Severe Acute Necrotising Pancreatitis

“We’re flushing his body with the antibiotic equivalent of strong bleach” My body was fighting high temperatures and possible infection, they needed to keep the temperature down and safegaurd against possible septicaemia. At times i’d become very hot, then very cold. My room in the Surgical High Dependancy Unit was air conditioned and I had two fans. It’s odd that at this point I was my most aware but yet my memories are foggy. I was still hooked up to the Oxycodone and able to administer my own doseage by pressing a button. I was offered a meal but it all tasted funny and I really wasn’t hungry anyway… even though I’d not eaten for over a week… I was still confused.

I think it was (what seemed like) the huge bank of monitors behind my bed that made me believe I was in a sleep deprivation study. That and the pain from trying to find a comfortable sleeping position. There was a possibility that my bed was damaged and so the very expensive state of the art bed was swapped for another. The nurses soon set me straight and I began to ask what was going on… what had happened? Explanations by my doctors and wife at this point we’re protective of my mental and emotional state. A specialist nurse from Intensive Care was visiting SHDU on training purposes and I was lucky enough to have her look after me for a day or two. She had a soothing Scottish dialect and set about helping me wash, the act of moving was hard and I couldn’t understand why. She joked conspiratorially with me that I ought to try moving before the Physiotherapists arrived… A nurse friend of mine calls them Physio-terrorists! and I now know why: they push all patients to overcome the pain, to get moving. My task was to sit, to simply sit long enough to eat… even if I couldn’t eat that meal. They push hard and the pain just makes you want to stay still. It felt like the hardest thing i’d ever done. Things would get harder!

It wasn’t long before I was able to walk to the bathroom. Once I got there however nothing was happening. Strange stomach sensations and pain, the desire and need to go: but nothing. I was on tablets to help me go, they were strong but still nothing!

I was very aware of my catheter it was now causing me pain. I didn’t really recall it going in which I found odd because i’d heard they hurt. My Grandfather had a catheter insertion go so badly wrong that the loss of blood it caused led him to pneumonia and eventually death. I was keen to get the catheter out and was a glad a day or two later when it eventually went.

I’d been in SHDU two or three days now and could just about swallow a spoon full of a hot meal and eat a pot of jelly. It was time to move to a ward. Being “moved” is emotionally strange when you are so dependant, it’s scary. My high temperatures we’re still causing me psychological problems and the move to the Heptalogy ward went badly. I needed a new cannula needle for my drip and it’s insertion on the new ward did not go very well: it had been getting increasingly harder to get these small needles into my veins and after the sixth attempt by the Foundation Year Doctor in the new ward I was becoming distressed and confused as my temperatures started to soar again. I needed the drip for liquids, pain relief, temperature control and the antibiotics. A senior doctor came and also failed to get the needle into me and the decision was made to take me back to SHDU. My wife was furious i’d been taken from the specialised ward in the first place especially as my own consultant had suggested I wasn’t yet ready for the move. However limited resources had seen me bumped down as a priority and moved to Heptaology. Attempts to get the needle into me on SHDU also failed and so the clinical lead consultant, a brilliant but often intimidating doctor arrived with his typical great flourish to take over and told me I was going to have a central line inserted.

“Well that’s it. All done, they’ll want to come x-ray you and make sure i’ve hit the right spot but if you need me, me and my ‘dawgs’ will be kicking around for a while”

A central line is a big tube that they stick into your neck and runs all the way down into your chest. It’s useful because it has a number of “taps” that they can run multiple medications into and they can also take blood samples from you. As the pain relief was no longer running into my arm I was in quite some pain by now, but I was also rather delusional from the high temperatures. However I do remember being tilted backward on my bed as they inserted the tube into my neck and I very clearly remember the consultant saying “Well that’s it. All done, they’ll want to come x-ray you and make sure i’ve hit the right spot but if you need me, me and my ‘dawgs’ will be kicking around for a while”

“Did he really just say that?” I asked my wife “yes!” she replied.

He was a younger, slimmer Sir Lancelott Spratt. Dynamic, Terrifying but brilliant.

The plan was to wait for my body to come out of shock and once better bring me back into hospital for keyhole surgery… it all sounded very rosy. Everyone was pleased that I’d made it through intensive care, actually they we’re very pleased… I suppose it was around this time that I started to notice just how relieved everyone was, yet my own memories were so vague and confused I still didn’t know how bad it had been!

A day or two later and my temperature was behaving, so too were the oxygen levels in my blood and a move from SHDU was back on the cards, I was still marginally delusional and confused, I was still not eating and losing weight and the sisters from both wards got together to plan a move with my wife going ahead to the new ward to help too. That they have time for this attention to detail is a real credit to the NHS.

Are you really Lactose or Gluten Intolerant?

Are you sure? I was convinced I wasinstead I was on the edge of death.

I guess it started around eight years ago (2006) when my then girlfriend and now wife noted that after consuming dairy products I became bloated, experienced abdominal pain, gas, wind and diarrhoea.

It worsened in 2010 when it seemed bread was also a problem.

As the symptoms worsened I went to my doctors and they suggested keeping a food diary to monitor the problem and to identify problem foods. In late 2011 convinced I was coeliac I went for a test… but the results disagreed and the conclusion was that I was suffering from IBS with an intolerance to Lactose and Gluten. However after a while I noticed something quite alarming: Occasionally I could eat without problems!

“I wish I’d pushed all of my doctors more because less than a month later I was in intensive care fighting for my life.”

In 2013 my “intolerance” took a nasty turn. What had been mild gas (Burping) became physically unbearable and the only way to relieve the pain was to vomit. Yet I was in so much pain I couldn’t make myself vomit… instead I had to wait until my stomach could cope no more and would simply “ejected” it’s contents. Unfortunately every-time this happened and by sheer coincidence alone i’d also recently eaten tomatoes. There is some evidence that tomatoes can cause problems for some people but not with the violent symptoms I had. I visited my then Doctor and she said it was possible I had an intolerance to tomatoes, I wish i’d pushed her more. I wish I’d been clearer about the violent nature of the pain and vomiting… I was one very simple test away from the truth

I wish I’d pushed all of my doctors more because less than a month later I was in intensive care fighting for my life.

It was a lovely sunny July morning and I’d been to a local farm shop and tearoom with my wife and three month old baby son, I’d treated myself to a less than healthy organic sausage sandwhich. An hour later and I was stripped naked and in indescribable pain, vomiting into a bucket. I don’t remember removing my clothes. but I do recall being very hot and then very cold, and then very hot again.

“we need to tread carefully, we’ve lost too many like him recently”

I recall speaking and joking with the paramedics… at one point I almost didn’t go to hospital because the pain momentarily vanished. But I did go and was taken to A&E department at Nottingham University Hospitals Queens Medical Centre in Nottingham (In the USA you might know A&E as ER) the vomiting increased and seemingly would not stop, it didn’t seem possible that I could have so much fluid in my body and when the strange brown specks that looked like freeze dried coffee that the nurses told me was blood appeared I realised I didn’t! The last thing I remember before being quickly whisked away to intensive care was reaching out to hold my baby sons little leg: so tiny, perfect and unaware of the troubles around him. I was unconscious when a doctor told my wife “we need to tread carefully, we’ve lost too many like him recently”

I have vague memories of an ultrasound being taken, I remember nurses pleading with me to relax and try not to vomit. I recall a hushed conversation between a doctor and a nurse about my amylase count being higher than anything they’d seen before. I don’t really recall all of the tubes going in and thankfully I don’t recall the pain – they tell me that often when the pain is that bad you just don’t remember, I’m also fortunate that it wasn’t long before I was hooked up to morphine. But this was only the start.

“It’s Pancreatitis” the doctor told me. I don’t recall anything of that day other than this short conversation in which I was asked if I drank alcohol. “rarely”, I replied. “The ultrasound also showed you don’t have gallstones, the only other causes of Pancreatitis are alcohol and very rarely medication.” I’d had perhaps 5 units of Alcohol from January to July. The doctors agreed it wasn’t alcohol. It had to be one of my medications.

I don’t recall the pain or the screaming, but my wife assures me: I did scream.

I knew from school biology that my pancreas had something to do with creating digestive enzymes. I also knew Pancreatitis could be bad and would possibly involve surgery. And then darkness came, I either fell to sleep, passed out or my memory fades because my brain protects me from the pain. As I said before they tell me it’s common for your brain to protect you from these things. I don’t recall the pain or the screaming but my wife assures me: I did scream.

My memory of the next few days is very hazy, the pain and the morphine meant my brain was creating all kinds of stories to protect itself. I had moments of clarity followed by hazy memories. When you are conscious you quickly become aware that Intensive Care is a very noisy place. The machines are noisy, they beep and buzz and ring. The doctors and nurses are noisy, the very few visitors are also noisy… the patients however are quiet. They’re generally either unconscious or very heavily sedated or hazy from strong medication.* You don’t really think it can get any noiser, but it can: The buzzing and beeping becomes intense, it’s followed by shouts, calls and the noise of a very highly skilled hard working team of professionals who are not paid nearly enough. On a number of occasions the noise ended in tears and a look in the eyes of the doctors and nurses that I won’t ever forget. These moments always seemed to be very clear in my memory.

It wouldn’t be long before I was diagnosed with Severe Acute Necrotising Pancreatitis: I’d have to fight for my life not once but twice, undergo two surgical procedures and face feeding through a tube in my nose or stomach for the rest of my life. I wouldn’t see my son until he was almost a month older and i’d still be in hospital four and a half months later.

I really was not Lactose or Gluten intolerant and Tomatoes were definitely not the problem!

If you’d like to read the full story please read on in this and future posts!

Continue reading

The Morning Nude

I love mornings…

Image of naked girl in bed

Morning © Martin Paling 2013

There are lot’s of good reasons to wake up in the morning.

Camera: Rolleicord IV

Film: Fuji Neopan Acros 100

Stand Developed in Rodinal 1+100

Image © Martin Paling 2012, All Rights Reserved. No part of this image may be reproduced without written consent, please contact me for more details.

Auto Focus is for Wimps!

And for people like me who can’t quickly focus on demand it seems! Although to be fair this image of a Porsche at the 2012 Rally Classics 60th Rally Costa Brava was shot with a Twin Lens Reflex and they are not really the choice of camera for sports photography… or for that matter anything that moves faster than a glacier.

Blue Porsche, Rally Costa Brava 2012 © Martin Paling 2012

Blue Porsche, Rally Costa Brava 2012 © Martin Paling 2012

Though I do quite like the result… had it not been a cornflower blue car I wonder if I would have felt the same… I’m not sure why I think the colour makes it work.

  • Film: Portra 160
  • Camera: Rolleicord IV
Golden Porsche © Martin Paling 2012

Golden Porsche © Martin Paling 2012

I thought I’d also upload this image of a Golden Porsche, but only because Mogwai wrote a hauntingly great piece of music with the same name.

  • Film: Kodak Gold 200
  • Camera: Canon TLb
  • Lens: 75mm-210

Porsche – Rally Costa Brava 2012

Porsche, Rally Costa Brava 2012 ©  Martin Paling 2012

Porsche, Rally Costa Brava 2012 © Martin Paling 2012

On a trip to Girona, Catalunya my brother and I stopped off to watch a navigation stage of The 60th Rally Costa Brava. This photo was taken under the cool shade of an avenue of trees in the city centre. The drivers and navigators had just finished a stage and were waiting for scrutineering.

In total we counted 205 cars ranging from high power Porsches and Lancias to small Seats, Fiats and of course the classic Mini Cooper!

Camera: Rolleicord IV

Film: Rollei Retro 400 s

Development: Rodinal 1+25 at 10:30 minutes

Image © Martin Paling 2012, All Rights Reserved. No part of this image may be reproduced without written consent, please contact me for more details.

Follow

Get every new post delivered to your Inbox.

Join 39 other followers