Archive for July, 2012

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Illness as an aversion therapy to food


2012
07.31

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I’m convinced the nine days in the hospital, pumped full of antibiotics and watching commercial TV from dawn til dusk, changed something about how I’m wired for food.

Sitting in the hospital bed with 50 channels of basic Comcast cable to keep me company, I was shocked at how many of the TV ads that run during the day are pitching food to people. And it’s shit too, fast food, heavily processed snacks with no nutritional value, and other high-margin stuff that really, in a perfect world, no one would eat.

I went into the hospital weighing about 336 pounds. Yesterday I stepped on a doctor’s scale for the first time since June, and I weight 311. I’ve lost 25 pounds since my hospitalization. 25 pounds in a month is quite a bit; I’m sure next month won’t be anywhere close to this. But it’s a positive trend.

This isn’t because I’ve adopted a radical new exercise regimen – in fact, because of the condition of my foot and the presence of a PICC line in my left arm, I’m not allowed to exercise at all. It’s simply because I’ve totally lost interest in eating all the crap I used to.

What’s more, seeing imagery of people eating that stuff on TV makes me feel a little ill.

I’d love to righteously trumpet that I’ve consciously made this decision, but I have a different theory.

When I was 20 I was living in Southern California, crashing at my mother’s apartment and working a tech support job in Irvine. That year an exotic form of a stomach bug cropped up and I got it, and got it harder than I can ever remember getting an illness before then except maybe for chicken pox.

For a good two or three days, I was able to move about as far as the bathroom, to either puke or shit bilge water, then to the kitchen for a glass of water, then back to the sofa and in front of the TV.

This also happened to be when McDonald’s was pushing the McRib big-time. Almost every commercial break featured an ad for the McRib – this processed pork patty on a roll with pickles and onions.

Under other circumstances I might have found it appetizing. But seeing as I did through the filter of being violently ill, it made me want to puke.

The first time I drove by a McDonald’s after I recovered, I pulled in and bought a McRib. I opened up the container, caught one whiff of it, spied it in the box, and ran to the bathroom and dry-heaved for a few minutes. To this day, I haven’t been able to eat a McRib.

I’ve been able to eat plenty of other McShit over the years, and can enjoy a pulled pork sandwich with the best of them, but the McRib is my Waterloo.

I’m convinced that for me, anyway, being ill triggers an aversion response to certain things that become a constant stimulus. In this particular case, I’ve completely lost interest in the typical junk that American families cram their faces with – fast food, high-sugar high-cholesterol snacks, and so on. Because that’s all I saw advertised on TV from dawn to dusk.

Remaining on a steady diet of intravenous and oral antibiotics since then has, I’m sure, helped me along with appetite suppression. But I don’t think that’s the only difference.

Obviously this behavior change for the better. As a diabetic with a BMI squarely in the “morbidly obese” range, eating that shit is about the same to me as playing Russian Roulette. I want to lose weight and have wanted to for a very long time.

It just took a long stay in the hospital, being sick in front of the TV, to trick myself into agreeing.

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Back at home


2012
07.10

Posted in Family Matters, Navel Gazing | 1 Comment »

In all the commotion I haven’t had the presence of mind to update Tikkabik since I was discharged from the hospital this past Friday. I’m home now, resting comfortably.

The doctor has prescribed antibiotics that are being administered through an IV, which I have to push myself three times a day – 5AM, 1PM and 9PM. It’s a routine, and while I’m not that coherent first thing in the morning, I’ve gotten pretty accustomed to it. Usually a nurse from the VNA shows up sometime mid-morning to change the dressing on the foot.

That’s pretty much my excitement for now. I’m “homebound,” according to the hospital and the nurses, which means I’m not supposed to go out unless I have a doctor’s appointment or some other necessity. And the foot is supposed to only be “partially weight-bearing,” so I can’t walk on it for any extended period.

It’s a little frustrating to be so limited, but I understand the healing takes time – more so, in my case, because of the diabetes and some of its complications, particularly how it affects vascular health.

It’s probably just as well, because quite frankly, I’m wiped out by about 7 or 8 PM every night. I can barely keep my eyes open, and often find myself dozing.

Bonnie’s been great throughout all this. She’s had to coordinate the kids’ many trips to doctors, orthodontist, therapists, etc. by herself, as well as picking up groceries, medical supplies for me and everything else. It’s a lot of work for one person to deal with, especially since we broke those duties up as best we could before.

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Hospital livin’


2012
07.02

Posted in Navel Gazing | 5 Comments »

So if you missed the news on Twitter, Facebook etc., I’ve been in the hospital since last Wednesday. I managed to get an infection in my foot that went septic and required surgery; I’ve been here ever since.

This is my first hospitalization. I think the most serious procedure I’d ever had done before this was my tonsillectomy, and as I recall, I went home that day.

I first noticed a problem with my foot a week ago last Saturday, when we were on the road. I had some swelling and redness, which isn’t all together unusual when I’m on my feet more than usual, so I didn’t think too much of it. But by Sunday the foot had swelled more and I was having trouble walking, so I knew something bad had happened. I went to the doctor Monday, who discovered that I had stepped on a 1.5 centimeter-long piece of sharp black plastic; something rather polished looking that looked like it broke off a toy or a gadget.

I don’t know where it came from or what it was, or, for that matter, how long it had been there. I hadn’t felt it because I have neuropathy – very limited nerve sensation in my feet.

She packed the wound, bound the foot and sent me home with oral antibiotics and a warning to call if anything changed for the worse.

By Wednesday, it had. Bonnie noticed that a new wound had opened near my third toe and was bleeding. The toe had swelled up more and turned an ugly purple color. So we went to the emergency room, and I was admitted, fully expecting to lose part of the foot. A foot surgeon saw me within a couple of hours and I was wheeled into the OR, knocked out, and when I woke up, my left foot was packed and bound.

The surgeon thinks, in retrospect, that I’d had an infection on that toe for some time, but the added trauma of the wound on the bottom of my foot sent things into overdrive. Cellulitis turned into sepsis, and I was one very sick patient.

It’s a small world: the foot surgeon who operated on me shares office space with doctors whom Bonnie worked for several years ago. He remembers her well.

The next couple of days were a bit hazy for me. I was very sick, getting and breaking fevers every few hours while my body fought the infection along with some exotic IV antibiotics. At one point my temperature was near 103. But by Saturday I began feeling like myself again.

Since then it’s been rest and recovery. I’ve strict orders to stay off the foot as much as possible while it heals. I’m allowed to walk from the bed to the toilet and back, but that’s about it. Fortunately, I’ve got a wheelchair, so when I get really bored I can go for a spin around the floor.

This morning I had a PICC line installed – an IV line that runs from my upper arm into the superior vena cava, one of the large blood vessels connected to the heart. This is so I can get IV antibiotics long-term – the ones in your hand usually only last a few days before the tissue gets irritated or an infection sets in. When I go home, I’ll need to continue to get IV medications administered. The doctor suggested that a month or so would probably be a good idea.

In the second case of “it’s a small world,” the IV nurse who installed the PICC line is the mother of a child that James has gone to school with since kindergarten. I’ve dropped him off for a few play dates and birthday parties and their house over the years, and I’ve seen her countless times at school functions, field trips and the like.

As to the care I’ve received, I couldn’t be happier. The staff in Mugar 5 at the Cape Cod Hospital have all been excellent. And since I’m in one of the taller buildings in this part of Hyannis, I have a gorgeous seaside view facing towards Lewis Bay and Nantucket Sound beyond – a reminder that it’s summer on Cape Cod, and in the scheme of things, it doesn’t suck too much to be here.

I’ve been hearing for years about the dangers diabetics with peripheral neuropathy face. I’ve had a few small scares – foot ulcers caused by poorly-fitting shoes, a staph infection on my big toe. But this by far is the biggest, scariest thing that’s ever happened to me, and I don’t want to repeat the experience ever again. I’ll be taking special care not to walk barefoot (or even just with stocking feet) around the house from now on, and I’ll make a better point to visually check my feet when I go to bed.

Unfortunately, beyond that, there’s not a lot more I can do. While I can do a better job of managing my diabetes through exercise and diet, the neuropathy is pretty much here to stay – it’s not reversible. I can just hope that my body will finally get over this infection, my foot will heal and I can get back on with my life.