Weekly Inspiration – 2017 Week 3

Weekly Inspiration – 2017 Week 3

hope | faith | Bible | inspiration | Scripture | Jesus | God | Christ | Lord | Christian | prayer | Catholic | healing | love | strength | cross | family | verses

My very good friend, Daniel Mathews, is guest-authoring this Weekly Inspiration post. It has been an honor to have him in my life and truly a blessing to be a student of the religious proficiency that he brings to the table. He is a Good Sheep of our Great Shepherd and I cherish the time I have with him to sit and reflect on the Good News of the Bible. This is a story that hails from Dan’s recent vacation to the Tampa Bay area.

Just when I thought this trip couldn’t possibly go any better, two experiences took place which… well, you’ll see.

Blessings To Count

As I have done every evening since I got here, I repaired down to the water tonight to watch the gorgeous sunset over the Gulf of Mexico. There was a young married couple standing next to me. The wife asked me if I would mind taking their photograph against that dramatic backdrop, which I did. Then we got to talking. It came out in the conversation that he is a youth minister for his church. He told me that the most important lesson he tries to impart to his students is to be grateful.

HE:     God is so very good to us. If only people would take time to be thankful for all that they have, instead of focusing on what they don’t have, perhaps their attitudes about life would be better. Just listen to all those beautiful sounds… The crashing of the waves, the cries of the seagulls, the live music being played on the beach… And the smell of the salt air, the scent of the barbecues and the fine cigars… How could we not be grateful?

ME:     I quite agree. There is so much for which to be thankful… Of course, standing here on this beach I suppose it’s easy for you and me to say that. Most people on this planet have it a lot harder than we do.

HE:     Perhaps. But they still have blessings to count. Everyone does.

At that point dinner beckoned, and I rose to take my leave. I held my hand out to them and bade them good night. I was a little surprised that he didn’t take my hand. He just stared at me.

SHE:    Mark, Dan is holding his hand out for you to shake.

HE:     (finally extends hand)

ME:     (looks in confusion from him to her, and back again)

HE:     You’ll have to excuse me, Dan. I’m blind.

ME:     (shaking his hand) You see farther than most…

hope | faith | Bible | inspiration | Scripture | Jesus | God | Christ | Lord | Christian | prayer | Catholic | healing | love | strength | cross | family | verses

 In a second way, on this very same night, experiencing the kindness of others and the grace of our God, Dan was enlightened by a simple gesture of a tiki bar guitar player. Cindy, Dan’s dear friend back at home, was certainly on his mind.

 On the way back to my hotel, I was drawn to a musician who was playing at a Tiki Bar. I thought that if I greased his palm he might consider playing a song for Cindy (with whom I was speaking on my cell phone). I did, and he said into the phone, “Cindy, this one’s for you.” Then he played on his guitar and sang “Souvenirs” by Jimmy Buffet, to Cindy’s great delight. When it was over, he took the phone from me.

HE:     I hope you enjoyed that, Cindy! It was a pleasure to play for you. God bless you.

SHE:    (clapping over the phone) Thank you!

I had never heard the song before, but the final verse stuck with me:

“Pieces, bits and pieces
Add up through the years,
I’ve collected a small fortune
In souvenirs.”

What a day. What a night. WHAT A LIFE!
I bid you all a heartfelt good night.
Daniel Sean Mathews
Tampa Bay, Florida
January 16, In the Year of Our Lord 2017

hope | faith | Bible | inspiration | Scripture | Jesus | God | Christ | Lord | Christian | prayer | Catholic | healing | love | strength | cross | family | verses

Weekly Inspiration for 2017 Week 2

Weekly Inspiration for 2017 Week 2

hope | faith | Bible | inspiration | Scripture | Jesus | God | Christ | Lord | Christian | prayer | Catholic | healing | love | strength | cross | family | verses

Since I was literally stumped by this week’s calendar verses, I decided to take a different route this week: I received a lot of get well cards when I was in the hospital, recovering from surgery. This was the text on the card that hit me the hardest. I think it speaks volumes to God’s love for us and how we can use it to propel us into a new year of health, happiness and prosperity.

Acknowledging His presence the whole year through

“Take hold of your gentle Father’s hand…Walk in His Son’s footsteps, for they will never lead you astray…Let the Holy Spirit fill your soul with the joy of the season and the peace of knowing how deeply you’re loved. Whatever your dreams, whatever your hopes, may they come true for you in the new year through God’s leading and His loving grace.”

HOW GREAT IS YOUR GOODNESS…    – PSALMS 31:19

psalms

He is with you Always

The first step is to acknowledge His presence and know that He is with you always. Take His hand. Not just when you need it, but before you need it. Let Him guide you through the fields of challenges you will face each and every day…be they large or small. With your hand in His, you are already a step ahead of meeting those challenges with strength, grace and humility on your side.

Footsteps in the Sand

We all remember the “Footsteps in the Sand” poem. As God walks with us, there are two sets of footsteps and we eventually ask where He has gone when there remains only one. “It was then that I carried you,” says God. I believe that taking His hand is the first step to having a relationship with Him and when times are good, you hop, skip and you jump with joy as you travel together. When times get tough, if you’re already holding His hand, it’s that much easier for Him to pull you close, pick you up, and carry you through to better times. And when it’s your time, He will literally carry you to the Light. Stay close to Him, and allow him to walk beside you…welcome Him to be by your side.

footprints

Walk in the footsteps of Jesus, “for they will never lead you astray.” The Bible says that we were created in His image. I have to believe that to be created in His image, it seems only logical that we were divinely intended to be like Him in every way. Now, the devil and the sin of man have led us astray as a people, but if we walk in His footsteps, and abide by His teachings, we can come back to Him. Everything we need answered in our life, is addressed in the Bible and by heeding his direction and doing our best to walk in His footsteps, we can come around to humility and hope in the glory of Life Everlasting.

A Christ for All Seasons

The season can be any season. I know this card is referring to Christmas and the rebirth and dedication of a new year, but we should let the Holy Spirit fill our soul with the joy of every season. Most especially, we should rejoice at the birth of Christ, but think of how fulfilling our life could be if we were rejoicing around every corner of the calendar at the wonder that is Jesus Christ. He has no timeline for your salvation. Come to Him whenever, and as soon as you feel so moved.

Unimaginable Love

He loves you more than you can imagine and whether or not you think you love Him at any given moment, HE LOVES YOU, regardless. There is something unique and lovable about every human being, and whether or not you can find it, God knows what that thing is, and frankly, He probably has a whole list. He loves you EXACTLY as you are at this moment. With all your faults and your failings, you probably hold yourself to a much higher standard than God does. Sure, we need to try to follow Him, but as we fall short, God loves us no less. This, I believe is what this verse means by “the peace of knowing how deeply you’re loved.” We can’t comprehend the depth of God’s love for us. But we can certainly accept it and share it with someone else. Reach out a hand to someone who needs it and see if you can’t get that struggling soul to reach out their other hand to God, with your help.

How do your plans and God’s plan match up?

“Whatever your dreams, whatever your hopes, may they come true for you in the new year through God’s leading and His loving grace.” This too, is a powerful statement. “Through God’s leading,” I believe is the most important part. We all have dreams, we all have hopes. Many times, they don’t line up with God’s plan. That doesn’t mean He thinks your plan is bad or your timing is right. I know for sure that when my dreams in life fell short, my hopes seemed smashed, it wasn’t because they weren’t noble or I wasn’t worthy. It most often meantt that I had some learning to do first and some challenges to overcome on my way to earning the right to see these come true in my life. Many I’m still waiting on, but God hears my prayers and I trust that in His time – which may not even be when I still walk this Earth – all of my hopes and dreams will come true. I bow to His great plan and accept that I have a duty and a purpose in this world that take precedence over my earthly rewards. We’ll leave that for Heaven…I hear it’s nice there.

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Please see the other posts in “Inspiration”:

Weekly Inspiration of 2017 Week 1

Weekly Inspiration – 2017 Week 3

Weekly Inspiration of 2017 Week 1

Weekly Inspiration of 2017 Week 1

depression | anxiety | sadness | bipolar | therapy | mental health | therapist | OCD | suicidal | recovery | overcoming | struggles | battling | treatment | medication | severe | support | coping | alone | feelings | demons | inspiration

For Christmas, my beautiful and thoughtful wife gave me a “Daily Verse” calendar in which each day lists a short line from the Bible. Since I find searching online overwhelming to begin with, it would be difficult for me to find a ‘daily devotional’ that I could settle on, to be the one to follow out of what I’m sure are thousands. Plus, I wouldn’t have the discipline to get onto the site each and every day, without being distracted or more likely, falling behind. Finally, while I already own a few books of daily devotionals, again, I lack the discipline to open them up on a regular basis in order to use them to their full benefit.

 

So, I loved the idea of a calendar that can keep me on track! I have a daily verse to read and reflect on and I know right away if I’m falling behind. I keep this calendar hung right above my computer at my desk and I vow to keep up with its passages. I may not use them all for this blog, but with a goal of reflecting weekly, I’m sure there will be two or three each week worth emphasizing.

At the same time, as a brand new blogger, I was starting to get concerned that I may run out of material eventually. I’m now confident that won’t be the case, as with this calendar in hand and the Bible in my back pocket, I know there are endless subjects with which to reflect on. I hope this is the first of 52 posts, for starters!

Now, I am no pastor. I have no formal religious education. So, I encourage you: Take my reflections with a grain of salt and if anything feels “a bit off” in your mind, run it by your own pastor, please. I’ll start with Thursday the 5th, which is from Philippians 4:13.

I can do all this through Him who gives me strength.

Wow, could this be more appropriate for the six weeks my family has just endured? I was three weeks in the hospital and three weeks of recovery at home. My wife kept working her teaching job, getting the kids up extra early in order to get them to daycare, which is usually my job. Then, picks them up after school and gets them home for dinner and the whole bath-time, brush-your-teeth, get-to-bed routine…for two kids, aged four and one. My wife has been so strong through this ordeal and I know she owes it to the strength she gets from our Lord. She, unlike me, does follow a daily devotional online, and often leaves me notes before work with her favorite verses. I really appreciate that she takes the few minutes to do that once in a while. She knows me, and knows the verses that I will connect with.

Thankfully, my parents arrived from Florida shortly after my surgery, to help Sybil with the kids’ morning routine and be with us. As devout Catholics, I know for sure that my parents’ strength comes from the Lord as well. I’ve witnessed it my entire life. As for myself, two separate visitors of mine at the hospital had brought me “comfort crosses.” These are small, usually hand-made wooden crosses, meant to be held in your hand to feel close to Jesus. I literally cried when the first one was handed to me, because it was exactly what I needed. For the rest of my three week stay, I had that cross in hand around every turn. I endured a lot of pain, a lot of anxiety and thus, I prayed a lot. And to me, the cross in hand seemed to multiply the effectiveness of my prayers and certainly did its job of comforting me. The more I worried, the more I grinned, the harder I squeezed that cross. I know He was there with me. I could feel Him.

Most importantly, where do you garner your strength? If we set the Bible aside, there are a limited number of answers: The support of my family; my physical strength; the depths of my passion or enthusiasm; the breadth of my intellect. Are there more? Maybe a few. When we allow the Bible to direct and inspire our hearts and minds, the scope and scale of our strength becomes absolutely limitless! We can do all things in Him! There are no challenges that aren’t addressed at some level in Scripture.

So, Friday the 6th is the Epiphany:  In Christianity, the Epiphany refers to the realization that Christ is the son of God. Western churches generally celebrate the Adoration of the Magi (the Three Kings) as the Incarnation of the infant Christ. Today, the calendar reads, from 1 Peter 1:3.

Praise be to the God and Father of our Lord Jesus Christ! In His great mercy, He has given us new birth into a living hope through the resurrection of Jesus Christ from the dead.

This is not a verse that needs much explanation. This is one of the most basic ideas of Hope that comes from the Bible: Through the resurrection of Jesus, we are reborn into a world with renewed Hope. I haven’t yet published them, but I have many a blog post written already about my struggles with depression, and all of my healing can be traced back to Hope. I pray that you have Hope in your life and that you recognize that our Hope comes from Him. Stay tuned for much more on this subject.

Finally, one of my favorite Bible quotes. Saturday the 7th comes from John 13:34.

A new command I give you: Love one another. As I have loved you, so you must love one another.

The first part of this verse, “A new command I give you:,” I didn’t know how to reflect on. I was unsure of its meaning. As I said, I am not a Bible scholar. My wife, however, has a significantly more amount of training than I do. As she read my post, she taught me about this phrase. Why is this a “new” command? She explained that this is a reference to the Old Testament versus the New Testament. In the Old, there is the notion of an “eye for an eye and tooth for tooth,” which this New Testament phrase is often compared to. It represents the somewhat harshness, or matter-of-fact, crime-and-equal-punishment sentiment found in the Old Testament. Sybil said that the prophets often spoke of the ‘Mighty King’ and ‘Rule Enforcer’ to come, whereas the Savior who arrived was in contrast, a humble, gentle, forgiving soul. So, the fact that loving your neighbor as yourself or as the Lord loves you is referred to as a ‘new command,’ speaks to the hard and fast rule of law depicted by the Old Testament versus what in fact, was to manifest into the true Grace of God.

Then, certainly love is one of the most talked about themes in Scripture. This one speaks specifically about loving your neighbor, even to the extent that Jesus loves us. Is that possible? Can we possibly love another to the depth that Jesus loves us? Perhaps. Perhaps not. But what he does is raises the bar extremely high. He gives us something to reach for, which He thinks is possible. Can you imagine the type of world we could live in, if our love for each other approached the level of love that Jesus has for each of us? Something to shoot for!

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So, this has been my first week of devotional reflections. My hope is that by following my blog – and if you’re so inclined to appreciate the love of Christ in your life – that you’ll find that following a weekly devotional easier to stick to than a daily one. Remember, I’m no religious authority, but I think as a Christian community, if we can share our own personal thoughts on how Scripture reaches us, then there’s value in that. I hope that you’ll comment and share your thoughts on the idea of helping each other understand the Bible.

Weekly Inspiration for 2017 Week 2

Weekly Inspiration – 2017 Week 3

Surgery 4 Recovery; post 3/3 in a series

Surgery 4 Recovery; post 3/3 in a series

Surgery | J Pouch | Ulcertative Colitis | Colitis | Crohn's | Recovery | Hospital | Ileoanal Anastomosis | Colectomy | Colostomy | Trauma | Abdominal | Scars | Medical | healing | adhesions | bowel | obstruction | ileus | peristalsis

So, one evening, at about 11:00, a half dozen nurses come into my room carrying these beautiful puppies. One of the nurses rescues pregnant dogs and helps them deliver and on this night, the nurses were so excited to share them with me. A little puppy therapy was just what I needed!

WARNING: THIS POST CONTAINS GRAPHIC PHOTOS OF SURGICAL INTERVENTIONS

Recovery from surgery is no fun. There were a couple of temperature spikes, which are scary. They often produce vomiting and just an altered mental status that thankfully now, allows me to not even remember them. But at the time, I guess I was in rough shape. Actively cooling me with ice in my armpits and anti-nausea medication, but not before the awful feeling of throwing up and the chills and the sweats and all that. Fortunately, the staff is well trained in dealing with these flare-ups and they got me under control quickly. You just have to be careful what the cause is…is there an infection and is it minor or something major having to do with the surgery itself, deep in your abdominal cavity. Luckily, the couple of fevers I spiked were nothing too serious, just scary. But when it comes to recovery time, every little setback means 3 or 4 more days of observation.

So, I think I had about 6 CAT Scans while I was there. Most of them, were of course, focused on the lower abdomen. But with a high pulse rate over a number of days, my fantastic surgical PA, Meg Parker, had the inkling to do a full set…the abdomen, all the way up to my chest. With great thanks to her, this test found a Pulmonary Embolism, which was basically a blood clot in my lungs. Fortunately the clot itself was not too serious, the doctors were confident that it would dissipate on its own and not travel to anywhere dangerous. However, the priority immediately shifted to the prevention of further clotting. After all, I had been lying in a hospital bed for more than two weeks at this point with very little walking or exercise and the risk of clots forming in the legs and traveling to very dangerous places was a serious consideration. My condition was contraindicated for blood thinners, so therefore, the course of action would be the installation of a vena cava filter to catch any would-be clots that might want to travel up to my heart or lungs.

The procedure is not painful really, but a bit unnerving. You lie awake on a surgical table with your head turned to the side. Local anesthetic is injected into your neck, so that the interventional radiologist can then make an incision into your Jugular Vein (yes, just knowing this is going through one of the largest veins in your body is a bit disconcerting). With image guidance, he inserts a catheter through the vein, down through the heart and into position in the Vena Cava, the largest vein the the inferior section of your body, carrying all the deoxygenated blood from your lower extremities back to your heart. There’s a lot of pushing and prodding at the site of the insertion point in my neck and the specialist guides this catheter into place before deploying the filter itself, which attaches to the inner walls of the Vena Cava and helps to block any large clots from moving upward.

filter

A bit scary to think that this antiquated looking device is the only thing standing between me and a potentially life threatening blood clot, but I guess it’s the standard of care and I should trust it. Apparently, it can come out in about 5 or 6 months. So, again, another procedure that warrants a few days of observation before considering discharge. Here we are over two weeks post surgery and I’m still waiting patiently for all the stars to align that will lead me home to my family.

The biggest frustration is the ileus. Ileus is defined by Wikipedia as a disruption of the normal propulsive ability of the gastrointestinal tract. Although ileus originally referred to any lack of digestive propulsion, including bowel obstruction, up-to-date medical usage restricts its meaning to those disruptions caused by the failure of peristalsis, the normally symmetrical contraction and relaxation of muscles that propagates in a wave down a tube, allowing food materials to travel through the bowel in a normal, one-way pattern, toward the exit. So, when the bowels are significantly rested from lack of food, and certainly man-handled as in surgery, they fall into a state of ileus and are just not capable of doing their job yet…so you wait.Yet another thing you have to observe for days before going home.

So, the nurses come in every so often and listen to your bowel sounds. You’re hoping and praying that they hear something, ’cause you’re not going anywhere until they do! And the GI tube up your nose doesn’t come out until they hear something – can’t have food and fluids in there if they’re not moving. Finally, a little gurgling, finally the idea that we can try some clear liquids to see if they travel your tract properly. At first, it’s very uncomfortable. You’ve been in IV nutrition for almost three weeks now and none of your insides are used to anything being in there, so it doesn’t exactly feel normal as the process winds up again. Gas pain, you’re taking it very slow, just hoping that things stay down. The food TASTES amazing, but you’ve got to be careful to not over-do it. Finally, with success, they decide it’s time to take the GI tube out and try some more normal, yet soft foods. You get the idea, nothing happens fast…so it’s a process of waiting and trying and praying that your body gets back to normal as soon as possible.

Three weeks was about my limit! People constantly asked me how I didn’t die of boredom while I lay there so long. For the first few weeks, you have very little time to actually get too bored. There’s a lot of desire to sleep, and the way the nurses are these days – or at least were for me – they were very good at not waking me up just to take a set of vitals. In the past, it was an every few hour thing that you got woken up to get poked and prodded. I felt thankful that my nurses let me alone when I was sleeping, for the most part. When you’re not sleeping, there’s always some procedure you’re mentally or physically preparing for, or meeting with the doctors that you’re looking forward to. Then there’s the watching of the clock to request your pain medicine at regular intervals. You don’t want to miss that, so that keeps you occupied too. And when it comes, the next hour or so is lost to space and time because you feel so good and relaxed. The time eventually drags a bit, but you know you’re there to heal, so I tried to embrace the rest and just let my body relax. A little bit of TV here and there, but mostly rest and reflection. Then, there’s the guests. I had at least a couple guests every single day, which meant the world to me. So, was I bored? Not really. But at the three week mark, I started to get EXTREMELY bored. Like I said, that was about my limit and I think it probably had more to do with knowing that going home was just a day or a few hours away and I just couldn’t wait any longer for that culmination of excitement to ensue.

And finally that day came. All the IVs were disconnected, I was eating regular hospital food, and getting visits from the case worker, who coordinates my home care – the visiting nurses to change my dressings every couple days. I saw a nutritionist, who provided some guidance on what foods to stick to and avoid. Some last minute visits from doctors to wish me luck and send me off, expecting to hear from me for follow up appointments. A couple of quick procedures: One to pull out the triple lumen (also called a picc line, or central line). This is the IV port that the surgeon installs during surgery into your mid-clavicular area, that goes almost straight to your heart. Think about it, a single IV in your antecubital space (the opposite side of your elbow, sometimes called the “elbow pit”), is not very practical for a three week hospital stay. You’re constantly moving your arm, so as to irritate this area and compromise the site’s integrity. Not to mention, when you’re on the amount of IV fluids and medication that I was, you need more than one site, so the triple lumen allows for three semi-permanent ports to be used to hook you up to all the stuff you need to be hooked up to. Not only this, but they were taking blood almost every single day. Can you imagine being poked for three or four vials of blood in a different vein for three weeks? The triple lumen makes it easy, they unscrew an IV, pop in a blood collection vial and grab the blood they need over and over from that same site, painlessly.

So, anyway, that central line has to come out. It’s a funny feeling, but doesn’t hurt. Though anything that you know is directly aimed at your heart is a little disconcerting to think about. You just hope nothing goes wrong – and nothing almost ever does – but it’s just one more thing you pray about…and follow directions very carefully. The worst part about the going home preparation was the removal of the tension sutures on my incision. This was the last thing to be done, but certainly the most uncomfortable. Here’s what my incision looked like at this point:

incision

I know, I’m sorry, it’s disgusting. But it is what it is. Eighteen years ago, after my first surgery, they simply sewed me right up the first time and after that second surgery, stapled me up all nicey nice, so what you have appears as a completely closed up incision…no redness, just closed skin. Apparently, over the past 20 years, what they’ve learned essentially from the battlefield, is that it is much more effective to let an incision heal in the way you see here. Closing it up completely was leading to more infection right under the surface of the skin and concerns with fluid discharges, etc. Instead, now, they leave what looks like more of an open wound, and allow it to heal up from the inside out, exposed a bit more to the oxygen in the air. This is supposed to create a safer healing experience and healthier skin growing over the incision eventually. But, before going home, these sutures come out. So Meg, the surgical PA, arrives to do this and these are not thin pieces of suture thread. They are thick wires, wrapped in a rubber tubing to protect the surface of the site. They have to be tugged on to snip in the right place, the tubing cut off, and then pulled out over the width of this scar…underneath the surface. This did NOT feel good. It wasn’t necessarily painful, but it made me lightheaded and close to fainting as she pulled out the first two, because it is so disconcerting to feel the pulling and tugging through what you consider a very sensitive area. Fortunately, my triple lumen wasn’t out just yet and she called for my nurse to push 1 mg of Dilaudid pain medicine through the IV to help me through this process. That was heavenly. It only takes a minute or two to take affect and then pulling the other four was a breeze. I thanked Meg for her gentleness and expertise and I was off to the races. I’ll spare you the picture of what it looks like without the sutures. It’s not pretty, but they said it would be closed up and skinned over in 2-3 weeks. Until then, regular dressing changes by the visiting nurse and I’d be on my way.

Dad drove me home from the hospital after gathering all my things. All the pictures that had donned the walls, colored by my nieces and nephews and sons. I know they brightened the day of every nurse that ever walked into that room. I was so grateful for their empathy. I met some incredible people over those three weeks and as I rode the wheelchair down the hall to the elevator, I got lots of hugs, kisses on the head, even some nurses who teared up and a big round of applause. How special is that? Then, my buddy Yvonne ran out from the nurses station, calling out to me as I rolled into the elevator. She jumped in and gave me a big hug. It was a heartwarming experience and I hope very much that I get to visit the 5th floor every now and then and see some familiar faces. For now, a bouquet of flowers and a Christmas card would have to do.

So, that was my fourth experience with abdominal surgery. My lovely nurse, Yvonne, put it best when she said I had the GI tract of a 70 year old. Great, thanks Yvonne, I really wanted to hear that. But it’s okay, I accept it. I am here, I am here for my kids, I am here for my wife and all the people who love me for another length of time, however long God deems that to be. And I am eternally grateful. It’s been slow-going at home. Just walking around the house tires me out and I take a lot of naps. Fortunately, this is the time when I started writing this blog too. The personal reflections of the past few weeks were the impetus to share my story…my stories. I hope these posts touch some people who can benefit from them.

Until next time…

Ulcerative Colitis…the extreme cure – post 1/3 in a series

Surgery Number 4, eighteen years later – post 2/3 in a series

Surgery Number 4, eighteen years later – post 2/3 in a series

Surgery Number 4, eighteen years later – post 2/3 in a series

Surgery | J Pouch | Ulcertative Colitis | Colitis | Crohn's | Recovery | Hospital | Ileoanal Anastomosis | Colectomy | Colostomy | Trauma | Abdominal | Scars | Medical | healing | adhesions | bowel | obstruction | ileus | peristalsis

WARNING: THIS POST CONTAINS GRAPHIC PHOTOS OF SURGICAL INTERVENTIONS.

The first time I had surgery, when I was 21 years old, I had been smack dab in the middle of taking an EMT course. Fortunately, when my surgery was done and I had the chance to heal for a few months and gain some strength back, I was able to jump into a subsequent course, finish my training and go on to take the National Registry test and become certified. This was in late 1999. I was working, at the time, for a small local bank in Thomaston, CT and so I volunteered for the Thomaston Ambulance Association once or twice a week and was able to get a little bit of experience under my belt. Soon, life and school and work got in the way and after the first three years of my certification, it hadn’t made sense for me to renew it and it fell by the wayside. I had always missed it, however. I loved the adrenaline rush of an emergency call, the unpredictable nature of what you might be thrust into and of course, the ability to help and make a difference. And driving the ambulance was fun.

Fast forward eighteen years. I had been jumping from job to job, trying to find my lot in life. Trying to find a good employment fit after nine years of running my own business that had shut down. As I struggled, I thought, being an EMT has been in the back of my mind for eighteen years, I had always enjoyed it and though it would never pay very much, perhaps I should take another course, get re-certified, and then if all else failed, I could fall back on something I know I would enjoy and always be able to find employment. I made it more palatable in my mind by thinking that I could even go on, eventually, to become a Paramedic, be that much more trained and that much more employable at a higher rate. I’ve always enjoyed the medical field, ever since my first surgery. So, this is what I did. I enrolled in an EMT class this past September and was having a great time getting to know my new classmates as friends and eating up the knowledge that the course provided. I absolutely loved the idea of being able to help, not just as a member of an ambulance crew, but as an everyday citizen. In my excitement, I bought a jump bag to keep in the trunk of my truck, and loaded it up with every piece of trauma and medical equipment you would ever need…I turned my personal vehicle into an ambulance in itself. I had c-spine collars, trauma dressings, splinting materials, BP cuff and stethoscope, tourniquets, a bag valve mask and even an OB kit, in case I ever needed to deliver a baby! I loved the idea that if I ever came upon a scene, I knew I could help. I decorated my truck with a star of life and a bumper sticker that reads, “My other ride is an ambulance.” I was all in.

Well, again, God had different plans. Just as He had done during the first EMT class I had took, luck would have it that I wouldn’t finish this one either. I had been doing some ride time for my course at the local Winsted Ambulance Association on the Sunday night before Thanksgiving in 2016, the holiday which also happened to land on my birthday this year. I arrived at 6:00 pm and inhaled a Quarter Pounder with Cheese and some fries. At exactly 6:15, I started to experience what I thought was the most intense bout of indigestion and acid reflux than I had ever before. The pain started right below my sternum and stayed there throughout my shift. We had one call that night and drove in the snow up to Colebrook for a motor vehicle accident that was nothing serious. I was done by 9:00 and went right to bed when I got home.

By 11:00 pm, I was awoken by some serious pain that had radiated down into the lower quadrants of my abdomen. It was a pain that I was not used to and it immediately concerned me. I kept saying, “30 more minutes, 30 more minutes,” to see if it was going to get better. Well, when 1:00 am came around and it hadn’t, it was time to get to the hospital. Over the past 18 years of my condition, I had experienced periodic pain before, but it was generally much lower…down in my J-Pouch, which was referred to simply as pouchitis. An inflammation of my pouch, causing pain that was usually handled quite simply with some antibiotics and anti-inflammatory agents. I could tell, however, that this pain was almost certainly a blockage of some sort.

So, against the will of my wife, who wanted to wake up the two boys and package them up for a trip in the snow to the hospital, I demanded to drive myself. I explained to her that while it was painful, it was not the kind of pain that was going to drive me into a tree. I could handle it and let’s not disturb the boys. I’d call her as soon as I got there and again as soon as I knew something. So, I arrived and they got me right into CAT Scan rather quickly. It was confirmed by about 4:00 am or so that I indeed had a blockage. The scan showed a constricted area just South of a rather bloated area…a clear sign that something was not right. So, I was admitted and sent upstairs, luckily to a private room that turned out to be one of the best rooms in the hospital. Two windows and the quiet end of the hallway. I was scared, but content that they would figure out how to fix me up.

So, standard procedure ensued…IVs in, blood work like crazy, stool and urine samples, and constant vitals taking. Then, the dreaded GI tube! Uuuggghhh! That nasty tube up my nose and down into my stomach to suck all contents out. The idea here was to give my bowels a rest. It was explained by the doctors that almost 100% of folks who have had abdominal surgery in the past, will, at some point in their life, end up with abdominal adhesions that cause a small bowel blockage. So, that was the diagnosis. In my mind, I was thankful for what I considered a good run for eighteen years. Something to be thankful for. It was further explained that an abdominal adhesion is basically fibrous tissue that forms, often at the site of scar tissue, that binds together things that aren’t supposed to be bound together. At the same time, the hope was that with a little bowel rest, the blockage may work itself out. Apparently, the small bowel is a very mobile organ. It doesn’t just sit in one place, but moves around as it processes food – twists and molds and contorts like a small slithering snake might do if you held it in your hands. With this in mind, the hope was that it would “un-kink” itself. Because basically, the adhesion had connected two outside surfaces of small bowel, kinking itself into a loop that wasn’t allowing food to move through it. So, we waiting for a few days to see if it might naturally release. It didn’t.

I had another CAT Scan on Thanksgiving and it was confirmed that the blockage was still in place. When the surgeon, Dr. William McGeehin – a highly regarded local surgeon with an impeccable reputation – came to see me the day after Thanksgiving, it was about 8:00 am. “Well,” he said, “it looks like the blockage is still there, not getting any better and we’re going to need to go in and fix it.” I asked him what he thought about timing and he said, “how’s 10:00?” Okay, so that was a lot to digest all at once. We weren’t wasting any time and perhaps thankfully, I wouldn’t have a lot of time to dwell on it. I quickly reported the news to Sybil and she came right down.

I was comforted by the professionalism with which I was informed of the surgery and what was to take place. In contrast to my first surgery, I was fully informed of what to expect when I woke up and exactly what they were looking to do when they got a look inside. It would be somewhat exploratory, because it was impossible to predict exactly where this blockage was, which was a contraindication for laparoscopic surgery. So, yes, there would be another quite large incision, but they were going to take very good care of me. As an aside, it was a special experience to speak with one of the surgical nurses, who actually was there when I had been in that same hospital 18 years ago. Mark Dallavalle and I had a special connection the first time around and I had given him a book back in 1999, which he immediately brought up as he spoke with me and my wife before this surgery. He remembered me and how he appreciated the gift of that inspirational book I had shared with him all those years ago. He praised my strength to Sybil and I was happy he was on the team.

And so they did their thing. It was just under a three hour surgery…much easier to come out of than that eight hour one in Boston. Still the GI tube, and the big incision, but this time, no drain tube and certainly no colostomy bag. I felt some significant discomfort, but for the most part, I felt great. Happy it was over and thrilled with the report that everything had gone smashingly. And of course, my wife was soon right by my side as I recovered. The doc had actually even taken a picture of the surgery that he shared with my wife and I. I hope this doesn’t gross you out, but I’ll share it with you.

blockage

As I understand it, the section that the surgeon is holding with his three fingers at the right, was the “kinked” section of the bowel. The two holes that you see at the left, top and bottom, are the sections of the bowel that were stuck together by the adhesion. So, the surgeon had to snip the adhesion itself and then sew up the resulting holes in the bowel.

What I loved about what they were able to do, was basically give me a thorough check-up from the inside out. You would never willingly go into major surgery just to check around and see how things were going in there. But, because they had to go in to fix the blockage, the added benefit was a full review of how everything else in there was doing. Were there any places where things were festering that could leave to problems down the line? In fact, the connection of my J-Pouch to the anal sphincter got a bit of a repair job while they were in there, which cleared up some minor bleeding that I had been experiencing for a few years prior. So, a fixed blockage and an internal check-up…I was happy as a clam. For a couple days or so.

…to be continued.

Ulcerative Colitis…the extreme cure – post 1/3 in a series

Surgery 4 Recovery; post 3/3 in a series

Ulcerative Colitis…the extreme cure – post 1/3 in a series

Ulcerative Colitis…the extreme cure – post 1/3 in a series

Surgery | J Pouch | Ulcertative Colitis | Colitis | Crohn's | Recovery | Hospital | Ileoanal Anastomosis | Colectomy | Colostomy | Trauma | Abdominal | Scars | Medical | healing | adhesions | bowel | obstruction | ileus | peristalsis

When I was about 19 years old, I was diagnosed with Ulcerative Colitis. Not a fun disease. It was characterized by lots of cramping pain and lots of rectal bleeding. For a few years, we treated it with medication – mostly steroids – giving me that stereotypical bloated face look…sickly to say the least. It kept me from going on trips of any length, and certainly kept me from any place where a toilet was not readily available. It was embarrassing and debilitating. Finally, on my 21st birthday, a couple days before Thanksgiving, I called my doctor one more time with unbearable symptoms and he told me to go to the hospital and that they’d be expecting me.

For the next 30 days, I was on IV fluids, TPN (IV nutrition), steroids, antibiotics and yes, they stuck that GI tube up my nose and down into my stomach to keep everything out of my bowels in order for them to rest and hopefully, heal. If you’ve ever had a GI tube inserted, you know the agony. It’s so unnatural to stick a tube up your nose and all the way down your esophagus while you’re awake…horrible. I had colonoscopies that certainly showed polyps and bleeding ulcers and the whole nine yards. I spent so much time in that Torrington hospital just waiting for things to ‘turn around’ naturally…or at least…on a bunch of medication, but it was beyond me why the plan was just to ‘wait and see.’

Finally, my parents were contacted by my cousin, Heather, whose sister-in-law had had a then somewhat revolutionary surgery to cure her colitis, and it was performed in Boston by Dr. James Becker. It was a quick, easy decision to consider this avenue between my parents and I. I was getting no better sitting there at the local hospital, and nobody had any idea if and when I would get better along this track. So, shortly after spending Christmas in the hospital, after already having spent Thanksgiving there, I took an ambulance ride up to Boston Medical Center, the training facility for Tufts University. The very day I arrived, Dr. Becker got me into colonoscopy immediately. Following this, he rearranged his entire surgery schedule for the following day to get me into surgery immediately. I was that sick.

So, as slow – or non-existent – as my progress was in Torrington, all the while I retained a hugely positive attitude. Call it the narcotics I was on, but I like to think that I had been brought up to remain optimistic. I knew I was there to get better…I was treated well and I knew eventually that I would be better, and that kept me going positively. Getting to Boston was the final step in getting better and I was elated to be in a place that could take my care to the next level. I was so excited about surgery. Little did I know what surgery was going to be like. In my naive mind, I would go to sleep and wake up cured, back to my old self, ready to take on the world. Well, let me tell you what threw that off course.

Perhaps it was the rush of the emergency surgery, or just an oversight on the part of the surgery team, but whomever was supposed to explain the surgery to me and what to expect upon waking, did not do their job. Now, yes, I was on heavy narcotics for more than a month and perhaps I just forgot the orientation, but I don’t think so. I think to me at the time, that “surgery” was almost an abstract term. But in reality, exactly what they were about to do was absolutely nowhere in my realm of understanding or expectation. It wasn’t until a week after surgery that someone finally explained exactly what had been done to my insides, and they did so on the back of a napkin.

That being said, after an almost eight-hour surgery, I slowly began to come out of anesthesia. I can remember yelling at nurses walking by and being so frustrated that nobody was responding to me. I had come to learn later, that this experience is a common occurrence – thinking you are speaking, but nothing is actually being verbalized. That was just the beginning of my frustration, as I started yelling obscenities – or so I thought – at all these people who continued ignoring me. Then, I had heard someone say that the morphine didn’t work for me. Now, in my state of mind, I thought that meant that I had just endured a long major surgery without any pain medication, which was why I was now basically on my death bed. Of course, they would have simply found another medication that did work, but I didn’t know that. As I said, I was not prepped for what to expect when I woke up, so the tube in my nose, the oxygen mask, the almost 12 inch incision, the drainage tube, the – oh my God – colostomy bag! I had no idea any of this was part of the plan and I was devastated and scared…extremely scared.

Yes, come to find out, I had endured a total abdominal colectomy with ileoanal anastomosis J-pouch surgery. Ileoanal anastomosis surgery (commonly called simply J-pouch surgery or IPAA, for Ileal Pouch-Anal Anostomosis) allows you to eliminate waste normally after removal of the upper and lowest parts of the large intestine (colon and rectum). J-pouch surgery avoids the need for a permanent opening in the abdomen (stoma) for passing bowel movements. However, in order for the organs and new artificial connections inside to heal from the trauma of surgery, I would need a stoma and colostomy bag temporarily. Can you imagine waking up from surgery to find a huge incision and a colostomy bag without ever expecting it? I was in rough shape, physically and emotionally.

But the healing ensued. After a week of recovery in the hospital, I was on the way home. Weak and slight and in pain, but going home. Unfortunately, after only a few days at home, I was vomiting and nothing was getting through…another blockage. I would have to make the two and a half hour trip back up to Boston for an exploratory surgery through the exact same incision, to find the source of the blockage creating the problem. Not fun, but certainly necessary. Finally, I was able to heal at home for the next few months. And after a frustrating run of pooping out my abdomen and dealing with emptying colostomy bags, it was time to put me back together. Thus, a third surgery was performed, called a “take down surgery,” to removed the stoma and colostomy, sew my remaining small bowel back together and let the J-pouch start doing its job. It was a long road, but essentially, this series of procedures cured my ulcerative colitis.

No more pain, no more bleeding. Much more frequent bowel movements, since I’d never have the storage capacity that I used to have, but I was cured. And I had a great run for 18 years. I owe my life…the quality of my life…to the surgeons in Boston who worked their magic. I thank God every day for the second chance at life I had because somewhere, doctors figured out how to remove a major organ (the large intestine) and believed that we could live without it with a little mechanical and medical ingenuity. I am forever grateful to Dr. James Becker and his surgical team at Boston Medical Center.

Surgery Number 4, eighteen years later – post 2/3 in a series

Surgery 4 Recovery; post 3/3 in a series