Of Milkshakes and Medicine

1909 advertisement.  'Our beers are pure liquid food'.

Grendel has struggled with food all of his life- extreme diet restrictions, constant dysphagia, operations and tests and medicines, diagnosis of Eosinophilic esophagitis.  Hospitals in NC, SC and Texas...resulting in not only treatment of various successes but an addiction to video games (thank-you MUSC! seriously, it's turning into a career that might actually end up paying his student loans!), the realization that riding a mechanical bull is *not* the best way to dislodge food, and that if you are yacking into a trash can loudly they will move you to either the top of the emergency room line or into a more private waiting area as to not gross out already sick people.

Well, this whole thing stayed more-or-less under control for the past few years- one episode in the last two years that was a quick extraction and roto-routing... luckily not ever when he was adventuring off in another country or traveling.  And then, it all blew up again full force on Wednesday.

He came home from work, thought I was coming to the city to see Dr. Mike, invited me to dinner- but I cancelled Dr. Mike (and dinner) because of an assignment I had to finish for grad school.  So he went to the Japanese place (where he goes lots) and got a steak bowl to take home.  This is not normal steak, but rather the very thin soft stuff, similar to the steak in philly cheese steak, that is cooked on the grill with mushrooms and onions and served over rice.  Very small pieces, very soft, eaten with lots of sauce if you are a Grendel.  Anyhoo, he took his meal home and had maybe two bites of it when everything got stuck.  He's been through this twenty zillion times before, so he knew what to do, and some came up but then he started bleeding.  Hospital time.  No available friends to take him, and even if he had a car he wouldn't of been able to drive this way, so he called me- and luckily I was still at school, almost finished- so I picked  him (and his trashcan) up and off we went.

They took him in right off, not only because he had the gross trashcan, but he was yacking up blood and it was quite dramatic (as well as the whole blood-borne-pathogen risk).  We went back into triage, into our little room with all of our stuff (we are absolute champs at this- he had his traveling bag packed with: clothing, toiletries, laptop, cell phone, ipod, homework, books- it weighed a zillion pounds but we have been stranded like this before for days), I wasn't as prepared having been at school and in panic-mum mode, but I still had two bags with sketchbook, paperwork, textbooks etc.  We settled in and they came in and gave him some dilaudid  for pain (strong stuff- Mr. Owens had it for his back- it knocks the pain out and makes you loopy), an IV and a newfangled blue plastic thing to hack into.  The orderly picked up the trash can and said 'do you want this?'....uh, no thanks.   We saw some of our old emergency room friends- a former student who is a tech, the nurses aid who looks like Stevie Wonder (complete with braids, sunglasses and strangely white teeth)- SW has worked there for 26 years, seen kabillions of people, and always remembers us.

The drama continued- Grendel's nose started bleeding as well, quite dramatically (nothing could go down his throat, and the bleeding had to come out somewhere), and he was texting everyone that he had hit up for a ride to tell them all was well (they were frantically texting/calling- his text tone sounds like a bird chirping, and that was kind of cool) and called his dad, the doctor (Dr. Saure, pronounced 'Sour' who is a very tiny, pretty lady under 30, looks like she should be a tv doctor, but she is extremely fierce as we will find out in a bit.  Still like her though and the boy? he has a doctor-crush) showed up and I was exiled to the waiting room, where I got out the laptop, finished my paper, turned it in.  (As a side note, I get a gold star for extreme homeworking- in the emergency room, under stress, on his laptop which he uses for the hardware part of school- meaning that it gets unbuilt and rebuilt all the time.  Luckily it was together enough to work, except that the 'e' 'i' and 'k' keys were missing- so to type you have to hit these little jabby things...ow, ow, ow.  Emergency room was mostly full of sick kids and parents watching politics on tv. Not so bad)

After the roto-rooting out of the food, they came and got me.  And I found the fierce side of Dr. Saure- she gave me quite the talking to about that this was "the worst case she had ever seen, did I realize that this is a life threatening condition and that he not only needs to have a 'GI specialist in his life', regular checks, daily medication and ......well, I felt like the worlds-worst-mother.  Even though he is grown and on his own.  But I respect that- and I like that she was passionate and fierce about his condition, so she gets to be the 'GI in his life'.  (Side note: she gave Grendel the same talking to before hand, minus some information from the procedure.  He later told me "I wouldn't mind having her in my life" in a doctor-crush kind of way.  Hum...she is a bit older than him....I wonder if she is married....plot, plot.  Stranger things have happened...and through all her righteous rage she did mention that he has incredible hair).

What the results were basically was this:  there was an allergic reaction that caused the incident, but the esophagus was already inflamed and patchy.  The blood happened because he tore the lining again- a long deep tear but luckily not a perforation. She explained that because of his history with all this that his esophagus is a mixture of scar tissue, which is thick and doesn't contract correctly for swallowing, and the contracting parts which are thinner than normal because they have to stretch and do all the work all the time.  Food gets caught in the narrow places, everything contracts but the food is wedged where the scars are and not able to move.  Just like any other muscle, the parts that are able to contract become stressed with over work and can tear- but because the tissue is so thin, the whole thing could tear open, which would not be good. Scary.  We are due back to see her Feburary 10th.

In the meantime, he has the steroid inhaler to swallow again, is on a liquid diet and absolutely forbidden from eating meat, bread and potatoes- even mashed up stuff.  She told us that depending on what things look like after this tear has healed that he may never be able to eat those things again-  imagine.  I can't think about that lots right now, and I know there are recipes and other types of solutions, but still- no bread? or potatoes? or meat? and no pills, all medicine has to be liquid from now on......lots and lots of rules.

It took him forever to wake up- like the rest of our family, he has naturally low blood pressure, and the combination of pain meds/ anesthesia/ and blood loss kept causing his pressure to drop very, very low.  They filled him up with IV liquids, bed propped up and had me keep rubbing his feet...and they kept trying to wake him up and ask him questions, which was a bit entertaining.  At first he had no idea where he was, but he did know the date, the President of the US, and his name....but my all-time favorite answer was to the question 'How many toes do you have?' he replied '10, no- wait- 8 because three of them are in a box.'  They turned on the TV and told me to try to get him interested in it and talking- not a watcher of regular TV I was astonished at the choices for late night viewing.  We could watch: politics, golf or preaching (not things that were especially akin to waking someone up) or reality tv including: Jersey Shore, Dog the Bounty Hunter, Redneck Extreme Vacation, Toddlers and Tiaras, Battle of the Exes or a cooking show involving the preparation of Mountain Oysters.  All of which were very disturbing shows..... but eventually he was awake enough to go home.

We drove around until we found an open fast food place with a working milkshake machine in order to get him something cold for the throat (oh- no sodas either- acids.  But she did ok beer).  We went back to his apartment, he went instantly to bed, I finished the uneaten evil steak bowl (which was really good and caused me not a problem at all) and fell asleep on his couch (surprisingly comfortable).  I did wake up when Charles called to check on us...and got to here the neighbor in action.  Grendel's neighbor (kitchen roommate) apparently has Tourettes which manifests as growling and grunting.  I thought that Grendel had exaggerated the situation a bit, but no....it sounded like a rather angry pitbull was next door.  Then he started to sing, which stopped the growling.  So imagine being in a city apartment, late at night, after a stressful day and not much sleep, and there is this odd vocal singing from next door.  No words, no recognizable tune, but it was strangely beautiful and haunting.  I fell back asleep, woke up at 7 in enough time to magic up some lessons for my kids at school today (no easy task since this is only the second day of class in the semester), went back to sleep again.  Later we went to Walmart for his prescription and new groceries- juice, vitamin water, yogurt, pudding, ice cream, soup, naked juice (it's like liquid salad)....then back home again.

I am glad that he is ok, I am worried about the future, I know we will find away to take care of it.  One of the things I worry about is this- the whole episode required approximately $500.00  (and that is just the copays- there will be additional percentage bills for the emergency room, anesthesiology, surgery etc.).   I am lucky because at the moment he is on my insurance and I had some student loan money available.  What if I didn't? I know the emergency room has to take you regardless of ability to pay- but there would be no follow up, no medicine, no life-time care that he is going to require.  What do people do?  How do you cope with that? Why is there not some way that we can all get the care we need?  Think about it.  Think for a moment about the amount of money that gets shelled out monthly..... the new insurance standards (for my work insurance) require that our family pays more for insurance because I'm fat  (they go by BMI), Charles smokes and Grendel has this condition.  Ok, I can accept that.  They also now require that we see our doctors *monthly* in order to get medicine refills- which is 35 x 2 for Charles and I, the GI will count as a specialist, so that is $81.00 co-pay a pop.  Grendel is an independent student with a part-time job without benefits- there is *no way* he could afford his health care....and when I can't carry him on my insurance any longer (he will be automatically kicked off when he graduates and/or becomes 25) he will have to pay higher premiums because of his condition.  This scares me to death.  I can't even find a humorous way to look at it....

At the moment though, I am thankful that Grendel is ok, that I had the money, that we have insurance, that he is not allergic to dairy (otherwise, what would he eat? Not a clue)....and that life goes on.