Tuesday, March 20, 2012

When Bellyfat is not Bellyfat

This is not a pretty sight. This is an ascitic belly. This photo was taken after my 2nd paracentesis where they removed 2 more liters-you can see where they inserted the drain from the marks.Also the bruising where I am now getting Fragmin injections as an anti-coagulant.

OK I quit smoking in Nov. of 2010 and have gained a few pounds this past year. I tried dieting but the darn weight seemed to have settled right in my middle and wasn't planning on going anywhere soon.
Mind you my stomach wasn't excessively large at this point so I wasn't really worried.
I just increased my exercise to walking laps around the track behind the local high school and making sure I got in my 10,000 steps a day on my nifty little pedometer.

Still my spare tire lingered, giving me that matronly shape we women of a certain age long to avoid and I resorted to spanx and control top panties, thinking this was my lot in life so accept it and move on.

Well Summer moved into Fall and then into Winter and now it was the year 2012 and I received a friendly reminder with my paycheck at work that my annual physical was due so would I please comply and give a copy to staff development for my records.

Now being a nurse one would think that I would be diligent about this but the truth is that I rarely ever go to see a doctor. Why? Who knows-maybe it goes back to the fact that I grew up in a large family in rural Georgia and we were very poor with no health insurance. One just didn't waste money going to a doctor if Mama or some other wise sage in the family had a perfectly fine home remedy that worked as well.

The truth be told it was not uncommon for neighbors to appear at our back door with one ailment or another that they needed my mama to "doctor up" for them. She had a reputation as the one to go to and darn it all-she was quite good at it too!
Anyhow all 10 of us kids managed to grow up in one piece so there you go.

But I digress. Sorry.

Anyhow I called my husbands doctor who I'll refer to as Dr.W.
He is supposed to be my doctor too as his name is listed on my insurance card although I hadn't actually seen him as a patient- entirely my fault-that old "if it ain't broke, you don't fix it" mentality of mine.I always tell my patients that an ounce of prevention is worth a pound of cure so I actually am a pretty good nurse-just a lousy patient-go figure.

I spoke with his assistant Valerie and set up an appointment for an "employment physical" I remember joking with her that it need not be anything fancy (nothing from the waist down ha-ha) Just something to show my workplace that I was fit to continue my duties.
My appointment was scheduled for Mar.14th so I circled it on my calendar and went about my business.

I continued to work the 11-7 shift at the nursing home where I am employed as an LPN.
I work a flexible schedule as a per-Diem staff member picking up shifts here and there as they are available.
I have an elderly special-needs family member at home that my husband and I care for so these hours suit my needs perfectly.

It was around Feb 2012 that I began to notice a lingering fatigue whenever I worked the 11-7 shift. This shift has always been one of the harder ones (at least for me) to adjust to so I always make sure I get plenty of sleep on the days before I am due to go in. As long as I have had plenty of rest I can breeze right through my shift with no problem.

That night Feb 18th I noticed how it felt excessively hot on the unit I was assigned to and I generally felt pretty sluggish and my shift had barely began.
Staffing consisted of myself and 2 cna's with a patient census of around 37.
As I did my first rounds and safety checks I again noticed how hot it seemed and how tired I felt.
I was also very thirsty so I drank lots of water but I also noticed that my abdomen
seemed to be even bigger than usual-bloated in fact.

As the night passed I did my usual routine of various paperwork, answering call lights and passing meds and a few dressing changes.

Now the med cart we use is pretty standard fare for nursing homes. It is a big bulky box with drawers on wheels that the nurse pushes up and down the corridor to each patients' room to dispense the various medications. It weighs roughly 200+ lbs and normally I have no trouble maneuvering it along.

On this night I had to lock it up several times and sit down and rest before continuing-although I wasn't really feeling short of breath, I did feel utterly exhausted and wondered if I might be coming down with something. I checked my temp which was normal and even my 02 sat which also was fine.I also checked my b/p and cbg, they were all good.
Then I decided to step onto the big old industrial scale we use to weigh the patients. It said I weighed 6 more lbs than my scale that I use at home. This got my attention. Either there was a large discrepancy between the two scales or I was retaining fluid somewhere because there was no way I had gained that much weight in one day. Heck I was dieting for pete's sake!

Finally my shift was over, I wrapped up my paperwork and gave report and went home. Before going to bed,  I took some laxative as I couldn't recall when I'd last had a bm and figured that might help with the bloat.
Later that afternoon I woke up and talked to my wonderful husband Dave about my "bellyfat" as I insisted on calling it.

Now Dave is a quiet, laid-back guy but he is very smart and has loads of common sense so he says "Go see Dr. W" and of course I remind him that I have an appointment for next month. I tell him that I will report my symptoms then if they are still bothering me.
Besides I have now convinced myself that I am constipated and drink some prune juice and eat some raw fruits and veggies to hasten things along.

The next day is a Monday Feb.20. I finally have a large bm-hip-hip hooray!
I actually felt better and my bloat seemed to have eased somewhat. I resolve to eat healthier and continue to exercise regularly.
Tues. Feb 21-uneventful
Wednesday Feb.22-Ugh-awoke feeling tired and sluggish and more bloated that ever.
Stepped on the scales and I am up 5 lbs. My abdomen is now grossly distended and feels oddly spongy when I press on it. I have positive bowel sounds and am passing gas. I look 6 months pregnant.
I sleep most of the day and later that evening I tell Dave that I know something is wrong and I finally pick up the phone and call Dr. W's office.
I relay my symptoms to his scheduler and tell her it is not an emergency but I really need to see him before my March appointment. She fits me in for the next morning.

To be continued...

Love, Dixie

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