Di-ver-tic-u-what? —Me
Two smiles before the first of three emergency surgeries
In honor of Men’s Health Awareness Month, I post this chapter from “A Cup of Tea on the Commode” as a reminder, especially for caregivers of the male persuasion.
Third Time, No Charm
Once in a while life throws you a curveball. On June 4, 2013, it threw me a humdinger.
It all started back in February at my annual check-up in Los Angeles. I was physically fit. I exercised daily. I ate a healthy diet. But my doctor said, “You’re in your fifties. Get a colonoscopy just to be safe.”
When I got back to New Jersey, I contacted Anthem for gastroenterologists in my network and scheduled an appointment.
I researched the cost. The average price of a colonoscopy was $1,185. Having a high deductible, I expected to pay most of it, if not all. Curiosity got the best of me, so I called the doctor’s office for a quote.
The nurse refused, stating, “Every case is unique.”
This made me suspicious, but when she threatened me with a $200 cancelation fee I kept the appointment, trusting Anthem to protect me.
All appeared to go well. The doctor found and removed a benign polyp, and I felt no pain until the $8,500 bill arrived. Never trust your insurance company, but that’s another story.
Feeling violated all over again, I canceled the $500 post-procedure appointment. The doctor retaliated by refusing to give me my full report. That report contained information that could have saved me a lot of pain physically, emotionally, and financially. So much for “do no harm.”
Six weeks later, I felt a pain in my lower abdomen after working out in the gym in the renovated basement. Figuring I overdid it, I took a break the next day but returned to the gym the day after. That night, the pain got worse.
I checked out the symptoms on WebMD. A hernia? I had an umbilical hernia years ago. This felt similar. With proper rest, I hoped it would heal on its own.
Then on Tuesday, June 4, 2013, I was minding my own business while doing my business on the commode when boom!—an intense stabbing pain shook me to my core.
That night Michael cooked and cared for Mom. Good thing because I was in no condition to do so. I had chills, and even though it was ninety degrees with 90 percent humidity outside, I slept in flannel pajamas with a space heater running at full throttle. The fever broke and the pain subsided, but twenty-four hours later it returned with a vengeance. This was one hell of a hernia, but I continued to believe in healing thyself. So, I waited it out another day. Clearly, I didn’t have my much-needed mother’s intuition.
Finally, after doubling over again on Friday, I gave in and drove myself to the Valley Hospital emergency room.
“I have a pain in my lower left abdomen,” I blurted out.
“Sounds like diverticulitis,” the nurse shot back immediately.
“Di-ver-tic-u-what?” I’d never heard of it, couldn’t even pronounce it, but they could. I was admitted after a doctor and a CT scan confirmed the nurse’s initial diagnosis.
I called Michael.
“I’m in the hospital. It may be serious. You need to get someone to cover for me.”
All I heard was, “Oh shit,” not knowing if this was in response to his predicament or mine. Either way, “oh shit” summed it up.
The doctor also discovered a rupture in my colon, which had caused a life-threatening infection, which had caused my fevers. He didn’t share the “life threatening” part with me until I was out of the woods, but he did share three scenarios to ponder.
- Treat the infection with antibiotics. No surgery required.
- Primary bowel resection. Traditional surgery to remove the diseased or ruptured part of the intestine, which is then reconnected to the healthy segment of the colon.
- Bowel resection with colostomy. If the parts cannot be reconnected, all waste would collect in an external bag.
I had my preference, but my body had its own.
Surgery.
When the doctor broke the news, tears flowed. I worried about Mom. I worried about my snack business. And I worried about the long recovery. At twenty-six, I had abdominal surgery to repair my umbilical hernia. It laid me up for several months. How long would it take me to recover at fifty-six?
But I had no choice and little time to worry. The doctor scheduled surgery for the next morning. Caryl drove up from the Jersey Shore for moral support, but when the surgeon described the procedure, she totally lost it.
I grabbed her hand. “Don’t worry. I’ll be fine. Now get out of here. You’re depressing me.”
They couldn’t determine scenario two or three until I was under the knife, which left my pooping future uncertain. Three hours later, I woke up in recovery and immediately searched for the dreaded colostomy bag. I came up empty-handed.
I thought, this might suck, but it could’ve been worse.
Later that night, it got worse. Much worse. I have a high-pain threshold like Mom, but when the anesthesia wore off, I thought, This is ridiculous.
“Give me the Michael Jackson cocktail and put me out of my misery,” I begged the nurse.
Desperate, she called my surgeon. After several failed attempts, he came up with an effective pain-reducing, mind-altering cocktail that, along with the excellent ice chips, nearly made the entire experience tolerable.
Nearly.
While I was stuck in the hospital, not knowing when or if I’d ever get out, the search for my temporary caregiver replacement began.
Marina, whom Michael had hired to care for one of his clients, became available after a perfectly timed passing. Marina needed the work, and we needed the help. Unlike many of his previous hires, my Brother Teresa hit a home run with Marina. She stepped right in and picked up where I left off but understood and accepted my intention to resume my duties when able.
Eight days after bidding adieu to eight inches of my colon, I returned home to an emotional homecoming, but only in my dreams. No one told Mom where I’d been or that I’d almost died.
When I entered the kitchen, I felt like a ghost. Mom sat at the table eating her coffee ice cream with Marina by her side. Nothing could steal Mom’s attention from that bowl of frozen delight. I was in too much physical pain to deal with that emotional punch to my stapled gut.
I hugged my mother and headed to the basement with my bounty of medications to begin my recovery. Just like at Valley Hospital, the well-equipped man cave provided all the necessities: an adjustable bed, a television, and a bathroom mere steps away.
I was in no physical condition to do otherwise, so I sat and observed Marina in action. Knowing I’d set a high bar, my siblings worried about how we’d get along.
Marina had a different way of doing things—no better or worse, just different. The critical issue for me was how she and Mom got along—all good on that front. Marina was a pro. She always dressed in white. She showed respect by addressing us as Miss Genevieve, Mr. Mark, and Mr. Mike. She needed no prompting, never left a mess, and even offered to care for me during my convalescence. Nice.
After sitting in silence for a few days, I added my two cents. Marina accepted only one. Ruffling my feathers was no way to start our working relationship, but seeing how serious she took her job, I yielded. And after seeing how serious I took mine, we bonded and became a formidable team. We shared the common goal of making Mom’s life joyful and carefree.
But twelve days after my initial surgery, complications sent me back to the ER. A CT scan revealed an obstruction caused by adhesions which required me going under the knife again. This trip included a nurse jamming a nasal gastric tube—sans lubrication—up my nose and down to my stomach, a diet that consisted of ice chips for nine days, and the loss of twenty pounds I had no business losing. I also contracted MRSA, a deadly staph infection that required isolation or, in my case, semi-isolation with an obnoxious WWE wrestling fan who kept me up every night until 4:00 a.m. glued to the fake action on the TV.
After eighteen days of little sleep and little healing, my doctors released me back into the wonderful world where watching “professional” wrestling was still a choice.
By this point, Marina and Mom had their routine down, and it brought me greater relief than my bevy of painkillers.
Okay, maybe not.
Marina’s years of practical experience did ease my concern. They came in handy when nagging issues persisted and when new ones emerged. She solved Mom’s itching issue with a cream I’d never heard of. When the podiatrist had no solution for my mother’s blood blister, Marina stepped in and healed it in days. And if Mom refused to eat, Marina spoon-fed her.
“Just one more, Miss Genevieve, just one more.” And she didn’t let up until the bowl was empty.
Marina, or as I called her, “My Savior from El Salvador,” was always cheerful, kind, and patient. She also had an excellent sense of humor. And though nowhere near fluent in English, she got my jokes and often punctuated her hearty chuckle with, “Mister Marrrrrrk.”
Even though she was devoted and tireless, Marina didn’t treat herself well. She took Sundays off to go to church and stayed the night at her own apartment, and I assume, to sleep in a proper bed. But at our house, she curled up on the couch instead of sleeping on the futon bed I purchased for her.
Why? I don’t know, but the first time I caught her we had a talk.
“I need you to be happy, healthy, and well-rested. So, please sleep in the bed.”
She yielded.
With Marina well-rested and taking good care of Mom and me not content sitting still, I—perhaps sooner than recommended by four out of five doctors—returned to unfinished business: renovating the first-floor bathroom. Working late into the evenings, I often left the heavy lifting and cleanup for the next day. Every morning I’d wake up to find the workspace spotless, and all debris bagged and stowed in the garage. This workhorse of a woman possessed phenomenal strength and stamina. I guess she wanted to make sure I stayed happy, healthy, and well-rested too.
My Savior from El Salvador indeed.
After finishing Mom’s house, I took on a new renovation project, for one of Michael’s clients.
But in the spring of 2014, just as I regained my strength and my twenty pounds, a familiar jab doubled me over again.
When my surgeon suggested I return to the ER, at first, I refused. “They never let me out.”
He countered with a reasonable question. “What’s the alternative?”
The third time was certainly no charm. Another CT scan revealed yet another obstruction, which required yet another surgery. This trip to the ER became a twenty-three-day hospital stay that included another NG tube—lubricated this time—another ice-chips-only diet, a new surgeon, the removal of three inches of my small intestine, the loss of my recently regained strength, and another twenty pounds.
I was not happy to be back in what now should be renamed, the Porro Wing. But I didn’t take it out on the staff as I had witnessed so many patients do. I tried to have fun with them, even the dietitian who recited daily, and at full volume, the entire three-meal menu to my carousel of roommates while I endured my nine-day-ice-chips-only diet.
“Pamela, that’s so unfair. They don’t get ice chips?”
I made a special effort to be cheerful and to express my gratitude to all my nurses. Though it was not my intent, brightening their day paid big dividends, like foot massages, being a buffer between doctors with drill-sergeant bedside manners or coming to my rescue after my nine-day fast ended.
“All I want is a toasted English muffin with melted butter,” I said.
“That’s not on the menu,” the dietitian insisted.
But a nurse overheard and smuggled in for me the Best Toasted English Muffin Ever.
“How do you take your protein?” another nurse asked me.
“That’s a loaded question,” I said. “I dare not ask you the same.”
She cracked up and later helped move me to a private room for some much-needed peace and quiet.
Twenty-three days later I dragged my emaciated body, my even shorter digestive system, my long thrice-stapled incision surrounded by multiple laparoscopic ones, and my collection of painkillers home to begin my long, painful recovery all over again.
New Name, New Role
After my trio of surgeries, my nephew, Sawyer, gave me a new nickname: “Semi-Colon.”
Funny, but I paid a painful price for that laugh. Also new was my caregiving role. Since I had a ticking time bomb that threatened to send me back to the ER at a moment’s notice, Marina assumed full-time duties. Other than on her day off, I became a full-time observer.
There was a silver lining to my diverticulitis three-peat. It deepened my empathy for Mom, and it gave me a preview of what I could look forward to, hopefully, in the far distant future. I drank Ensure and Pro-Stat to keep up my strength, just like Mom. I required assistance on my daily walks, just like Mom. I had little control over my bowels, just like Mom. I saw imaginary people, just like Mom. The powerful painkillers caused hallucinations so vivid when I woke up in the middle of one, I kept the conversation going to not be rude, just in case he was real. And as the drugs wore off, my skin got terribly itchy, requiring major scratching, just like Mom.
My experience also made me realize no one is immune to the physical and emotional stress of twenty-four-seven caregiving. Not even those in denial, like me. I ate well, I exercised regularly, didn’t smoke, didn’t drink too much.
Oh, I can handle this, I thought.
But lack of sleep was an issue, in addition to my constant worry. Is Mom awake? Does she need anything? Is she still breathing?
Not to mention the stress caused by months of dealing with Tammy and the Tweedles, renovating the house, struggling to keep my snack business alive, hosting holiday dinners, and generally wanting everything to be perfect. I didn’t take proper breaks, in length or in number, because I wanted to keep my mother alive and happy. The irony of it all, she almost outlived me.
The pros know what they’re talking about. My stress crept up and up and up until boom!
If you yearn to learn more about Mark Steven Porro’s multi-award winning memoir, click here.
To purchase A Cup of Tea on the Commode, click here. You’ll laugh out loud. You’ll cry out loud. (Sorry for the crying part).
#Humor #Memoir #eldercare #acupofteaonthecommode #Men’sHealthAwarenessMonth
