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Thursday, May 2, 2013

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I was pretty sure I had a hernia. I had a lump and some pain. All the males in my family have had hernias. I was just waiting for my turn. I figured I would go to the doctor in a week or two. Then one evening the pain started getting intense. My wife was reading about hernias on the Internet, never a good idea. She was telling me that when a hernia becomes incarcerated and is not treated within six hours, the intestine can die and the patient will have to have a colostomy bag. Things get ugly.

The colostomy bag thing convinced me to go to the ER. Becky took me. I was triaged quickly and before too long I was on my way to a room. I was shocked at the speed of the whole thing. Less than a month earlier my wife had sat in the ER for six hours with a perforated appendix. The doctor came back to see me. It was Dr. K___. On our family's many ER trips the past several years I had met him before. I like him. He is friendly and has a trait few doctors, at least in my experience, have. He listens. He lets you finish saying whatever it is you have to say, he looks you in the eye, asks follow up questions. He also keeps you informed. He examined me and ordered some scans.

While I waited for the scans I was put on IV painkillers. Dilaudid. I was also given some meds for the nausea. The nausea medicine burned all the way up my arm. I mentioned this to the nurse, but she wasn't listening. She was too busy talking about how much she loves to give IV's. The pain medicine started to hit. I could still feel the burning, but it was distant now, and I didn't care so much about it. I remember talking a lot, but I can't remember what I was saying. Apparently it was funny stuff. Becky said I was very random.

After the scans Dr. K___ returned to tell me I had a bilateral inguinal hernia. That's right, not one, but two hernias. Thanks to the dilaudid all I could think of was the Count from Sesame Street saying, “One, Two hernias, hah, ah, ah”. I think I had a drug induced smirk on my face during the entire conversation. Then Dr. K___ had me stand up and began to examine my groin again. He pressed with his hand on the bulge on my right side. I felt the second worst pain of my entire life. All I could see was a bright white light. I was literally in blinding pain. I thought nothing. Not a single thought, just a bright white light. Then I thought, “this is it”. This is the end. The Minnesota born son of Nigerian diplomats killed me by pressing on my groin. The light faded, the pain dulled. Color began to be restored to the room quickly followed by people and objects. I was allowed to lay down.

Becky says I was completely white. I wanted to die. I laid on the gurney in as close to the fetal position as I could get. I think I understood how someone must feel after being water boarded. Not relief at being alive, but disappointment that you have to live with the horrible pain and the recent memory of thinking you were going to die. It could just have been the dilaudid.

I was sent home with a referral to a surgeon and some pain pills. The surgeon was the same surgeon who had done Becky's emergency appendectomy. She also had a consult two days after my ER visit with him about her umbilical hernia. Yes, we were living with three hernias. His office did not have any openings for a month, so I tagged along with Becky. The surgeon was great. He gave us both consults. Was thorough in explaining the risks and benefits of the procedures. He showed us our scans. The two holes in my abdominal wall were clearly visible. Becky had her surgery scheduled. Because of the mysteries of insurance, I would have to go to my regular doctor to get a referral.

The next day I went back to the ER because I had a strange infection spreading rapidly up my arm where the nurse had stuck my IV in. Turns out she didn't dilute the Benadryl properly and damaged my vein and gave me an infection. Super. The nurses and doctors were all extremely nice and attentive. After some tests I was released with a heavy duty antibiotic prescription.

After securing the needed referral from my primary care provider, she is actually a Nurse Practitioner; I waited to have my surgery scheduled. Then I got a call from the surgeon's office that my insurance was denying my claim. The same afternoon I received a helpful letter stating that surgery would only be covered if one or both of the hernias became incarcerated. In other words, I had to wait for a dire emergency. The good news was my ER visits would be covered.

Several weeks later, I was vomiting and in pretty bad pain. I went back to the ER. The triage nurse asked me the dreaded pain scale question. “How would you rate your pain on a scale of 1 to 10?” I hate that question. I hurt, it hurts bad enough that my wife drove me down here at 10:00 at night. It is not a "1" or a "2". I suppose it is not a "10" because I have had worse pain, and I imagine that I could hurt even worse than the most painful experiences of my life. I said "8", hoping that was enough pain to get treated, but not too much that I seemed like a drug seeker. I was given more dilaudid and nausea meds. There was no burning this time. The dilaudid did feel warm as it entered my blood stream, but that is normal. As the warmth of the painkiller spread through the room, the color of everything started to fade. It was like going from Oz back to Kansas. I fell asleep. I had dreams. Trippy dreams. Everything was in the color palette and style of the Beatle's Sgt. Pepper cartoon, except everything was happening on Mars. My body felt extremely heavy.

I heard the curtain part, the doctor was coming in. It was Dr. K___. He began to examine me. While staring at my groin he tells me, "I remember you." I think I saw the nurse crack a smile. I wasn’t sure if I should be proud or alarmed that the doctor remembered my junk. I went with proud. More scans were ordered and everyone left. After I had the scans and was back in the room my nurse came back in to tell me Dr. K___ was probably going to come back and "reduce" the hernia. She got a page and left. I turned to Becky and said, does "reduce,” mean what I think it does? She told me it did, Dr. K___ was going to lay his hands on me again and try to kill me. The nurse returned. I was looking a little pale. She asked if I was okay, and I told her I was not looking forward to having my hernia "reduced". Her reply was exactly as follows, "I totally understand. Dr. K___ is really strong. He once squeezed my shoulders and I had a bruise for weeks. I can only imagine how that would feel in a sensitive area." 

I laid there with my mouth open. There were a few things I wanted to say. Instead I just said, "Could I have more dilaudid?" She gave me another dose. Dr. K___ came in and "reduced" my hernia. At least I got to lay down this time. It wasn't as bad as last time, except when he said, "I can't push it all back, hold on." I did. I grabbed the sides of my gurney. The bright white light returned. I noticed this time that not only could I not see anything but the white light, I couldn't hear anything either. Once the color and sound returned to the room, I was alone with Becky. She said Dr. K___ wants me to follow up with the surgeon and that he couldn't completely "reduce" everything.

I am still fighting with my insurance and waiting to get my surgery. The insurance also has declined to cover my ER visit for the infection. Apparently, it was not a medical necessity. I disagree. I am fighting that as well. I only hope that I will not need any more "reductions". That and I hope the surgeon remembers me when he checks out my junk.


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