Monday, August 02, 2010

Blood, Guts, and Tattoos: My recent ordeal

“I'll never get a tattoo,” I've vowed to myself more than once. While I have many friends I like and respect who sport body art, I've never had any desire to have someone inject ink into my body. The vast majority of tattoos I've seen are no improvement on the original, natural skin. But I'm no crusader against the tattoo industry or against those who have tattoos. I just don't plan on getting any myself.

But recently I found that I had three “tattoos” of India ink, though they were in a place almost no one could see. And while I never consented to them, I was glad I had them. I'm not certain whether any trace of them remains. They served their purpose.

Over the past dozen years, I've had problems with gastrointestinal bleeding. In the spring of 1999 I spent close to a week in Elkhart General Hospital due to G.I. bleeding. The doctor told my wife I didn't have stomach cancer, colon cancer, ulcers, and probably a few other things. But he couldn't locate the bleed except to say that it was in that vast, 18-foot-long small intestine. The bleeding stopped on its own, and the doctor said it was probably a “vascular malformation,” in which a weakness in a small vein manifests itself in bleeding. I was told not to use aspirin or ibuprofen. For me, the Columbine massacre will always be linked to my time in the hospital.

The next year, at around the same time, I had another bleed, and another hospitalization. This time, a colonoscopy detected the problem—a lesion in the large intestine. The lesion was cauterized, and I had no G.I. bleeding for a decade.

But on Thursday, July 8, it came back, first in the form of dark stools, and by Saturday the 12, I it was clear that I needed to check myself into the hospital. I drove back from my job at the South Bend Amtrak station, left a note for my wife, and drove myself to Elkhart General Hospital.

I was there for just over a week, while the doctors and technicians tried to locate the source of the bleeding. I had an upper-G.I. endoscopy, which ruled out the esophagus and stomach. I had a colonoscopy, which eliminated the large intestine. Once again, I was bleeding from the small bowel. After a capsule endoscopy, in which I swallowed a capsule that took pictures of my intestines, gave inconclusive results, it was clear that Elkhart General had done all it could do. On Sunday night, July 18, I rode in an ambulance to the University of Chicago Medical Center, one of the nation's best hospitals for gastroenterology.

Things went slowly at the big hospital. While I did the preparation for the double-balloon enteroscopy on Monday (drinking a dreadful laxative concoction called GoLytely, which supposedly doesn't drain the electrolytes from the system, though it wipes out nearly everything else), I didn't have the procedure until Thursday. But once I finally had it, the physicians found the problem. The team spent about three hours checking my small bowel first by way of the anus, and then by way of the mouth. And in that second scan, they found “submucosal lesions,” which were responsible for the bleeding. And to mark the lesions, as well as the part of my small bowel which was not surveyed, I received three “tattoos” of India ink.

The next day, Friday, July 23, I had laproscopic surgery. I awoke to find five small scars on my belly. Later I learned that the surgeon had removed about 3 feet of my small intestine. “You'll never miss it,” he said.

I sill have to do follow-ups, and there's some possibility I'll have to do a round of chemotherapy if the labs find anything potentially cancerous. But right now, I'm glad to be home. And since I haven't heard anything from Chicago, I'm hoping no news is good news. And I'm happy to be in the land of the living, albeit with 20 percent less guts and perhaps some vestige of India ink tattoos.

Photo: University of Chicago Medical Center (Wikimedia).