Update

When I had my first ERCP on November 3, 2009, it turns out there was a 4 cm leak where the pancreatic duct was gone. Fortunately there was still some pancreatic duct left in the tail of my pancreas, so they ran a wire and placed a stent. When they did another ERCP on December 24, 2009, the leak was down to less than 1 cm, and my GI doctor replaced the stent.

I had another ERCP on Friday, February 5, 2010, and the leak has sealed up. So my GI doctor removed both the wire and the stent and cleared me for surgery.

Cold Mountain

Back in August I started working on Cold Mountain by Kieran Foley. The plan was to have it done in time to wear to my friend Lynn's wedding on October 3. I used JaggerSpun Zephyr Wool-Silk in the colorway Ebony.

I actually managed to get a good portion of it done before I got sick. This is the second Kieran Foley design I have done, and I think it was easier than Seascape. After I started feeling like knitting again, I tried working on it, but I would find mistakes and get frustrated, so I decided not to work on it for a while. Then I received an invitation to the wedding of a friend's son. That was the motivation I needed to finish. I was so close to finishing on January 22, 2010, I decided I was finishing that night. It did not happen. I ended up having to rework a section three times, but I finally finished it on January 23, 2010.

Here are a couple of pictures of it I took before blocking.




I am not enamored of the yarn. The first skein of yarn had a number of bad spots where either the yarn simply came apart or otherwise looked bad. By the time of Irish Fest, I had spliced it seven times. A couple of my friends have used this yarn and not had any problems with it, but I happened to mention it to one of the judges for the knitting contest, and she indicated she knew what I was talking about. I ended up having to splice it another time before joining the new skein and one time after joining the new skein. And then to top it all off, it ripped along the bind off edge when I was blocking it!

I had been incredibly careful when blocking it, but I guess this yarn just is not very strong. Or maybe it was just the skeins I bought that were bad. Fortunately I was able to undo the bind off and splice the yarn again. This time I bound off even more loosely. I did not block it again, but it is not terribly noticeable.

Back to Knitting

While I was in the hospital, I did not feel well enough to knit. Even after I got out of the hospital the first time, I did not feel like knitting much. It was Cailyn Meyer's Wintergreen Gloves that got me interested in knitting again. The pattern calls for Knit Picks Palette yarn, so once all of the colors were available, I put in an order.

Before I started the Wintergreen Gloves, I did finish a pair of black fingerless mitts for me using the Maine Morning Mitts pattern in Lion Brand Wool-Ease yarn. I also made a pair of fingerless mitts for my friend Shane. His were based on the same pattern but made longer and with a few stitches added to make for a better fit. Unfortunately I did not think to get a picture of him wearing them when I gave them to him. And somewhere in there, I started on another pair of socks.

I started the Wintergreen Gloves on October 29, 2009. I have worked on them on and off, sometimes opting to work on the pair of socks and other projects depending on my mood. My Habitat hat is hiding from me, so I ended up making the Yarn Harlot's Unoriginal Hat out of some Rio De La Plata bulky yarn I had. The pattern went fairly quickly and it only took me a few days to complete--good thing too with all the snow we have had.


I also ended up making a hat for my stepsister and her partner. Originally I was going to make the Unoriginal Hat for each of them. I had bulky yarn in colors they liked. Then it occurred to me that they probably would not appreciate hats that could not be thrown in the washing machine. About that time, the Winter 2009 Knitty went live and I found a pattern I really liked: Knotty But Nice. So I went looking for Lion Brand Wool-Ease in suitable colors.

It was easy enough to find Wool-Ease in green for one hat, but I did not find anything in brown other than one called Woodland Print. Well, I started knitting that one up, and it was looking too much like camo--which would be great for some guys I know, but not for my stepsister. So the Saturday before Christmas, I managed to drive myself to and from the Yarn Barn in Lawrence to get some Plymouth Encore in a light brown color.

I started the green hat on December 15, 2009 and I actually finished it while at the pub on December 19, 2009.


Knowing I was close to finishing the green hat, I had taken some of the brown Plymouth Encore with me to the pub, and I started my stepsister's hat that night. I finished her hat in the wee hours of the morning on Christmas Eve.



Once I finished the hats, I went back to working on the Wintergreen Gloves. I finished the right-hand one yesterday.

Happy New Year!

When I posted a year ago, I mentioned that something told me 2009 was going to be an interesting year. Interesting was certainly one way to describe it. I recently learned that one of my cousins had an aortic aneurysm in January. He survived, but he had to have another repair surgery to replace his aortic arch later in 2009. However, he is doing well. In March, one of my friends had a heart attack. Fortunately, he survived, and his recovery is going well. I have other friends who have equally, if not more stressful things that happened in 2009 as well.

Then on September 6, 2009, I developed a moderate case of acute pancreatitis. My recovery is ongoing, but it seems more tangible than it did even a week ago. On Monday, I got a call from the nurse practitioner that works for the primary radiologist on my case. She told me they wanted to reposition the remaining drain catheter. She mentioned that they were booked this week, but that there might be a cancellation. Said cancellation happened on Wednesday.

I was not really understanding why they needed to reposition it, so I asked. It turns out that the drain catheter was rather close to the replacement stent my GI doctor put in last week, and they thought that the stuff was draining through the drain bag instead of through the pancreatic duct.

However, I did get good news. The radiologist told me the pseudocysts had resolved, and that the drain might be able to be removed next week. I have a vague memory of him injecting a local a local anesthetic, and the next thing I remember is waking up, and they were done. Better yet, they did not have to give me any painkiller other than the local.

It turns out they actually inserted a new drain catheter. The drain bag is smaller and lighter, and I can actually fold it up and tuck it in my waistband instead of having to carry it around in a bag. There was not anything in the drain bag when I got up Thursday morning, and so far there is very little in there, so that is a very promising sign.

So in some ways 2010 is already looking better. Not that all of 2009 was bad. I made some new friends, and I paid off my student loans. I also kept my resolutions. I had resolved to keep enjoying life, to trust my instincts, and look into getting my concealed carry permit. The first one was pretty easy to keep. The second one was a little harder, but I think it ended up saving my life. My GI doctor said that waiting another hour before going to the ER that night probably would not have made much of a difference, but if I had waited until the next day, I would have been much worse. I kept the third one as well. I took a class in February 2009, and I turned in my application a little over a week ago.

So for 2010, I am going to make the first two resolutions again. I was already pretty aware of my own mortality, even before the pancreatitis, and even before the nearly fatal anaphylactic reaction to an allergy shot nearly six years ago. So enjoying life is an important resolution. Trusting my instincts has proven equally valuable. I am also resolving to put myself first more often than I used to.

Happy New Years everyone! May 2010 be a better year.

Update

Yesterday's ERCP (an endoscopic procedure) went well. When I had the one on November 3, 2009, they overdid it with the anesthesia. My dad thinks that perhaps they did not take into account that I was also on a pretty healthy dosage of morphine at the time. This time, I was not on any heavy duty painkillers, and I would not let them give me any. They mentioned another possibility, but since I am allergic to non-steroidal anti-inflammatory drugs (ibuprofen, aspirin, etc.), they could not do that. Either way, I am glad I did not let them give me narcotics, because I came out from under the anesthesia just fine.

Before going under anesthesia, I did talk with my GI doctor briefly. Apparently this remaining pseudocyst is not resolving, because there is a leak in the pancreatic duct. I did ask him why the radiologist needed to talk with him so urgently, and it turns out he was just wanting an update.

I did not talk with my GI doctor after the ERCP, but he did talk to my dad. It is my understanding that I have made a lot of progress in the last six weeks. They replaced the stent in the pancreatic duct, and hopefully things will heal up this time.

It sounds like I will have a follow up with the radiologist next week. My guess is they will inject dye into the drain catheter again (better that than into my veins).

And the Other Shoe Drops

When I had my last CT scan on December 2, 2009, the radiologist who I saw that day indicated he wanted to do another one early the next week. However, for whatever reason, that did not happen. I did end up getting a lower dosage of my pain meds so I could start tapering off them, and when I went to my GI doctor's office to pick up the prescription, they set up an appointment for Wednesday, December 16, 2009.

When I saw the doctor, he told me my surgery may end up being sooner than later, and it might not just be my gallbladder that is removed. He said that they may have to remove the distal portion of my pancreas. The first thing that came to mind for me was whether or not that meant I would end up needing insulin, but he told me a person only needs part of their pancreas to regulate blood sugar.

He did a really good job of explaining stuff, but I still do not quite understand it all. The remaining pseudocyst is apparently communicating with the duodenum, which is why the drainage out of it has looked bilious. There may also be a blockage contributing to the problem. I know he placed a stent in the pancreatic duct during the last ERCP (an endoscopic procedure). If I understood correctly, it was because the duct was damaged due to the pancreatitis. However, there may be a chance the duct is not sealing up right, and that could also be causing some issues. He did indicate he wanted to do another one, so that has been scheduled for this upcoming week before Christmas (trying to get as much done before the end of the year, because my health insurance deductible and co-insurance start over on January 1). He also mentioned that even though the surgeon did not want to do surgery until the last psuedocyst resolved, he may have to go ahead and do surgery and rig it so it drained through the digestive system.

I have also been having some issues with the insertion point for the remaining drain, so I called the nurse practitioner I have dealing with. She indicated she would call in a prescription for something I could use and that she would leave a new drain bag at reception in radiology. Then she mentioned that the radiologist needed to talk with my GI doctor about something. She said something about how they probably would not schedule any procedures next week, so I told her that I had an ERCP scheduled. She indicated that the radiologist she worked for would need to talk to my GI doctor that afternoon. So, I am not sure what else is going on yet, but apparently something is.

Waiting for the Other Shoe to Drop

I know I have been really quiet lately, but the road to recovery has had a lot of obstacles. I had a CT scan on October 26, 2009 which ended up showing that the pancreatic psuedocysts they had discovered on the previous CT scan were evolving. Then I ended up going back to the ER the next morning (October 27, 2009). I felt horrible, was in pain, was throwing up, and had chills. Turns out I was reacting to abruptly stopping my pain meds. Apparently it did not occur to the hospitalist who had discharged me on October 5 that I needed to gradually reduce the dosage of pain meds I was on.

On November 3, 2009, they did the endoscopic procedure that they had tried to do previously. This is when I learned about the pseudocysts evolving and found out one was invading my liver.

They overdid it with the anesthesia. Prior to this, I had had anesthesia on four different occasions. The first time, I was not able to breathe when I came out from under the anesthesia. The second time, it was even worse. The other two times, I had a great nurse anesthetist (I specifically requested him for the second of those two procedures), and I had no problem coming out from the anesthesia. This time I did not have the problems breathing like I had the first two times. However, I felt too sedated to breathe, and it took a very conscious effort to make sure I did breathe. I also tried going to work the next day, but I was unable to function and ended up having my dad come get me after a couple of hours. My boss told me to stay home the next day, which I did. Then I ended up having a couple of drains put in on November 6, 2009.

The drains were put in by a radiologist under a sedative and local anesthetic. They did a CT scan without the dye and contrast to see the pseudocysts and figure out where to place the drains. They put one in one of the pseudocysts on my pancreas and the other was put into the one that was invading my liver.

On Veteran's Day (November 11, 2009), the surgeon informed me they could not do my gallbladder removal (scheduled for November 19, 2009) at this point, because it could kill me. He did not offer any other explanation, and frankly I was too shocked to ask. I called my GI doctor's office the next day, and they contacted the surgeon. He told them he was worried about the pseudocysts rupturing and causing peritonitis. I have had peritonitis, and frankly, pancreatitis hurts more.

Two days later (November 13, 2009), I was in for another CT scan. I had been running a fever of 102 according to my thermometer, and I was told to call if that happened. One good thing that came out of it was that they discovered the psuedocyst on the liver had resolved, so they removed the drain.

Later that night, I felt really sick and texted my stepsister. She is a nurse and her partner is a professor of nursing. My stepsister decided to come over and check my vitals and brought her partner with her. I also called my dad as a precautionary measure. I had a fever, but we determined my thermometer was not giving accurate readings, so we do not know how high it was.

I ended up going to the ER, and this time I got in right away. They decided to admit me for pain management and bowell rest, and then they discovered I had an elevated white count, so the hospitalist who took my case ordered high powered antibiotics.

Low and behold, I ended up on the same floor I had been on during the last week and a half of my previous hospital stay. At least I was not in the same room (which it turned out was right under where the helicopters landed--okay so there was an empty floor between that floor and the roof, but it did not really do much to muffle the noise).

I have to admit, I was not quite as easy going this time. I was frustrated about being sick and in pain. They did another CT scan on Monday (November 16, 2009) and discovered the other pseudocysts were getting bigger. If not for the fact that I had already had a shot of blood thinner that day, they would have put in another drain that day, so they scheduled it for the next day (November 17, 2009).

Since they did not give us a specific time, my dad ended up being at the hospital all day (on his birthday no less). My stepmother got to the hospital sometime either right before the procedure or during. I cannot remember which--my memory is a little hazy on that. I do remember asking the radiologist where he was going to put it, and he indicated it would be about the same level as the other.

However, that was not the case. It turns out he could get a the one he had thought he would not be able to get to. So I ended up with a drain inserted pretty much right below my right breast very close to the diaphragm. I was in so much pain when they got me back up to my room that I consented to the pain pump that I had refused earlier that morning.

The pain pump did little good. It was not set to deliver a consistent dosage, so I only got pain killer when I pushed the button, and it was set on a 15 minute lock out. I apparently slept for a little bit that evening, but I woke up sometime before nine, and according to the nurse assigned to me that night, I did not fall back asleep until sometime after 4:30 a.m. The syringe in the pain pump ran out early--big surprise there--that had happened to me three times during my previous stay. This time I told them to take it away. When they started it, they neglected to tell me they would have to start another IV to run my antibiotics and pepcid. However, I would not let them--I told them to stop the pain pump while the other stuff ran. That did not go over very well with the nurse I had during the day shift (we had a bit of a personality conflict the last time I had been in too). Of course they would not do it without the doctor ordering it.

The doctor ended up switching me over to a patch, which worked somewhat better, but there were times I had to ask for more painkiller.

Friday (November 20, 2009), they did another CT scan. This time they gave me some Zofram ahead of time to see if it kept me from getting sick from the dye. No such luck. About a minute after they injected it, I got sick. Getting sick put me in incredible pain, and by the time I got back upstairs, I was in so much pain, all I could do was ask for painkillers. Dad had to explain to the nurse what had happened.

The doctor ended up deciding to keep me there over the weekend, because he did not want to send me home and risk something going wrong. However, on Sunday (November 22, 2009), I had another hospitalist, and she indicated she would discharge me if Interventional Radiology okayed it. Later that afternoon, the surgeon came to see me and he indicated I was not being discharged. However, that was not the case. Apparently the hospitalist signed off on the order that morning, contingent upon Interventional Radiology's approval. Around 6:30 p.m. a nurse came in and told me I was being discharged, so I called my dad. Turns out they had gone out of town for dinner. Fortunately a couple of friends had come to visit, so they took me home.

I went back to work Wednesday (November 25, 2009) then had two days off for the holiday. I ended up staying home both Thursday and Friday, but I did go to Thanksgiving dinner at a friend's house on Saturday.

Two days ago (December 1, 2009), I had a follow up appointment with my GI doctor. They tried flushing the drain that was causing discomfort, because it was barely draining. However, the saline solution started coming back out. Oddly enough, the other one went into overdrive.

Yesterday (December 2, 2009), I had another CT Scan, and they tried injecting the dye into the catheter . Today they called me and told me they could remove the drain that was causing so much pain, but that they needed me to come in for another CT scan tomorrow. The painful drain is out, and I have already contacted my GI doctor's office about getting a lower dosage of pain patches so I can gradually stop using them.

I am really trying not to worry about what tomorrow's CT scan will find, but I feel like I am waiting for the other shoe to drop. The radiologist who looked at the CT scan yesterday apparently spent a lot of time looking at it, and there is some concern about where the catheter from the remaining drain is. I guess I will have to just wait and see.