I'm Shawn. I'm married to an absolute darling named Heidi. She's very sick right now. More on that later.
We have a son, Owen. He's incredible. He's 2 months old. He spent the first 16 days of his life in the NICU. He's doing great now.
We own a red minivan, which we affectionately call the Cherriot. I am unapologetic in my love for the Cherriot.
We live in Southeast Iowa, the most beautiful section of the most beautiful state in the most beautiful country on the face of the earth. Take that, Canary Islands!
That'll do for an introduction; I'll bring in other characters along the way, just to keep you on your toes.
On March 20th, 2018, I raced Heidi to the University of Iowa emergency room (henceforth called "the ER" or "hospital"), where doctors diagnosed and removed a fairly large gallstone that was giving her alarming "10 on a scale of 10" levels of pain. This coming from a woman that knows a thing or two about pain, what with enduring 24 solid hours of agonizing labor just 6 weeks prior. The gallstone was a substantial 6mm troublemaker. It had exited the gall bladder, carved and scraped a lumbering path down the Common Bile Duct, and had wedged itself against a sphincter. I say 'a' sphincter because I discovered that the human body has all manner of sphincters, when all along I had conservatively placed the "number of sphincters in the human body" at "probably just the one". This particular sphincter (I promise, I'll stop using that word) wouldn't allow the passage of the stone, which prevented bile from safely draining through the duct and caused an inappropriate amount of bile to back up and visit the pancreas. What is an appropriate amount of bile backup, you ask? Zero, probably. Bile should not visit the pancreas.
Now some of you are saying "hey, he said a word about a thing I may or may not have heard about at some point!" Good on you, my friend. You're sharp! The pancreas is the organ that produces insulin and keeps most people from diabetes. I'm not most people; I have Type 1 Diabetes. The pancreas also produces several different enzymes that help digest food. Store that nugget of information away for later. The gall bladder is nestled comfortably against the liver, where bile is produced. The liver is very eager to produce bile. It just makes more and more and more of the slimy, yellow-brown enzyme like it's doing the world a favor. The gall bladder acts like a holding tank for extra bile. "Whoa there, hoss. This food doesn't need that much bile!" the gall bladder is often heard saying to the liver. Occasionally, the gall bladder accumulates little bits of cholesterol and hardens them into gallstones. This is surprisingly common. I say 'surprisingly' because I was under the impression that gallstones happened to elderly, crotchety men that spent their time swilling whiskey sours and muttering bitterly about the economy.
"In the United States, an estimated 10 to 15 percent of adults have
gallstone disease.
About a million new cases are diagnosed each year,
and some 800,000 operations are
performed to treat gallstones, making
gallstone disease the most common gastrointestinal
disorder requiring
hospitalization." -US News
That's a lot of grouchy alcoholics. If you would like to read more about gallstones, check this link out. It's where I pulled that excerpt from, so when you get to that part of the article, you can say "Hey, I read this somewhere before."
The gall bladder, liver, and pancreas all share a hallway where food-devouring, highly acidic juices are pumped into the small intestine. This hallway is called the Common Bile Duct. So we've got all these neighboring glands and organs, workin' hard behind the scenes to hide the evidence of your 3am run to Taco Bell. Some cholesterol gets caught undigested in the gall bladder, where concentrated bile juices harden it into a stone. The stone can sit in the gall bladder indefinitely but at some point, without so much as a "howdy do", it'll roll out and slam through the sphincter. I'm sorry, I said sphincter again. I just don't know how to describe these events without saying "sphincter". Perhaps I can substitute "Muscular Opening In Slippery Tunnels", or MOIST. The gallstone's journey to the MOIST causes a severe amount of pain. The pain is not as severe as a kidney stone, but it's still up there in the "very unpleasant" territory. Heidi would feel like she couldn't breathe; as if a vise was squeezing her lungs. She would be doubled over in pain for about 20-30 minutes before the pain relented. Oh yeah, I forgot to mention that Heidi had multiple gallstones. At the time, we had no idea what was going on. We'd be winding down for the evening and just crawling into bed when SLAMMO (Sweet Lord Almighty, My Midsection's Ouchy) a gallstone would have Heidi gasping for her next breath. Heidi was pregnant with Owen at the time, and we weren't sure if this was a worrisome omen or just one more funky side-effect of manufacturing a human. It turned out to be a worrisome omen, or WOmen...uh, that's enough acronyms for one blog. This happened three or four times during Heidi's pregnancy, with each instance causing more and more concern. Was this a spiritual attack? Heidi and I would spend time praying and crying and the vise-like weight on Heidi's lungs would release and she would once again breathe freely. I'd ask Heidi if she wanted to travel to the ER, but she's a tough little cookie and would say "no, I think I'm alright."
Fast forward to March 19th, Monday evening. Heidi was feeling short of breath and nauseous. She was no longer pregnant, so we couldn't blame her symptoms on that. We decided to stay at home rather than join our weekly prayer group. Her pain didn't let up, and by Tuesday afternoon, she had vomited several times. When I got home from work, Heidi informed me that she was unable to keep any food down, and was now unable to keep even water down. "I need to go to the hospital," she said.
When we arrived, the ER was busily attending to a roomful of people that were also having a rough day. Heidi's vital signs were checked in a tiny entryway/hallway by a technician who swooshed around on a wheeled office chair. Once he was satisfied that Heidi's vitals looked stable and she wasn't suffering from heart problems, he sent us back to the waiting room. We waited for an eternity, which turns out to be around 40 minutes, to be ushered into a consultation bay where Heidi was more thoroughly examined, poked, and prodded. The pain was mainly in her abdomen; it fluctuated in waves up to her chest and down to her pelvis. Heidi was asked about previous hospitalizations and surgeries, of which she'd had none. She was given some pain medications and we were sent back to the ER waiting room to stay until a hospital bed opened up. An ultrasound was ordered, and revealed several things: a gallstone causing mayhem and a very inflamed pancreas. Well, I think it was the ultrasound. Honestly, I'm not sure the ultrasound showed the gallstone. My memory is pretty foggy. I'll try my best to recount things factually but I am by no means a doctor, so feel free to take my account with nutritionist-approved amount of salt. Anyway, a gallstone removal was scheduled.
By that night, Heidi was placed in a room shared with another patient. I took Owen home and spent the night discovering just how much Heidi did to take care of an infant when most people are sound asleep. Once again, I was not most people. Before I was able to get back to the hospital on Wednesday morning, Heidi had already undergone the procedure to remove the gallstone. They had done an ERCP, which stands for Endoscopic Retrograde Cholangio-Pancreatography. Basically, the doctors used an endoscope to observe the pancreas and remove the gallstone. More basically, good people used a camera on a bendy straw to look at Heidi's innards and make the pain go away. While removing the stone, the doctors made a small incision on the bile duct sphinc, uh, MOIST, to let any additional stones pass through without hanging up. Additional stones? Yep, the doctors were fairly certain that Heidi's gall bladder had additional stones, waiting to cause additional mayhem. A cholecystectomy was ordered. The "Chole" prefix refers to the gall bladder, the "-cystectomy" is the removal part. Surgical removal of the gall bladder.
What does a life without a gall bladder look like? The gall bladder stores excess bile, bile helps dissolve fat, fat makes food delicious. Therefore, no gall bladder = no delicious, right? My math is impeccable! Well, not quite. Without the extra bile on hand to dissolve Thanksgiving Dinner properly, a person's stool might become--I'm using a direct quotation from a doctor--"more floaty". "So Heidi won't have to go on a low-fat diet the rest of her life?" I asked. "Certainly not," her doctor replied, "In fact, she could have an onion-ring eating contest if she wanted. Of course, if she feels nauseous or pained, she should cut back on fatty foods." The day before, I had never heard of a gall bladder surgery. Now, I was being told by members of my church that they'd had the surgery and were doing just fine. That's fascinating to me...people that I'm acquainted with have had surgeries done to their bodies and they're not talking about it, for some reason. If I had a part of me chopped out by professionals and I lived to tell the tale, it would most likely be the second thing I tell you; the first thing being my name. Nevertheless, it was reassuring to know that Heidi's experience was not ultra rare.
The ERCP procedure stirred up quite a bit of stuff and Heidi's body reacted by turning up the heat. Heidi soon had a fever of 101, with occasional spikes to 102. This was an expected reaction, but the fever lasted for a week, which was not expected. It became evident that her pancreas was severely inflamed. The inflammation was worrying the doctors.
Three days into Heidi's hospital visit, her heart rate spiked and her blood oxygen levels dropped. This indicated a clot in the lungs which got all sorts of doctors running, literally. I was sitting with Heidi, Heidi's parents Alan & Jean, and Owen. A nurse quietly mentioned to Alan & Jean that she would like to escort them to a family waiting room. Some doctors were coming to see Heidi, and the small room was about to get crowded. Heidi's parents took Owen with them. Two minutes later, 13 doctors and nurses were crammed into the room, shouting for vitals and an oxygen mask. Some of the doctors were huffing from their sprint across the hospital. The nurse attending Heidi had been told to alert the doctors if there was any sudden change in her vitals, so when her oxygen dropped and pulse spiked, the nurse hit the "ALL HANDS ON DECK" button that paged the doctors. A technician wheeled in a portable X-ray machine, propped Heidi up in bed, and placed a lead shield behind her back. X-ray photos were taken of her lungs. At this point, she was taking shallow breaths but the oxygen mask was bringing her oxygen back up to a tolerable level. Heidi was whisked to the ICU, hospital bed and all. I followed closely behind, wheeling a cart with Heidi's bags.
The next three days were spent in the ICU. I would video message Heidi from home so she could see baby Owen, who was not permitted to visit his mama in the extra dangerous germ-ridden ICU. The X-rays of Heidi's lungs showed no clots, which was an incredible blessing. Heidi would be on an oxygen cannula for the next 10 days, which just added to the host of tubes and wires and hoses covering her body. Heidi was on two separate IV's and had an array of sensors monitoring her pulse and blood oxygen saturation. She had a blood pressure cuff on one arm, automatically taking readings every 30 minutes. She had a catheter installed, so she didn't have to get out of bed to urinate. She was being pumped full of bags of saline fluid, along with a high-power antibiotic and Dilaudid, a concentrated form of morphine.
I would travel home each night and return to Heidi each day. I would work during the daylight hours and then visit Heidi in the evening. Heidi was asleep most of the time; napping in between the barrage of CT scans and vital checks. We discovered that portions of Heidi's pancreas had necrotized. The pancreatitis, or inflammation of the pancreas, had been more advanced than we first thought. Remember that nugget about the pancreas producing enzymes to digest food? Well Heidi's pancreas had been producing insane amounts of enzymes, which were busy eating the pancreas itself. "How bad is it?" I asked the doctor. "Is fifty percent necrotized? Eighty percent?" The doctor paused for a moment before responding "We'd say it's closer to eighty percent," she said. The necrotized pancreas was the reason Heidi was getting pumped full of antibiotics. The doctors had not seen any signs of infection, but since the pancreas was this damaged already, any infection would be life-threatening. Better to risk the side-effects of continuous high-power antibiotics rather than find an infection and be three days behind. One of the side-effects of the antibiotics was the potential to cause a sustained fever. I commented to the doctors that I'd like to see her taken off the antibiotics, or switched to a different one, so that Heidi could get a break from her fever. They complied and changed Heidi's antibiotic. It was a variety that was still just as strong, but was not known to cause fevers. Heidi's fever remained a few more days, and finally subsided. We are not sure if it was due to the antibiotics. Meanwhile, Heidi's daily blood draws were showing excellent results. Two of her enzyme levels, which were supposed to remain below 100 and 80, respectively, were initially at 2,400 and 1,200, respectively. Those enzyme levels lowered day by day, until they settled to an elevated level around 200. Her white blood cell count had elevated, and then lowered back to normal parameters. Her heart and kidneys were functioning splendidly. There was minimal fluid buildup in the lungs, and the liver looked good. The gall bladder was quiet, like a dog that knew it had done something naughty and the owner was looking for a newspaper to roll up. We were waiting for the pancreas to settle down in order to schedule the gall bladder removal. The doctors wanted to have the surgery performed while Heidi was still in the hospital, to finish everything in one visit. They had hoped it would only take a day or two, but as the days stretched into weeks, the doctors began to consider postponing the surgery to let Heidi recover at home.
At this point, we had a clearer picture of what was happening. The pancreatitis was caused by the gallstone. The pancreatitis caused the pancreas to start digesting itself. The inflammation was causing continued pain, even though the gallstone was gone. In order to keep from irritating the pancreas, a feeding tube was pushed down Heidi's nostril and lowered into the duodenum, an area of the small intestine just below the pancreas. There, oatmeal-colored protein juice could be fed into Heidi right past the pancreas without it knowing a thing. A "bridle", the fancy term for what looked like a white shoelace, was pulled in one nostril and out the other to make sure her feeding tube didn't get yanked out in her sleep. With Heidi's fever faded away and her doctor-mandated stint of antibiotics completed, Heidi was released to come home. She had been in the hospital 14 days at this point. Her feeding tube had a kink in it, so she had to have it removed and replaced with a new tube, which wasn't as traumatic as the first time. As I drove her up the lane to our place, she burst into tears.
Heidi is still on her feeding tube, and was given enough protein slurry to remain on it for the next several weeks. With time, we are told, Heidi's pancreas will recover and she will not become insulin dependent. We spent Easter in the hospital and thought about how Christ rose from death to life The gall bladder removal will take place at some point in the future, depending on how smoothly her pancreas improves. For the friends and relatives that suggested lifestyle changes or natural ways to reduce gallstones and avoid the gall bladder surgery, we are so grateful for your concern and for the way you would like to see Heidi keep her gall bladder. We understand that fully. At the time, we had no idea how life-threatening her condition was, and after talking to the doctors, we feel very much at peace about removing the gall bladder so that Heidi's pancreas is not threatened again.
Many friends and family members bathed us in prayer through our entire hospital stay, and we are so grateful. Heidi loved all the gifts, cards, flowers, texts, phone calls, words of encouragement, and visits while she was in the hospital. Heidi's mom stayed by her side for several days and nights at the hospital, and cared for Owen for several days. My parents cut their trip to Florida short and drove home a few days early to help me out and check on Heidi. Dear angels brought vast supplies of frozen breast milk for Owen and groceries for me, which was incredible. Others sent cash for things that we needed. Several of Heidi's friends came over to make sure dishes and laundry were taken care of. Several ladies from church with great big Momma hearts babysat Owen while I worked. We were absolutely, thoroughly pampered and blessed in so many. Others offered assistance and help if I needed anything. I was completely blown away by the outpouring of love and help by our community, and it was a definite blessing to have both my family and Heidi's family close by. We have a journey of recovery ahead, but Heidi's a warrior princess and things are looking good. If you think of us, please continue to pray for swift recovery and ample rest for Heidi.
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