Reverse Peristalsis

My how things have changed! What was initially just persistent nausea erupted into a geyser of...of...let's just say the entire contents of the small intestine. It was the most extreme example of reverse peristalsis; I think it started at her toes and just kept coming.

The good news was that, with the contents of her newly formed GI tract, the episode also brought instant relief from the nausea. She's actually been nausea free since the whole, awful ordeal. The doctors have been largely un-phased (I'll discuss my reaction shortly), one even commented that she finally cured her nausea. There was some discussion of NG tubes (nasogastric tubes) to relieve any pressure in her stomach and possibly doing a cat scan to make sure there aren't any blockages down there somewhere. They're hard pressed to go for aggressive treatments and tests when she honestly looks better than she's looked in days. Caution is the order right now: back to clear liquids, very sparingly, and keep walking and moving around. One of the surgeons remarked that sometimes it just takes a little longer for the entire intestine to "wake up". Best guess right now is that there was one or more sections down there that were reluctant to return to work and caused a brief stoppage. If there is no more nausea/vomiting and she continues to tolerate fluids, they're gonna leave her alone.

The foley catheter is tentatively scheduled to be removed tomorrow morning, hopefully with the abdominal drain. If she looks good, they may discontinue the PCA pump (her self-controlled, push-button drug dealer) also.

Now for my two-cents on this day's events. I am not a puke person. Some may be wondering: "Who the hell is a puke person?" In the medical field, there are just some things that you have to deal with. When your job is answering the call of the sick and injured, vomit, feces, urine, blood and any other bodily fluid you can imagine are sometimes encountered. Early on I realized that, you can bleed all over the place, piss in my ambulance or crap on my stretcher and, for the most part, I'll be fine. Unfortunately for me, one of the dozens of traits I inherited from my mother is that I'm what she affectionately refers to as a "Social Puker". Simply put, if you puke, I'm puking too; a relationship forged in emesis.

Caren has been nauseas for two full days, but hasn't vomited. The retching killed my appetite a few times, but I knew I had to "cowboy up" and help her out. So this afternoon, as I'm hanging up the phone after checking in on the kids with Eric, she starts reaching for the basis, and I really had no concern that this would be anything more than another false alarm. Oh dear, I could not have been more wrong. It took every ounce of will power in my body to fight the urge to ask her to share that damn basis and start puking right along side her. I got caught so unprepared, I damn near threw up right down her neck and back as she leaned forward and purged the demons from her soul. But no, I held it together! I'm balancing the bucket in my right hand and fishing around in my backpack for a pack of mint gum I forgot I had finished yesterday.

And she just kept puking! Oh my goodness, where the hell did it all come from? I had to run out in the middle of the whole thing to see if i could get another basis. No really, I was concerned that she was going to overflow the one we had, and I'm not referring to the little kidney bean thing that holds a thimble of fluid. We were rapidly approaching the carrying capacity of the big mama-jama basis that small children can bathe in. I'm in the hallway yelling at the nurse, who, by the way was holding her anti-nausea medicine in her hand (too little, too late), and I can still hear her doing her best fire hose impression. I came hustling back in to the room to see her look up from the bucket and announce plainly: "I puked." I spared her any the snide responses that went rushing through my head and simply replied: "I noticed."

I have no clue how much that basin holds: a gallon, maybe two? But I know when the fury of the Gods was done erupting from my poor wife's gullet, the darn thing was more than half full and I was struggling not to top it off for her. Her stomach settled almost immediately, I stopped churning about an hour later. And now we wait. Wait to see if the nausea returns, possibly indicating an intestinal blockage. If she gets nauseas again and certainly if she vomits again, in the words of Dr. Kim (one of the surgeons on her case), "She will earn an NG tube." Until then, clear liquids and patience. I can only hope that the next 24 hours are not as interesting as the last 6!