Wednesday, February 13th
We met Kelly in Vail for lunch. After that, we went to the PO across the street to send a money order for some item for the Cobra project. Then I took Trout to Kelly's shop to work on whatever was the work of the day. Kelly showed us the great cabinet doors he was doing for the upcoming ASID show. Trout hit the can. It seemed like a typical day in Tucson.
I was rearranging stuff in the Highlander so I could get on with my afternoon errands. Then I got a call from Trout. He was still in the can and had had a big bloody blow out. He sounded scared. Having some experience with these things, I went in to see the situation. It was bad and it was a mess. While he cleaned up and prayed for it to stop (it did), I contacted our medical people and they said to get him to the emergency room.
We took off in the car, protecting the passenger seat with towels and a blanket and knowing that we'd pass several fire stations with EMTs enroute. It's at least 45 minutes from Vail to any emergency medical facility. We got to the UMC ER fine, Trout checked in and we waited about 2 hours before they got him into a room. I've always heard that what gets their attention is vomiting or bleeding. He wasn't actively bleeding at the time, so he didn't get to go in right away.
The first incident occurred at about 3:30 pm. He was in a room by about 6. The initial prognosis was diverticulosis and there was some talk of letting him go home. We decided I would run home and get him some clean clothes to wear for the trip. I took his bloody clothes with me. That was about 7:30 pm. I got back at about 9 to find him with a cut above his right eyebrow and drying blood sort of all over him. As it turned out, he had 2-3 more incidents depending on how you count and had passed out. We think he actually was cut by the edge of his glasses when his head hit the floor.
Do you think the hospital staff was a little concerned about him being left alone and falling? Yeah...they have to report falls to higher authorities so it was a very big deal. The room he was in had a solid door with no window. He was in too big of a hurry to get on the commode to call anyone for help. After he gained consciousness, he managed to pull himself up on the edge of the bed and punch the call button. He had passed out because he lost so much blood. His BP went down to 80 over 40. This is for a man who has to control his HBP with drugs and even then it's usually at least 140 over 90.
They wouldn't let him get out of bed because his BP was so low and they set up to give him a transfusion. Things seemed to take an awfully long time to do. By 10, I was starving. The UMC cafeteria stays open until midnight, so I went down for a sandwich and to call all the kids and his brother about what was going on. It took me until about 11 to get that accomplished.
I went back to the room to find two docs from the ICU in the room with him. Since he was pretty stable, he was going to be moved to ICU during the night. His BP came up so well with one sack of blood, they decided not to hang another one. I gave up about midnight and went home to go to bed. There was nothing I could do, and get this, we had visitors, Neil and Patty, coming in from WA the next morning before noon!
Thursday, February 14th
I talked to him in the morning and during the night, they had done lots of tests, reminicent of House. These weren't bad ones involving needles, knives or drills though. They were mostly MRIs. He thinks they were more concerned about a potential concussion than the bleeding. He didn't hurt anywhere except the cut over his eyebrow. That was mostly because they deadened it, then took so long to come back and sew it up that they had to deaden it again.
And of course there was the pain when they indadvertently ripped out one of his IVs (he had 2) when transferring him from the MRI table back to his bed. Oh, yeah, and then there was the pain of them trying to get another IV into his semi-collapsed veins. Usually they're like the Alaska pipeline, but not at that time. He later said he developed a lot of sympathy for what I sometimes have to go through.
We decided over the phone that I wouldn't come until Neil and Patty got here and I would bring them along. So by the time we got there, he was stable enough that they had moved him to a regular room and we got to see him there. I never even got to see him in the ICU. He had been cleaned up significantly and he had on red booties.
Anyone who has had a hospital stay knows that they put booties with a non slip bottom on you to keep your feet warm and make it safer for you to walk if you get out of bed. It turns out that the red booties have more non-slip stuff on them and also serve to alert the staff that you're a faller. There were also signs up that he could see telling him not to get out of bed without calling for help. Yeah, they were concerned all right.
As always, he was in good spirits. If you've kept up with the timeline, you know this was Valentine's Day. We had all planned to go someplace for dinner, but I cancelled the reservations and ended up taking Neil and Patty to El Charro. It wasn't very romantic but the food was good. While we were doing that, poor Trout was doing the prep for a colonoscopy. There wasn't much in there by now, but he did push through a lot of coagulated blood.
Friday, February 15th
Neil and Patty decided to go to the Gem and Mineral Show. They also had an engagement for dinner that night. They invited me to go, but I decided to stay with Trout. The GI docs did the colonoscopy Friday afternoon. What did they find? Nothing. No diverticula. No obvious place for the bleeding. Nada. Trout agreed for them to go ahead and do an endoscopy to check the upper GI tract, but he couldn't officially sign the consent form because he was sedated. So I signed it. If you don't have a Medical Power of Attorney for your spouse or partner, I advise to do one now! Anyway, you guessed it, there was nothing obvious in the upper GI tract either.
So what can we do these days if we have to see what's in the small intestine? The pill camera. I had to sign for that, too. We had to wait until he was awake enough to swallow the thing. He said it went down really easily. He had to wear an apparatus strapped around his stomach that downloaded the data during the night. He was able to take it off when the lights indicated that it was done the next morning.
Saturday, February 16th
This was a dithering day on the part of UMC. They fluctuated back and forth between saying he needed to stay until someone read the results from the pill cam Monday or Tuesday to saying he could leave to saying he couldn't even have liquids by mouth to saying he could eat some real solid food. You get the picture. While we were there visiting (we joined the other 3 people who were visiting him), they decided to release him, so he did get to come home late Saturday afternoon.
That was cool because our next door neighbor was having his 60th birthday party and we thought Trout wouldn't be able to come. We were able to bring Trout to Tony as a present. Trout took it easy on the eating had fun playing a little music with Tony and the kids and we bagged it pretty early. Neil and Patty were there, of course, as were some local friends, Don and Patsy, who had made a few trips to see Trout in the hospital. I believe the quote from one of our kids, Dory, who called that night while he was at Tony's was, "That's some rockin' hospital!"
The rest of the holiday weekend was spent with Neil and Patty and Trout did fine. He was very careful with his eating. Here's a picture of us in front of one of our favorite haunts, Todd's at Ryan Field.
And here we are in our living room at home with Guido.
And here's Trout at home with his shiner healing quite nicely. It actually didn't show up until Friday, but I didn't have my camera at the hospital.
He got the stitches out on Thursday, February 21st, and he has quite the character indicating scar there now.
We worried about the pill cam results and were told that if it was bad, we would've heard right away. I'm cynical about that, but he did get in to see his GI doc at UMC on Thursday, February 28th and ... and ... they found nothing! Well, almost nothing. There was an area in the upper small intestine that was "blood stained." This leads the doc to think the bleed was higher than that. The huge volume of blood lost indicates it was arterial rather than veinous.
His marching orders are to get to an ER right away if it happens again. He's supposed to tell them about this incident and that it is not diverticulosis but rather higher in his GI tract. He's also supposed to tell them that he needs to have an endoscopy or swallow another pill cam or both within 24 hours of the bleed so the source of the bleeding will be more likely to be seen. The doc thinks he just healed up too quickly for them to see what really happened.
So if he's with any of you reading this, and he's unable to tell the ER folks or the EMTs about all this, please be my surrogate and do it for him. They can always call me for more formal permissions. He did tell me later that he'd had two other times where he felt he was in life-threatening situations, but this was the first time he really thought it was serious. There's just something about seeing big volumes of your blood outside of your body that gets your attention. I welcomed him to my world.
Postscript: He had another scare on March 2nd. His stomach started hurting about bedtime that night and by about 3 am Monday morning, he was puking like crazy. Now Trout never throws up, so it was very scary. A couple of hours later, the diarrhea started. Fortunately, there was no blood out any orifice this time. He stayed in bed all day Monday the 3rd and was on the mend by Tuesday. We think it was food poisoning or a gut bug of some kind. I'm voting for the former because he had no fever and I didn't get it. Unfortunately, he had plane reservations on Tuesday to go to WA for an enduro and he was so sick he had to cancel out on that. You all know he had to be very sick to not go to a race.
