Last week: Friend wars.  Can a girl get post-traumatic stress disorder from those?

And now:

The appendicitis odyssey

I’m going to skip forward a few years.  They were largely unremarkable, trust me.  I wasn’t anything special in high school.

At fifteen, I entered my first serious relationship.  This pulled Margaret and I further apart, but in the summer I was sixteen, she invited me to go with her to a star party.

Margaret was and continues to be an amateur astronomer.  My interest lay mostly in continuing to spend time with her, though I did enjoy learning about the constellations and how to recognize them in the night sky.

Margaret and a group from the local astronomy club headed down to Star Fest that August with me in tow.  The weekend went well.  We stayed up late to look through various telescopes to see planets, nebulae, and galaxies far, far away.

The day we left, though, I wasn’t feeling so hot.  I had a stabbing pain in my gut.  That was the first attack.

Others followed and though I went to my doctor, my pain didn’t present as typical appendicitis.  It wasn’t in the right place.  So I had tests.  And more tests.  All with varied but negative results.

As the school year wore on, I started to fall asleep in science class, which had to that point been one of my favourites (organic chemistry-yay!).  I was still serving as acolyte at my parents’ church, looking more like Quasimodo as I walked, hunched over, to light and snuff the candles.  The pain got worse, and after a particularly terrible day, my parents took me to the hospital.

Typical presentation or not, emergency exploratory surgery was ordered.

Once again, I don’t remember the surgery, but I woke up feeling rotten with a drain poking out through my stomach.

For those of you who may not have had this particular medical procedure, let me describe it.  First, a six by six gel patch was placed over the incision site to stabilize the soft flesh.  Then a four inch incision was made.  There was a lot of infection inside of me (I’ll get to that in a bit) and so a length of surgical tubing was inserted to let it drain out, the wound packed, and I sent to recovery.

The doctor explained that I had not only an inflamed appendix, so inflamed that the complications were the same as if it had ruptured, but that I also had a grapefruit-sized (he described it to my parents as a softball) abscess on the appendix.  The reason it didn’t present as typical appendicitis was that my bowel was inverted (upside-down) and the reason ultrasounds had found nothing was that the massive, puss-filled abscess had obscured the appendix and unorthodox arrangement of my innards.

The appendix had not been removed.  The infection was so wide-spread that the surgeon would have had to remove most of my bowel along with it and leave me with a colostomy.  He had a daughter about my age and decided that he couldn’t do that to me (bless you, Dr. Keeley!) but this would mean a second surgery in a few months and intensive antibiotics in the meantime.

I was in the hospital for over a week.  They couldn’t get me back on solid food and I was so weakened by months of infection that my veins kept collapsing.  I had holes all over my hands, wrists, and arms by the end of it.  I wept when they had to change the intravenous site for the sixth time.

Other than the obvious, though, I had no clue that anything was amiss.  Friends and family all came in to visit, smiling, making small chat, all except my then boyfriend.  He came in and sat, silent and moping the whole time.  Eventually, I demanded to know what was wrong.  Why come to visit me if he wasn’t even going to bother talking to me?

“I almost lost you!” he blurted.  And that’s how I learned that I had nearly died.  Again.

He was certainly entitled to his feelings, but his selfishness astounded me.  In short order, as ill as I still felt, I returned his gifts to me and told him to hit the road.

The next three months were a trial.  Lots of antibiotics, and though the drain was removed before I left the hospital, the incision remained open and had to be packed, the dressings changed twice a day.

It stank.  Pus seeped through the dressings and my clothes on a regular basis.  The scar remains a puckered mess to this day.  My body is fond of forming cheloids.

The second surgery, the actual appendectomy, was coordinated with a test for malignant hyperthermia.  The condition had been detected in my family some years before and the test required the removal of a six inch strip of muscle.  Three were for the actual test and the other three for research.

Malignant hyperthermia is passed on genetically and is a condition which requires me to avoid both stimulants and standard anaesthetics.  Certain substances accumulate in my muscles and in situations of high stress, temperatures, or with exposure to certain anaesthetics, my body will go into a hyperthermic reaction.  My temperature rises until my muscles, including my heart and the intercostals, which facilitate breathing, shut down.  Cardiac arrest.

Fortunately, I’ve never had a full reaction, though I have always “run hot” and my muscles will twitch from time to time, often after exercise.

The surgeon for the second procedure was a clinician, and though excellent, was somewhat lacking in bedside manner.

Following that surgery, I was informed that Dr. Keeley should have removed the appendix and all the infected tissue the first time and that not to do so verged on malpractice.  A colostomy would have been better for me than the subsequent risks from the continuing infection.

She could not use the same incision site because, even after three months, I was still full of infection.  I had hoped that she would have been able to use the same location, if for no other reason than to remove the existing, twisted wound and create a more or less “normal” looking scar.

I was then informed that I had the highest level of the disease (there are eight) and that I could no longer have anything containing caffeine (coffee, tea, pop, or chocolate), alcohol, antihistamines, or any pain relievers that included muscle relaxants.  When I began to tear up (remember, I was only seventeen at the time, and I kind of enjoyed a lot of those things that she said I couldn’t have anymore) she looked at me, somewhat incredulously, and said, “I don’t know why you’re crying.  This is a good thing.  You’ll have a much longer, healthier life.”

At the time, researchers did not know everything about malignant hyperthermia and outlawed a lot of substances on the chance that they might predispose me to have a reaction.   Since then, I’ve learned that moderation is the key.

I missed a lot of school and barely made it through some of my courses.  It was my final year of high school too and though it was a little tense, I was actually accepted to my choice of universities for the following fall.  Other things happened that year too, but I’ll leave that for my next post in the series.

So that was my second brush with death.

Next week: Trauma mounts and depression rears its ugly head in earnest.

Has a routine surgery changed your life?  How so?  What came of your adventures under the knife?