Friday, March 1, 2013

Ow, dear God ouch - post-tonsil bleeding emergency

at 2:17 PM
Tuesday night around here was not a pretty siiiiight (/Genie). When you get your tonsils out, they tell you there's about a 3% risk of bleeding about a week post-surgery, if one of your scabs comes off in a weird way or something. For some people the bleeding stops after a gargle with ice water, for others it requires another trip under the knife. I had my tonsils out last week, and am proud to say I'm part of the 3%. The rest of this story isn't really for the soft of stomach.

I woke up around 3 AM for a quick piss. It was one of those late-night zombie walks to the bathroom, the kind you don't even remember happens. As I finished up, I noticed the telltale taste and feel of a trickle of blood down the back of my throat. I thought, fuck me, last thing I need to do is drive to the hospital in the middle of the night. I crossed my fingers in hopes it would die down and got back in bed. With too much blood in my mouth to simply swallow, I turned to the bedside trashcan. A single mouthful blackened that entire heap of tissues - that was about the moment I started to get nervous. I headed back to the bathroom, leaned over the toilet, and watched in distress as my mouth became a running blood faucet. That, of course, was the easy part.

Bleeding from the throat is a piece of cake. A bloody mess, sure, but that's what flushing the toilet is for. It's stopping the bleeding that causes the trouble. Your body, ever helpful, kinda wants to form a blood clot. Now, I say "kinda", because the body is also determined to fight against this. See, when a hunk of coagulated blood starts to form at the back of my tongue, in the exact location where my gag reflex is triggered, I'm gonna have a tendency to gag. As a matter of fact, I can't not gag; my course of action is hardwired, designed to keep my breathing passage clear. So in a horrific situation like Tuesday night, I have two automatic functions battling each other: my blood trying to clot in a lump at the back of my throat, and my throat trying to remain clear of breathing obstructions. The result is an approximately 30-second cycle in which blood spews from my mouth until a clot slowly forms, I choke and gag on the clot until I vomit it forth, I reach back into my throat to drag forth the remaining slimy tendrils of the clot causing me to further gag, and blood begins to spew again. The largest clot I choked out was nearly golf-ball-sized.
In a nutshell, this^
While I was struggling to manage THAT (and struggling not to swallow any more blood than I had to), I also had to get to the bedroom, grab my phone, and call the doctor. They tell you not to call 911 if you have bleeding, but to call the ENT on duty (the E[ar] N[ose] T[throat] is the doc who does tonsillectomies). Of course, they never describe that this is what throat-bleeding entails - I may have been a severe case. I managed to put in a call to the operating service so they could page my doctor, and after about a half hour, he finally got back to me - the operator made some screw up with phone numbers. Aside: massive credit to my ENT, that guy is fantastic. He woke up at 3:30 AM to personally talk me through this, then showed up two hours early at the hospital to fit me in for surgery before his normal full day of surgery began at 9. But I'm jumping ahead.

By the time I had the doc on the phone, the intensity of the bleeding had died down a bit. I was only gagging out clots every two or three minutes. He instructed me to proceed by gargling hydrogen peroxide. If you're lucky, you've never had to put peroxide in your mouth - this is mostly because it's toxic and tastes like pencil lead. I had to pour a full glass of it (mixed with ice water) and gargle through it one mouthful at a time. It turns out that gargling (an activity I already hate with a passion) is even harder when your throat is bearing open wounds and actively bleeding. It also turns out that hydrogen peroxide forms a kind of soapy foam when bubbled, making it completely impossible to avoid tasting, which of course caused further gagging. Between the blood and foam dripping from my lips, I'm sure I was bearing the countenance of one with rabies.

The gargling slowed the bleeding to a manageable level, but I ended up in the ER anyway, where a torturous session of clot suctioning (dragging one of those suction tubes - like the dentist has - across my wounds) thankfully led to sedation, stomach pumping, and emergency cauterization surgery. Again, I can't express enough appreciation to my surgeon for showing up for that, and to my dad too, for coming to pick me up at 5AM to spend his day with me at the hospital.

Today, Friday, I'm feeling back to normal (that is, pre-throat-bleeding normal, which is still post-tonsillectomy normal, which is crappy), so I thought it would be fun to share my nasty little story. Next week is probably gonna be quiet here, because I don't have any posts at the ready - I was expecting to be healthy again. But when I do get back to it, I'll regale you with tales of all the games I've finished while I've been out of work! Check out this list: Sleeping Dogs, SMB3: Warioland, Mutant Mudds, and Darksiders. Hm, I actually thought it was more than that. Oh well, still a lot!

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