A Botched Biopsy and the Ultimate Colon Cleanse

TMI Warning

Note: this is my first post on Substack. You can read my previous stuff here.

Okay, friends, let me be upfront about this post: you may not want to read it. To be frank, I don’t want to write it; it’s embarrassing and long. But I find that I sometimes process things through writing, and right now I am processing more things than an Oscar Mayer factory.

Last Wednesday I had a biopsy on my prostate. Some tests this fall had shown it had enlarged, which did not surprise me since I have become a card-carrying member of the Tiny Bladder Club. (We meet on Thursdays; in the men’s room).

Urology of Indiana scheduled a MRI of my abdomen in October. It was inconclusive, so they set me up for the biopsy. I was asleep for this, fortunately, but basically involves sending up some sort of probes and needles up your rectum to remove tissue, which then is sent to a lab to determine if it is benign or . . . not-benign.

And here is the TMI part that you may want to skip.

The discharge papers lived up to their name, since in this case they warned you of actual discharge: blood in your urine or from your rectum. And boy howdy did that happen.

About an hour after getting home I felt a pressure in my bowels, like if I had diarrhea. But what came out was pure blood. And it came out . . . forcefully. The toilet looked like a murder scene in a Quentin Tarantino movie. I had to wipe off blood from the rim of the bowl and underside of the seat. But, hey, at least I felt better now.

For 45 minutes.

Then it happened again.

And again an hour after that.

And again, literally ad nauseum

After around 10 rounds of the ultimate colon cleanse, I finally got the bright idea that maybe this wasn’t the discharge that the discharge papers had in mind. I called the urology office and they told me what I did not want to hear: go to the ER.

I really, really, did not want to do this. I’m a prude about bodily functions, and did not want to to walk in saying, “Ah, yes, I’m bleeding out my bum. Could you kind people please take a look at it?”

But after another 45 minutes or so it became inevitable. I had another battle with the toilet (which I lost), and suddenly felt so terrible that I didn’t care what anyone did to me. I could barely walk.

The people at the JMH ER were very cool. They got me right in and put me on a bed with some monitors hooked up. My vitals looked good, but I noticed my heart rate was MUCH higher than normal. I used to toilet twice and again had to wipe it down afterwards so they next bloke didn’t think some sort of satanic ritual had just gone down.

The ER doctor, Dr. White, came in after that and asked me how many times I had gone to the toilet like this and how much blood I had lost each time. I said about a dozen times, and I guesstimated maybe two to four ounces of blood each time. I actually tried to underestimate, since I didn’t want to be a drama queen.

Dr. White then told the nurse that they had to start collecting the blood. My next toilet wrestling incident showed I had been wrong about the amount: it measured 300 milligrams, or about 10 ounces.

The nurse and the Dr. were both surprised, but, over-achiever that I am, I managed to outdo that. My next episode (about 45 minutes later) yielded 350 milligrams.

And this is when they started getting rather nervous.

I got more IV’s hooked up, and Doctor White told Amy and I that an ambulance would take us to St Francis Hospital, where an Interventional Radiology Team would work on identifying the source of the blood loss, and perhaps insert a metal coil that would somehow stop the bleeding. He said I had likely lost over 2 liters of blood in less than 10 hours. He took away my walking privileges.

And that point we engaged the prayer group at our church to begin praying in earnest that the bleeding would stop. And I asked our elders if one of them would come up to the ER and pray with us. They pretty much all showed up.

I visited with a couple of them and then sent them out so I could bleed into the bedside commode peacefully. Amy went with them so that they could all pray together in the waiting area. It was at this time I had my worst episode. Not in the volume of blood (not sure how much was there) but in my response. Sitting up and transferring to the bedside toilet caused my mind to start going blank (I know, no big change, right?) and my heart began racing. Since I was on a monitor, 3 nurses immediately came in with an EKG machine. I almost passed out, but only ended up vomiting.

Things settled back down after a while, and now my bedside commode privileges were removed. I had to use a bed pan.

But when I did so (about 35 minutes later) the volume of blood was lower: about 150 millimeters. Now this is still about 5 ounces of blood, but it was the first sign that perhaps the amount of blood loss was decreasing.

After another hour the ambulance people came in and I got a nice ride to St. Francis. Since my vitals were stable (and it was now past 1:00 in the morning) they did not call in the Interventional Radiology Team. Instead I got a nice room in the CCU with a lovely view of the hospital’s lower roofs.

This is actually the first time I had been admitted to a hospital since I was a kid. I’ve had skin cancer removed, lymph nodes removed, a spine surgery and a bunch of other stuff done to my body, but no hospitalizations.

However, I have made hundreds of hospital visits in my years as a pastor, and Saint Francis has always impressed me, especially in their nurses.

RN’s are the backbone of the hospital, and the single person who makes or breaks a patient’s experience. Especially in critical care units, they must be able to perform needed tasks professionally while also being able to interact well with various kinds of patients. It is a huge bonus if they can do this while also being fun and engaging, and both the night nurse and the day nurse were great at this. I would normally be incredibly embarrassed at the type of monitoring they had to do, but their chill mannerisms (and the fact that I wasn’t thinking or caring too much about anything at this point) made that a non-issue.

My dear Amy slept (or tried to sleep) in a chair next to my bed. It was comforting having her by my side.

Sometime in that early morning, with the prayers of many people rising up through the darkness, the bleeding stopped. I baptized my last bedpan somewhere around 3 a.m., and it was only about an ounce of blood.

Thank God.

Dr. Salva from Urology of Indiana showed up about 6:30 and said that a vein had likely been nicked during the biopsy, but since the bleeding had stopped their was no point going in and poking around my insides anymore. I was relieved to hear this, since the last thing I wanted was another procedure at this point. He said that as long as the bleeding did not return and if my hemoglobin levels stayed above a certain level then I could go possibly home that afternoon (Thursday). Which is what happened.

My hemoglobin levels run normally around 16 gm; when I left they were at 10.1, which is very low but not life-threatening.

I was given very little information in terms of what to expect after discharge from the hospital. The floor RN gave me two a document with two or three lines about taking it easy and not making any decisions. Seemed like generic instructions they would give to most anyone. No one from Urology of Indiana talked to me at all.

The reason I bring this up is because I have been floored at how bad I have felt since I left the hospital. It is now Tuesday morning, and I still feel incredibly weak and somewhat disoriented. I have a good deal of dizziness, especially when I stand up; but sometimes also when I am just sitting. I can’t drive, of course, and usually have to alternate sitting with laying down.

And I am struggling with some anger that the urology office never checked on me. I expected they would on Friday, but let it go. It would have been nice to have gotten a call over the weekend but I did not expect it, of course. Finally, late yesterday afternoon I contacted them; the nice woman on the phone told me that did not know I had been in the CCU or had experienced that much blood loss. They had a failure of communication somewhere. She told me they could fit me in to see Dr. Rayburn (who performed the biopsy) on December 31st. Three weeks from now. Yes, you read that right.

She also said he would likely give me a call when the results of the biopsy came in. So I got that going for me, which is nice.

I’m feeling pissy about this, to be honest. Which is not my usual attitude. I guess I am just annoyed and starting to get a bit depressed because of how I am feeling.

But, as I have said, I process by writing, and even having putting all this down in pixels makes me feel a little better. And as I do so I also am reminded of all that I am thankful for in the midst of this.

First, I feel so much gratitude for Amy. She is an amazing person; the best person I know. She did not freak out, even when the ER doctor was talking about an immediate procedure to stop the blood loss before I lost consciousness (or worse). But she was there EVERY step of the way, to care for me and to cheer me with her good attitude. She is truly the face and hands of God in my life.

Also, our daughter Sarah hopped right on a plane when she heard the news, and was vital to helping me and cheering me up when Amy had to work. It was obviously inconvenient for her to do so, but it has made a world of difference. Our other daughter Rachel cheered me up in the ER that first night, and will also be helping transport me to some (unrelated) medical visits tomorrow.

Most importantly, this whole incident, and especially the episode where I almost passed out, reminds me that I am not in charge of my life; it is a gift that I should be grateful for. When I was about to pass out what struck me the most was my utter lack of control. I was in pain, which I could not alleviate, and I was losing consciousness, which I could not stop. I was not dying, of course, but this must be what death feels like: pain and loss that you cannot control. And this reminded me of the most important fact about me: I’m not in control. I can’t even control when I live or die. I certainly can’t control lesser forms of pain and loss.

I am a creature; I have been given life from beyond myself. And some day that life will be taken from me.

I believe that this will not be the end; for the One who gave me life is also able to do it again, in a new and better way. That is my hope and belief.

But for now, I have been reminded of my own dependency on God in a very, very deep way. And I will do my best to walk before Him even more in trust and thankfulness.

Update: I had a blood test done yesterday afternoon, and my hemoglobin is at 10.2, so basically the same as when I left the hospital.