Ileus ~ aka: Another Bump In The Road

So after several really good days, I came in Thursday morning and Parker's abdomen was huge. I mean like a woman pregnant with twins. Or even quadruplets. HUGE! I mentioned to the nurse that it looked distended and she agreed. That's all she said. So I showed it to Dr. Weingarten.

Only thing it could be is gas....

Okay sorry but even I know better than that. Ugh. Dr. Weingarten is supposed to be the Critical Care guy, but there is this line the doctors won't cross because anything to do with Parker's gut is under the surgeons care. I knew it was more than gas.

Dr. Garcia, the surgeon came by. I showed it to him. Yup, he's distended. that was it.

But he's also in so much pain today, I told him. Dr. Garcia answered that by increasing the Dilauded.

Throughout the day Parker's abdomen continued to grow. I sat with him all day and watched that white blanket get bigger and bigger. When Parker asked me to turn the fan off I knew something was much more wrong than just gas. He never wants the fan off.

To make a very long, agonizing story somewhat shorter, we spent a horrible night with Parker screaming in pain. He'd already had so much pain medicine throughout the day he was positively loopy. But he kept begging for more and more and more. Dr. Garcia was called and he added something for gas. Parker had delusions that were terrifying. At one point he was positive he had cut off his own head and left it in the parking lot, and he was pleading with me to go get it for him. I tried to reassure him it was the drugs, but he was in such a panic I had to have Jim come and reassure him too.

Parker, buddy, you didn't cut off your head because if you had I wouldn't be able to talk to you right now, right?

This seemed to make Parker a little calmer, and he finally settled down until the next episode. Like I said, a long, long night. By the time it was over he had emptied everything from his lower intestines ..... several times .... and he had thrown up enough orange, pulpy vomit that smelled like sour orange juice to fill two milk jugs.

He shouldn't have been throwing up because he had the NG tube in suctioning everything from his stomach, remember? Clearly there was something wrong. They FINALLY turned off the tube feedings (the feeding tube goes past his stomach and into his small intestine, so the NG tube doesn't pick it up and suction it out).

We got a CT scan ordered and thank God we had two of the best nurses we have had the entire stay. Simona is from Romania. She was teaching Lisa, who is from Fairfax, VA. Both were exceptional and compassionate and didn't miss a thing. I was so grateful to have them yesterday.

By the time they came on board, Parker's stomach had deflated somewhat from losing all the stuff that had been blocked from going down his intestines properly. But he was still sore, very drugged, very emotional, and afraid. Me too. He also had a fever during the day, and his heart rate started to climb again. Those two things alone are enough to send me into an internal panic. To me they suggest another septic infection brewing. My hands shake just to write that part. I definitely need a shrink.

CT scan showed Parker has a repeat of the ileus he had when he was in South Austin Hospital, when he first had the acute pancreatitis. Before it got as complicated as it is now. Ileus is when portions of the intestines get temporarily paralyzed and lose their mobility, so it is the same as having a blockage. That's what showed up on the CT scan. There are a number of reasons that could have happened. One is that the lasix he has been on all week, which drained 38 lbs. of fluid from his body, reduced his potassium level, which not only caused irregular heart firings, but also temporary ileus. Another reason it could have happened was if there was another cyst growing.

Dr. Garcia said this morning the only thing cyst-like are the two small cysts that were there in the beginning at the tail end of the pancreas, but they are supposedly smaller than they were and "nothing to worry about."

I really, really hope he is right. I am tired of there being evidence of something amiss and the wait-and-see attitude that then leads to another problem. I want Parker to get well. He wants to get well. Parker needs to become more mobile so his gut starts working better and things begin to resolve, but at the same time, the doctors and nurses need to listen to him when he says something is wrong.