B F P W

This ends us with eight possibilities. Which position/bottle is the smallest and which is the largest (neither dwarf nor giant) is not stated in the book (though the characters could obviously see this). I don't believe it can be further reduced without knowing which positions are the Smallest and Largest bottles.

Possibility "A1" : P W F P P W B
Possibility "A2" : P W P F P W B
Possibility "B1" : B P F P W P W
Possibility "B2a" : B P W F P P W
Possibility "B2b" : P P W F B P W
Possibility "B3a" : B P P W F P W
Possibility "B3b1" : B P W P F P W
Possibility "B3b2" : P P W B F P W

The question now comes: "Can the puzzle be solved if we knew the missing information that the characters of the book would have had?"

It is revealed in the book that the Smallest bottle turns out to be the way Forward, and that the bottle in position 7 is Backward. The reveal that 7 is Backward indicates it is an "A" possibility. However, these are reveals and not clues or data known to the characters.

Neither dwarf nor giant holds death. It doesn't seem to matter which is which, so here goes.

Either the Smallest or Largest (s/l) is in one of the seven positions and the other is in one of the remaining six positions. This yields 42 possibilities of where they are. If s/l is in position 2 or 6 then the other s/l cannot be in 1 or 5. If s/l is in either 1 or 5 then the other cannot be in 1 or 6. This eliminates 8 possibilities leaving 34 variations.

If either 2 or 6 are either Smallest or Largest (s/l) then it must be a Possibility "A", and if either 3 or 4 is s/l then the puzzle is solved. So if the book situation is any of these 4 variations then we and the characters could solve the puzzle and the solution would be either A1 or A2.

Do any of the other 30 variations of s/l positions solve the puzzle?

If s/l are in both positions 1 and 7 then the puzzle can NOT be solved. If s/l are in both positions 2 and 6 then the puzzle can NOT be solved. This eliminates four more variations since the characters DO solve the puzzle.

Do any of the other 26 variations of s/l positions solve the puzzle?

I'll leave it at that for now since my brain is going dead.