Monthly ArchiveApril 2004
Medical Wesley R. Elsberry on 30 Apr 2004
Thursday, April 29th, was uneventful. My appetite does appear to be returning gradually. There is some stiffness in the abdomen on rising that is unconfortable.
I was able to do a bit more work on the computer during the day.
I still don’t thermoregulate well. I have to take off or put on a sweatshirt or extra covering to keep myself comfortable as the temperature changes. And it doesn’t have to change much.
Still getting used to the ileostomy arrangement. I suspect this is a matter of practice.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4400 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1534 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 29 Apr 2004
I’m still on a trend of gradual improvement. Wednesday, April 28th, marked a longer time spent awake during the day, more food intake, and two walks, each twice around the cul-de-sac. I was able to do some work from home in the morning via computer and Internet. Diane’s brother, Joe, and his wife, Angela, came by in the afternoon and stayed for dinner. Sometime in there, I got a phone call from my sister, Emily Kay, who is currently in Alice Springs, Australia.
I also got a call from my gastroenterologist, who looked at my pathology report and also says that it appears that my ailment was ulcerative colitis. My prednisone taper will be ten days of
10 mg, ten days of 5 mg, then stop. The imuran will continue as a maintenance medicine for the remnant of rectum I still have.
My weight very early on April 29th was 182 lbs.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4100 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1499 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
General Wesley R. Elsberry on 28 Apr 2004
It’s a sale of a wedding dress… It’s a rant about ex-wives from the ninth circle of hell… it’s a tattooed gent being the model for the dress… it’s at $31,900 and 10 hours left to go, and over 2,000,000 hits on the counter.
Check it out. Expect a made-for-TV movie to appear next season.
Update: in the 15 minutes since I wrote the above, the price has gone up to $600,100.00. I am not making this up.
Another update: price is down to $331,952.00. The other bid must have been retracted.
April 29th: It looks like a carnival of bid cancellations occurred. The final winning bid on the wedding dress was a somewhat less insane $3,850. The hit counter stands at 6,905,664. The fellow selling the dress says there will be a web site set up about the experience. I still expect the made-for-TV movie to follow.
Obviously, selling stuff on eBay is a social phenomenon, not just an auction. The intrinsic value of the item in this instance comes nowhere near the winning bid price. But the high bidders apparently believed they were participating in something more than just the sale of a wedding dress in this case. Whether they were making a statement of support for divorced men having bad experiences in marriage or were just trying to claim a part of the attention that this event has generated isn’t clear.
I’ve been planning to sell various things on eBay, and this incident argues strongly for including information that I previously would have considered irrelevant to an eBay ad for an item. Maybe it will do no good, but perhaps it will.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4066 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1510 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 28 Apr 2004
Tuesday, April 27th, marked more incremental improvement in my appetite and my ability to off-gas the upper GI tract. I took a walk around the cul-de-sac our house is on with Diane after breakfast. I was able to function enough to solder connections for a couple of speakers. I had a mid-morning nap and a mid-afternoon one. Made a bit more progress on a book review that I’m working on. Alan Gishlick and Nick Matzke visited in the afternoon, and we watched a DVD that Nick brought with him.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4146 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1517 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 27 Apr 2004
Monday, April 26th, marked some slow improvement. I’m able to eat more at a sitting than before, and I think I’m getting better at relieving gas pressure in the upper GI tract. I was able to sit at the computer for an hour or so at a time.
I think I’ll note here my weight as I remember it over this crisis.
Pre-flareup: 205 lbs.
Emergency room weight: 199 lbs.
Post-surgery weight (April 14th): 188 lbs.
Discharge weight (April 24th): 182 lbs.
April 27th weight: 180.5 lbs.
I think I need to gain another three to five pounds and work on restoring lost muscle mass.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3997 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1528 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 26 Apr 2004
Saturday, April 24th, I got home from the hospital. That evening, I threw up a small amount of clear liquid and a rather larger amount of gas. Gas in the upper GI tract appears to be my particular bugaboo for recuperation. I never learned how to effectively belch or burp, so my body seems to resort to “dry heaves” to get it out. This puts my incision at risk. Since then, I’ve been doing a lot of mouth-breathing, which seems to allow small quantities of gas to exit the upper GI tract from time to time, and I have (so far) avoided another bout of regurgitation.
Sunday, April 25th, continued with balancing the need to get nutrition into the gut and keeping the system happy enough that I don’t regurgitate. I seem to tolerate tea, Ensure, and small helpings of rice, toast, chicken, and beef. I’m looking forward to the return of my appetite.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3992 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1492 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 24 Apr 2004
I’m at home now. The discharge process started at 10 AM, and I actually exited the hospital around 3 PM. Diane and her mother, Marguerite, came to pick me up.
No stooping, bending, or lifting for 3 weeks. No driving in that time, either. I got instructions on diet and care of my ileostomy.
Now I have to see if I can keep up with my metabolic demands and hydration. I’m still pretty weak.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3935 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1505 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 24 Apr 2004
My condition continues to improve. I went on an ileostomy diet on Friday, April 23rd. This diet has soft solid foods. I seem to be tolerating the amount of food I’m eating, though there is some discomfort.
My surgeon indicated that if I continued like this, I might be discharged Saturday or Sunday. I think I’m ready to go home.
I am off IV fluids and antibiotics now.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3973 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1511 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 22 Apr 2004
I was tested late Wednesday, April 21st, on the amount of liquid being retained in my stomach, as an indication of whether it was safe to begin allowing me nutrition by mouth. I passed the tests, so on Thursday morning, April 22nd, my NG tube was taken out.
My surgeon said that I could take clear liquids today, and if that goes well we move on to solid food. He said I could be discharged by Sunday if things continue to go well.
I’m starting with a small amount of intake, aiming for about 8 ounces of chicken broth, jello, and tea. I don’t want to overload the system. So far I’ve had a breakfast and lunch, and taken a bit of a walk in the hallway after each to encourage motion in the gut. So far, so good.
My gastroentorologist came by to talk about maintenance medicines. I’ll be taking imuran and prednisone to start with, though we are tapering off the prednisone with a view to eliminating it within about six weeks or so. The touchy part is making sure my adrenal glands are producing once the prednisone stops.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3866 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1498 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Photography Wesley R. Elsberry on 22 Apr 2004
I think I was twelve when my parents gave me a Kodak Instamatic camera and some film. I don’t recall having any great fascination with getting snapshots then.
In high school in my sophomore year, Ms. Schick asked me to stay after school for a bit. What followed was a bit of a surprise. She recruited me to join the yearbook staff as a photographer. I think my primary qualification was that I didn’t seem likely to run off with the photo gear and pawn it or something. But I walked out of the room with a Mamiya 1000 DTL 35mm SLR with 55m normal lens to try out. That did start something. I was on yearbook staff for the remainder of my time in high school. I learned to process black and white film and print it. I read up on photography techniques. I got better acquainted with a friend of the family, Lamar Philpot, who did photography professionally in Bradenton, Florida. Lamar gave me practical lessons on getting good exposures, developing, and printing photos. He also gave me the gift of encouragement. I won several awards in local competitions and the like, and just enjoyed doing photography.
In college, my parents encouraged me to take a part-time job so I could partly pay my own way. The job I got was as a staff photographer for the Independent Florida Alligator. This was a quick step into the realm of photojournalism. The folks I worked with were very serious indeed about photojournalism, and I learned a lot from them. By this time, my personal photo gear was primarily two Nikon F2 SLRs and a few lenses. My favorite lens was a 24mm f/2.8 Nikkor, which actually was the first piece of Nikon gear that I had purchased, under the advice of Lamar Philpot.
During my undergraduate studies, I took several courses in fine art photography through the U. Florida Fine Arts department. I was able to take courses from Wallace Wilson and Evon Streetman. My schtick then was taking panoramic photos with long exposures at night, adding light via flash and flashlight. I don’t think my instructors thought a lot of it, but I enjoyed it.
After graduating with my BS degree in zoology in 1982, I had to find myself a job. Demand for people with zoology degrees being quite limited, I ended up leaning on my photography experience to obtain a job working the darkroom for a photographic studio, Media Image Photography. This is the studio of Randy Batista, and at the time I was there, Laurie Hitzig ran an art print gallery in the same building. My job was to do copy photography, black and white film processing, black and white printing, and toning as necessary. Quite a lot of the business was in the copy photography, where we would produce enlargements from prints. As time went by, I was able to assist in other aspects of the studio’s work as well.
But I wasn’t going to stay in a photo studio, no matter how good, forever. I kept looking for employment that would relate to my biological training, and eventually found an opening in 1983 at the University of Florida in the Anesthesiology Department of the College of Medicine. The title was “Laboratory Technologist III”, but once again it was the photography that got me the job. What they wanted was audio-visual support. In those pre-PowerPoint days, the slide projector ruled presentation of technical materials. The deparment hosted continuing education seminars five days a week starting promptly at 7 AM. Part of my job was to arrive early to open the room, get the AV gear ready, and, most importantly, to make sure the coffee cart made it down to the meeting room. While in this job, I also got to learn to work various bits of diagnostic equipment in the lab. But most of my time was spent converting artwork into slides. The basic process involved Kodalith high contrast film and applied dyes. I developed a technique of masking with rubber cement that allowed me to color much smaller elements of slides than the department had done before, which increased my workload as the researchers took advantage of it. I also did some public relations photography for Shands Hospital during this time.
This was still a job with not enough biology, so I eventually found another job within the University in 1985. This one was titled “Biologist I” and really meant it. Photography was a part of the equation for getting the job, but not a major one. The fact that I had picked up use of personal computers and could also handle reagents for histological work in addition got me the job. I became essentially a research assistant to Richard Hill Lambertsen. Lambertsen is a researcher into the histology, physiology, and evolution of baleen whales and especially fin whales. While I was there, animal rights groups including PETA targeted Lambertsen because of his association with Iceland and their scientific take of fin whales. When I left in 1986, Lambertsen was essentially under siege on campus. He was later denied tenure in what I consider an act of cowardice by the school administration. I produced photographic prints of photomicrographs for publication while working this job. Lambertsen had a sweet Nikon photomicroscope that I learned a lot about, including setting up Kohler illumination.
Life shifted. Diane got a job offer out of her electrical engineering BS degree for over twice what I was making. We moved, and I entered a master’s program in computer science. But I did insist on setting up a darkroom in our garage. One disappointment that I had was that I could never get Diane interested in spending any time in the darkroom. It simply held no interest for her.
My next two jobs were based upon my computer science degree, and photography wasn’t a big part of my life during this period. I had discovered things like “bulletin board systems” and arguing evolution/creation issues online.
Things continued like that until Mark Todd and I attended the 2000 Consumer Electronics Show. We stopped by the Creative Labs booth and dropped entries in for one of their presentations that included drawings for prizes. There was a $1000 gift certificate being given away, and the announcer pulled a card and announced that “Chuck” had won. He then considered the fact that “Chuck” was the only thing written on the card and said they weren’t going to consider that an entry. He pulled another card and called out my name. I converted the gift certificate into a Sony CyberShot F-505 camera, a 2.1 megapixel digital camera. This relaunched my interest in photography. What’s more, Diane got interested as well. It seems that getting away from the darkroom made all the difference for her.
I also started doing event photography in 2000. Diane wanted me to go to dog sport events that she participated in, and wanted to know what that would take. I said that I could tolerate most things viewed through a camera. The money made by selling prints to folks at events has gone back toward paying for photo gear. The goal is to make this hobby self-supporting, if not profitable. A major purchase was obtaining a Fuji S2 Pro digital SLR in 2002, so as to go digital with the event photography. It took until fall of 2003 to make enough to pay back the hobby debt on the body. It permits digital photography without excuses, delivering better results than I had been achieving with film for the event photography.
I’m also using the Fuji for our personal photography. See this page of photos of a hawk walk for a sample.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4182 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1581 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 21 Apr 2004
The rest of Tuesday, April 20th, passed uneventfully. Diane came by, and Genie Scott visited, leaving some magazines and DVDs. I was cut back to one cup of ice chips per shift.
I watched “Quest For Fire” which Genie had brought, that I had not seen before. This was a flick concerning encounters between prehistoric tribes of various species or subspecies of hominids as a trio of Neandertals search for fire for their tribe. The credits listed Desmond Morris as providing the behaviors and Anthony Burgess (author of “A Clockwork Orange”) as providing original languages for the film. Unfortunately, the apparent target audience was anthropologists, and this intriguing film didn’t do too well in its run in theatres. Of course, the, er, uninhibited aspects of primate/hominid behavior depicted probably didn’t help with mass-market acceptance, either.
The medical phrase for Wednesday, April 21st, is “paralytic ileus”. It’s a fancy way of saying that my guts aren’t yet moving. We’re proceeding carefully. I just completed a four-hour test of my gastric output. My NG suction was turned off for that period, then turned on and stomach contents measured. Over 150 ml would have been bad, but I had 80 ml. Now I get to do the same for an 8 hour period. How that turns out will determine if I start taking nutrition orally again tomorrow or not.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 3914 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1487 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Science Wesley R. Elsberry on 21 Apr 2004
For several years of my Ph.D. studies, I was part of research into marine mammal hearing and biosonar. My introduction to these was pretty much the “immersion” sort of experience: I spent two and a half months on San Clemente Island assisting in data collection and analysis for a study on the hearing of white whales at depths down to 300 meters.
Diane and I also provided programming for data collection and analysis and assistance in experimental design for tests of hearing and temporary threshold shift in bottlenose dolphins and white whales.
In 2001, Diane and I were able to visit the Point Defiance Zoo and Aquarium, where hearing tests of the sort we had contributed to were being conducted. I was able to take some decent photos of the proceedings. We put together a web page and got permission from the kind folks at Point Defiance to release it to the public. (Photographs taken at facilities like Point Defiance are usually not publicly publishable without obtaining a site release or specific permission.) On the page, we explain the basics of performing behavioral audiograms on marine mammals, show a graph of audiogram data for white whales and bottlenose dolphins, and provide a short bibliography of technical literature on behavioral audiograms and hearing tests for these species.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4036 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1556 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Antievolution Wesley R. Elsberry on 21 Apr 2004
Some time ago, an Insight article by Stephen Goode quoted ID advocate and Discovery Institute Senior Fellow William A. Dembski as saying that biologists opposed to “intelligent design” were like the repressive former Soviet regime. Knowing something of the history of science under Soviet rule, I knew that the actual lessons of history were being completely inverted by Dembski. Scientists who applied principles of biology accepted in the West were, in fact, repressed under Soviet politically mandated biological doctrines, specifically those teleological principles of Michurinism promulgated by Trofim Denisovich Lysenko.
I joined with Mark Perakh, who lived through Soviet scientific repression and encountered Nazi materials in World War II, to write an essay that explores the ID advocates’ deployment of invidious comparisons of biologists to the Soviet and Nazi regimes. We conclude that these comparisons cannot be sustained, that they can only be proposed through thorough ignorance of the actual historical record, that politically mandated biology is a costly proposition, and that the elements of self-aggrandizement in ID advocacy ironically echo the Soviet and Nazi regimes that they invoke as being like their opponents.
Medical Wesley R. Elsberry on 20 Apr 2004
Monday, April 19th, passed uneventfully, and Tuesday, April 20th, so far has done the same. I pretty much stopped using the morphine for pain relief, since it apparently also was slowing down the recovery of my guts. I can still request pain relief specifically, which depends on the speediness of the nurse in delay between request and receipt.
I was given some albuterol treatments overnight to help keep my lungs open.
This morning, I had visits from two of the surgeons. From one, I got the word that the pathologists think that my problem was “ulcerative colitis” rather than Crohn’s. This is good news at this point. The cure for ulcerative colitis is removing the colon. The second surgeon recommends I spend today with the NG tube in place and we evaluate things again Wednesday morning. I agreed that I’d rather get the timing right on moving my system forward.
I’m dropping weight on the IV nutrition. It was explained to me that the TPN is meant to reduce the amount of muscle wasting that occurs. Too much intake on the TPN could place the liver at risk. Because I am on steroids and post-op, my metabolic demands are high.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4227 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1615 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Falconry Wesley R. Elsberry on 19 Apr 2004
OGeorge put a request in comments that I say something about the Harris’s hawks in the blog banner.
When saying anything about falconry, it’s best to state up front that all this activity occurs under state and federal supervision and permitting. Diane and I hold master’s falconry licenses through California state and report to the federal office of the Fish and Wildlife Service in Oregon. All trapping of hawks occurs during prescribed times of year and with additional permits as required. Hunting with the hawks is in compliance with the set hunting periods for taking game with falconry, and we have current hunting licenses from California.
“Rusty” is a female Harris’s hawk featured in four of the photos in the banner. Diane trapped Rusty as a passage bird in 1991 near Hebbronville, Texas, sort of as a graduation present to herself for her master’s degree in biomedical engineering. I wasn’t there; I was already relocated to Richland, Washington, where I was working for Battelle’s Pacific Northwest Laboratories. I visited the Fort Worth area at Christmas that year, and Diane brought Rusty over to Janice Bauer’s house. Janice had collies, and Rusty gave her opinion of “coyotes” loudly and often, which is why she is named “Rusty”: it sounded like a rusty hinge to us.
Rusty’s arrival proved a turning point in our falconry activities. We had had kestrels and a red-shouldered hawk before, and our attempts to turn these birds into hunters simply did not work well. We were ignorant and timid, I think. Once we started putting Rusty up over game, things quickly changed.
Rusty was a driven hunter. I don’t know that we taught her much of anything, but we sure learned a lot from her. Mice, rats, and cottontails started things off. She then showed us that she really wanted to hunt upland birds: quail, chukar partridge, and pheasant. But the real surprise to us was her sudden interest in ducks. We were then living next to the designated flood basin of the Yakima river, and there were ducks down on the river. Rusty found that she could fly up to a tree overlooking shallow water here and sometimes surprise a duck in very shallow water.
Rusty and I have developed a rapport that I think is unusual between falconer and bird. There was a research project, “Deep Hear”, that took me away from home for two and a half months. I was sure that I would have to re-establish an acquaintance with Rusty on my return, as she is very suspicious of strangers. But Rusty hardly batted an eye, and we went right back into our earlier routines. I have been able to convince Rusty to return to me even when she is pretty full and would otherwise simply veg out in a tree and enjoy the weather. Rusty shows a definite preference for coming to me for food before anyone else, including Diane.
One of the photos in the banner shows two male Harris’s hawks perched on a padded backpack frame that I wear in the field. (More photos can be seen on this page.) Diane and I applied for non-resident take of Harris’s hawks from Arizona state in 2002. We each received a tag for a Harris’s hawk. We made a trip to the Tucson area in June 2002 to visit with Jeffrey Shallit and his family (then on sabbatical in the area) and to see if we could find our Harris’s hawks. Tucson’s Harris hawk population seemed to be in trouble; the only families we could find were at the Sweetwater waste water treatment plant and in the city cemetery. In November, Diane and I attended the 2002 Vizsla Nationals in Prescott, Arizona, and followed up by asking Jamaica Smith where to find trappable passage Harris’s hawks. Jamaica not only gave us advice, but flew down to Phoenix and met us at her apprentice’s home there. It turns out that the northern suburbs of Phoenix have a high population density of Harris’s hawks, and we were able to catch our two males within a 24 hour period there. The usual minor injuries to the humans led us to give them the names, “Biter” and “Beater”, from the elven-swords in “The Hobbit”. It is Diane’s hobby to propose alternative names to these. “Biter” she is now calling “Shelby”, but she hasn’t yet come up with another name for “Beater”. We were able to take them on their first free flights as falconry birds within a month of trapping. That’s perhaps not speedy in relation to what other falconers do, but it represented an improvement for us.
Flying Harris’s hawks in a cast is something that is pretty new in falconry. These birds are unique in their cooperative hunting techniques, and flying them in a cast allows the falconer to see something of what their life in the wild is like. Since Diane and I are wildlife biologists as well as falconers, we have a special appreciation for observing these behaviors.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 5771 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2372 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 19 Apr 2004
The past few days have been challenging.
On Saturday, April 17th, I was put on a clear liquid diet to start things off. I think I started off too fast on this, though, for I experienced a lot of gas, bloating, and associated discomfort.
By the morning of Sunday, April 18th, it was clear that I was in trouble. My abdomen was distended and I was experiencing nausea. I began running a fever, and regurgitated three times through the day and following early morning. I mostly slept.
This morning, Monday April 19th, my surgeon asked about placing a naso-gastric tube to suction out the stomach contents, reduce the distension due to my stomach activity, and reduce the risk to my incision posed by regurgitation. I agreed. Getting the NG tube installed was unpleasant, but perhaps not quite as bad as I had feared. And the relief to my system was almost immediate. Much better than having to regurgitate stuff. I’m no longer running a fever.
So I’m back to just ice chips going in. We’ll see how I’m progressing, and hopefully match things up correctly this next time around.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 4055 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 1556 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 17 Apr 2004
Up until April 5th, 2004, I had never been admitted as a patient to a hospital. There were several instances where I have had to use the emergency room, but never a following admission. That changed with this latest flareup of my Crohn’s condition. I was in severe pain, unable to eat and unable to keep myself hydrated. I dropped about ten pounds of weight over the weekend prior to entering the hospital.
Once admitted, I received aggressive medical treatment to attempt to bring the runaway inflammation of my colon under control. It appeared to be working, such that by Sunday, April 11, the doctors were talking about possibly discharging me on Tuesday the 13th. In order to get there, I had to be increasing the amount of my diet taken orally, and that apparently stressed the system too much. As best I can reconstruct events, I must have perforated my intestine late Sunday evening, which coincides with a sharp onset of pain I noticed in my shoulder. Monday morning, my gastroenterologist got this report and ordered an x-ray. Around 11 PM Monday, I received word from my nurse that the x-ray showed free gas in my gut cavity. By 3 AM Tuesday the 13th, I had an abdominal CT scan to attempt to determine the extent and location of the damage. Around 6 AM Tuesday, I had a surgeon briefing me on the necessity of having surgery to find and correct the damage. I learned that having the surgery likely meant that I would be losing the whole colon.
This news was quite a bit different from my expectations for the day. I asked about how critical the timing was on getting the surgery, and was told it would need to happen that day. I decided that I would defer consent until Diane could arrive and take part in the discussion. She was at the hospital by 8:30 AM, and we started going over the various bits of information in earnest. We also requested a second opinion.
Around 10 AM, another surgeon arrived to brief me and obtain consent. He would be performing the surgery. He was very straightforward and blunt about my situation. The odds I risked as he saw it were that I stood a 20% risk of dying even with emergency surgery. Attempting to simply take a medical solution (lots more antibiotics) would give me less than a 50% chance of survival. Given that the location of the perforation hadn’t yet been determined, I asked that if some other part of the gut had perforated that they not remove the colon simply because it was there and having some trouble. The surgeon said that they would do what seemed necessary, and I agreed that the best outcome and outlook for keeping me alive was the goal. So we concluded going through the consent process by 10:30 AM.
Diane and I had some time together before I was transported to surgery, and we both tried to comfort the other. We have both a marriage and a friendship, which helps tremendously. The possibility of separation weighed heavily upon us. By noon, though, I was off to the operating room.
The lead-up to the operation was not a pleasant time. Upon awakening, I had pretty much the same view of hospital ceiling as I had before, and similar levels of pain, which caused me to ask whether I was still pre-op or post-op. I at least got the “post-op” response, which meant that the pain I was feeling was a residual one rather than the presage of more to come. I was cramping up in the abdomen, which of course had already been worked over well in surgery. Even with pain medicine, I vocalized well on the severe cramps. Diane stayed with me through much of this post-operative stage on Tuesday evening. I have thankfully forgotten much of it already, but I think Diane will be remembering it for a long time.
My recovery has progressed from Wednesday, April 14th, when I had severe pain on any motion involving the abdomen, to now, as I have relatively little pain on motion. Cramping can still cause high pain levels, but is now infrequent.
Since the morning of Friday, April 16th, several things have changed or been learned.
My NG tube was removed that morning, which I was glad of. Around midnight last night, I was also relieved of my Foley catheter.
My guts seem to be moving toward recovery after anesthesia, so I also was allowed ice chips to suck on and swallow. One of the doctors indicated that I would start on clear liquid diet by mouth today in addition to the IV nutrition that I have been receiving.
Even my surgeon, who has consistently painted the severest risks concerning my infection status, agreed that my lab signs are improving. Conditional on things continuing in the positive direction as they have been, he said that I may be able to go home “after the weekend”. I’m interpreting that as Tuesday, give or take a day. The only thing that was out of place was my calcium level, so I received an IV supplement of that yesterday.
I do continue with aggressive IV antibiotics. My steroids are being tapered down such that I will be sent home on a daily dosage of 20mg oral prednisone.
On pain management, the background level of morphine drip has been discontinued, and I have the option to take 2ml doses up to four times an hour via a timer-based self-dose unit. As my guts continue to wake up, I expect that I will appreciate the occasional bit of quick pain relief.
Mark Todd, a colleague of mine from San Diego, has been visiting since Thursday night. Alan Gishlick and Nick Matzke from the National Center for Science Education came by yesterday afternoon. They brought a greeting card with notes from the rest of the office and extended NCSE family. Mark had brought a selection of DVD movies and TV shows, so wehad a screening of some comedy on the laptop for our little group. Diane had a busy day at the University of California at Berkeley campus as she continues to try to find a paying job in the academic field. She arrived here very tired last evening, but seemed to recover somewhat sitting here with me. Mark will be around from time to time today, and leaves for San Diego again Sunday morning.
Nanci Blackwood and Bob Barton had sent an arrangement of flowers on Thursday, and Mark Todd also brought one. They grace the cabinet across the room, adding some much-needed color here.
I had two longish strolls in the hallway yesterday. I have to push around my loaded IV pole with its battery-backed dosage pump. It acts as a sort of rolling walker on these outings.
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I’ve started my personal weblog here near the bottom of things. On Tuesday, April 13th, 2004, I had major surgery removing a perforated colon. My colon was compromised by a couple of decades of “inflammatory bowel disease”; my most recent diagnoses and treatment were based on it being “Crohn’s disease”.
The surgery was successful. However, I’m still dealing with the very real possibility of life-threatening infections that could follow, since my treatment for Crohn’s involved severe immuno-suppression. Thus I remain in the hospital under close observation and aggressive antibiotic therapy.
As the doctors do their thing, which is to imagine the bad and prevent it, I am trying to do my thing, which is to imagine the possible and achieve it. In this, I have the help of people who love me, people who share their friendship and support, and I have my personal faith. If I make it through all this, I have the sense that so little credit will be due to me personally as not to matter. What will matter is making the rest of my life a worthwhile thing, not just for myself, but for those who have given so much of themselves during my crisis.
One thing to be said for steroid-induced insomnia is that one has time for ideas. I now have a surfeit of ideas for things to be done, and an ever-widening gap in having time to implement them. At least one thing that I hope to keep up with will be this weblog, as a place to keep in touch with this vision I’ve had at the bottom of things and looking up.
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