But, Why is it purple?

     I woke up to notice an unusual cough and a foul taste in my mouth. I proceeded to walk myself to the bathroom where upon I discovered a color I didn't think could come from a person. The alarming color I saw was a dark purple with chunks of all different types of foods that I'd eaten all day. I presume that it was possible that it may have been something that I ate, so I proceeded to go through all the different foods that I'd eaten that day in my head. Whatever the potential culprit was, I slowly drank some water and sat upright as I awaited the next round. I was aware that this was not finished.

     The color, the smell, the taste, everything about it seemed unusual. And at 4 AM this is something I needed to keep an eye on. As the morning crept forward I would again find myself face to face with a porcelain halo. I proceeded to dump even more of a purple - now what appeared to be dark red into the bowl. At this point I was certain somewhere inside me... I was bleeding. I have tasted blood that'd been drying in my stomach before I have tasted fresh blood from the back of my throat but this taste this chemical popcorn taste was unlike anything ever that I had willingly consumed. From there I cleaned myself up yet again and sat on my bed waiting for one last thing to make sure. The curious thing about an internal bleed in your GI tract is that there are two areas you can watch: your mouth and your butt so now I was merely waiting for the moment to pass so to speak. Upon inspection I found absolutely nothing unusual, and it was at this point I proceeded to make some phone calls and be on my way to ER.

     While waiting for my dad I sat upon the steps to my home. The cool breeze coming up from the canyon, my arm gently resting on the handrail so that if something may happen perhaps I may lean on it for support. My stomach burning from the inside out and a plastic bag in my hand. Prepared for the worst, a towel over my shoulder waited to clean up any unwanted messes. After a moment I was on my way. There was nothing unusual about the ride except for me vomiting along the way. Thankfully, I had my plastic bag! When we arrived to the ER I handed it off to my father, he proceeded to attempt to give it to the ER nurse which was entertaining to say the least. The next part is a touch hazy as within perhaps an hour of my stay in the ER I was under mild sedation. A 20 gauge needle in my hand was a sobering reminder of the potential impending problems. (A needle gauge between 18-22, is used in case of blood transfusion)

            Thankfully my nursing staff was quick and very accommodating throughout the entire process. It was smooth and easy, it's one of the things I prefer about Sharp Healthcare. My nurses were fantastic and made the entire experience significantly more bearable.

       While in the ER I proceeded to vomit a few more times before they rolled me upstairs to the ICU. Most nurses are kind of confused when they first see me on the ICU floor because typically speaking to someone on the ICU well ummm...is practically dead. There are number of reasons why the ICU is typically where I end up going, one of them has to do with conscious sedation and the other with the fact that my status may change within a moment. When the new doctor came in prior to the procedure to introduce himself we went over the basics of the procedure's complications, and a little bit of my own patient history. He was very surprised at both the number of treatments I've failed, my outstanding health otherwise and my age. Saying " I'm not going to lie, you are very unlucky."


   

The procedure kept getting pushed back, so hours went by where I refused pain meds because of the impending fentanyl required to scope me. So when he came in and said "Long time no see." Well, I couldn't help but respond a lil sassy as i said "Yup." I'm not certain exactly what happened after that because at this point everything kind of gets really fuzzy. Fentanyl will do that to you. The procedure I had was unlike my typical endoscopy. This was something a little bit deeper it's called a gastroendoduandoscopy.
If you thinking to yourself what the fuck is that? Then perfect we're on the same page. Let's break it down...
Gastro: Stomach
Endo: Esophagus
Duadno: Duodenum (it's an area after the stomach, prior to the intestines)
-oscopy: inspection by scope.


      After the procedure in my state of delirium I was greeted by my friends. I apparently was quick to adorn myself with the title "Two Socks" and co-opted them into my newly formed band.

My surgical team, doctors and nurses were on point. My GI doc did a fantastic procedure and didn't bruise my lips. (If you go in for an endoscopy, wear Chapstick, you're basically gonna make out with Legos for ten minutes.)

The scope revealed no real threatening abnormalities.

The bleed had been caused by irritation and some scraping in my stomach.

I have little recollection what happened after the procedure, I remember flashes of a car ride, constant requests by me for Tajima Ramen, and suddenly being home.

While there was no major issue (unless you count the lack of Tajima Ramen), the entire debacle was exhausting to say the least.

I'll have a follow up in a few weeks, from there we'll determine when treatment should occur.

I'm going to use this whole shitty experience to highlight one incredibly valuable lesson I've learned to value greatly. 

Besides my HCV, I am healthy and fit. It's paramount that when you live with any disease you must mitigate comorbidity (multiple diseases/medical issues) by minimizing your risks. Physical and mental fitness are your friends :)

This wasn't a cake-walk getting to this point, it's hard and it's a little maddening and it took months. Every day, every moment is its own unique struggle. I look at one hurdle, isolate it, and take it down at my leisure. My first three weeks were a constant struggle as I combated the daily one to two hour muscle spasms. But once I built up the muscle and began to better fight my atrophy, it slowly became easier. I would vomit once a week from simpler work outs... my point is that it's not easy, but do it anyway, find what works for you and....

Start.

Cold compresses and hot soups

Every time I go under for an upper endoscopy there's always some type of clarity that happens the following day. I typically sleep so soundly, It's hard to describe, but it's a mental calm. A lot of the constant stresses aren't as intense. It's a nice pause, for what it is. While they test for RAVs and see what they can do for me, I wait and see.

The endoscopy gives me a chance to give my friends a view into some of what I have to do regularly. Nearly a dozen of my friends have been my driver for the upper endoscopy. They'll relay important information back to me, regarding any RXs I'll need or any suggestions the doc has. Since I have little memory of the event, I am completely reliant on whomever is my driver.

I used to think of it as a chore, but now I view it as an honor. Because it takes a deep level of trust to give someone that level insight into my life and the responsibility of taking care of me for a day.

I have yet to find a friend unable to take on this near half-day inconvenience. My girlfriend was my driver this time, and she relayed good news. No banding this time! Yes! Getting banded is not so bad when it's winter time and soups nice and hot...but it's pushing 90 Degrees Fahrenheit and soup just doesn't have the same draw that it does in the winter. ( When banding occurs, soft food diet restrictions can last a week or two.)

I've also learned that my acid reflux is worse than it used to be. So I've started avoiding foods 2-3 hours before bedtime, and sleeping in a reclined position.

Which was great last night...until I accidentally snapped my pinky toe.

What a useless toe; my toe caught on a chair, and well... it snapped out of place to a 45 degree angle off my foot. So I just popped it back in, it's pretty swollen and bruised. But as I see it, if my knee can withstand a car without breaking, my pinky toe can withstand a weak and cowardly chair. Thankfully, I've equipped my home with first-aid response kits and cold compresses. R.I.C.E. (Rest Ice Compression Elevation) every hour for 20 minutes or so has brought to wonder one thing about this experience overall. Why is Ice the second word in the RICE acronym? It seems like an odd choice, it always forces me to second guess if the I really stands for Ice.

Long story short, I now get to sleep in a weird V shape, while having to get up every 2-3 hours out of pain or having to pee. I can't help but laugh at my situation. It's not horrible, it's just terribly inconvenient and annoying. Which brings me to the point of all of this:


It's not so bad. While yes, at times I may not be able to walk because my legs have ballooned to look like overfilled sausage casings on the verge of bursting, or the muscles spasm out of control because I messed up my electrolyte balance. Or the increasing joint pain that makes my knees ache...I can walk mostly, I can move on my own power. And though I have times of incompetence, It's not so bad.

I may forget what's going on, become confused easily, have strange heartbeat patterns, my eyes will ache easier than they should, and I bruise like a person more than twice my age. My bone's are still strong, and while my back may ache from the liver pain, I stand up tall and enjoy what is here, because it's not so bad.


I could go on ad nauseam, but what I've seen is that there is good hidden within troubles. I've come to appreciate things that may seem strange to others, even this stupid toe injury. I can't help but laugh at my own misfortune. Seeing the good, has always helped me find hope in every hardship.

This is part of my mentality, why I refuse to give up, and do every treatment I can. I will do better, and with each step forward I will do best. Because I have not so easily resigned myself from this life. I shall live as best I can, as I can, because best is enough.

They're gonna shove what down my throat?

Next Week I'll be under the knife so to speak. Every 4-6 months I go in for an outpatient surgery. There's not really a knife involved there is however a scope, some bands and other odd-looking tools. The procedure is called an Endoscopy.

The regular procedure started occupying my calendar after an incident in 2011. I felt weak, light headed, had unusual breath, stomach pain and black tarry stool. I pushed through it for five days before going to urgent care where they explained to me the severity of what was happening. I was bleeding internally through ruptured veins in my esophagus. Since there was a lot of blood in my stomach they used a Balloon Tamponade.

Balloon Tamponade

When I went in the first time, they used this incredibly painful contraption, made all the more painful thanks to the ambulance ride across town. I had the pleasure of watching the dried blood get pulled from my stomach through my nose for a few hours. They also gave me morphine, which just makes me feel like I'm on fire.

Since then, bleeds have happened half a dozen times, varying from catching it on my routine endoscopy, to a blood transfusion and trip to the ICU.

There are several versions of an endoscopy. What I will be doing next week is an Upper GI Endoscopy, which means they'll be looking at my esophagus down to the stomach entrance. It's a rather quick procedure typically taking a few minutes, longer when banding occurs. In the US we use anesthetic to minimize the discomfort and make the process faster. Some people will retch regardless,
I am unfortunately one of those people. When you've got a tube down your throat and you begin to retch, it becomes more likely to burst a vein.


But that's probably the best time to burst a vein, since the doc can fix it real quick.

The banding process is interesting. Essentially a rubber band ties off the bleeding vein, causing them to balloon and completely rupture. The residual blood is digested and reabsorbed.

Banding 

If you happen to get banded, the throat becomes incredibly sensitive, and it's a soft food diet for a few days to a week. So if you suspect you've got varices have some pudding, soup, milk, juice, yogurt at the ready.

I also prep by shaving my face the day prior, while it's not necessary, it does help make sure they don't break your lips, or give ya some hardcore chaffing from the gag.

an example of an endoscopy gag

It can also be a pain in the neck, literally. The discomfort from an endoscopy typically sticks with me for four days to a week. If i get banded, it's a week to three depending upon the bleeders and how much i retched during the procedure.

Typically the discomfort goes away quickly, unless you retch a lot, then it sticks with you.

In addition to my procedure next week, i may find out a little more about the future of my treatment.