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Location: DownByTheRiver, Central Iowa, United States

Husband of the world's most wonderful wife, father of the world's four most brilliant children, grandfather to the world's eight most beautiful granddaughters and two handsomest grandsons

Tuesday, May 17, 2005

The Great Pumpkin

Monday afternoon found Mr. and Mrs. RRR trekking to the Big City to have a care conference at the VA. Once again the specialist had canceled, but this time she had forgotten to call and tell us. We sat quietly in the waiting room, waiting, waiting, waiting. People donate books to the VA for the vets to read while waiting or to take home and in the middle of the rack I found a treasure. “Fremont, Pathmarker of the West”, by Allan Nevins. Thick biography of the explorer, published in 1955, it has 695 pages and is written with charming detail and skill. A curl up by the fire book.
On the wall of the waiting room was a poster showing cross sections of the liver in the four stages of liver disease, beginning with the healthy pink, only slightly scarred stage one and ending with stage four, the gray, swollen and disgusting looking end stage. I paid particular attention to one and two, certain that's where my status stands and convincing myself that the pictures didn't look THAT bad. At last, Marsha, the clinic nurse accepted the fact that Jennifer, the nurse practitioner who stands in for the specialist was not going to be found, not hiding in the building, not at home, not on her cell phone. Marsha took us in an exam room and brought up my records on her computer. I had eyes only for the biopsy results, already knowing all the labs.
Stage three, I'm at stage three. Not one, not two, but three. And I've been there since at least 2003. Stage three progressing. Progressing to stage four, full blown cirrhosis. The Great Pumpkin Disease. I realized a new wind was blowing through the RRR's landscape. Yes, we'll keep trying to treat the hepatitis. There will be tests coming up and more tests. I'll likely do another year on another brand of Interferon, or at least move to maintainance dosing. (The mild flu for the rest of my life as opposed to severe flu for 48 weeks at a time) But the focus is off the virus. “We've done about all we can.” Now we are looking at the Great Pumpkin Disease.
It starts with swelling of the ankles and lower legs. (“Do you have that now sir?” “Well, yes, but that's just the blood pressure medicine, right?” “Does it go away over night?” Well, MOSTLY, I mean sometimes, uh... it used to completely.. but now..”) Then the abdomen. (Is it fat or is it ascites, only his Gastroenterologist knows for sure). Red palms, spider veins on the face and abdomen. Loss of sexual functioning. Loss of hair. (This is just male pattern baldness, right?} Anorexia, every problem has some positive side. Clubbing of the fingers. Then the dreaded internal bleeding, maybe with vomiting and tarry stools. The breath gets foul and bat like from digesting blood. By now the body retains great amounts of fluid. Jaundice, pronounced swelling, the arrival of the Great Pumpkin. Then encephalopathy... brain dysfunction. Finally death, usually from something like pneumonia, drowning in all the fluid the body can't expel.
35 years ago shot up heroin 4th man on a dirty needle. Had to try it, see what it was like, Just one won't hurt. Nice high, great feeling of comradery with the three soul brothers who went first. One's dead, maybe he lasted through the Apache's retreat from Saigon and died in the last stand in Laos or Cambodia. The other two? Who knows? The other time was a speed ball, mixture of heroin and cocaine. Did it with a medic. Not long before he stepped on a mine. A big one. Went to pieces, you might say. Just those two times. I tend to believe it was the former, not the latter. The scar, maybe ¼ inch across is still on my right forearm. It gets red when my face flushes in anger or embarrassment.
So where from here? Take the tests. Pray for a miracle. Watch the diet. High protein, low carb, fairly low fat, it says even in my 1956 Merck Manual. My 1899 Merck suggests hot cloths laid over the liver and “Diet”. Laugh as you will, we bought a heating pad yesterday and I'm sleeping with it draped over my right side.
A lovely gray bird just landed on the steps outside my window. All gray with a black head. Junco maybe?
The county hospital just called and wanted me to work day shift. (It's 0630) I declined, as I'm already scheduled at noon at the private hospital.
I'm tired, Ranger Readers, I'm going to huddle up to my heating pad and go back to bed for a while.


Blogger Eutychus said...

Brain Dysfunction has been observed and chronicled for AT LEAST the last 51 years that I know of.

12:17 PM  

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