OW! Kidney stones

 

OUCH!!

Surgery today.   Stone free, now.
Ok...enough already.
It would be better if the stones were diamonds or pearls.
Ordered not to lift more than 10 pounds for at least a week. ...Yippee. Let those boxes alone!  Bring on the bon-bons and People magazine.
Thanks for the well-wishes.

Septic Shock newsletter-- finale

I emerge from my experience of septic shock not yet able to tell the story in a way that feels quite right.   There is much to process -- much good and much that is just much-- intense and interesting and that still needs digesting. In literature I find words that help me.  Here is a section from a wonderful book by Molly Gloss called "the Dazzle of Day"- Quaker science fiction. Ursuala LeGuin meets Rufus Jones. A wonderful book.  In one chapter a woman is working on a boat and trying to save a person that has been injured. She is preparing to jump with him from a small raft to the main boat and instead hits the side with her shins, misses her landing, and says....

"I lost hold of the boat and sank with him, straight down.

I had been afraid, waiting to jump, but now I wasn't afraid. How quickly our ties and ballasts are cast off! I was of the Owl Strait, suddenly my outstretched elbows were resting in fjords, my palms outspread on the cobbled beaches. Inside my body there were forest of lichens, galaxies of starfish and lamp jellies, and in my bones the shields of turtles, the teeth of balenoj. I felt in my blood the long slow tide, straining after the sun -- I was water, and its unknowable alchemies, dreading nothing, simply streaming and alive. This was one of those times when your mind and body cohere and you understand suddenly what the poets say: To die is different from what you had supposed, and luckier.


Then unpredictably I began to rise up through the muffled darkness toward the dazzle of the daylight -- Kikuma was hauling me up-- I remembered I was tied fast to the boat. There was a curious moment: I had a sense that I must now make an accommodation to the world, as if I had lived a long time under the sea."


......I was grateful, exhausted. We were laboring through heavy seas with the edge of the puso weather whining in the windpipe, but I didn't try to hold this or anything in my mind. I lolled in the bottom of the boat, my skill rocking dumbly among the sliding scraps of salvage. While Kikuma was steering for a lee shore, I suppose I stood up from my life and let it stream around me in a clear cataract. I was freed from time, not lying inside a dream but standing in the compass of heaven where everything goes onward and outward, nothing collapses -- and when I lay down in my life again we were beating noreast along the cape. When I looked over the gunnel of the boat, across the strait toward the rocks there was a break in the sky and the sun broke fleetingly across the water in long bright reef - the puso weather had gone over our heads onward."

The details of  my own story-- the fall into illness & the moments with death nearby-- the similarities and differences from what the author describes here are important to me.  But, I appreciate that it is close enough and that it helps me. The word "cohere" struck me because it is exactly the one that was in my mind when I was so deeply ill.   I was considering whether to melt or cohere.   How quickly one becomes ether and water and then the effort required to return and remain embodied, combined with gratitude.

What I learned was good news about dying and living and it is this quiet calm and relief that I want to tell you about.  I hope as I carry the experience forward and live it that in time I'll find a creative expression that suits it. Who knows, fiber arts, song, silence, drawings, or simply growing old as a woman touched by life and death.


 Be well and happy and thanks for the kindness from so many.
Sharon

 

Greetings! It has been a long time since I sent out a blog post, a tweet, or a facebook message.   My journey into septic shock and back was very engrossing. Convalescence has been a circuitous and much slower process than I would have predicted despite years of medical training. 

I offer messages of thanks and gratitude for the many people who provided aid in my hours (and weeks!) of need and in the all ways it came.  And, of course, I have philosophical views and thoughts from the very edges of life. There is much to learn from life-threatening illness, but today I want to start with lighter fare.

There is a new section on the website called "stories” in which I share the background for some of the pictures on the website: the crazy, effortful, funny, and surprising behind-the-scenes events of Gay Bumgarner, photographer extraordinaire pitting her wits and patience against the goddess of nature.  Using her photography journals, the writings of Jim Bumgarner her husband, my own eye-witness accounts, video clips, and occasional poetic license, Mother-Daughter Press gives you a peak behind the creative curtain.  I hope you enjoy the unusual behind the scenes views.

The first photo-story is brief and it’s called Bugsy the Watch Turkey

If you want to see larger versions of the pictures, go to the new gallery called "Series in Nature"
 
Welcome to this new feature on the website, and enjoy the story-ettes. Please let me know what you think and feel free to share your own stories. I even take requests, if you have a picture you have wondered about let me know.

To make finding the stories easy, we have added it as a choice on the navigation bar of the website.  If you want to automatically get story updates you can subscribe to the blog or send a note.

Most of all thanks for all your well-wishes and kindness in this difficult time

Sharon

Septic shock newsletter part IV: stone less and back home again!

Dateline: 5 May 2011, Peacham, Vermont

Sharon’s stone-less and back home again after surgery! 
Bring on the puns- stones, rocks, boulders, blocks, obstructions, you name it. We can take it.

Today, Dr. Andrew Nisbet (and all around good egg), Sharon’s urologist, removed a bodacious great mondo-stone and some little satellite stones from Sharon’s left kidney. The surgery went more easily and more quickly than Dr. Nisbet had expected, as the stones were more easily broken up than anticipated. What was expected to take 3+ hours only took about 1.5 hours. Turns out the equipment for this procedure resembles something Playstation would make-- a video game with fiberoptic lasers blasting away at rocks and then clearing those out--all while keeping your "health up". Dr. Nisbet confessed it was fun and did make a case for there being one useful purpose for practicing video games as a means to master practical skills in later life.  

Sharon’s blood pressure and medical condition during the surgery were excellent, and her anesthesiologist commented how much easier today’s surgery was than the one on April 20th, when she was in septic shock and the goal was to be fast and drain the infection, try to keep her blood pressure up, keep her alive.

Dr. Nisbet collected samples of the stones for analysis and the big mystery now will be what is the stone made of?  There are different types of kidney stones and the most common are made of calcium carbonate.  However, Dr. Nisbet wondered, given how soft these were, if they might be uric acid stones.  We take bets here and award prizes for both the most thoughtful and the most imaginative or silly answers. Time and laboratory analysis will tell! Sharon still has a stent (a plastic tube) that that connects her left kidney to her bladder.  The tube travels inside her ureter and maintains an open channel from her left kidney to her bladder so that any postoperative swelling cannot obstruct the outflow of the kidney which can cause infection which can cause sepsis and well....that nasty little cascade of the past 2 weeks. Next week we hope to have the stent removed. 

The other big mystery is Why stones at all?  In addition to analyzing these particular stones Dr. Nisbet suggested that we try to figure out what might be causing recurrent kidney stones by evaluating various possible causes and to have a CAT scan in a few months to assess whether any stones are reforming. Considering many in her family have had them and she has had at least 5 documented kidney stones in  her life it might be time to get a wee bit more curious.

Sharon is ecstatic to have survived the surgery and to have had such a successful surgical outcome. She is resting relatively comfortably this evening, and Gib is tending to her every need. Natalya again took care of the domestic menagerie, while Sharon and Gib were at the hospital. Natalya’s teacher and family friend Nene Riley brought chicken curry and rice for Gib and Sharon’s dinner. All in all, it’s been a very good day!

Gib and Sharon


Now a photo treat......We are dumbstruck with gratitude

This slide show features nests, eggs, nestlings, fledglings-- the must vulnerable life -- and nest tenders and minders of all sorts.  It is dedicated to our friends and family who stepped in during my illness. Your notes of kindness, food, phone messages, cards, visits, food, books, articles, poetry, FOOD, garden help, phone tree, jokes, tears, and food helped so much. Thanks Peacham Vermont and of course Northeastern Vermont Regional Hospital staff. It seemed liked nestlings and their helpers were the right images to illustrate how big the world felt and to express our gratitude for coming when we needed you. THANKS to the Senturias, Nancy Lou Saidi, Suzanne Rhodes, Laura, Stan and probably other members of the Fickes family, Mel, Rod and Rachel Reis, Dave and Marilyn Magnus, Karen Joyce, Margaret Caudil-Slosberg, Helen Perry, Abdi Nur Iftin, Hassan Iftin, Ano Lobb, Jenny Hyslop, Wendy Morgan, Julie Hansen, My brothers, Morgan McDonnell, Richard Mendenhall, Jane Flink, Randy and Toni Dillon, Dan and Diane Friedman, The Prudential committee, Peacham Town Clerk team, Peacham Library (great movie suggestions too), Susan Moran, Natalya McDonnell, Annie Danielson, Meg Harper, Barb Melnick, Pam Parrish, Camille Parrish, Randy Parrish, Claudia Micare, Kate and Kathyrn Roosa, Alex Thorngren, Libby Gill, Marjo Price, Ben Bellows, Jeff Passe, and so many more that I am forgetting just this moment at bedtime. THANKS!


Nests & Nestlings - Images by Sharon McDonnell
 

---

Septic Shock Newsletter Part III

There is no place like home!





Sharon returned home from the hospital late yesterday morning. She spent much of yesterday afternoon resting. She gets happy and weepy over the spring flowers.  She slept well last night and remains afebrile today (max temp of 99.6), which is a great relief. She is taking ciprofloxacin for her infection and oral pain medications for her continuing flank and bladder pain related to her large kidney stone and/or the large plastic pipe (stent) that is in place. She still has bilateral pleural effusions (Water in the space between lungs and it’s lining, the pleura).  She is sort of like an insulated thermal cup.  With the fluid and infection it is very important that she maintain her “pulmonary toilet.  This is a process of coughing, and positioning herself to assure that her lungs drain, get lots of air and do not become infected.  She practices inhaling deeply using her inspirometer, which she named “Steve, Too” after her brother who is an  unrelenting and effective advocate that this breathing stuff is a priority activity.  Fortunately, it fits in with great yoga techniques too and is good for all sorts of ailments. 

Today she was eating meals at the dining room table and had  visitors and calls. Her appetite is good and to raise her serum albumin and iron she has relaxed some of her eating practices (Happy meat and plant based diet).   She appears to have lost most of the extra fluid that she accumulated during her illness. People are not as inclined to call her “lumpy” or “sausage girl”. I am not sure anyone was ever brave enough (except mayber our children) to ever call her that really.   It appears that she will not need to take more diuretics at this point.  During her last day in hospital her body decided to sweat — a process called diaphoresis. She sweated at least a liter of fluid off in what she says was like the worlds longest hot flash. No one is entirely sure of the mechanism for this but at one point Sharon said that maybe her body was wise and decided it needed to increase the loss of fluid or alternatively, her body was responding to seven solid days of adrenaline. When they were all pondering this she said “I don’t know, I have been a little stressed”. This was met by silence and then followed by a hearty laugh all around.

Sharon and friend Margaret Caudill-Slosberg were reflecting on life in the hospital and she wondered about what could be learned from a qualitative study of the language used and names applied to a patient as a reflection of how sick they are. Sharon says she was called honey, sweetie and dear for 4 full days and only when she was mostly out of the woods and on the road to recovery did people begin to use her name. Maybe this is something woordle or the like could illustrate — if not for science at least for fun.

It is hard for her to be home and not be involved in all the things she normally does here. She is a slow moving guest trying to keep her whims within reason and yet not forget to ask for help. I am deeply grateful for all of the offers of support and help with grocery shopping, garden clean up, and dinners. On day 3 of Sharon’’ illness I came down with an impressive sinusitis and upper respiratory infection which has been annoying and persistent. Perhaps I have been stressed. Sharon likes to have me around for naps being someone seldom inclined to take them otherwise. We turn into a puppy pile (with cats).  We have not had to send Natalya out with a bow and arrow yet due to the largesse of our friends and family. Morgan has even offered a mercy visit home next week sometime.

Tomorrow morning, Sharon has an appointment with Dr. Nisbit, the urologist, to discuss surgery to remove the stones in her left kidney. Based on our meeting with him yesterday morning prior to Sharon’s discharge, its possible that she might have the surgery next week. We will continue to make updates available on the blog and please feel free to share them with others and leave comments and suggestions. Good articles, books, podcasts or entertainment shows are all of interest. 


Understandably our friends are shocked to learn of our latest adventure. They just turned away for a moment and next thing they know the whole shooting match has gone crazy.

Stay in touch, thanks for your kindness to our family and enjoy the spring.

The Septic shock newsletter Vermont

Posting from Gib
"It’s been a rough week for us in Vermont, but fortunately it is now much better.

Last Tuesday (19 April) about noon, a large stone in Sharon’s left kidney—Sharon has a history of kidney stones—moved so as to obstruct the flow of urine from that kidney into her left ureter. That blockage caused an infection in her kidney, which later that same day spread to her bloodstream, producing a condition known as “sepsis.” This in turn resulted in a drop in her blood pressure and the loss of fluid from her blood vessels into the surrounding tissue, a condition known as “septic shock.” Sharon underwent emergency surgery early Wednesday morning to open up the blockage. This was done by inserting a small plastic tube—a “stent”—from her bladder through her left ureter to her left kidney. Although the stone wasn’t removed, the insertion of the stent allowed the infection in her kidney to drain. After surgery, her blood pressure remained unstable for several hours, and the hospital staff worked heroically to keep up her blood pressure and prevent further complications of septic shock. By Wednesday night, her blood pressure was reasonably stable, but she remained critically ill. Thursday through Saturday, she gradually improved, and by Saturday night she was well enough to be moved from the intensive care unit to the medical ward at the hospital. On Sunday, she continued to improve and was able to stand unsupported and do most basic tasks by herself (eating, washing, dressing). Fortunately, it does not appear that any of her organ systems sustained any significant long-term damage, and she should recover fully from her ordeal, although it will take several weeks for her to be back to normal. She will still need surgery to remove the stone, so that a similar event doesn’t recur. This surgery will probably take place in early May.

Today (Monday, 25 April) Sharon’s condition continues to improve. Hooray! She has no fever, her blood pressure is normal and stable; her platelets (important for stopping bleeding), which had been low, are increasing; her white blood count, which is indicative of infection and was very high, is closer to normal levels; and her lungs remain clear, although she has some fluid in the space between her lungs and her chest wall. She is now eating (and enjoying) solid food and is up moving around to use the bath room. All indicators are positive at this point. The foci of treatment at this point are keeping Sharon’s lungs clear and free of infection, reducing the edema fluid that she accumulated during her crisis, and reducing her pain and discomfort from the kidney stone.

This afternoon, I am well enough to contribute to the narrative with Gib. I think of this as the septic shock newsletter and there are a few themes:

1. First hand experience is updating my medical knowledge. All things are connected. The theoretical interactions learned in medical training about fluids, electrolytes, platelets, infection, shock, are amazing. Personally experiencing these terms from my bedside while floating in a spiral fog will take awhile to absorb.

2. The body exists in the moment, in here and now. I crashed into the moment with identical body time, thought time, and emotional time via severe illness, and I am stunned with gratitude.  The kindness of my brothers and sisters-in-law, Abdi & Hassan Iftin in Nairobi (see post about this story! Abdi escapes Somalia) , Gibs' family, and friends such as Mel and Rodney Reis, who knew  what was happening and kept track of our crazy course with support and encouragement is overwhelming.  I kept sending out little messages via Gib saying "hold us in the light," and the notes came back and they helped.  Wednesday night I believed I would live, and I listened to the weekly webinar on "the body" by Clarissa Pinkola Estes in my ICU room.  I had dreams about that community of people and their support that night, and it was a rich source of connection between before and after. (See Sounds true: Clarissa P. Estes and The joyous Body

3. In keeping with "health through imagery" (Health through imagery) I have commented on and critiqued all pictures around me, and people have been very patient with me.  The images in our environment matter-- I have asked Gib to link to two favorite pictures. First, is the trio of barn swallows (Hirundo rustica-- thanks, Mom, for a name I would never have known otherwise) sitting on the strand of barbed wire at evening time. I hope to donate it to NVRH  when I leave here. It would look so good on the wall in my hospital room.   Tres Barnswallows

Second, Ecola Bay State Park and the Oregon Coast. This is a favorite -- the sea air, the sunset, the sound of water on rocks, and wind comes fresh and fully to mind.  Ecola Bay, Oregon Coast

4.  It only hurts when you don't laugh. I have named my spirometer (the little plastic toy-like object for maintaining lung function) Steve Too after my brother Steve, who calls each day to remind me to BLOW BLOW and Blow.  Natalya left me with a drawing on a white board with numerous sayings, including "Never give up never surrender," and humorous greetings from our pets.

My husband is amazing.  I knew how sick I was by watching his face.  His wonderful and even his most irritating trait have wound around each other  into an indistinguishable collection.   He has done so much to help me survive and want to survive than I can say.

I shall leave this to Gib except for the last line about him.'
Love to all"

Sharon (and Gib)