Thursday, April 12, 2012

3- Questions and Actions


 What is going on with this guy?  How did this seemingly healthy man's well being deteriorate so drastically?  Once again, the answers to all the questions were buried in all the medical papers.  Out of shear curiosity, I definitely want to know.
     
After two full days on my bedroom floor, I was taken to the ER.  I was still completely unresponsive, and remained that way for another two days.  The physicians had to figure out what was wrong with me, and they couldn't ask me any questions.  I was seriously dehydrated, and losing blood from an  undetermined source.  

The blood loss was causing a number of other bad effects.  My blood pressure was dangerously low, and my body temperature was down.  Also, my pulse was very erratic. With more tests, they found that my liver was failing, my kidneys were distressed, and my whole digestive system was a mess.  All of these troubles were due to my blood loss from esophageal varices.
  
This happens when your liver becomes so scarred that blood can't flow properly.  Picture a drain pipe with a screen across the entrance.  When that screen fills up with sticks and garbage, the water has nowhere to go but over the sides.  The same goes for your liver.  

With chronic liver disease, or cirrhosis, backed up blood begins to cause increased blood pressure in the artery and smaller veins that lead to your liver.  A lot of the symptoms of cirrhosis and varices mimic heavy drinking.  Upset stomach, memory loss, who doesn't have these from time to time?  I have to say that my sex drive was the polar opposite of loss of interest in sex, though.  Just sayin'. 
    
A gradual build up of pressure over the years causes the vessel walls to weaken.  The weakened vessels start to balloon, and that can lead to a rupture. This is the varices. A rupture in my esophagus created a hole three inches in diameter.  All of that blood was draining into my stomach and intestines.  All the while, I was still drinking and hauling cases of beer, or just moving around a good bit in general.  That's why everything seemed so sudden.
     
This bleeding has to be dealt with immediately.  All of the blood loss can cause your body to go into shock or death.  This could be from heart failure or damage to the nervous system.  To stop the bleeding, they did something called banding to my esophagus.  It is just what it sounds.  They put rubber bands around around the esophagus. Kind of  like a tourniquet.  This was also to keep any blood from going into my lungs. 

While doing this, they put a ventilation tube up my nose leading toward my lungs so I would have a clear airway.  They also pumped my stomach full of air to try to maintain that airway's clearance.  Meanwhile, the physicians had to empty my intestines of all blood.  That couldn't have been pretty.
      
To compensate for the blood loss, your body starts to use water and electrolytes from tissues and interstitial spaces to increase plasma volume and accelerate the formation and development of blood cells in the bone marrow.  This includes taking blood from less vital parts of the body, such as your extremities or your digestive system.  As usual, your body is doing everything it can to keep the heart and brain alive. 

While this action maintains adequate blood volume, it decreases the viscosity of the blood. Diluted blood flows faster and more turbulently than normal blood and can cause heart problems. While my body was tapping fluid from my organs, it was causing these tissue functions to deteriorate.  Virtually all of the tissues that are considered less important to maintaining life can be used for this.  So, when tissues fail, organs fail.  When organs fail, whole systems begin to fail.
    
 The physicians also gave me three units of blood during this time. At this point, there is a lot of overcompensation going on, and your body becomes more confused.  All these mixed signals are sent to your heart.  Therefore, you have an erratic heartbeat.  All of these issues are compounded when you are simultaneously headed into severe alcohol withdrawal. Confusion and malfunction in your nervous system is another whole list of issues.  Central nervous system.  Kind of important.
     
Alcohol withdrawal syndrome starts within the first 5 to 10 hours after your last drink.. Symptoms worsen after 48 to 72 hours, and can last for weeks. I had already been without alcohol for 48 hours when I was still at home.  By now, I was starting to slip into the Delirium Tremens (or dt's).  Not DWT's, although its been called that by many.  The initial 96 hours, I was unconscious.  Obviously, I don't remember that.  After waking, it became the most bizarre days, weeks, or months.  I'm not exactly sure.
     I'll get into this soon enough.

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