Life & Health Update 2022

Hey y'all!

It's been a hot second since I've written...life gets busy and I forget to update, sorry! That being said, I wanted to share an update on me and request your prayers.  This may be kind of long, per usual :).

So, as you may remember, I had a bowel obstruction surgery back in January 2021 (you can read about that here if you missed it). Well, ever since that surgery I have been experiencing similar abdominal pains once every 4-6 weeks. I kept my medical team in the loop, but we thought it may be tied to diet and gas pains. My team had me tracking symptoms to see if we could identify the cause with no luck.  

Well, fast forward to Memorial Day Weekend 2022...that day I spent the afternoon at the pool and enjoyed some sun and relaxation.  As I walked back to my apartment around 3pm I began experiencing those same pains. They always start the same way - back pain first, and then intense cramping right in the middle of my abdomen dead center just below my ribs, and the pain stays there cramping on and off. Typically taking Gas-X and waiting an hour or two would make the symptoms go away.  After about 2 hours, I was still hurting so I decided I should take more Gas-X.  Roughly 1-2 hours after that I was still in pain curled up on the couch and decided to call mom. The paid was eerily similar to the last bowel obstruction, though at the time it was not as intense as I had remembered previously.  Mom and I decided I should call the Bariatric Fellow on call to get their opinion. He told me if it got worse or if nausea began as well to go the nearest ER and if it required additional attention they could transfer me to Duke Regional.  At that point I decided I better let Jax out to potty just in case it got worse. He and I got to the base of the stairs, just outside my apartment and the pain became unbearable and I got extremely nauseas and light headed. It was all I could do to get back inside with him. I knew at that point I needed to go to the ER. I called mom again and she gave me 3 choices:

1. Wait for her to come get me
2. Call 911 and go by ambulance
3. Drive myself to the ER

Well, I knew I couldn't wait an hour for her to get here so option 1 was out. I also really didn't want to pay an ambulance bill so I ruled that out. Up until that point I was ok if I was sitting, so I figured if I could just get to my car and get seated I could drive myself. I only live about 8 minutes from the hospital, I thought I'd be fine.  So I grabbed my wallet and insurance card and headed that way. I made it about 3 minutes down the road before the nausea hit again and I pulled over into a parking lot thinking I was going to be sick. At that point I was halfway between home and the hospital. I knew either way, no matter where I went, I wasn't going to be able to get out of my car. I figured it was better to be at a hospital surrounded by medical care than at an apartment complex parking lot. So, I decided to continue the drive, hopped on the highway right off that parking lot, and made it just off the on ramp down about one exit before I got so dizzy and lightheaded I had to pull to the side of the highway. I knew if I kept going I was going to the ER by ambulance one way or the other - either call them, or get in a wreck! (Lesson learned - don't drive yourself to the ER when you're in that much pain, just call EMS) I called 911 immediately to request an ambulance and then called mom just so someone was on the phone with me. She & dad then started making their way to Duke Raleigh, but when I say I felt like death, that doesn't even cover it. The pain was unbearable and I was so dizzy and nauseas. It felt like forever for that ambulance to show up. They finally got there and got me into the ambulance. On the ride to the ER she pushed 2 rounds of fentanyl, and then gave me a 3rd as we arrived at the ER. She warned me they were busy and I'd have to wait in the waiting area - ugh! They got me checked in and mom showed up shortly there after. I remember getting triaged, and they gave me some phenergan (sp?) for nausea since I already had an IV from the ambulance. It didn't help at all. I just remember shaking uncontrollably, dry heaving, and reeling in pain.  They eventually called me back for a CT scan where I had to lay flat on my back - I couldn't get out of the fetal position at this point, it was not a fun scan! Shortly after I was given a room in the ER and they told me the CT showed I had another bowel obstruction that would require surgery again. They had already spoken with my bariatric team and were going to transfer me to Duke Regional in Durham. They also pushed a round of morphine at this point. They also told me that the bariatric team wanted me to get an NG tube to be safe. The doctor said the transfer orders were in and they should be there in a couple of hours.  At this point, mom decided to go with dad (who had been waiting in the parking lot since only one visitor is allowed in the ER) to pick up my car off the highway, get Jax, pack me a bag, drop him off at their house, and then come meet me at Duke Regional. All of that should have aligned well with the transport timeline - so we thought.

So, at this point, mom had left and the nurse came in to give me the NG tube. Let me just stop here and say that if you've never had an NG tube COUNT. YOUR. BLESSINGS.  I was not prepared!  Mind you, while this is happening, I still can't get out of the fetal position. Three rounds of fentanyl and 1 morphine at that point barely got me to a 9/10 on the pain scale.  So she tells me to lean my head down and when the tube hits the back of my throat to drink from a straw until she says stop.  This tube is big y'all. She tried my right nostril first, jamming this tube up as hard as she can but it wouldn't go in and I had to make her stop. My nose of course starts bleeding from that side and she then tries the left side. She had to push it in really hard a couple of times but it eventually took. Of course I'm gagging on the tube, but they get it in. However, fun fact, when you get an NG tube they can't turn the suction on until x-ray confirms it's in the right spot. So, the nurse leaves me at this point with a rag to try and stop the nose bleed and this tube up my nose and down my throat.  X-ray comes, and then the ER goes on lock down. I see nurses rushing up and down the hall, police officers back and forth, they're over the intercom telling people to secure the doors, it looked like chaos. Someone had a knife wound is all I could figure out. But, that meant I was left completely alone in serious pain with a major nose bleed for 3 hours. THREE HOURS!!!! I was covered in blood and throwing up blood left and right by the time the nurse came back and got approval to turn the suction on and give me more morphine. Of course by that point there was nothing left in my stomach to pump out because I had been vomiting for 3 hours. Miserable does not do this entire experience justice. I truly felt like death. It was well after midnight by this point, I honestly don't even know what time it was, I was just ready to get put under and not be in pain any longer.  Once the hospital lifted from lock down Duke Life Flight got there within an hour to take me by ambulance to Duke Regional.  While on that ride they gave me an additional round of fentanyl and I finally got pain down to about a 6 and slept most of the ride to Durham. I think it was 5 or 6am by the time I got to Regional?? Mom could tell you for sure. Bariatric came in to see me to explain the surgery, get consent. and all that fun stuff, and before I knew it I was being rolled up to surgery. Best part of the day was when anesthesia came out because I knew I was within moments of being pain free! Fun part was Dr. Ransom ended up being my anesthesiologist that day - we know him from Grey Stone! It was nice to see a familiar face.  Fast forward to after surgery, I wake up in recovery feeling 100x better. The recovery nurses said not many people wake up looking better than they did when they went in, but I did! I said going from a 10 pain score for 12 hours down to a 2 will make anyone look and feel better!

Thanks to mom for this lovely recovery photo haha

Sunset view from my room each night

So, during recovery we found out from my surgeon that this obstruction was almost identical to the previous one. They also discovered that my ascending colon (right side) was not attached to my abdominal wall which is the cause of these obstructions. My colon has literally been flopping around my abdomen and causing those pains I felt every month, this time it just flipped too far to fix itself.  Apparently your colon is supposed to attach to your abdominal wall when you're formed in the womb, but mine did not. It is very rare to catch this at my age. It typically shows up very early in life or very late in life. However, they think that when I was overweight that the fat likely held my colon in place enough to prevent any issues. When I lost the weight, my colon suddenly had room to move thus causing these obstructions.  Since I'm so young, and this surgery was done in an emergency setting, they decided the best course of action was to try and suture my colon to the abdominal wall in the hopes that it would hold. They did tell us though that this has a very low success rate and the only permanent solution is to remove that section of my colon. They had me follow up with a colon specialist after surgery to get a second opinion, and he agreed.  He told me that if those pains came back at all to notify him immediately and they'd get me in for surgery to go ahead and remove that section of my colon before another full obstruction occurs.

Well, fast forward to end of August 2022 and sure enough those pains returned. I had 3 pretty painful events across one week, and I'll be honest that I tried to ignore it or write it off as food issues the first 2 times. However, the 3rd time I hadn't eaten in a few hours prior and it was bad enough that if it had continued another hour I would have gone straight to the ER. I immediately messaged my colon specialist and they got me scheduled, but he wasn't available for a month.  Luckily I have not had any other rounds of that pain since then (knock on wood), but I finally saw him at the end of September.  Sure enough, he wanted to go ahead and do the surgery, for which I am now scheduled to have on November 10th. I was already scheduled for a colonoscopy on November 7th, so he suggested doing my surgery after that just in case they find anything. Better to have one surgery instead of two so we went with the 10th for my surgery date. He says it will be done laparoscopically and should not have any major effects on my quality of life after surgery other than maybe going to the bathroom more than once per day. My nutritionist told me this section of the colon is where a lot of water is absorbed, so we'll need to keep an eye on my hydration and nutrition following surgery, but other than that it *should* be a pretty simple surgery.

Well, if that wasn't exciting enough, on September 17th I pulled a muscle in my back hanging clothes back on a rack. In the days following, my sciatica pain returned (I had back surgery in 2014) on my right side and it became so bad that walking has been next to impossible even on heavy medications. My doctor has me on narcotics, muscle relaxers, and gabapentin and it's barely touching the pain. She also had me start PT which began on October 3rd.  That day the pain was so intense that I called mom in tears contemplating needing to go to the ER. I went into PT, and cried more than that sweet doctor was probably expecting, and she did some treatments to try and reduce the pain.  Those treatments helped a little, but she also found weakness on my right leg, reduced reflex in my achilles, and decreased sensation on the right side and suggested if the paid was bad enough that I could go to the ER and get an MRI now instead of waiting the 4 weeks in PT that insurance typically requires. My primary doctor had suggested the same thing. The pain was rough, so mom and I decided the ER was the best plan of action. I got there around 5pm that evening of the 3rd and mom met me there. (Side note - bless my mom for always coming to my rescue and sitting with me through all of these crazy ER adventures!) I was eventually taken back to a room in the ER about 4 hours later. The doctor was hesitant to give me an MRI, because even if it showed a spinal issue she would just refer me back to my neurosurgeon and wouldn't treat it there. However, after reviewing my symptoms and chart, she agreed to the MRI. She warned us though that MRIs can take a long time to get in the ER, up to 6 hours or more, so to get comfortable for a bit. Mom decided to leave the hospital at this point to pick up Jax and head home - no need for us to both just sit and wait. Surprisingly about an hour later MRI was in the room and wheeling me back! The scan was pretty uneventful, and a couple hours later they confirmed I had a bulging disc again at L4/5.  The doctor gave me a methylprednisolone (sp??) shot in my arm to help with pain that night and suggested I follow up with my previous neurosurgeon since L4/5 is where my previous back surgery was in 2014, and then I got discharged.

I tried calling neurosurgery the next couple of days, eventually getting through, but they could not see me until November 1st.  I booked it, but I knew there was no way I could continue with this pain for another month, I needed to be able to walk. So, I also found the Duke Spine & Pain Management team that's connected with my neurosurgeon and had my primary doctor refer me to them. It took a few days to get them to answer the phone too, but once I did she too was telling me an initial consult wasn't available until November 8th! I begged her for another option, so she checked the other doctor's schedules and found one opening for Monday, October 17th, but she needed his approval before she could book it. She called me back about an hour later and said the doctor reviewed my chart and said due to my history we could skip the consult and schedule an epidural injection for that Thursday if I wanted. Of course I said yes!  So, I had that injection yesterday, Thursday, October 13th. The procedure itself was pretty much painless, which I was pleasantly surprised by! I didn't get immediate relief, but I did see some improvement right away. They told us it could take 7-10 days for full effect, so I'm hopeful and praying that relief continues to grow and get better this week! I went from about an 8-10 on the pain scale when walking down to about a 5-6, which is better than nothing! I look forward to being able to walk pain free again, but for now a 40-50% improvement is better than where I was! They did say sometimes a second shot is needed 2-3 weeks following the first one, but we will assess that at the 7 day mark. I can't have a steroid injection too close to my colon surgery date, so we are having to juggle two major treatment plans at once. I will still meet with the neurosurgeon as well, just so we cover all bases, but I'm really hoping we can get this under control without another surgery. Back surgery is no joke, and I would love to avoid a second one if at all possible!

All that being said, if you've read this far (ha, sorry I told you it would be long!), there are a few ways I would really appreciate if you could pray for me.

1. Prayers for my upcoming surgery on 11/10. That the procedure would be uneventful, successful, and have a quick and easy recovery following.
2. Pray for an easy transition diet and hydration wise following the colon surgery
3. Prayers for my colonoscopy appointment on 11/7 - that it would come back clear and uneventful as well (multiple family members have been diagnosed with colon cancer so I'm getting this as a precaution)
4. Pray for continued relief of this sciatica pain through the injection medicine over the coming days
5. Join me in praying that these injections will provide full and lasting relief so we can avoid a second back surgery
6. Prayers for financial guidance and coverage as I navigate all the medical bills that I've been faced with this year
7. Prayers for my many medical teams I'm now working with, that they would make the right medical decisions for me as we juggle multiple treatments at once

Thank you in advance for your prayers!

<3 Allyson