Addiction, Pain, and Public Health website
Acute Abdomen Land Theme Park
Acute Abdomen Land is a wild ride indeed! Actually, folk
here would probably get something out of the experience; along
the lines of 'a person who has himself for a physician is a
Yes, Acute Abdomen Land is a wild ride indeed! Actually, folk here would probably get something out of the experience; along the lines of 'a person who has himself for a physician is a fool.'
had been constipated for a week or so, and understand I've
little experience with constipation. Some abdominal discomfort
caused me to stay home a week ago Friday, but I was able to lift
and carry 50 lbs sacks of mulch uphill in the heat that weekend
without acute pain, and ascribed the mild mental dullness and
fatigue to psychological reasons and stress. I went to work
Monday but left at 3pm with a feeling of bloating with
occasional stabs of pain I ascribed to 'gas.' I became
progressively more irritable and restless Friday evening, but I
was also fighting on phone with Hospital attorney and talking
with the resident who was being wrongly screwed by same, and
anyway, irritability and anger come quite easily to me under the
best of circumstances.
eight PM I made the fateful decision to 'treat' my condition and
went to local Rite Aid for MOM and drank half a bottle of same
on walk home. I became progressively uncomfortable and restless,
but the real fun began about midnight when I entered an almost
hallucinatory state in which I spent the rest of night till dawn
unable to lie down, in pain that caused involuntary cries,
staggering about the apartment bent over muttering stuff like
"please, no more pain," and "I'm okay" over
and over and over again.
come the kicker (actually kickers):
my surgeon, the best surgeon in the Bronx IMO, was 15 minutes
away and I get along with him fine; he’s my father.
Finally at 8 AM the pain became constant and seeing-red intense and called said Surgeon who wearily told me to “get your ass in a cab and meet me in the ER” of a hospital in the Bronx. I was moaning all the way on the cab ride (potholes! OUCH) and was barely able to crawl into the ER where my father and my friend Steven Berger from medical school, who is an excellent surgeon in his own right, and my fathers protégé and partner (aka "the good son"), examined me. I received 1 mg of morphine (I said, "Steve, your kidding, right?" He wasn’t.) Then to the CT scanner (stretched out on coldest, hardest slab imaginable - OUCH!) babbling quietly to myself while getting confirmation of a ruptured diverticulum of the sigmoid colon. Then up to the Operating Room where I was given Versed (midazolam) and morphine (Bless you kind doctors!!) and laparotomy revealed pus filled abdominal cavity with peritonitis - classic ruptured diverticulum with peritonitis - which yielded me the loss of a foot or so of sigmoid colon, and a temporary colostomy.
learned a lot about pain; exquisite pure pin-the-gauge max pain.
There is a limit; 10 is 10, max is max, and that is the point
you are quite willing to die to make the pain stop (which is not
thoroughly logical but makes a *whole* lot of sense at the
time.) But it doesn't kill you; you don't die; you can tolerate
it (at least for 12 hours or so). (This is perhaps akin to labor
course, “Pain” is not the only ride in Acute Abdomen
Land. There is the “Opiate Analgesia Roller Coaster”
in which one attempts to explain, through post-anesthesia haze
and post-op pain, that the correct dose of morphine is the dose
of morphine that works, not some damn, dogmatic
this-is-what-we-give rule (which finally ended with me demanding
the anesthesiologist - the only other person in the Bronx who
understood opiates it seemed) and even then, now on 7 1/2 mg of
morphine every 2 hours (up from 5 mg every 4 hours) the pain was
dulled just enough that I was awake the entire night in order to
be able to truly grok “Post Op Pain Land” with a
clear head while not slugging nurses. So I now have a lot to say
about pain relief in America, which is a national shame IMO, and
about the 'opiates are dangerous, evil drugs' mentality which is
all too common even in our enlightened field. I ended up
requiring 12.5 mg of morphine every 2 hours for the rest of the
who could forget the realization which comes, once you get home
and the opiates wear off, in a sort of 'The Scream' intensity,
that you've gotten on the “Oh My God There's a New Hole in
My Body Ride” in which one is wracked
with sobbing without clear content but which hurt my poor
wounded body almost as much as the uncontrollable laughter set
off when I first thought the words 'Acute Abdomen Land Theme
I admit I'm nuttier than most, but I am not the only one. While
in the hospital I heard about the urologist who treated himself
for non-specific urethritis for months while missing the bladder
cancer which killed him, and the very similar-to-me cardiologist
who treated himself for heartburn with Maalox for a week whilst
missing the evolving Myocardial Infarction (aka 'heart attack,'
or 'coronary') that was the true source of his pain.
who amongst us with the power of the script has not written
antibiotic, pain, or psych meds for self or
good doctors, beware.