Update #15 – The Pitt, My Fab 4, and What Now?

Upon first viewing, The Pitt (HBO Max) failed to reel me in. Aside from the graphic in-your-face blood & guts medical procedures, I kept waiting for the camera to break from the sterile constancy of the ER. (Me: “Do they ever go outside… I mean, ever?!?”) Hence, Laura and I initially relegated The Pitt to the stockpile of shows that have fallen short of our dubious standards of bingeworthiness.

Then, we decided to give it another shot in February.  Beyond the fact that we are now most definitely reeled in, for me, it’s been a case of life imitating art. How so? 

Well, imagine my surprise to find that two of the procedures played out on the show — 1) Digital Disimpaction; 2) NG Intubation (NG = nasogastric) — were performed on… me… just last week. Yeah, barely a week after laughing along with the rest of the world, I actually lived the now infamous “Poop Episode.” (Only, my doctors came up with nothing to show for it, proving that sometimes, shit does not happen.) In other words, the digital disimpaction failed to… er… disimpact.   

Then, only a few days later, I found myself in a Portland-bound ambulance — for the second time in 5 days — only this time I had the NG tube descending 65 centimeters down through my left nostril to my stomach, effectively sucking out that which my stomach could not expel.    

It all started in the middle of February when my bowel system was just not getting the job done. Although I was initially feeling OK, this history major reasoned that the growing imbalance between that which was entering my body vs. that which was exiting did not constitute a winning game plan. Thus, began a timeline that went like this:

– Feb 17 – Boston: After examining me, my Mass General (MGH) urologist orders a pelvic MRI and moves my decennial colonoscopy from 2030 to now. I did get to take a stroll through a snow-covered Public Garden:

And the history teacher within me was somehow comforted to find Paul Revere warning me about the medical challenges ahead.

 – Feb 24 – Boston: Pelvic MRI conducted. Although it showed an undefined mass blocking things — more on this, later — it also showed no evidence of any new cancers invading my body. (A good thing)

– Mar 2 – Portsmouth, NH: Meeting with my MGH oncologist

– Mar 3 – Brunswick, ME: The day a valve seemed to close: No gas. No bowel movement. Lotta abdominal pain and nausea. A discussion with a Midcoast Hospital gastroenterologist quickly transitioned to a wheelchair ride to the ER.  As day turned to night, doctors conducted the aforementioned failed digital disimpaction. Meanwhile, my expanding belly felt like it was going to explode. (Me to a nurse: “Can we skip the pain meds and go right to the cyanide?”)  

– Mar 4 – Following a sleepless night in a Midcoast ER bed, doctors and staff scrambled to the task of finding me a bed… any bed… at either Maine Med or MGH for emergency colostomy surgery.  Doctors were concerned that internal swelling could reach a critically dangerous point. At 6 PM, I’m a grateful passenger in an ambulance headed for Portland’s Maine Med Hospital.  After dropping me off in a room, I’m told to be ready for anything.

– March 5 – Maine Med (Portland) – Awakened at 1 AM; on the operating table at 1:30. A few hours later, I came to and learned that I now had a loop colostomy to match the urostomy I acquired 15 months ago. Although this version of the colostomy is potentially reversible, there are no guarantees, and I was not thinking much about that at the time.

– March 6 – Released and sent home.

– March 8 – After a day of “Feelin’ Alright,” I woke up Sunday AM feeling terrible: intense nausea and stomach pain. So, back to the Midcoast ER I go.  Doctors there concluded that the problem lay in the fact that any food I was ingesting was not leaving my stomach. Bring in the NG intubation.  (Note: You do NOT want one of those!) Next thing I know, once again, I’m en route to Maine Med via ambulance. As uncomfortable and downright weird as the NG procedure is, at least my stomach was drained and I was no longer feeling as bloated or nauseated.

– March 9 – Happy Birthday!!! – Suffice it to say that the removal of the NG Tube was the best present I received that day.  

– March 10 – My second surgery in 4 days, doctors perform a flex sigmoidoscopy, a procedure sometimes called a junior colonoscopy. I’m home that night.

– March 11 – Daughters Mahalia and Scout fly home to support Dear Old Dad. 

So, what now?

As uncomfortable as the past few months have been — e.g., the adverse skin reactions my legs had to the immunotherapy over the Holidays, the January blood clot, the February Type A Flu, the current bowel/abdominal issues — the most important question remains: What is happening with the cancer?

At this point, my MGH urologist — with me for 15 years — called me on the phone and observed, “We still don’t know what caused the original blockage that led to your bowel issues.” Hence, he has ordered a needle biopsy — scheduled for the end of March — where tissue samples will be taken from the aforementioneed “undefined mass.” As he said, “Let’s find out what it is and then, if need be, apply the appropriate treatment.”

Sounds like a plan. More to come. Onward, Malcolm #tfc