Friday, March 17, 2006

 

In Which The Bill Comes Due...


Wow, time sure can fly when you're sick.

Hard to believe it was two weeks ago yesterday that I was admitted to the hospital, raving about bus accidents and my family being eaten by alligators.

Since that time, you'll be pleased to know I've done very little aside from answer some kind emails (thank you. You know who you are), post a little bit about my misadventures in Florida, and sit around the house, drinking enormous quantities of water and coughing up every brachial tube in my lungs.

I was told to stay home from work the first week and I almost managed it. Except Wednesday we had a story pitch meeting and my designer--a truly inspirational fellow who is undergoing a second round chemotherapy for a very aggressive kind of sinus cancer--emailed me to see if I'd be there. He was home, sick from the chemo and a secondary infection that had made his face swell painfully, but he was planning to come into the office long enough to be there for my pitch meeting.

Well, damn, if he was well enough to go, I sure as hell was.

And what a pair we made at our pitch meeting. I've never had an editor-in-chief applaud for me before, but when the designer and I walked in, we got a standing ovation. We made our three or four crucial presentations, got them approved and then the Chief begged us to go home and rest. We didn't argue.

Boy, have I been tired. It really has been like a preview of my senior years. I've been wandering around the house grumbling and crabbing and making disgusting noises as I try to clear every upper-body cavity of phlegm. Then I sit and fall asleep in front of the Weather Channel, snoring most of the afternoon away before waking up in time for dinner and then shuffling off to bed.

This week, was mostly a get-back-my-strength week (what will I do without my 2 o'clock nap once I go back to work full time?), so I've been on half-days and I've actually been pretty good about sticking to that work schedule.

Thus I feel pretty good this week. Well, physically good (we'll get to my emotional state in a bit). For the first time I can take a deep breath without coughing violently or feeling pain in my lower rib cage. I actually walked up a flight of stairs without seeing spots floating in my field of vision. And the residue from the super adhesive they used to affix the IV to me has finally peeled off. My arm hairs should be fully regrown in another six to eight weeks.

On a less jocular note, I almost dropped dead from shock when I got the statement from the hospital today. I knew it wasn't going to be cheap, and yes, of course, I know my insurance should cover most of it (or else there better be a damn good reason why such a painful chunk of my paycheck goes to medical every two weeks). Still, that knowledge doesn't do much to buffer the initial shock of realizing your three days in hospital cost well over six grand. And to think I was lamenting all the money spent on my vacation! My God, being sick at Disney was bargain in comparison, and they had more comfortable beds plus a much wider assortment of rides (at the hospital, you only had your choice of two: ER Gurney! and Wheelchair: Adventures into the Radiology Dept.).


Of course, I have no one to blame but myself, now do I? I probably could have avoided the illness and the expense if I'd been just a little more watchful. But then I would have robbed someone of a rare moment of glee. For while I was still swooning from the bill, the phone rang and who should it be but my Dad, who usually enjoys commiserating with anyone about How Expensive Things Have Got. But I underestimated his pleasure at my complaints.

"Oh holy-O jeezuz, don't this make my day!" he cried, and even over the sound of the cackling I could hear him slapping his knee. "Some pricey at the hospital, ennit?"

"I don't see what's so funny," I said.

"Well, that's cos you don't have my broader experience when it comes to putting you up in a hospital."

"What are you talking about? This is the first time I've ever been admitted to a hospital--"

"I guess the hell it ain't. I oughtta know." He paused to catch his breath and, I'm sure to wipe tears of joy from his eyes. "You know, 40 years ago, when your brutha was born at the Elliott Hospital, I picked him and your mutha up and they give me the bill. Guess how much it cost have a baby in 1965?"

"Er, a thousand dollars?" I hazarded.

"One. Hundred. Fifty. Dollars," he said, pausing for emphasis. "One-five-oh. And that was for a week in the hospital cos your mutha had toxi-whatchamahoozee and she and your brutha was both under observation."

"Really. What a great story."

"I ain't finished. Two years and eight months later, I had to make the same trip to Elliott to pick you up. Not even three years later, and guess what the bill was?"

"Er. Three hundred?"

"Don't I wish. Seven hundred and fifty goddamn dollars. I just about shit my pants, now I'll tell ya. And you and your mutha was only in there three days. I swear to Christ, when I saw that bill, I almost turned around and wheeled you both back up to maternity. You know what seven hundred and fifty dollars bought back then? The pick-up I was driving only cost me a hundred. I coulda had a friggin' fleet of trucks for what you run me. That was some piece of change and I didn't have it. I was making $60 a week back then, and most of it was going to bills and feeding the $150 kid I already had."

"Well, you must have managed it. I didn't grow up in an orphanage."

"It was a pretty goddamn near thing, I'll tell ya. Luckily that year I finally got into the union and they had a health plan that covered almost--but not quite--half of the bill. But I had the pay the rest out in installments, just like you was a refrigerator from Sears." Here he paused wistfully. "Actually, I'm pretty sure a Sears refrigerator would've only run me a couple hundred bucks back then. Including delivery. And I'd a had my choice of pea green or harvest gold for colors."

"So now I know why you never had three kids."

"Damn right. Way too much money. But it's almost worth it now hearing you bitch about your hospital bill. By gorry, you made my day."

Well, at least one of us was happy.

As good as I've been feeling this week, I've been less and less content--and not just from the hospital bill. It appears that her super-human efforts to wrangle the kids and me home safely have finally taken their toll on Her Lovely Self. I'd love to tell you that she picked up a cold or even a flu. That would almost give me the same joy as news of my exorbitant hospital bill gave my dad. I say that not out of cruelty, but because I know exactly why my wife is ailing, and I'd rather she had a simple cold or virus than what's troubling her now.

Some years back--in fact about a year before we bumped into each other in Chicago, Her Lovely Self began to fall ill. It was just a month or so after she had graduated college and moved to Chicago and started her first job in the magazine business. And then she was hit with a tidal wave of symptoms: nausea, fever, abdominal pain, loss of appetite, anemia, dehydration, and all manner of digestive complaints that I needn't go into here.

She was diagnosed with a simple flu, but the symptoms persisted for more than a month. During that month, she saw a variety of doctors, each of whom had a different diagnosis. One thought she was pregnant (which would have been a very neat trick at the time, seeing as she wasn't seeing anybody); another assumed she had an eating disorder; someone else thought she had leukemia. One memorably dismissive doctor told her the symptoms were all in her head.

Meanwhile, she ate and drank less and less, the abdominal pain grew worse. Eventually, she collapsed at work and ended up in the hospital, hooked to IV fluids and nutrients. When they admitted her to the hospital, she weighed 86 pounds. She's petite, but that was extreme even for her. She was in the hospital for almost a month. On the bright side, a doctor finally gave her a correct diagnosis.

Her Lovely Self has Crohn's Disease. I don't know why, but I suspect there's more than a few of you out there who already know all about this particularly nasty form of inflammatory bowel disease. There are plenty of unpleasant details about this disorder, but the basics are this (and forgive me if I'm off on some details. I'm a little too tired to fact-check myself just now): for reasons that aren't clear, parts of your digestive system can become inflamed. During this flare-up period, the inflamed area can close off almost completely, at best making it hard for your body to absorb nutrients from food, or simply causing lots of pain as food passes through the inflamed, narrowed areas. At worst, the inflammation can cause so much narrowing of the tract that it can cause dangerous and even fatal bowel obstructions. In some cases, the inflamed tissue can have a corrosive effect on other nearby tissue, causing perforations in neighboring loops of intestine, which leads to problems such as internal bleeding (hence the anemia) or even peritonitis. In this way, the disease is similar to another inflammatory bowel disease--ulcerative colitis--and they used to treat both problems the same way--with surgery. However, in the case of Crohn's, they found out that half the time they removed a diseased loop of intestine, the inflammation returned in a previously healthy area of the digestive tract. So much for surgery.

By the time Her Lovely Self was hospitalized and diagnosed, it was determined that the disease was mostly confined to the ileum, a part of the small intestine, which was so badly off they estimated that the ileum was constricted to an opening of roughly a quarter-inch wide. By the time they got the inflammation under control (thanks to a series of really unpleasant steroids), Her Lovely Self had developed permanent scarring in that part of her digestive system.

That's more detail than I meant to give (and certainly more than she would want me to give. No one likes to publicize their health problems, especially when they pertain to your digestive system, and HLS is a particularly discreet person anyway). But it's important to have the back-story. And it's important to understand that she is somewhat in denial about this chronic health problem of hers. In her own way, she's as much in denial about it as I was about being really sick in Florida.

It's not entirely her fault. Her Crohn's is considered a relatively mild case, and as such, she's not subject to constant, pain and problems. She suffers flare-ups. After her first and worst flare-up, she didn't suffer any problems again until about a month after we were married. We had just moved to a new city and she had just started a new job when she started waking up mornings feeling nauseous and complaining of a clenching pain in her stomach. I was young and stupid then and thought she had an ulcer or was--Good God!--pregnant. And she allowed me to flounder like this for more than a week before her symptoms got so bad she finally told me the whole story, a story I had not really heard before we got married (not that hearing it would have changed my decision to marry her). Despite her angry protests, I took it upon myself to find her a gastroenterologist and practically had to drag her to her first appointment. In the end, she had to admit it was the right thing to do. Aside from the doctor in the hospital, she had never been under any consistent care for the disease, and thanks to the aid of a specialist, she was able to get the flare-up under control in a much shorter period of time and with far less troublesome meds than the steroids she'd been on before.

And so it went. Every 2 or 3 years, HLS would stop eating or have that telltale clenching pain and she'd go on some meds and try to eat a very low-residue diet to avoid any irritation of the inflamed area or put herself at risk for an obstruction (she's only had one close call, thank God, and it was one of the scariest nights of my life. They wanted to operate--obstructions are damn painful and can kill you fairly quickly--but surgery increased the odds of spreading the disease to other parts of the digestive system. In the end, her gastroenterologist prevailed and they gave her a massive dose of prednisone. The inflammation was gone in an hour and the obstruction resolved itself without the aid of surgery, but that was one bad night. My brow is sweating even now at the thought of it).

We've been lucky the past several years. Her last flare-up was just before she was pregnant with Thomas. She remained free of Crohn's symptoms for years afterward, well after the Brownie was born. She had a minor flare-up when I took the job I have now and we moved to our new house, but once again, with the right meds, she got over it quickly.

Careful readers may notice a correlation between HLS's flare-ups and major life events, such as finishing school, moving, starting or changing jobs. Most doctors say there's no scientific evidence to support this, but every Crohn's sufferer I've ever spoken with feels pretty damn sure that stress can trigger a flare-up. I've seen the evidence myself. That dangerous obstruction HLS had? It came within hours of learning her beloved grandfather had died unexpectedly a couple of days before Christmas and we found ourselves rushing to cancel holiday plans and finds two seats on a plane going anywhere near the funeral. She was as upset as I've ever seen her then, so it's little wonder that a few hours later I was carrying her into the ER because she couldn't walk from the stomach pain. From that day forward, I've never doubted the link stress can play in triggering flare-ups. Which is why whenever we seem to be going through a rough patch--too many sick kids or dying relatives, too many demands on work and life, too many personal or professional problems cropping up--I find myself watching my wife. Because she won't tell me if she's feeling bad, see (remember what I said about her being as stupid as I am?). But she can't fool me. I know what her face looks like when she feels that telltale clenching in her stomach.

And I just realized this week that she's been wearing that face a lot. I was just too sick myself to notice before.

I shouldn't be surprised. Having a sick spouse in a place far from home is stressful enough. But add in taking two kids--by yourself--to the largest amusement complex in the solar system and throw in having to get everyone home safe afterwards. And then immediately follow that up with getting your spouse to a hospital and being told that he could have gone into cardiac arrest and died.

Well, I guess that'd make my stomach clench too.

Now that I finally have a clue, I've confronted Her Lovely Self, but she insists she doesn't need to see her doctor. Still, I can't bear to see her wake up every morning holding her stomach, gritting her teeth against the pain. Inevitably, it gets bad enough that she starts feeling nauseous. And then she starts eating less and less. And the she gets weak. And then...

I'm not sure where she is on the disease's continuum right now. I've been out of the loop for two weeks. But I'm watching her now. Carefully. As I type this in bed, she's asleep beside me, her face creased with pain. And I'm cursing myself, blaming my own stupidity for this, just as I did today when I got my statement from the hospital.

But this is no piddling 4-figure bill. This is a bill come due that I can't bear to pay. I've caused pain to something in my life that is irreplaceable and I have no one to blame but myself, getting so sick that I allowed her to become sick. Watching her suffer, even in her sleep, I'm having a hard time letting myself off the hook for this one.

Time sure can fly when you're sick.

But man, it crawls when someone you love feels sick, and you know you're the one who helped make her feel that way.

Tomorrow, I'm calling her doctor.

Yours,
From Somewhere on the Masthead


Comments:
My prayers and thoughts are with you both. I hope everything turns out okay! You all are certainly due for some peace and comfort after the past month...
 
This is not going to be easy or cheap, but you know what you have to do, MM. Good luck.
 
eek. well, they say things come in threes. maybe you will be off the hook for a while, once you and hls are back up to snuff.

hmph. remember that doctors just recently said that chicken noodle soup was good for you when you were sick. given the chemistries involved, of course stress would have a significant affect. frustrating, though, isn't it?

i wish you both a speedy recovery, and smooth sailing for a while.
 
you're right, call the dr, get her in, and get her through this episode. I hope she feels MUCH better, soon.
 
Don't blame yourself, MM. I'll be praying for you both...take care of that little lady of yours...
 
Hang in there MM gang. I know the link between stress and IBS. Been there done that. You and HLS need some time off together. Don't go anywhere just stay home in bed. Take care
 
i wish you both a speedy recovery, you're such a caring husband!
 
Praying for you. Hope everything turns out alright.. take care of yourself; I don't doubt that you'll be taking good care of her.
 
My step sister has crohns disease and I've watched her go through the medications (steroids) which chaged her face and made her sick. She's on maintanance right now and life is treating her good, so she's managing, but I worry for her.

Well, now you know you have to get back on HLS duty. She's the mom and we mom's take care of everyone else. Lucky for her, you actually are sensitive enough to notice her needs.

Waste no more time feeling badly, and go about the busines of taking care of her. That's the best thing you can do.

Good luck to you all.
 
Don't blame yourself. She should place a higher priority on herself and get to the doctor at the first sign of trouble. But do be the good husband and nudge her along until she does go.

I'm really glad you are ok.
 
Troubles always seem to come in bunches, unfortunately. Whatever my prayers are worth, I've said one.
 
Let go of yourself, let go of your sense of yourself, let go of your inner monologue. Focus on Her Lovely Self and the kids (don't lose sight of the fact that they will be stressed out, just like you were when your Mom was in the hospital)... You're a good man. Don't let people snow you, the road to Heaven is paved with good intentions.
 
MM

Have her checked for celiac disease as well, symptoms of which can be similar to Crohn's.

From experience, do I speak.

Your pal the bunny.
 
You're right about others knowing the disease; when you listed the symptoms, I scrolled down to see if it really was Crohn's. My grandmother, (who I live with) has it, and she suffers often from it. She has the bland-diet technique too, she can't eat anything acidic, etc.

Best of wishes to Her Lovely Self. Breathe, and don't blame yourself; and if you do, don't let her see it. It's hardly your fault you got so sick, and she'll feel bad to see your guilt.
 
You are a good man, MM. The fact that you feel so responsible for her state shows how much you love her. You will take good care of her.

I'll keep you all in my prayers!
 
This comment has been removed by a blog administrator.
 
I'm sending loads of healing mojo to the Magazine Mansion and wishing a speedy recovery to you both. Me thinks, the Universe is trying to tell you something. It would serve you well to listen.
 
my sister has crohns too with ulcerations around the ilium and in her stomach. ulcerations around the ilium prevent a body from being able to absorb iron from food and then the aneamia causes the body to have no energy to break down any food and weight loss and nausea and malaise result. one thing she can do every day to prevent crohns flare ups naturally is mucosaheal, a vitamin supplement that has all the good stuff for crohns sufferers to be assisted by naturally to have good digestive function when the body can't take care of it for you.

their website is
www.absorbplus.com

i am australian and totally unaffilliated with them, i've been reading you for months and love you, hls, your kids and your wee blaze and only hope for the best for all of you. my sister was in intensive care and nearly died from system shut downs relating to crohns but since taking mucosaheal in conjunction with a new attitude and modified medication has been well for the last 4 months which has been like a miracle compared to the 4 years prior where she just got sicker and sicker until she ended up in intensive care. this is an insidious disease that needs to be taken care of every day, my love goes to hls and to you. take care. i'm sorry this will come up anon, i'm a blog reader rather than blogg-er, xx jill
 
My best wishes go to HLS for a speedy recovery. I think you both need another vacation, to recover from your vacation. Seriously, I hope it's just a minor flare-up and she gets better soon.
 
MM, blogs - I think, and this is just my opinion - are a way to view life through the eyes of another, through their lens with all their subtle notions injected into it.

So when we read about your illness and Her Lovely Self's illness, we naturally will pick up quite a bit of the worry and fear that you are feeling... Or at least I did.

That's the real shame about the blogosphere, I think, that we can all be neighbors in one respect but we can only cast well-wishes to our neighbors. Then again, prayer is nothing too shabby, and there's a few with the names of you and Her Lovely Self.

Take care of her and take care of yourself. There's a bunch of us out here pulling for you, and not just because everyone likes a winner - seeing as how you've been the underdog a few times. We just like the good guys (and gals).
 
Best wishes to both of you.
 
Hope all goes well with your recovery, and certainly with the other's Crohn's disease - I have ulcerative colitis and understand how difficult can be when there is even a hint of a flare-up.
 
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