Urgency of treatment for hernia after long term illness

[Tezcatlipoca]

Please read and consider. Sometimes lately I’ve been convinced each individual in the world is unwilling to do as much work as was required for their last homework assignment toward preserving someone else's life, other times I think better that this is a kind place because of people.  It goes with the person and the moment. If you could make it that world, no matter what is wrong with me, I don't know how to articulate what it would mean or what to say.  I’ll try to make it that world too with what I have left.

And if I’m wrong I’ll spend my life sorry for all this. I’ll try to make amends to all the individuals I touch and to the world. If it is a delusion, it's right now impossible for me to see around. You have to understand it's real to me. I am not talking about “feels very real.” I am talking about it is my reality. All I can do is go by what my instruments tell me. We all are tied to that.

The history is complicated; I don't know exactly what's important.  I'm just going to put it all out there as objectively and devoid or opinion as I can get it and hope somebody can sort it out, because I'm desperate.   I do know some more than the average layman about medicine as a former biology and briefly a pharm student and a long time student of science. But I am ignorant of a great deal and what is often incomplete or restricted by not knowing related knowledge.

I am 30, I had never had an important physical illness a year ago. I have anxiety, but it's never been like this.  5mg of Abilify and CBT did wonders for it.  I was taking adderall for attention problems. It was prescribed by a psychiatrist after computerized tests and I have taken it for 10 years without any important changes.  I was and am taking 50mg of atenolol for high BP.  

I didn't realize it until a 2 months ago but over the last year I have been sick more than I've been in my whole life combined.  Two months ago I got this gradual arm pain in left arm while I was working focused on a project. I eventually had to stop working. It got so bad I could not move my arm up. It was at the elbow. Later I considered it was the same arm my GP treated me for bursitis in twice in the month prior I would realize later but don't know if important. After the arm pain got bad things got scary (after about an hour?).

I started having chest pain. It got really hard to breathe. It felt like my chest filled up with fluid. I've never had anything like these symptoms. I made my brother sit up with me for a few hours until my GP opened.  In retrospect I should have gone to hospital but they are far away I was scared to move and also I had been sick so much and treated without improvement, symptoms dismissed as anxiety over the past year that my confidence had eroded and I was not sure somebody I didn't have a history with would be able to get through what I believed to be anxiety that had very quickly gotten much worse to find out what was wrong.

In addition to the left arm pain I started feeling these sharp pains in places. It felt deep and very scary.  I remember one seemed to be move from like my elbow to my wrist (my middle finger went numb at the tip and stayed that way for weeks). It moved to near my ear. Also somewhere in my leg; at my ankle. In my head it felt like it was in my vasculature. So then I was having what I thought could be symptoms of a heart attack and a stroke simultaneously.  

I was convinced I had lost it and was a basket case.  Part of the reason I didn't go to ER. I chewed an aspirin and tried not to move. That seemed to help or else it just got better over time. By the time the doctor opened it was better but far from gone away.  I went in very worried, he seemed to think it was unfounded and anxiety. He told me there were no nerves in the heart, that I wouldn't be able to feel it hurt (feel now like he has a bad habit of keeping important things from me, misdirecting me with medical info out of context, even straight out lying all toward defusing what he believes is simple anxiety). He gave me an EKG and listened to my heart and couldn't find anything. He sent me home with an SSRI.

At this point I started to think about my health over the last year.  How many times I had been to the doctor... and how often I had been sick especially stuff I'd never had before. It was a lot. I keep an archive of all my text messages. I pored through it for times I had reporting being sick or having symptoms to other people.  I created a document cataloging them. It starts out slow and relatively harmless, as that's how it happened in time. The document is not exhaustive, at least a month out of date and it also does not strive to be objective. It puts forth a hypothesis about all this.  I started reading about infectious disease in general and circled in on the listed hypothesis after some specific symptoms that seemed really distinctive and specific to my incomplete reading. I read diagnostic manuals, research papers, textbook sections, treatment manuals and came away convinced this hypothesis would bear out.  I'm not sure this is a great way to present it now, but I don't really feel I have time to alter it otherwise at the moment.

[Tezcatlipoca]

My chest stayed filled with fluid for like 3 weeks. I was utterly exhausted always I had like 4-6 good hours out of the bed each day. I got fed up. There was no getting around it. I woke up and in the waking moments it was there. It did not abate. I felt it yet I was told it was not there. It didn’t leave when I was happy or sad or tired---name it.  I felt it drain as I layed in certain positions, I even heard it with my ears. I know that is an incredible claim.  I am making it. Sounded like my stomach make sounds as stuff moves around, but in conjunction with sensation of movement in my chest.  

I basically strong armed a doctor friend into telling me what antibiotic I could take that we had in the closet if I was right in my hypothesis.  Someone in the family had a whole course of Keflex. That was the winner. It seemed to keep it from getting worse or either it stayed the same for around 10 days.

At ~8 days I went back to the GP and tried to convince him.  I asked out of curiousity interrupting the rest of the case I was presenting if there was a cavity in the groin because lying at an incline I could feel something draining down there.  It didn’t seem important compared to the other stuff. That seemed to inspire concern.  He said I had endocarditis and a hernia.  He was weirdly noncommittal. He did not run any labs. He did not suggest any follow-up.  He gave me Augmentin twice a day. He gave me a refill on it. And I just assumed hernias resolved themselves over time for the time being considering all that.  I only had a couple days of Keflex and "finish your antibiotics". I hadn't studied antibiotics in much depth related to susceptibility related to my hypothesis so I didn't switch.

One night my head on one side was pounding and I was burying my face into a pillow to the point I couldn't breathe too well because my neck was so stiff. My head was lolling as I walked. I was very confused. My ears were ringing loudly.  Every time I woke up I was increasingly confused and afraid--in delirium talking nonsense and all for like 10 minutes at times.  My family attributed all this to my sleeping in a different room?  They took care of a dementia patient in my grandmother where that happened. And beyond that, unbenounced to me they decided I was going insane. I didn't learn that until later.

As for the acute symptoms I didn't realize them until I switched to the Augmentin on what amounts to a whim. I cannot explain why I did very well as I did not have my faculties for the decision. Twenty minutes in I realized my ears were ringing crazy loud and every ambient sound was terrible and annoying and made me really agitated. Around that time I also realized that I had somehow been disconnected from my sense of pain to some extent.  By 45 minutes in my whole body felt nicked by a dull knife in the inside and the pain from my head became a realization.  By like two hours in I was terrified as I realized I had been like walking dead for like a day. My chest finally drained for the most part at this point. By morning it was clear though there was still some pain.  I described all these symptoms to my family as together they terrified me, but did not know what specifically they could mean or look them up until a day or so later to find out an idea of what could be going on.  

I felt like it was an open and shut case from this that I was dealing with an important infection, I began taking it to my uncle (a GP with a thriving practice and a wall full of small town awards) this time worried about it all; unsure now of the original GP's competence and concerns.  My uncle dismissed it all as anxiety, or as lying, or just out of hand. He did a lot of hand waving and attributed it to mental illness.  I say that feeling good there is little prejudice attached to the statement.  There is a family history in his immediate family and this seems to inspire him to expect it.  I asked him to do a culture on my sputum and some other labs.  He wouldn't but did a rapid strep test. He said it came back negative.  I hadn't had a sore throat for months and months. I am unsure now if that matters.  

He said the armpit rash presented in the document was contact dermatitis from my deodorant but I had stopped applying it for like 5 days to check all while applying it to my chest.  Nothing on my chest. Rash persisted. He did an EKG and a chest x-ray. He didn't see anything.  He told me the abscesses were acne. As part of my anxiety I was skin preoccupied.  I am certain they were not, or at least importantly changed and relapsed after a year of near complete absence. I had near 15 years of experience with acne to base judgement on this. I was having joint pain in my toe at the time. He said it was gout. I pointed to the wrong joint apparently. He said, "huh" and it went no further. Overall he waved his hand on very many things.  He told me it was Adderall. He told me Hitler used amphetamines and so forth.

The next day I found a lab in a nearby metro that took labs without an order.  I ordered their only available diagnostic test for my hypothesis even.  It had a 30% false negative.  I also ordered a CBC as well.  Again I had a family member drive me. Again the travel seemed to make things worse.  The diagnostic test came back with a negative score by a good margin.  My WBC was within range at 7.6.  The composing values were off.

[Tezcatlipoca]

The night after next things turned so hard and had me so keyed up that I went to a very small hospital nearby with a bad reputation. I got my second blood test. I looked terrible and my mother accompanied me.  The doctor began shaking his head as I tried to list even the first and most important portion of this history and symptoms.  He said they were for the most part insignificant and would not listen to more.  I put forth my hypothesis over his objections demanding firmly that he explain any belief against or contradicting evidence. He said I was probably right about the rash and other important symptoms that are criteria of a portion of what I suspected. He did not seem to be familiar with what that meant in any depth as far as my knowledge goes. His prescription was to "go play a sport". He told my mother she was "enabling me". He told me he was going to take a nap and that we would wait for him to return for discharge.  

After an hour a nurse came in instead with a computer on a cart for discharge.  I demanded my labs.  There was some push back but they eventually brought them.  My Troponin I was at 0.04 indicating intermediate AMI by the range.  The nurse reiterated there was nothing was wrong but also quickly informed me to see my GP on the next weekday. My EKG triggered the auto-diagnosis for "Sinus Tachycardia". I was told that was an error that the doctor OK'd it.  I am not sure why. I wouldn't have attributed much significance to that.  My potassium was low, seems likely from my antibiotic use. RDW was low compared to range. My WBC had climbed, according to the test, to 9.7 from the previous. The composition was still off. She turned the monitor away from me and made me sign the discharge stuff blind.  In context it seemed an attempt to keep me from seeing that I could refuse to be discharged.  For some reason this offended me so much that regardless of my health I needed to leave, the only time I know that I have been consciously willing to disregard in some way my life like that.

A day later my lungs felt increasingly full and I felt as though I could feel whatever was in them increasingly solidifying (from deep breaths and how my breath felt in general) though at this point my anxiety level is reaching new highs each subsequent night and I attribute some of that to this fact.  After doses of my Augmentin it seemed to soften and liquify for a few hours and I could bring some of it up, that I do not have the same lack of confidence on Between doses it would seem to solidify again.  At this point I take a more desperate and independent role with the antibiotics out of desperation and fear. I move the Augmentin to three times a day as per the Merck treatment guide for the illness related to my hypothesis.  I pushed it some further than that after a couple of days though I had insufficiently studied the consequences. I hoped nausea or something with the stomach would likely happen to indicate something before important damage occurred. Things seemed increasingly dire to the point I thought I should gamble. I had less and less energy. Less and less time awake.  Things that seemed red flags appeared: the cartilage in one of my ear lobes went mushy at the top.  My BP was 178/105 lying down (for hours prior) after my PM dose of atenolol several days after my discontinuation of Adderall.  

But then it felt like finally something gave in the lungs. I assume from the antibiotic push though I do note I cannot rule out its being an unknown effect (to me) of the antibiotic push.  With great difficulty I coughed up several cups (I filled the bottom inch or so of a small trash can at least) with clearish viscous product.  I noticed it forms a film on water. But while trying to blow my nose, as I was holding my breath for a blow, I felt the inside of my chest pop like a balloon. My best guess is that the hernia has closed and popped back open. My breath started to stutter. I insisted my family take me to an ER in the nearest large metro.  My mother drove me the hour to a teaching hospital.   The motion of the car seemed to aggravate things. My chest began hurting. Breathing became harder during the travel.  When I arrived I felt as if I were going to pass out.  I went in and sat down and scribbled notes about as quickly as possible all this expecting I would soon go out, terrified I would never wake up but also expecting I would soon be cared for.  

They made me wait maybe two hours. Then they called me to a room in the lobby and brought someone in with a folder and no lab coat.  She began asking questions.  I began answering trying to get them over so I could receive care. I soon realized to profound surprise it was a psych eval of some kind that was to result in a crisis plan. She said she had been informed that I was suicidal or there was some danger.  (I would come to understand my mother notified my uncle of our plans and he through some contact or connection informed and set up the hospital for a psych problem related to delusions of illness.)   I started asking why and how and questions about my rights.  It frightened me that this was obstructing diagnosis/care/treatment at such a time. I was not familiar with the process.  I tried to demonstrate my sanity (what was left of it) and demonstrate the potential for urgency.  She seemed to catch with this at some point and hurried things. She put down basically that I was convinced I was sick and that I might be sick.  She told me it was important to take care of this document, but I did not understand why that could be important and did not. It was later taken from my effects.

I was brought into see a doctor who was ready to listen to everything I had to say. I found this encouraging. He even seemed to really consider all that I said carefully following out my ideas and conclusions correcting where necessary, supporting when appropriate.  We talked for well over 30 minutes, maybe closer to an hour in all. I got the distinct impression--though I have little in the way of evidence--that he was expecting it to be clearly unsupported delusion but then felt himself forced to consider it and became somewhat convinced by the end.  He said that he would give me a Penicillin G shot if it would ease my mind. It sounded to me a lot like he did not want to admit out loud he agreed.  

He left while the CBC was prepared. Again the WBC had risen a little--don't have the exact value--and the composition was off.  But when he came back something seemed to have changed.  I don't know if he was expecting the labs should be worse or what.  I had to really push, almost beg, for the Penicillin shot but I would get it later. The doctor left the room and soon I could hear him arguing with someone outside about seeing me and several other things.  I am going to break the attempt toward objectivity to say: this woman is a terrible person and I hate her. I could not hear it all but I could hear her when her voice rose to assert some authority and said basically she was walking in the room. The doctor got dragged by the collar into introducing her and accompanying her in the end.  She the doctor and my mother told me I should voluntarily commit myself very forcefully presenting it as if there was no alternative.  I understood quick though I was floored by all this and refused just as firmly. The doctor was quick to relent and they essentially argued in the room around us.  She asked them to leave.  

[Tezcatlipoca]

She tried to go through some questions on my state to determine if I was a danger and some basic information.  She implied it was for the protection of society that couldn't be refused calling to mind recent tragedy.  By that time I was suspicious enough to refuse to provide simple identifying information like address and history "just for her records to record she had come by".  Her guilting and suggestion that my refusal implied danger got to me somewhat though. I could see no harm in answering the questions about mental state to prove I wasn't a danger to anyone or myself without the other information to store with it.  We answered those, but I did not like the tone she took or the progression with follow-ups that seemed disconnected from my answers.  She was single-mindedly trying to achieve the goal of committing me.  She had travelled there to do it and she was going to do it--it was like the Terminator. She casually tried to stick questions on basic info like address in later conversationally. I asked her if she would correlate that with the question answers. Her answer was non-sense. She told me they would commit me involuntarily if I refused but was fuzzy on how upon questioning and my exploring my rights.  

She then tried to present a crisis plan as a formality to allow her leave for her job. I said I already had one. The blank at the top where it lists the nature of the issues was blank.  I wouldn't sign.  She literally said to me something to the effect, "there will be a price for that" or something similar.  To me this is the kind of thing from movies or books, I would have guessed against there being people that I might run into by the numbers somewhere out there doing it.  And unless I'm just completely out of touch and never will be and don't understand it this altogether must sound absurd or near impossible to believe. I don't have much to say to that. I had no idea this could happen to anyone much less that there was a danger it could happen to me. Some of it is record I guess. For example I have my copy of the document as she altered it next.  It says "Suicidal or homicidal thoughts; hearing voices."  That comes well and truly out of thin air.  Never. Nothing like it.  She wrote then that I "refused to sign in front of my mother" who she brought in for the occasion, a daisy chain that for all I know has got my name recorded on some kind of list connected to those things.

I got the Penicillin shot after that.  As I remember it, it was only a few minutes when I felt something like waves go through my body.  I went to sleep on the exam table for a while after that. I can't and don't imagine the immune system could make that quick of work of anything like that. So I can't come up with anything strong other than the obvious idea (something psych was going on there). I thought maybe they just shot me up with a benzodiazepine or something instead of Penicillin, but beyond all the common sense stuff that suggests a doctor wouldn't do that and for practical and then liability reasons couldn't do that, the doctor gave me information and records for Penicillin G to take to follow up care. More tangibly I still have the bubble on my hip/butt 3.5 weeks later.  ...but I do think it's possible to draw two medicines in the same shot?

But the doctor never checked for the hernia.  When I got back in the car and I could process this, I was the most shook up I can ever remember. I'd say like "fractured." But I thought I at least now had a decent chance to survive for at least 3-4 weeks in the event I was right.  When I got home I very stupidly I drank three beers for the first time since the chest pain.  Later as the battery in my car is dead, I asked to borrow a car from my parents. I told them it had gotten dangerous for me around them and I had to go. I did so unkindly. They gave me permission in words to do so.  I went to a friend's house.

He was incredible to me and restored my shattered faith in every extant thing. He told me we were going to get this taken care of the next day and instilled some confidence in me.  As we were talking it began to feel like I was peeing into my own leg. That's the only way I can describe it.  I have to believe this is the hernia and maybe the alcohol.  We decide to go to another hospital. Another hour drive. It makes me again feel worse to travel. And from everything in the day I had become incredibly confused on basic facts about medicine and history.  We manage to get enough into his head for the event I truly do go out this time. Getting out of the car I went faint. But it didn't last.  He rolled me in a wheelchair.  

We saw somebody from triage and even got put into a room quickly I tried to explain everything and started out strong but got confused.  They seemed to become doubtful after that and interested in getting me out of there.  They kept us waiting longer than I've ever waited in an exam room, something like three hours. We got an x-ray. They decided to come back and take a third one further down after the first two. A nurse practitioner came in and told me she believed I had a hernia but it wasn't clear from the x-ray, and that it wasn't an emergency for them.  She gave me a referral and a prescription for naproxen. I again asked for my labs and the x-rays this time. They told me they couldn't get the x-rays until tomorrow for some reason but that they'd be available the next day online. We left and couldn't talk to each other on the drive. The next day they said on the phone at the hospital that online x-rays are only available before you are discharged.

During that time my parents called the car in stolen starting a chain of events that allowed them to easily press charges to hold me while they signed a writ to commit me. I was in jail until they could arrange a room. There I was kept in a booking cell for four days which is like solitary without the padded walls. I was very sick the first three days.  It's a small town jail.  The night shift seemed inhumanly cruel and would not come at all to my knocks.  I was unsure about the Penicillin for the reasons above and asked for Augmentin thinking I might need it to survive the night, only they wouldn't come to give it to me. It was misery.  Three nights passed with just me and a thin plastic pad (no pillows in jail I found out). One of the guards on one of the day shifts seemed truly kind and really couldn't face me. I believe he was too guilty about it all. I heard him get emotional and y'ell, "Just look at him, he's sick!" at the people at the desk at one point. I wish I could tell him I was OK now. Give a hug or something.

I started feeling better on the fourth day. Same day I got moved in with the other inmates going to a psych facility. By the time I got to that facility I was feeling more normal than I had in months. I was still really afraid and uncertain. I could write a book on the following two weeks alone, but as for illness and symptoms it was uneventful. I got completely well except for pain on the left side of my back that prevented me from bending over in some test the nurse practitioner there gave me. He said it was my colon. I was told I had to ignore it and all the delusions of illness.  That really makes no sense to me.  Why give the test in the first place? I had decided inside that the Penicillin had fixed everything and that I could go back to living.  I also entertained that important portions of it was actual delusion, though that does not completely compute. If that was the case I thought I had put that behind me too.

[Tezcatlipoca]

Then yesterday after my release I went straight to a good restaurant and had a huge meal after two weeks of cafeteria food. The waitress had to bring a big jug of Coke because I kept her running with refills. My first sugar in two weeks. My first caffeine in two weeks.  It gave me diarrhea really bad and I had to go back and **** four times at a department store I stopped at.

I had to drive a couple hours to get home.  As I got further into the trip I was confronted by some kind of Lovecraftian horror in that I began to feel a strange feeling and mild pain develop in my chest and stomach.  I tried to ignore it. I tried to deny it. I turned the radio up. I talked. I tried to avoid it and put it away.  But as far as my mind goes, it was and is real. I thought it was develop into the chest pain and those symptom. But it became clearer once I arrived it was mostly in my stomach. It feels really strange on the left side.  I’m really bloated. My whole torso is like physically tensed up. Bizarrely, I have the worst case of what I call "getting out of the pool penis", the glans of my penis has like retreated into the skin where I was circumcised. My breathing is funny to me. It comes out with a little stutter or wheeze. Sometimes my voice is like cracking or something; I feel like it has to do with the way I’m breathing.

I am just out.  I am lost.  I tried calling GI specialists to beg for unofficial advice on whether this was a matter for the ER and appointment or a psychiatrist. I couldn’t get past a receptionist.  I don’t have a doctor I can trust or a hospital that will treat me. I am not sure I could safely travel to one if I had one to go to. I was release yesterday from a mental hospital. I was ecstatic.  I can be put in anytime during the next 4 days if I show symptoms or people begin to worry. Even so I called the nurse practitioner there three times for some direction... And they can still put me back in for the next 4 days if I show symptoms and stuff.  I am just that desperate. I am just that in need. He won't call me back.

I have had those symptoms from yesterday the whole time I've written this. I had to get this out once. It's part hope and part catharsis. That's all I have to say.

[mkh9]

Firstly, we are not doctors are here. I am a microbiologist and can only give some advice. It is very hard to follow your very very long posts. I am lost in the details. It would have been easier if you could just list your symptoms and antibiotics taken or tests done and their results and reference ranges. No one has that much time to read a long story. I was ill my self so I couldn't get to you sooner because it took a long time to read it all.

So, over all
1. you shouldn't take antibiotic on your own. It can cause problems.
a. drug resistance because you are taking an antibiotic and are not taking the right one,
b. you can be allergic and not know it. Then have to be rushed to the hospital etc.
c. It just won't work. That is why the lab does antibiotic tests to see which one is right for each organism.
d. you can end up getting Clostridium difficile (a bacterial infection that comes from disrupting the bowel bacteria from using too many antibiotics).

2. I can't help with hernias on this site. I don't know anything about them.

3. I think you should get help from a counselor if you are not to deal with your anxiety and also try biofeedback breathing exercises to control some of the worries you have.

4. The doctor that said you had endocarditis it is possible or too much fluid on the lung. so why didn't you follow his advice and take that antibiotic that he prescribed right away? If you had questions about the other antibiotic you should have called him.  If you had endocarditis you would usually have a high fever.

5. The diarrhea may be from all the antibiotics you have been using.
If it continues and you get about 10 a day you may want to get checked for C. difficile.

So also when they listen to your chest they can hear fluid on the lungs and heart . That is diagnostic. And, a chest Xray of the lungs can tell if you have fluid on the lungs and just listening to the lungs can tell the doctor if you have pneumonia or pleuracy etc.

I know it is hard to trust doctors but sometimes we have to. If you don't like the first one get a second opinion. But I think the Augmentin sounded like it did or would have done the job. You may want to ask for a echocardiogram to make sure there are no structural abnormalities if you did have endocarditis. Get a 24 hour monitor as well it will check for arrhythmias.


mkh9