Nov 10, 2009

My Recovery Timeline

Since you're probably curious when all this will finally be over with, here's a timeline of all the major events leading up to my injury and recovery.

The days count down from -14 until I fracture my jaw in case you're interested in why I fainted when I did. If not, skip down to Day 0.

Day -14, October 8: I'd been having really bad Colitis symptoms for a week. I'd lost plenty of blood and was having pain. I call my G.I. doctor, who tells me to go to the E.R. to see whether I need to be admitted. I go in at 1 pm and continue to lose lots of fluids, have a CT scan of my stomach, and they put me on I.V. fluids. Time mysteriously flies, and I feel like it's been only 3 hours when I finally get admitted to a bed at 11 pm.

Day -13, October 9: They start me on "bowel rest," meaning I would eat nothing and drink nothing, staying on I.V. fluids all day. I also begin taking I.V. steroids (Solu-Medrol) to ease the inflammation and get my symptoms under control.

Day -12, October 10: They transition me to oral steroids (Prednisone) in the hopes that I can go home the next day. I'm allowed to consume clear liquids like broth, apple juice, and ginger ale.

Day -11, October 11: Prednisone doesn't work very well. My symptoms deteriorate again and I have to stay through the week. I begin to eat solid foods again, but am limited to a Low-Residue Diet, which means low fat and low fiber. As a practical matter, that means egg beaters, white bread, soup, but I had to avoid all vegetables. No fruit either.

Day -8, October 14: I had seen some improvement, so we try Prednisone again. This is partially motivated by the fact that I wanted to go to an interview the next day, and hoped to be released.

Day -7, October 15: I go home and nearly pass out just as I finish showering, so I immediately return to the hospital and am readmitted.

Day -6, October 16: I am exhausted and sleep most of the day, including a Flexible Sigmoidoscopy (a mini colonoscopy). This renews my bleeding somewhat because they take biopsies and generally scrape me up with the scope, an unavoidable result of putting a scope through inflamed, sore, bleeding tissue.

Day -3, October 19: The G.I. doctors who have been tending to me decide to take things to the last treatment level before surgery, Remicade. Remicade is administered every few weeks through an I.V. and is typically very effective, but is expensive ($1,800 per treatment) and completely stops your body's inflammatory immune response, which is normally helpful in fighting infections. This means I'm at an increased chance for serious infection.

Day 0, October 22: I see steady improvement since taking the Remicade, and am able to eat a few other foods like lean, grilled chicken and pasta with sauce. I'm still bleeding a moderate amount every day, but they tell me this is normal and will improve as the Remicade takes effect. I am released. All of my muscles have atrophied from being bedridden for two weeks and walking only to shower and use the bathroom, so walking home is exhausting. I also lose about 25 lbs in this two week span.

Day 0, October 22: I go to an evening class. On the way to the bathroom afterward, I faint and fall at about 10 pm. I came to as soon as I hit the ground and could tell that my jaw was off. I was spitting out blood and pieces of my teeth. I felt horrible because everybody told me to stay home instead of going to my night class, and I knew I was in for something awful.

Day 1, October 23: The docs wire my jaw shut in the early morning hours in the E.R. The doctor tells me I'll have the wires for about four weeks. I'm devastated. I also get some stitches put in my chin where I made impact on the floor.

They give me the wire cutters to carry around at all times. I also get started on liquid Penicillin 3x/day for one week, which brings my daily medications to: Antibiotic, Immuran (an immune-suppressant), and Prednisone. I had to have the hospital engineer me a special liquid version of the Immuran, and I dissolve the Prednisone tablets myself in water and OJ, which tastes awful. I spend the night in the E.R. observation floor.

My G.I. doctor visits me (personally) and says soberly, "I've never seen so much awful #%&! happen to one of my colitis patients before."

Days 2-4, October 24-26: My teeth hurt pretty badly. Two are fractured vertically and I'm told they'll probably have to remove and replace them. Those two hurt the worst, especially if I twitch when asleep and clench down on them. This woke me up about once a night for a few days.

Day 4, October 26: I go in for a follow-up. They take an X-Ray and look at my bite, say everything looks like it'll be set to heal, and tell me to come back soon to have the sutures taken out.

Day 7, October 29: The doctors remove my sutures, and say the scar looks like it'll heal well. Taking the sutures out wasn't even painful. He also checks my bite to see if it's lined up well, and it looks good, so they tell me to come back in two weeks for another quick follow-up.

Day 9, November 1: I have extremely severe Colitis symptoms in the morning and lose so much blood that I have to slump on the bathroom floor to prevent myself from passing out. I am sweating, feverish, have tunnel vision and blurry hearing for a few minutes. This is a huge setback because my symptoms had been relatively good so far. I call the on-call doctor at my G.I. doctor's office and he says if I lose any more blood that day, I will probably need a blood transfusion. Fortunately, I seem fine for the rest of the day.

Day 10, November 2: I have the same bad day as before, bleeding in the morning and fine the rest of the day. My G.I. doc tells me to come in to receive my second Remicade treatment early. I eat less and I keep my foods very bland and repetitive throughout to help speed the recovery of my colon. Unfortunately this means I quickly get sick of eating the same things. Plus I'm hungry all the time because I'm afraid to eat too much and cause my bowels to move.

Day 11, November 3: I have only mild bleeding. Remicade is apparently working. However, I'm now extremely anemic because I've only gone a few days without losing any blood at all for the last 5 weeks. I lay in bed most of the day and when I sit up, I get light-headed and can feel my heart pumping super hard in my neck. The experience is even worse when I stand. Normally my resting heart rate is 60-70 beats per minute. For the next seven days, it's more like Resting: 100, Sitting up: 120, and Standing: 150. I can only walk about 20 paces before I need to sit or preferably lie down.

Day 14, November 6: No blood for a few days finally, and I slowly start to replenish my fluids. It'll still be 4-6 weeks before my red blood cells are fully replenished, which means I will continue to be generally lethargic and weak until I'm eating again.

Day 19, November 10: My routine mouth inspection is very quick and very routine. The doctor tells me that she can feel a bump on the side of my face where my fracture is. She assures me this is normal and will probably go away, but even if it doesn't it won't interfere with my jaw function. She sets my date for wire removal for two weeks later, November 24th.

Today is the first day since fracturing my jaw that I return to class. I am miraculously able to walk around my small law school without feeling light-headed or exhausted.

I weigh myself in the morning and am now 33 lbs underweight. My BMI is normally 22.2, slightly above exactly normal. Currently it is 17.5, which is "underweight." Hopefully this has more to do with my colon than my wires, because my colon is healing but my wires are here to stay for fourteen more days.

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About Me

Boston, Massachusetts, United States
At the time of the accident, Gerrit was in his last year of law school. He is originally from Pittsburgh, Pennsylvania.