case study short bowel syndrome?!

THE ONSET:
It was 31st of December, 2009. We started an hour early from office fearing the dreaded year-end *** week-end traffic in New delhi. Midway to my parents' place, about 2 hours later, a slight pain started in my lower back just above the hip. We reached home, the pain stayed. Through the next 4-5 hours, I tried walking, every posture resting on bed, anything and everything possible. The pain still stayed. Worse, it got more intense and sharper.

It was nearing the new year and the emergency staff in the nearest hospital injected me with a pain-killer. Relief was immediate.

THE DIAGNOSIS:
The next day pain started again - same time - same place. It followed the same graph of time v/s intensity as the day before. My folks got serious this time. We were back in hospital and I was administered the same pain-killer as yesterday but this time I got admitted for further check-ups. The effect of the pain killer didn't last long and soon I was writhing with pain once again. The intensity kept on increasing to the point when it became in-tolerable. I asked the emergency staff to give me a stronger dose of pain-killer. I was clutching my waist with both hands. I was shouting. I was abusing. Just mere remembering that moment still sends a chill down my spine. Only I know how long that night was...

I passed out. My BP started dropping. The doctors became panicky and explained to my dad that 'exploratory surgery' was their only option now and that my situation is critical with slim chances of survival.

THE SURGERY:
Doctors found the entire length of my 20 ft long - small intestine black and blue and dead. They cut the dead intestine and joined the remaining 20 cm of intestine at the beginning to the start of the long intestine. What actually happened was that the blood vessel that supplied blood to the intestine developed a clot and the intestine choked for the want of fresh blood. Scientifically, the condition is called Short Bowel Syndrome caused due to superior mesentric vein thrombosis. How it happened is still a mystery.

I suffered from frequent bouts of stomach cramps, lots of stomach gas, frequent diarrea, extreme thirst, loss of appetite and extreme loss of weight(more than 1/3rd of my body weight was lost). I was administered intravenous TPN.

My body weight kept reducing as my body was unable to absorb sufficient calories from daily food and it 'fed' on the stored fat that had accumulated over the years. Soon at a mere 43 Kg, we realized that I cannot continue in this fashion and something had to be done to arrest the rapid loss of weight. The only solution was to fit a catheter in my centeral venous system so that the viscous TPN can be administered through it to maintain my body weight.
I felt more & more energetic and was ready to re-join office again. The plan was to administer TPN daily after office hours and remove it in the morning.


THE INFECTION:
The plan worked for a mere 4 days. On the 5th day, I developed cold and flu and decided to skip office for the day and recover over the weekend. When we started a new bag of TPN that evening, within 20 mins I began shivering. I was shivering so hard that it woke up my wife besides me. We checked the temperature and it was 107 degrees F. All of us were frightened and I collapsed and passed out on my way to the washroom.This meant that the catheter device had caught a bacterial infection and the best way to tackle the problem was to remove it. Removed it was.

The SECOND INNINGS:
Exactly a year after the initial surgery, on the 1st of January, 2011, a new catheter device was fitted again. A month later I re-re-re-joined office. Two months have elapsed since then, I have been able to perform routine tasks in office and home - walk, talk, eat out at times, drive and just about everything.

Now I have restricted the use of TPN to week-ends(friday evening to monday morning) - taking in a total of 5 Litres of TPN in a week. Secondly, a lot of extra care is taken not to infect the site - handwashes, gloves, sterile instruments, masks, etc.

And then, for sure, I will do things that I have so ignored when I was well and that I so longed to do in the past year - the simple joys of life, spending quality time with family - my wife - my parents, visiting places, trying out new things, meeting people...
There is one thing that I would NOT be a part of ever again - the maddening rat race.

IF ANY OF YOU WISH TO COMMUNICATE WITH ME PLS WRITE AT itshimanshu_singh@yahoo.com

My life- I am myself a SBS patient!