Just a hemicolectomy (III)
That Tuesday I was discharged under the same diagnosis, with a mysterious 'controlled' infection and the same decadent health which started two weeks before.
I followed the nutritional recommendations, but I wasn't improving. My adbomen was swollen and the discouragement was growing. I was losing breathing capacity, my voice was disappearing and drowned easily, even when I was speaking, I was walking much less and tried to ove the least I could. I went again to the GP, I told him with dispair about my condition and he ordered an urine and a HIV test.
Next day I had those tests and took them to the GP the next week. By then my condition was serious and my mother and sister-in-law went with me. The tests reveled nothing, so he order an appointment with a gastroenterologist under the diagnosis of Crohn's disease. The appointment was issued for 4 weeks later, on Friday Sept 3rd, 10:40. A cousin recommended a specialist to my mom and we scheduled an appointment.
He ordered many tests, which were completed two weeks later. We brought the result to him. My weight then was 70 k.
On thursday, Aug 26th he told me to be hospitallized and have surgery as soon as possible. He also ordered other tests and X-ray.
After having the tests done and consulting the Doctor and Health Services Provider (which by this point provided to be highly uneffective), we went to the other clinic covered by that provider and was hospitalized.
Then I was in room 234 and was seen by 3 surgeons, a gastreonterologist and a urologist. For a week they did tests to know exactly what was going on with me and discard from HIV up to a maligne tumor on the exterior wall of my bladder.
After a distressing week I went into a exploratory laparotomy, in which they removed a part of small intestine -about 30 cm long-, and another of large intestine -5 to 10 cm- in addition to remove several adherences developed by the appendix perforation after an appendicitis.
After surgery, the wound got infected and its central part had to be unsewed to be washed and cleaned continously. on Wed Sept 8th i was discharged against the opinion of the infections director at the clinic. I was prescribed pain killers and antibiotics to use at home.
There, a friend who is a nurse and my family took care of me until Monday, Sept 13th, when a different fluid was noted from the wound. The chief surgeon was called and we had an appointment that afternoon. Then, he determined I developed an enterocutaneous fistula, so part of the feces were going out through the wound. The wound had to be unsewed entirely to be cleaned and healed by second intention.
That day I was hoispitalized again throught the Emergency Room, in room 114 this time. Since that day oral feeding was suspended and a subclavian catheter was inserted to provide parenteral feeding and medications. New tests started to be performed to evaluate the fistula.
The surgeons scheduled another surgery to perform a colostomy on me. Due to the delicate condition and how weak I was, the clinic priest gave the extreme unction. (Read the other note "Beautiful day")
I was taken to the Operations Room and, being under anesthetia, the wound and fistula were checked. Due to the wound good evolution, they decided to wait for my organism to improve to perform the colostomy, about three months later.
Meanwhile, the fistula would be managed as a colostomy using barriers and colostomy bags on the wound in the closest area to the fistula, and at the same time the rest of the wound would be managed as usual changing the bandage every 3 or 4 days.
Due to a infection on the catheter I had a fever. It was removed and the fever disappeared. After a ffew day, the fever reappeared and I received more antibiotics for several weeks. At this point my weight was 58 k.
I also had two intestinal obstructions, which made surgeons think about another surgery. Fortunately both obstructions were solved naturally.
Some intestinal gases weren't going all the way throught the intestine. They may go through the fistula and get lost in the abdomen looking for an exit causing acute pain. To solve that, a nasogastric probe was used on me twice.
I was discharged again on Fridays Nov 22nd, after a week when my system reaction was tested without antibiotics. Later, the fistula closed by itself at the beginning of December and after that the wound healing process accelerated with less humidity and microorganisms.
As the wound was healing by secong intention I had to go to the clici every 5 days to change the bandage. That finished by late January and the scar was completed by February, about 5 months after surgery.
For six months, I went every two months for checks with the surgeon, who was satisfied about my recovery.
I followed the nutritional recommendations, but I wasn't improving. My adbomen was swollen and the discouragement was growing. I was losing breathing capacity, my voice was disappearing and drowned easily, even when I was speaking, I was walking much less and tried to ove the least I could. I went again to the GP, I told him with dispair about my condition and he ordered an urine and a HIV test.
Next day I had those tests and took them to the GP the next week. By then my condition was serious and my mother and sister-in-law went with me. The tests reveled nothing, so he order an appointment with a gastroenterologist under the diagnosis of Crohn's disease. The appointment was issued for 4 weeks later, on Friday Sept 3rd, 10:40. A cousin recommended a specialist to my mom and we scheduled an appointment.
He ordered many tests, which were completed two weeks later. We brought the result to him. My weight then was 70 k.
On thursday, Aug 26th he told me to be hospitallized and have surgery as soon as possible. He also ordered other tests and X-ray.
After having the tests done and consulting the Doctor and Health Services Provider (which by this point provided to be highly uneffective), we went to the other clinic covered by that provider and was hospitalized.
Then I was in room 234 and was seen by 3 surgeons, a gastreonterologist and a urologist. For a week they did tests to know exactly what was going on with me and discard from HIV up to a maligne tumor on the exterior wall of my bladder.
After a distressing week I went into a exploratory laparotomy, in which they removed a part of small intestine -about 30 cm long-, and another of large intestine -5 to 10 cm- in addition to remove several adherences developed by the appendix perforation after an appendicitis.
After surgery, the wound got infected and its central part had to be unsewed to be washed and cleaned continously. on Wed Sept 8th i was discharged against the opinion of the infections director at the clinic. I was prescribed pain killers and antibiotics to use at home.
There, a friend who is a nurse and my family took care of me until Monday, Sept 13th, when a different fluid was noted from the wound. The chief surgeon was called and we had an appointment that afternoon. Then, he determined I developed an enterocutaneous fistula, so part of the feces were going out through the wound. The wound had to be unsewed entirely to be cleaned and healed by second intention.
That day I was hoispitalized again throught the Emergency Room, in room 114 this time. Since that day oral feeding was suspended and a subclavian catheter was inserted to provide parenteral feeding and medications. New tests started to be performed to evaluate the fistula.
The surgeons scheduled another surgery to perform a colostomy on me. Due to the delicate condition and how weak I was, the clinic priest gave the extreme unction. (Read the other note "Beautiful day")
I was taken to the Operations Room and, being under anesthetia, the wound and fistula were checked. Due to the wound good evolution, they decided to wait for my organism to improve to perform the colostomy, about three months later.
Meanwhile, the fistula would be managed as a colostomy using barriers and colostomy bags on the wound in the closest area to the fistula, and at the same time the rest of the wound would be managed as usual changing the bandage every 3 or 4 days.
Due to a infection on the catheter I had a fever. It was removed and the fever disappeared. After a ffew day, the fever reappeared and I received more antibiotics for several weeks. At this point my weight was 58 k.
I also had two intestinal obstructions, which made surgeons think about another surgery. Fortunately both obstructions were solved naturally.
Some intestinal gases weren't going all the way throught the intestine. They may go through the fistula and get lost in the abdomen looking for an exit causing acute pain. To solve that, a nasogastric probe was used on me twice.
I was discharged again on Fridays Nov 22nd, after a week when my system reaction was tested without antibiotics. Later, the fistula closed by itself at the beginning of December and after that the wound healing process accelerated with less humidity and microorganisms.
As the wound was healing by secong intention I had to go to the clici every 5 days to change the bandage. That finished by late January and the scar was completed by February, about 5 months after surgery.
For six months, I went every two months for checks with the surgeon, who was satisfied about my recovery.
posted by Carlos @ 8:34 PM
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