March 12, 2008
“What’s wrong with me?” I asked the nurse.
“You have Varices.”
Those words echoed through my head as the nurse turned and walked away. Why was she so angry? And the tone…there was definitely a tone.
I was in a hospital bed out in the middle of the hallway waiting to be taken to a room. I was still groggy from the anesthesia they had used. From where I was I could see my wife talking to the Fellow Resident who had just finished doing my endoscopy. They stood behind double doors but I could see them through the windows. It looked like they were arguing. I didn’t know what they were talking about, but the nurse had upset me. I just wanted to know what was wrong with me.
Halfway through that weekend I had suspected I was bleeding. On Monday I made an appointment with my dermatologist but, it wouldn’t be until late Tuesday before I would get in to see him. The doctor called for a phlebotomist to come draw my blood. An hour or so later he confirmed my suspicions. I was definitely bleeding. My creatinine levels were way above normal and I needed to be admitted to the hospital. I was going to need a gastroenterologist to see me. They scheduled a endoscopy for the morning. The thing is I had been watching for a bleed.
For the past month I had been taking a powerful cancer treatment drug for leukemia, but I was using it for a different reason. I was using it to help clear my psoriasis. A year or two earlier I had used it and it had worked wonders. But there were also side-effects we had to watch for. Once a month they had to do a CBC to monitor my blood levels. The potency of the drug could compromise my immune system. I was susceptible to infections, bruising and bleeding and I had to watch for nausea and dizziness. There were also more severe side-effects that we had to watch for: stool color and vomiting. By Sunday I had both of the latter. For someone who was supposed to be watching, I didn’t do a very good job. I should have gone to an emergency room two days earlier.
The strange thing was, I had spent half a year on this medication before and I didn’t develop any complications. This time I had only been on it for a little over a month.
When the doctor who did the endoscopy came to see me she explained that I had a cirrhotic liver and that it was what caused my varices. As the liver hardens and shuts down, the blood reroutes, putting a massive volume through blood vessels not designed to handle the load. In my case, it's in the esophagus. I was already resigned to believing the medicine I was on had caused my troubles. Everything I imagined went out the window. When Lois and I had gone to the gastroenterologist years earlier, he thought I probably had twenty more years before we started seeing any problems due to the Hep-C virus. But there was no way of telling without doing another biopsy and it didn't seem prudent to do another one for a few more years. Twelve years had gone by since I was told that I had Hep-C and I was now starting to feel the effects of liver damage. What we didn’t know was the severity of it. In the next couple of days the doctors would explain everything to us. I have end stage liver disease.Without a transplant, I will die.
Over the next few months I would keep going back to that hallway. I would keep running it through my head. I understood why that nurse was angry, and why the Resident was cold...and I was furious.
They had already made their assumptions. Native American. Hepatitis C. Alcoholic. Intravenous Drug User. Sexual Deviant. Any of these things could have been the reason of why I was there. The one they missed -- the one that counted -- Blood Transfusion. 1969.