Antibiotics and AirPods

You can't make this stuff up

Dear Friends —

Well, do I have a doozy of a curveball story for us as we wrap up July. Some of you might remember that I continue to feel delightfully well, enjoying the long Summer of Slow, knowing I’ll likely have to douse the itty bitties in my lung as a smart precaution when the leaves begin to turn.

When I think about these days, I sometimes think that here on this mountain trek, I’ve been invited to bivouac in the most splendid meadow. Peaceful, wildflowers all about, a place to rest, and occasionally cartwheel after gazing on the wonders that can only come with views this high up.

And then just a week ago, the equivalent of the world’s largest wasp decided to sting me in the meadow, for no reason at all.

I had spent the weekend of July 22 doing all the usual delicious summer things. Hikes, time with friends, a manicure with Lucy, a book group. But in the middle of Sunday night I woke up with an odd sense of discomfort in my abdomen; I couldn’t find a way to get comfortable. I took some Tylenol, went back to sleep, and thought that was that. But then around 7:00a an awful wave of nausea arrived. Was this food poisoning? Why didn’t I have a fever? Is this some new Covid variant?

I reached out to a smart doctor friend of mine who’s deeply familiar with all my twists and turns over the past three years. He called immediately and suggested I go to the ER. Wait what? By 10:00am or so I was basically feeling normal again, just tired. This seemed like a well-intentioned over-reaction, so I sat on his advice for an hour or so.

I had let my team at work know I was feeling super blah so we might have to move a meeting back, still hedging on this whole ER command from someone who went to the finest medical schools and has basically called every single subtle mystery of my case correctly, and ahead of my terrific suite of specialists.

One colleague — Marcy — and I were texting and I mentioned that I had super mild but odd symptoms, but that I was getting a nudge to go to the ER. This is when something remarkable happened. Marcy texted saying: I’m in the Palo Alto office, so I can be to your house in 10 minutes. If you’d like anything I’ll be just be close by, waiting. And if we think it’s best to go the ER, I’ll take you.

We have to pause here in my rather wild tale so I can explain why Marcy discovered a magic trick. Since the dawn of time, a little dance has been ongoing among us. Picture two friends sitting in ancient Rome chitchatting about the latest aqueduct in the neighborhood, and one friend says to the other: “You know I have the oddest little (fill in grievance here — a twisted ankle, a broken heart, unexplained nausea), but yeah, I just don’t know.” The other friend then says — with a full and generous heart — “Oh gosh how awful. Please do let me know if there’s anything I can do.”

It’s a solid response. But we all know it’s full of tricky traps. The friend with the complaint is left sorting out the job that needs attention, and the friend who wants to help wants to be cautious by not stepping in too far by all of a sudden delivering casseroles with super specific baking instructions. We’ve all been there.

But Marcy — a daughter of Minnesota who happens to be a fan of tier 9 women’s winter sports — managed to thread the needle that’s been stubbornly elusive to billions of us since the dawn of time. She said, I’ll draw just a little closer to the situation. In drawing closer, it may be easier to see how I can help. And if you don’t need help, I’ll move merrily along.

How genius is that.

So Marcy arrived and we mulled on it all. Since she was at my house, I decided to reach out to my smart doctor friend one more time, more or less explaining that I was feeling basically ok so maybe this is all nothing and a trip to the ER might be too much? He responded with a one word text: Go.

Fifteen minutes later Marcy and I arrived at Stanford Hospital, where the ER is a model of excellence. I spent the first few minutes explaining it might be silly that I was here at all. “I mean I’m fine! Negative covid test. A little nausea! Ok some weird pain in my abdomen, but that’s sort of gone now too. You all are so lovely to do a quick check here.”

I was set up in a triage room, which is the place of both high drama and soul-crushing boredom. A breadcrumb of a new clue arrives — “Hey you have an elevated white blood cell count. That’s odd.” — and then another hour passes while you wait for the next nurse or ER doc to pop through the curtain. Luckily I had Marcy along for this ride, and she’s A+ in the small talk distraction department. We covered her fun wedding plans, why I seem to be the only who doesn’t like a particular Netflix show everyone else loves, puppies, politics. She also let me curl up on the exam bed and zone out for long stretches with eyes closed, bracing for something awful. The pain was back and growing steadily worse.

The ER docs ordered a CT scan, and I think we all know what happened the last time I was in the ER and a CT scan was ordered. Big breath, yes, ok.

A scan. And more waiting. It was 8:00pm before the answer arrived.

“Hi Ms Low? Hi right. Well it’s a good thing you came in today. You appear to have an inflamed appendix, and it’s likely already perforated. We’ll need to admit you.”

“Did you say my appendix? Hold on, did you see a met in my appendix?”

“What? No. This isn’t cancer. This is a ruptured appendix. This seems to be going around — have three other appendix cases even now in this ER.”

First, what a relief.

Second, ARE YOU KIDDING ME. A most horrific lightening bolt decided to strike me while I was cartwheeling around my Summer of Slow meadow and transformed Slow to Screeching Halt.

I reached out to my smart doctor friend with the news. His response (abbreviated here because I get to abbreviate things): “A perforated appendix? Ha! What a relief. Well glad it’s not more serious.” Context is everything, isn’t it? For the laypeople, when you say MY APPENDIX BURST, most of us will shriek in horror and race to the nearest exit, our arms waving madly with panic. But for all the doctors, they’ll shrug. Some might even yawn.

With that, THE WEEK OF HORROR officially began. I thanked Marcy as generously as I could, and got wheeled over to the old Stanford hospital building. Where the new hospital sparkles, the original building, erected in 1959, might get points for effort, but it’s hard to not be swallowed up by dread when you walk inside. Both hospital buildings were over capacity that night and so I was wheeled into a room the size of a closet. With a roommate.

A surgeon arrived around 1:00am and patiently explained the state of play for my dilemma. There are two standard treatments for a perforated appendix: a laparoscopic surgery (a “lappy appy” and how adorable is that medical nickname) to remove it, which usually means getting discharged just hours later. Or, you can basically carpet bomb the patient with an aggressive cocktail of antibiotics for 4-5 days, followed by a few days of an oral antibiotic. A few days after all that, some patients will have a little cleanup lappy appy.

“Ah ok. I get it. Well I’ve had a few hours here to ponder all this insanity, and my gut and I had a little meeting. We are officially done with my appendix. She has done zero things for us over the years and now she’s throwing a fit for no reason. She’s the worst. I loathe cancel culture, but in this case, she’s canceled. Let’s get her out, pronto.”

“Yeah well …” responded the on call surgeon. “The tricky thing here is that we may be past that window. You only have a small window to operate, and I think yours might have closed. Best route here is the antibiotic.”

“So hold up. I’m here for as many as FIVE DAYS?”

“Yup.”

This is the part of the story where you might be scratching your head, doing the timeline, and then realizing five hours came and went while various rings of doctors took a look-see at my images and then glanced back at my chart, hemming and hawing. If it makes us all feel better, go ahead and let out some steam for prolonged pontificating.

All I know is that I was now firmly strapped into this unexpected roller coster and there was no other choice than to just hold on tight. Friends, this lady has been through a lot. I’ve birthed two lovely children, I’ve rolled an ankle twice, I’ve gritted my teeth through 25 rounds of chemo spread out over 2.5 years, I’ve had two surgeries, and a few laser beams fired at my lung for good measure. But here I am, shouting out from my mountain meadow, to declare the pain that escalated Tuesday morning in the hospital was the outer rim of monstrous. It lasted about three hours, thanks in part to my janitorial closet sized room being located at the farthest edge of where the GI doctors were based on the full medical campus. Nurses can only do so much when a doctor can’t put in an order. And usually a doctor can’t put in an order to address such extreme pain without actually seeing the patient. Eventually my resident and his doc buddies arrived, but by then I had moved from tears to whimpers.

Fortunately, that was my low point. In the hours and subsequent days that followed I subsisted with mild misery in the Bad Luck Appendix Janitorial Closet Jail.

Yet in it all, the nurses and the GI docs on my case were stellar. In the middle of night three I realized that one of my little AirPods had disappeared. They have a noise canceling function, and without getting us into a rabbit hole about my hospital roommate, it’s important to know that the only thing keeping me alive that night were antibiotics and AirPods. My nurse stopped by minutes later to check on my vitals and asked if I needed anything. I told him about this mini tragedy and instead of muttering the standard, “Oh gosh what a drag,” Cody got out his pocket flashlight, crawled under my hospital bed, searched on his hands and knees and found the pod that went missing. There are unlimited ways to save a life.

My doctors were discerning, thorough, and here for each one of my questions, from the granular to the philosophical.

“Anyone else worried I might be running out of body parts?”

“Yeah, no. Any more questions?”

I was discharged yesterday, and am happily at home. I’m still quite tender and sore. I keep thinking this must be what it feels like to be attacked by a hippo, but I’m steadily regaining my energy so it appears I’m inching out of this mess.

The morals of this tale? For starters, trust your smart doctor friends. Second, brag on the nurses to the doctors, and brag on the nursing assistants to the nurses. There’s no sweeter praise than to hear it from someone a little higher up the chain of command.

And the next time a friend reaches out with a mild cry for help, resulting in one of those puzzling “gosh let me know if there’s anything I can do moments,” keep Marcy from Minnesota in mind. She showed us all how to thread the magical needle. And it didn’t hurt a bit.

xoxo

p.s. — if anyone out there is part of Club My Appendix Hated Me Too, do leave a comment. We are brave warriors, and it’s always fun to share a war story or two.