Elmore Leonard writes my scene at the stomach doctor

[I can’t write another post whining about c diff. Argh. Instead, here’s a post about it in a roundabout way. I’m a big Elmore Leonard fan. And I wondered what my recent meeting with the stomach doctor would have sounded like if Elmore had written it in a book. Let’s give it a whirl.]

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The king of dialogue

“I’m going to press on your stomach. Let me know if I cause you any discomfort,” Dr. Wilson said.

“I have a high threshold for pain, doc, press away,” Unknown said.

The doctor pressed, but not hard. More like he loved Unknown and they were courting, laying in the grass falling in love, his hands gently gliding over Unknown’s bloated stomach.

“Don’t hurt your hands, doc,” Unknown said.

The doctor looked like he was watching water waiting to boil.

“I don’t want to hurt you,” he said.

“You’re miles away from doing that. I was hoping for an exam not a massage.”

“These hands know what they’re doing. ”

Maybe 45 years ago, when he was still in his 70’s. Not now. Perhaps back when leeches were state of the art.

“I’m glad you think so, doc, cause I’m not brimming with confidence.”

“I’ve been practicing medicine a long time.”

“Everything spoils if you leave it out too long,” Unknown said.

“I suppose it does, but stomachs don’t and yours isn’t unique. It’s just like the thousands I’ve examined before.”

“Did you feel up all of ’em like you’re doing mine? You’ll need a cigarette afterwards, huh?”

The doctor ignored him and continued his Ouija Board session, looking with his fingers, like he wanted to find the magic spot. Then when he found it, he’d raise one hand in a claw shape high above and plunge it into Unknown’s stomach, ripping the evil spirit out. Unknown would magically feel better. So simple. But it didn’t happen that way.

“Get your clothes on and meet me in my office,” he said, no kiss, no hug, no tug, as he turned and left.

Unknown buckled his belt and walked out of the exam room into the hallway with its stained blue carpet. Five steps at most to the doctor’s personal office. He sat down and waited, watching three fish swim in the dirty aquarium. One of them, something black and yellow, was covered in white fungus. Unknown took his antibacterial gel out of his pocket and cleaned his hands.

The doctor walked in, hunched, but not slow like he needed a walker, yet.

“You may want to clean that aquarium before you lose the last three fish, doc.”

The doctor looked over for a second, a tiny glimmer of recognition the fish were swimming in their own filth and perhaps a new pump might be in order. But that look passed in the time it takes to exhale and he went back to reviewing Unknown’s thick chart.

“I don’t think’s it C diff,” he said, pulling out a single sheet of paper and handing it to Unknown. “Here’s a list of foods I want to you eat and others you’ll need to avoid.”

“You don’t think it’s C diff?”

“No, I don’t. I think you have some inflammation and you need to eat a nice bland diet for the next week or so.”

“What about the low-grade fevers?”

“You don’t have a fever now.”

“I took two Tylenol.”

“We usually don’t see fevers with c diff.”

Unknown sat there, taking in the  doctor’s words, unsure what to say to the man with canyon-sized wrinkles in his face who was writing something on a form. Maybe c diff didn’t cause fevers back in the day when fire was discovered.

“Have you ever used Google, doc?”

“I’m a Yahoo man,” the doctor said, like he was hanging with a group of doctors who were bragging about their alma mater.

Unknown turned his iPad on.

“Maybe you should switch search engines. I’m typing ‘C diff symptoms’ into Google right now. Wait for it. Wait for it. Here we go. Let’s try the first site, doc. What do you think? Oh, my, look what information from 2010 says under symptoms, low-grade fever. What? How can that be? Here’s another site, fever. There must be Yahoo C diff and Google C diff, huh? I didn’t know there was more than one kind of it.”

“I think we’re done. I stand by diagnosis. We’re finished. Hand the nurse this paper on the way out.”

Unknown looked at the doctor holding the paper out, and placed his hands on the armrests to push himself up with effort and control, taking his time. With two fingers, he pulled the exam paperwork from the doctor’s hand in a manner that was correct and polite, and gave the doctor a nice smile, nodding his head like he agreed with his diagnosis, yes, yes, yes. But Unknown didn’t agree and didn’t say anything. Instead, he turned and took two steps, and looked at the aquarium and the fish facing their last days swimming back and forth in water that reminded him of a lake you wouldn’t want to swim in.

He took the paperwork in his hands and rolled the dietary sheet and the exam form up into one tube, like a kid creating a spyglass, nice and tight. Then he took the end of the paperwork like he was placing a round peg in a hole and dropped it through an opening in the plexiglass cover of the aquarium, giving it a push with one finger until it was all the way in and the paper expanded and soaked up the dirty water.

Unknown turned to the doctor and said: “You should Google ‘how to clean an aquarium,’ Yahoo Man, before you kill all of them.” Then he walked out, took the elevator down to the parking garage and drove home.

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Clostridium difficile, day 16

How’s this for a stupid name for a bacteria: Clostridium difficile. Or C. diff to its friends. I’m on day 16 of this slow-moving nightmare and I can’t wait to wake up. It’s like riding a malfunctioning roller coaster all day long – I go fast. I go slow. I feel good. I feel bad. I can eat. I can’t eat. I don’t have the strength to write. I do. I don’t. I’m hot. I’m cold. I can beat it. I give up.

C. diff is wearing me out. Trying to work with this bacteria with the silly name is a drag, and I need it to clear out of my system asap.

Today, my CF doctor bumped me from 10 days of vanco to 14 and perhaps, if the stomach doctor has his way, up to 28 days. So, I took some measures of my own tonight and bought more probiotics, bringing my bill to $270 plus and counting. I had been taking over 150 billion cells per day. Today, I raised that total to over 430 billion. That’s Billion with a capital “B,” baby. That’s right. I’m the probiotic king.

Back to the name. A bacteria with this kind of bite deserves to be called more than C. diff, which sounds like the name of a rapper. When people ask me what I have, I’d like them to get a quick idea of C. diff’s nastiness instead of a blank look and the “what’s that?” phrase that follows. I need a name that impresses people. Something that creates instant recognition of the havoc C. diff causes.

I thought of a few like gut fire, blowfish tummy, and radioactive belly. But for some crazy reason, I liked King-Maker best. That’s right, King-Maker. It may not be the most frightening of names, but it captures the worst part of having C. diff – spending a good portion of your day sitting on the throne.

Someone shoot me, please.

I hate bacteria

I know there are good bacteria, like the millions in the probiotics I’ve been swallowing each day, but I hate the bad ones. Especially c-diff, PA and mycobacterium, the latter having worked its way into a new friend’s lungs. Why can’t scientists invent some form of good bacteria to combat them? Probiotics for the lungs? I’d inhale something like that. Instead I need antibiotics and more antibiotics.

The good news, though I’m afraid to write it because the last time I mentioned good health my two-week joy ride with c-diff started, is that today I may have turned the corner with the c-diff. The antibiotics seem to be doing their job finally and the rollercoaster of low-grade fevers, stomach problems, diarrhea, feeling ill and tired, and hot like the Human Torch has subsided.

Whew, doggie. That was something. Bacteria . . . wow. The damage they can do, as all of us know. It won’t be the cockroaches that survive all of us, it will be the cockroach bacteria. These tiny, invisible destroyers of life will survive all, I’m afraid.

The ironic part of my story is that it started thanks to a medication – Nexium. To combat GERD, the stomach doctor prescribed up to 80mg a day, suppressing my stomach acid to the point the c-diff could flourish and take control. Down with the hearburn, up with the c-diff. Right now I have the heartburn of a dragon and feel like I could blow fire and take out a tree or two, though cars would be more fun because they explode. I’m afraid to take anything to reduce the acid in my system that’s helping to kill the c-diff. I’ll live with the heartburn over the c-diff.

Equilibrium, such an elusive dream most days.

The Villain Identified

My stomach went south this morning. I felt better yesterday, bad today.

I spoke to my most excellent CF doctor in the morning and he said in a cool way like he was picking a race horse to bet on: I’m leaning toward C-diff now. But I had an appointment with a stomach doctor later, so he wanted to know what that doctor said before placing his final bet.

My regular stomach doctor is on a beach somewhere sipping sweet tea with rum while reading Good Guts Gone Bad Quarterly. So, I got the 123-year-old doctor I can’t stand who should have retired back when Apollo 11 landed on the moon. He placed his hands lightly on my stomach and told me to let him know if it hurt. When I say “lightly,” I mean like he was running his hand over the hood of his Mercedes as not to scratch it, all gentle and kind and loving. I could have had the stomach ache from hell and his light touch wouldn’t have triggered anything.

So, he and I talked. I told my story and how my doc and I were betting on C-Diff. Dr. Gentle Hands told me we were wrong and it was a virus irritating my gut. He handed me a list of foods I should eat and some I should avoid. And an Rx for an anti-spasmodic, which I can’t take because it can dry out secretions.

But what about the fever? I asked. It came back today.

You usually don’t get a fever with C-Diff, he replied.

Hmm, that’s strange, I thought, because the last few times I’ve had C-Diff I got the bonus prize of a fever. Must have been a miracle of science. I’m special and honored to have received such a rare prize.

I didn’t say anything to the animatronic doctor. I know fevers and C-Diff often come as a package, which my CF doc confirmed on the phone later. But at that moment with the stomach doc I knew that I had wasted my time. Why kill any more by arguing.

When I got home, my CF doc and I decided to see how I felt Saturday morning, but I filled the Rx for the Vanco just in case. And it’s a good thing I did because tonight a fever and some nasty stomach gurgling arrived, as did watery you know what.

Hello, C-Diff, it was you all along, you crafty bastard.

Digging holes

Strange that the bottles on the web site don't match the ones I bought.

The morning started out rough with me feeling like the Human Torch. Tylenol acted as the bucket of water. I resisted filling the Vanco Rx, which was the right decision, so far. I’m feeling better tonight. I spoke to my stomach doctor on the phone today and he allowed me to move up to Ensure, telling me that four of these a day would provide me with the protein and nutrients I needed. (But not much eating satisfaction.) Unfortunately, they don’t come in an M&M’s flavor. So, I had to violate the liquid diet this afternoon and eat a handful, or two, or three of real M&M’s. Though I did chew them up until they became liquid-like.

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My gardener came by in the afternoon. I hired someone else to do some water-saving landscaping. He did a crappy job and I got hosed for over $1,100. I didn’t really complain to my gardener about it. I just mentioned it in a matter-of-fact kind of way. I may have to go to small claims court for the first time in my life and my gardener may get the job after all.

So, there I was mentioning the botched job the other guy did when my gardener told me that he had purchased over 100 acres of land way north of here where he and his family would one day create a farm with corn and cows. And he’d retire there. Watch his kids work the land. Milk the cows. Eat the corn.

That’s really cool, I thought. Really cool.

He needed water on the land to do all of this. Of course. Corn needs it to grow. Cows drink it to survive. Makes sense. So he hired a guy to drill a well, which was going to cost him around 50K. He gave him 10K to start, then inspected the progress which was going fine. He gave the driller another 24K. The work stopped and the lawyers came out and the driller declared bankruptcy. My gardener got a half-dug hole and lost his life savings.

I knew he worked hard for that money, in the dirt. It didn’t come easy.

He wanted me to know because, I think, he, like many of us, wanted to share a painful story. And because he wanted to give me some perspective on what losing real money is like. I didn’t lose my life savings. He did. I wasn’t complaining, but my story triggered his.

When he told me it was going to cost him 25K to fill the hole, well, what can you say at that point. Of course I said something stupid like, can’t you just fill it in with dirt? Wrong, you can’t. According to the government, a 50K hole has a proper way it has to be filled. That put an end to my talking about my $1,100 hit to the wallet.

The situation reminded me of the times over the years when I’ve listened to someone talk about their health issues – they had the flu and had to stay in bed for three days, or they had knee surgery and stayed overnight in the hospital. Of course I’m thinking if you only knew how many days I’ve racked up in the hospital, my friend, if you only knew. But I keep my mouth shut in those situations. And I wish I had today.

Chicken Broth, Gatorade and Jello

See the two pieces of chicken? That's about what you get.

How much chicken does Campbell’s put in a can of chicken noodle soup? Well, in mine they put three tiny pieces.

I’ve been sick all day with a low-grade fever, stomach discomfort with no appetite, and the feeling I was going to burst into flames like a vampire in the sun. Luckily, I had a clinic appointment scheduled so I got to see the doctor. However, my plans for an oral glucose test, bone scan, and 3-hour azithromax study went to hell. My visit transformed from a yearly exam to a sick appointment. Argh.

The doctor thinks I have a virus or C-Diff. I have to suck down Tylenol to knock down the fever and drink and eat clear liquids, hence the chicken noodle soup broth, Gatorade and Jello. If I’m not feeling better by tomorrow, then I go on Vanco for C-diff. And if the Vanco does’t work, it will be the hospital for me.

I knew it was too good to be true on Monday when I wrote that post. Punished for hubris.

Stay well.

I should have known better

When I was writing last night’s post, I had this gut feeling that if I wrote about good health, CF would rear back and crush me with a blow to the head. And it did. I woke up sweating, which has been happening on and off for over a month, but hadn’t reached the level it did this morning. My stomach was upset but nothing major as far as pain goes. And, I had a bad reaction to yesterday’s allergy shot. I felt like crap and started to panic.

Hello, Xanax. I took it but it didn’t help with feeling hot and sweating, but did take some of the edge off the anxiety.

I took two allergy tabs. I ate breakfast. Then I started to feel a little better. I forced myself to lift weights this afternoon and felt like I had really good air. In fact, after working out I felt good. Then I ate some carrots and cherries, and 20, 25 minutes later the same cycle started again.

Then during my afternoon treatment, I had some thick blood streaks, which I hope were tied to the workout. Or to the sweating? Do I have an infection after all, somewhere the Cayston didn’t reach? I don’t have a fever, but am hot, sweaty and clammy.

Or is it a reaction to the allergy shot? Is it my stomach? Hormones?

I am amazed that yesterday was so different. I was happy that I’d escaped the hospital, but now I feel like I should check in. I just knew this would happen. I was punished for pride about doing something right.

It’s days like this when I feel like giving up.