Saturday, December 27, 2014

When In Doubt, Trust God. (Health Update)

To say that these past few weeks have been crazy, would be an understatement. 

Considering my history, this isn't the worst thing I have gone through.. but it's been a really physically and mentally exhausting week or so.

This "episode" started about a week and a half ago. I had been up the entire night with my usual abdominal pain and unbearable nausea.. but I just knew that something wasn't right. At around 7am, I decided to go to the ER. I was too sick to make it up to Newton (it's about an hour away and all of my doctors and specialists are up there).. so I just went to the local hospital.

They were able to get my pain and nausea under control, but my liver function tests were through the roof. I've had problems with high and abnormal liver function tests (since I had my gallbladder out) but they always went back to normal. Normal liver function tests should be under 50.. mine were in the 250's. They did an ultrasound of my bile duct and it came back normal... so they sent me home and had me follow up with my PCP and Dr. Levitzky (my gastroenterologist).

I was able to get in to see my PCP the next week (this past Monday) and he sent me right back to the ER, because I was still in so much pain and I needed more extensive tests done. Thankfully, I was already at the Newton-Wellesley hospital, so I didn't have to drive anymore or travel. They set me up with my pain/anti-nausea meds but nothing was touching my pain. My entire right side was stinging with pain and every time I moved, the pain skyrocketed. They took blood right away to check my liver function tests, but they came back normal. Part of me was relieved, but I was not surprised.. because they have fluctuated over the years. I was still in so much pain, but so tired and about to fall asleep when I was surprised by Dr. Levitzky. He out of nowhere showed up in the ER to see me. He was supposed to have the week off but came out of his way to see me in the ER. He wanted to check on me and told me that it was time to go through with the bile duct surgery that we have discussed for the past year or so. He was concerned about my liver tests in the past, but he's a pretty conservative doctor.. so he always wanted to wait on the surgery until we absolutely had to do it. He has the ER doctor give me a GI cocktail and another liquid medication that he prescribes me for abdominal pain just to try all of my options. Nothing worked. I was in agony. I was so blown away that Dr. Levitzky came to see me. Every time I have been in the hospital, he has gone out of his way to check on me.. he never fails to show what a great doctor and guy he is. I was so thankful and it made me feel better that he knew what was going on, when it was going on. He could see how sick I was and how I just couldn't take it anymore.

They finally decided to admit me and keep me for observation and pain control. It was about midnight before they got me up to a room. The care teams there are so amazing. I've never had a bad or rude doctor, nurse, or even CNA at that hospital. I always know that I am in good hands. 

I didn't sleep the first night I was in the hospital. At the crack of dawn, they came to draw blood. Bam. My liver function tests were in the 250's again. The hospitalist that admitted me came up to see me and let me know that one of Dr. Levitzky's colleagues from gastroenterology would be up to see me at some point in the day to evaluate me. 

Thank goodness it was Dr. Bailen who came to see me. Dr. Levitzky works with quite a few different gastroenterologists and Dr. Bailen has helped me before when he has been the doctor on call. He made the call to put me on a new medication that controls intestinal and abdominal muscle spasms and scheduled me for my surgery with Dr. Levitzky this next week. He also ordered an MRCP, which is an MRI.. but specifically for the digestive organs, bile duct and pancreas.

My pain level was finally coming down and they got me comfortable enough to go be transported downstairs for my MRI. I have a really tough time laying on my back.. my abdomen goes crazy when I am on my back, so it was tough getting through the MRI, but I did. It was kind of sad that I've had so many MRI's and the tech remembered who I was. But he was super sweet as always.

If there was one thing under control, it was my nausea. IV Zofran works WONDERS and that combined with my Reglan (for gastroparesis) almost always knocks the nausea. They kept me for another night, which upset me because I really didn't want to be in the hospital on Christmas Eve. I wanted to finish out the Christmas season at work and then spend the evening at church and then with my family.

I woke up on Christmas Eve and they came to draw more blood. The hospitalist that had been working on my case then came into see me. She shared my MRI results. The good news was that there were no visible stones in my bile duct, but it is completely narrowing and almost closed off at the bottom. It's likely a result of getting my gallbladder out almost two years ago. It's what was likely causing my liver function tests to be abnormal. So it was definitely a right call getting me set up for surgery.

At that point (late Christmas Eve evening) I was able to tolerate clear liquids and oral pain meds. It was time to go home until my surgery. (hopefully)

Surgery is scheduled for this Monday. I requested my pain management doctor (Dr. B) to be my anesthesiologist for the procedure. I'm praying that I get her. She is so sweet and has helped me a lot since I've been seeing her. It would make me feel so much more comfortable knowing that I have my actual pain doctor doing my anesthesia while my gastroenterologist does the surgery.

The surgery will consist of widening my bile duct, removing any stones that may be in there and cutting out a few muscles that are closing it up at the bottom and spazzing and causing severe pain. They may or may not keep me overnight, the doctor said that it depends on how the surgery goes. I was told that my surgery is risky in my case, because I have a lot of scarring from getting my gallbladder out and because I am young. They are also keeping a close eye on me, because I go into very high SVT (heart rate in the 150-200's) every time I am under anesthesia. The operation has about a 50/50 chance of giving me ultimate relief from pain and I have a 30% chance of developing pancreatitis. I am praying HARD that this is the answer to a problem that I've had for a while. I trust God. I trust my doctors. I trust this hospital and I am just staying positive about this.

I was discharged late Christmas Eve and was SO happy to be home for Christmas. I know how so many people ARE in the hospital for Christmas and it just breaks my heart. I wish that there was no sickness in this world and people could be pain-free and home with their families always.

It's been really tough to stay out of the hospital these past few days. While I have medications to manage my pain and nausea, they don't always work. I'm trying so hard to hang in there and be a trooper until Monday. I keep thinking "I can do this" and "God's got me" .. 

I just want to say that I feel SO blessed to have so many caring people around me. I had sweet friends who came to visit me at the hospital, sent me flowers, gifts and cards and who prayed for me and were there to encouraged me. I have been at one of my lowest points these past few weeks, but am beyond thankful for the people who have been there to lift me up.

I don't understand a lot of things and I don't understand why things like this happen.. but I do believe that God will use this for a greater good. I know He is watching over me. I refuse to give up on my faith, because it has gotten me through so much over the past few years.

I want to encourage everyone to keep their faith always. I want to encourage everyone to never give up. I want to encourage everyone to keep going.. even when you feel like you can't go on. One day this will all make sense, I truly believe that.

It's hard to be my upbeat, positive and silly self right now.. but I have to trust that God will get me through this. There's nothing else to it. 

Thank you everyone for the prayers, the thoughts, the love and the support. I feel so thankful not only for the sweet people in my life.. but for the AMAZING medicine that the city of Boston has to offer. I would be nowhere without my hard-working doctors. I must keep a thankful heart, even when I feel like giving up.

"In the middle of my little mess, I forget how big I'm blessed."

As far as my gastroparesis goes, that's a whole other ballgame. I'm sill struggling a lot, but my medications and diet (soft foods and liquids) have been helping me. The main focus right now is this surgery and getting my severe abdominal pain under control. It's tough, because I have so many GI issues going on, and it's tough to focus on them all at the same time. My IBS and gastritis have been under control (Thaaaaaaanks medications!).. so I am thankful for that.

Like I said, one day this will all make sense. It is my prayer that these trials help me become a better doctor one day. I can't wait until the day when I can take care of my patients the way that my doctors have been able to take care of me. I can't wait for the day when I can relate to my patients and give my ALL into being the best doctor that I can be.

Again, thank you everyone for the support. God bless each and every one of you.

Blessings,

Emily


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