Sunday, October 6, 2019

Sunday Stroke Survival: Incontinence? Nope. It's Worse!

When you talk about incontinence, you mainly think about the bladder. When you talk about bowel incontinence, it's something else entirely. I don't have this problem except in cases of diarrhea. But even the "norms" have a control issue with this, don't they? During these times, even they wish they had diapers to save wear and tear of their clothes, and embarrassment of accidents. But I'm already in them.

I had a incident this past weekend that caused me some real concern. Of course it happened over the weekend, it's an addendum to the old Murphy's Law. If something happens when you need your PCP, it'll happen on a weekend, holiday, or night when his/her office is closed. Then, you you have to weigh your options under is it bad enough to warrant an ER visit.

Now being a former emergency medical professional, I weigh this differently than most people. It's more of a question of "will it kill me if I wait until Monday?" I don't use the ER frivolously at any time after normal business hours. Things like a cut that needs stitches to close with bleeding I can't control by other means, broken bones besides fingers and toes, or true medical emergencies like heart attack or a stroke...all of these require emergency services.

 (this is gross, but true)
The event of the weekend just barely fell in both category. I decided to wait until Monday. As is my usual habit, my bowels decided to do it's weekly or biweekly purge...slight constipation (hard stone like bowel movement), followed by a couple of normal movements, and ending with a couple of really loose movements. This is not true diarrhea, but diarrhea type movements as a way to finish purging my bowels.

Except this time was different. By the time I reached by two loose stool movements there was blood tinged mucous. The cramping (I now feel it just under my rib cage in my back) didn't stop. This was highly unusual. After I walked the bathroom and sit on the commode, the cramping got so bad I vagaled. (profuse sweating, dizziness, low BP, hot flash, a high heart rate). Instead of the expected bowel movement I passed huge bloody mucous blobs. The bloody parts were bright red which told me it was a rectal vein.

This continued through the night. By Saturday, I couldn't pass gas without spewing blood. If it got any worse, I'd go to the ER otherwise I'd wait until Monday to see my PCP. By Saturday evening, the mucousy blood movements stopped, but were replaced by blood clots. So whatever ruptured inside was trying to heal in spite of my blood thinners. When you are on blood thinners, you can expect to bleed more heavily than normal. I was thinking that was the case here.

By Sunday evening, I had two incidents of passing clots and it finally stopped. All during this time I ate and drank normally. I applied witch hazel patches to my anal area to shrink whatever was it was causing the bleeding. So, it wasn't like I wasn't doing nothing. At no time did the bleeding turn darker, like an upper GI bleed, nor more profuse other than I described.

Caveat here, I am a trained emergency medical professional. I do know when the abnormal turns critical and warrants further intervention of others. If you are not, by all means, go to the ER.At times, the thought of going through my mind and I would have if the symptoms gotten worse than what I experienced, or hadn't slowed, or if the amount of blood was greater than a monthly menstrual cycle. I would definitely carried my unhappy hinny to the hospital, I'm not stupid. I just don't panic in "emergency" type situations. I observe and evaluate first as I was taught.

I know from experience that the ER would have done a wait and observe the progress with a possible admission for the weekend. With a cleansing ritual to prepare for a scope or colonoscopy for the regular work week. Been there, done that, and don't want to go through that again. The only conclusion the internist could make after that fact was that the area in question was healed or healing on it's own and ordered a stool softener for a week. I've got plenty of stool softeners here after the surgeries of spring and summer if I need it.

By using prior knowledge, I saved myself a ER visit, possible admission, a colonoscopy and a bunch sheer aggravation of wasted money. But yes, I will appraise my PCP about this when I see him next week.

Nothing is impossible.

2 comments:

  1. Wow, yeah, I would have gone to the ER, but I've never been a medical professional. Hope you're better.

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    1. By Monday, everything cleared up. My PCP was concerned, but happy it resolved itself. A scope view showed a tear in the lining of the wall of the rectum. It was healing. I was given antibiotics to prevent an infection. Yes, it was a busy Monday. The internist said, given my expertise I did the right thing.

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