A few years ago, after seeing a small amount of red blood in my stool, I went to my GP, who diagnosed a hemorrhoid. The best way to confirm that diagnosis is by digital inspection of the wazoonie. I am probably not alone in being reluctant to request such an exam. I need to get one annually, to make sure my prostate isn’t going rogue, but I confess that I’ve let years go by in the past without a digital root-around. I’ve begun to suspect that many doctors share my reluctance to deploy this investigative procedure.
Here is how I measure pain: Years ago, during SXSW, I woke up in my hotel around 3 AM with unbelievably intense hot throbbing razor sharp Cuisinart blades deep inside my viscera right below my solar plexus. Hot, sweaty, clammy pain. Maybe a heart attack? But my arms and upper body felt fine. No problem with my breathing. My pulse didn’t seem out of control. After 5 minutes of hot pokers in the gut, the pain subsided. I argued with myself about calling the front desk and asking for a house doctor or an ambulance. But if you miss your flight out of SXSW, it isn’t easy to find an alternative. My pre-ordered cab would pull up in front of the hotel at 6 AM — I tend to arrive at airports way too early, even in the pre-TSA epoch. I just had to make it through a few more hours.
On the way to the airport, the pain struck again. I guess it was audible. When the cab driver looked at me, my skin color was probably gray. He went directly to the nearest emergency room, helped me to a bench near the triage desk. He wouldn’t take me to the airport. He wouldn’t take my money. He just wanted to get out of there before I croaked. I was lucky that this ER was quiet at 6 AM. They gave me an EKG, took my BP, drew some blood. I wasn’t having a heart attack. The young doctor said that if I could still make that plane, I ought to get to a doctor in San Francisco and have my gall bladder examined. I got on the plane, had another pain apocalypse that night. I saw my doctor first thing in the morning. He looked at the ultrasound and made an appointment for surgery. Laparascopic removal of my gall bladder completely eliminated this unpredictable, squeezing agony at the center of my body. Three days after surgery, I got on another plane.
To this day, whenever I find myself engaged in impassioned discussions of the prices we’ve had to pay for modern technology (alienation, pollution, the best minds of my generation destroyed by madness, carcinogens in the environment), I feel compelled to pay simultaneous homage to the technologies of pain-management, immunization, antibiotics, and laparascopic surgery.
To me, the pain of attempting to pass a gallstone is a 9.5 on a 10 point scale, solely because it would be hubris to presume the impossibility of anything worthy of a 10. “Excruciating” ought to be reserved for the worst. I don’t want to think about a 9.7
I’d say that the abdominal pains I started experiencing on December 2 of this year peaked at an 8.5. A hot bath or acupuncture could reduce the pain to a kind of constant backround level of 3-3.5, but only temporarily. My reluctance to demand pain medication much sooner was an error on my part.
I was my mother’s advocate in the medical system a few years ago, so I knew already that a don’t-rock-the-boat approach could be fatal to me. If she had been more vocal about her pain and demanded a diagnosis, maybe they wouldn’t have had to remove a gangrenous colon. But that’s another story — except the thought that my mother’s gangrene could have been prevented if she had spoken up for herself earlier. I learned that it can be fatal for a patient to take it on trust that any doctor is going to tenaciously keeping looking for the cause of the symptoms.
My gastroenterologist poked my abdomen and ruled out appendicitis or an abcess. He recommended mint pills from Whole Foods and told me to make an appointment for a colonoscopy. But between my own trips to Paris and Portland and the doctor’s calendar, we couldn’t agree on an appointment until February. It was when he didn’t stick his finger up my rear end that I became determined to find an answer.
My GP sent me to a urologist, who DID give me the finger, and more importantly, ordered a CT scan. But while awaiting the results, the pain continued. This is not an aphorism. This is the truth: absence of pain is so often an underappreciaed pleasure.
So I went to my GP, who wrote a precription for a low-level combination of ibuprofen and hydrocodone. As long as I take two pills every four hours (except for the middle of the night, when I take one pill every five hours) the pain disappears. Disappears!
Today, I met my medical oncologist and discussed a treament plan. I’ll describe the chemo plan in more detail in future posts. I had a PICC line put in. Drove to Novato and hat a PET scan. Then I had a blood test. Each of these activities involved clipboards, questionnaires, triage nurses, labs, drives from place to place. All logistics, note-taking, chauffeuring, and companionship provided, as always, by my partner and best friend, precious Judy.
