A Sunday to remember

So yesterday I am getting ready for church. My pants were "fluffing" in the dryer and I had just leaned over the sink to fix my hair when I felt something running out of my nose. I looked down and it was blood...bright red blood and it was flowing fairly briskly. I've had nose bleeds before, so I got some toilet paper and put it in my right nostril. I waited for a minute and then noticed that the toilet paper was soaked. When I went to change it, there was a significant amount of blood that came out and I was still bleeding...BRISKLY.

I called Beth into the bathroom and told her that I might need to go to the Emergency Room. She said that she would drive me. Since she was teaching Sunday School and making the announcements during the service, I told her that it was no big deal and that I would drive myself. At this point, blood started flowing out of my LEFT nostril (it was the right one that started first).

This is when I said to Beth, "On second thought, you need to call someone to cover you and we need to go to the ER. Now."

So as to not freak my mother or mother-in-law out, I will not tell you how fast Beth drove to the hospital. You see, we live about 35-40 minutes from the hospital I work in. It was important that they go there, because I know they have ENT residents in-house and my ENT had privileges there.

By this point, I had surmized that I had an arterial bleed. The fact that I was bleeding so much and that the blood was so red, told me that it was arterial.

So we're in the car. Now you may be asking why I didn't call 911. Well, as I mentioned, we live 40 minutes from the hospital and I was convinced that it would take an ambulance 20 minutes to get to the house, not to mention the 40 minutes to the hospital. So we got in the car and drove. I get that from my dad. But that's another story.

In the car, with both nostrils packed AND holding pressure, I started swallowing a fair amount of blood. Now even I'm starting to get a little freaked out. I tell Beth to drive quickly, but safely. That when she came to a red light, she was to slow down, check for traffic, honk the car horn and go. Luckily for us, it was Sunday morning and there was very little traffic on the road.

I pick up my cell phone and called my ENT. His office message says that he is out ouf town and another ENT is covering. They give a name and phone number, but I can't very well hold pressure on my STILL BLEEDING NOSE, hold the cell phone, AND write down the number of the covering ENT.

So I called Hermann. I work there, remember. And asked to speak to ER triage. Then, I asked to speak to the attending physician. Luckily for me, it was one of the attendings that I know, and like. I told her who I was, that I had had surgery one month ago, and that I had an arterial bleed. I asked her to call ENT and told her that I would be there in 10-15 minutes.

We arrived at the hospital, Beth dropped me off at the front door, and then went to park. I walked in and asked for the attending. Again, luckily for me, the ER tends to not be a busy place on Sunday morning. I walk in, tell them I have an arterial bleed and that I've spoken to the attending. They get me in a bed, start an IV, and call ENT.

ENT was there within 10-15 minutes. It was soon determined that an artery in the posterior part of right nose was the artery that was bleeding. It was in a place that I couldn't apply direct pressure. That's why it didn't stop bleeding. And it wouldn't have without professional help. This is also how you can believe me when I say that I didn't cause this bleed because I was picking my nose. Digital trauma (nose picking) is still the number one cause of nose bleeds or epistaxis. But in my case, it was an artery in the posterior part of my nose. But I digress.

The ENTs were able to stop the bleeding there in the ER. They had just placed a surgical seal adhesive gauze thingy (yes, that's the technical medical name) when I started bleeding, AGAIN. They were going to send me home, but when I started bleeding again, and given that we live that far from hospital, we decided that it would be best for me to spend the night in Obs just to make sure everything was ok. We also decided to keep me NPO (nothing per os ((mouth)) in case it started bleeding again.

All of this, before noon. 2 wonderful friends from church brought Beth Whataburger and, yes, they ate it in front of me. They left and Beth and I took a nap and she decided to go home, let the dogs out, and would come back later. I called the ENTs around 5:00 to ask if they were going to let me eat dinner.

About 10 minutes later, one of the residents comes into my room holding a consent form. Guess what, no dinner for me. At least not any time soon. It was then that he told me Dr. Smith, my ENT, was on his way to the hospital, and that they were getting an OR ready for me.

Dr. Smith wanted to take me to the OR to cauterize the artery that had bled. He is going out of town this week, and didn't want me to start bleeding. This way, we would take care of it for good.

I called Beth and told her she might want to come back to the hospital sooner, rather than later. I actually felt bad for her, because I knew I would be in the OR before she could get back to the hospital. I did ask the ENT resident to make sure that Dr. Smith talked to her after the surgery.

The surgery went fine. They cauterized the artery and I went back to my room. More good friends from church brought Chipotle...mmmm, my absolute favorite. I slept on and off for the rest of the night and they let me go home early this morning.

Dr. Smith told Beth that he is concerned that I started bleeding this far post-op. The original surgery was one month ago. I should be well healed. We did go swimming Saturday and I did dive in the pool once, but he said that this shouldn't have made a difference. So, this Friday, I have an appointment to go see him and I guess we're going to talk about it.

I'm a little worn out, but no worse for wear. I am also grateful to my friend Mark who was working in the MICU who came down, said hello, held my cell phone while I was in the OR, and came to sit with Beth once she arrived at the hospital.

I must take a minute to brag IMMENSELY on my wife. She handled her self INCREDIBLY WELL concerning the pressure that she was under. She kept it together on the way to hospital, made phone calls that were necessary, and just did everything that you could ask for from the wife of a doctor who's bleeding profusely from his nose.

Double kudos for her having to hear over the phone that I was going back to surgery and that she wouldn't make it to the hospital before I went under. Again, the epitomy of poise and grace.

I'm a lucky man.

Trying to do better

So I make no promises as to the consistency with which I hope to blog. However, I am going to try to do better.

I am now 16 days into my 3rd year of residency. Which reminds me, I need to update my profile. People ask me how it feels to be a third year and I tell them it's a little scary because now people actually expect me to know something. Huh, the nerve! But then I run across an Intern (whose been a "practicing" physician" for 3 weeks now) or Heaven-forbid a 3rd yr medical student, and I realize that I really DO know something. Because let's face it...they know very little. You might think that July would be a dangerous time to visit a teaching hospital. Actually, I think the opposite is true. In July, EVERYONE is more careful, and the upper level residents (me) are checking EVERYTHING the interns say and do. So feel safe, just keep one eye open when some scared kid that looks twelve and was born around 1981 comes into your room, ask him if he's 100% sure about what he's about to do and then ask him if he asked his upper level (again, me).

I think I've said this is this blog, but my sister is pregnant with #2, so in January, Beth and I will be an Aunt and Uncle x2. We're REALLY excited!

Ciao

No more packing!!

Just thought I would post a post packing picture. I didn't realize until now, that I couldn't breathe through my nose. It's SO MUCH EASIER to breathe now! I am SO glad that I had the surgery. Thank you Dr. Smith.

I CAN BREATHE!!!

So I went back to the ENT's office today and he unpacked my nose! I CAN BREATHE!!! AND I can taste food again! I can TOTALLY tell a difference in my breathing pre-sugery and now post-removal of packing. The true test will be to see if the snoring is any better. How can it not be, right?

I am on call tonight and MD Anderson. I am covering any patient with a solid tumor. They don't even tell us how many patients that is because I'm sure it would scare us silly. Basically, I am here to give medicines to sleep, pee, poop, and pronounce anyone who might die overnight.

Beth and I plan on driving to Palastine, TX in the morning when I get off to see my dad. Kristina and Eric and Tori will also be there. It will be a quick trip as Kristina and fam have to drive home and Dad has to go to work. But any visit is a good one.

Thanks for all the support and making-fun-of-me in my hour of distress (Becky) during the past week. There is chocolate cake leftover from Beth's birthday and homemade cookies from Chelsie that I plan on making out with tomorrow when we get home. Why? Because I can, AND I can taste them!

Peace and Love,

J

Beth-a-pa-loo-za

So tomorrow is the day. The day that the love of my life leaves her 20s and joins me as a thirty-something. It's a bit surreal. I remember thinking that I'd never be 30. That there was no way that I could reach that age. Well, I have...and it's not so bad.

I do feel somewhat bad for Beth. This surgery of mine has put a bit of a damper on the normal week(month)-long Beth-a-pa-loo-za Celebration. Even though I can't taste food and have basically lived in my recliner for the past 5 days, I do still have a trick or 2 up my sleeve.

I would tell you here, but so far Beth hasn't managed to figure them out. WHICH IS AMAZING!!!! because the woman can smell a surprise for DAYS!!!

There will be some celebration tomorrow, but also, we are going to save some for once I am unpacked (my nose people, pay attention...or at least read that last 2 posts) so that I can enjoy the taste of a nice steak or a bottle of Spanish wine.

Now to the toast:

To the most amazing woman I have ever had the joy/pleasure of knowing and loving:

Welcome to 30. It's an amazing year and the beginning of the rest of your life. The past 29 have taught you many lessons that most of us spent a lifetime learning. You have handled them as well as anyone could expect. With grace and dignity. The thing that amazes me the most is that regardless of what life throws at you, you pick yourself up, dust yourself off, and keep going.

You are one of the funniest people I know. You are always making me laugh. And you laugh at me, I mean, at my jokes, even when they're not funny or when you've heard them 1 million times.

So this guys walks into the Psychiatrist office wearing
nothing but saran wrap for underwear...

You are fiercely loyal to those you call friends. You would give your right arm, without hesitation, to any in need.

You are talented beyond belief. Your knowledge of pop culture, alone, stops me in my tracks. You love music and art and poetry and the theater. Our kids will be blessed to have you for a mom. I'm quite sure you'll be the cool mom and I'll be the dork dad. I've been a dork a long time. It's a role I'm very comfortable in.

Your scrapbooks are unique and your talent flows all over their pages.

And your faith...you intimately know the God you believe in and serve. Your faith is your own and not some superficial feel-good. Your parents (all 3 of them) are to be commended. You are a faith giant and a prayer warrior.

Thank you for loving me and allowing me to share in this journey with you. It's been one heck of a ride over the last 8 years. I treasure each moment that I've had with you and smile with anticipation of those moments yet to come.

You give me reason to wake up in the morning and to come home at night. Your blue eyes mesmerize me and and pierce me to the core.

May you have the desires of your heart.

143.

Crash by Dave Matthews
You've got your ball,
You've got your chain
Tied to me tight, tie me up again.
Who's got their claws
In you my friend?
Into your heart I'll beat again
Sweet like candy to my soul
Sweet you rock,
And sweet you roll
Lost for you, I'm so lost for you

Oh, and you come crash into me
And I come into you
And I come into you
In a boy's dream
In a boy's dream

Touch your lips just so I know
In your eyes, love, it glows so
I'm bare-boned and crazy... for you.

Oh, and you come crash into me
Baby, and I come into you
In a boy's dream
In a boy's dream

And if I've gone overboard
Then I'm begging you
To forgive me
In my haste
When I'm holding you so girl,
Close to me

Oh and you come crash into me, yeah
Baby, and I come into you
Hike up your skirt a little more
And show the world to me
Hike up your skirt a little more
And show your world to me
In a boy's dream
In a boy's dream

Oh, I watch you there
Through the window
And I stare at you
You wear nothing, but you
Wear it so well
Tied up and twisted,
The way I'd like to be
For you, for me, come crash into me, baby
Come crash into me, yeah

Crash into me...
Crash into me...
Crash into me...

You know, I'm the king of the castle,
You're the dirty rascal, crash into me.
Please crash into me, baby...

Oh, no no no...
Yes, I see the waves
Come and crash into me.
See the waves come and crash into me.
Crash into me.

This is the pits

The next time I tell you that I want to have an elective surgery...SLAP ME (but not on my nose). I don't know what I was thinking when I agreed to do this, but I must have been temporarily insane.

I can't breathe through my nose. It's constantly dripping. I can't smell, which translates into I can't taste. I have a constant dull headache. And everytime I swallow, my ears pop.

I go back to the doctor on Tuesday and in the meantime, I have to figure out how I am going to go back to work without freaking out my patients.

Here are a couple of pictures for your viewing pleasure.

Post-Op Day 1

Let me begin by saying "OUCH!!"

When I awoke from the Anesthesia yesterday, I decided that I had changed my mind and didn't want the surgery after all. And then the nurse introduced me to Fentanyl. YEAH!!!

According to Beth, since I don't remember much immediately after the surgery, the bone spur was a alot bigger that Dr. Smith first thought. I don't know if that contributed to all the bleeding, but I bled so much that he decided to pack my nose, which he said he doesn't like to do. I now have 2 strings coming from both nostrils taped to my nose. I get to go to work looking like this! Even more YEAH!!

Beth still thinks that there's no way I will feel like taking call on Thursday, but we'll see. I already feel 10000000% better. I will spend the day in my recliner resting and getting better.

Oh and by the way: It's Beth-a-pa-looza! She turns 30 on Saturday.

Maybe I will aim for a post a day since I have a few days off to recover.

Maybe.