Not back home yet. . .

The GI bleeding is from an ulcer in Bob's duodenum (new word of the day . . . ), the first part of the small intestines, just beyond the stomach; discovered yesterday, by the GI team, using a scope down into Bob's upper GI tract. Right now, it's presumed to be caused by being on so many blood thinners, which are tough on the stomach, which also causes lots of bleeding, double-whammy . . . he was taking an antacid-type medication, but evidently, not enough . . . the bleeding stopped yesterday, not before losing a considerable amount of blood. Bleeding has stopped and he's on a more effective, potent regiment of antacids and stomach "protectors," (for lack of a better word there), but ended up needing 4-5 units of blood to replace what was lost, still very weak and not allowed to eat anything, which isn't a big deal now, because he's not much of an appetite, anyhow. . .

He'll be at the U at least another few days, as now a new problem has arisen: a partial bowel obstruction. . . his stomach has become quite distended, he's not having bowel movements, nor is he putting out much urine, despite receiving continuous IV fluids. . . Many tests are being done to determine the cause of the obstruction. It could be from the additional narcotics given for the GI scope and other tests (narcotics are notorious for affecting bowel function, causing constipation and sometimes worse; Bob hasn't been on nearly the amount of narcotics he was pre-surgery, so perhaps, as has been proven time and again, he's just so sensitive to the additional narcs and his body is reacting as such); it could be that perhaps the aggressive tumor is now growing and pushing into his organs and causing disruptions. . .

Doc on staff in the ICU ordered an NG tube to relieve the pressure of what "might" be just a minor obstruction; I asked why some kind of scan isn't also done right away, to immediately rule out the possibility that the tumor is growing into the GI or urinary tract. You know, that proactive approach I'm always bitching about . . . That was followed by a dirty look from the doc, who brusquely explained that the NG tube needed to be inserted immediately, to relieve the distention. Just asking . . . Shortly after, we're told Bob will be transferred out of ICU sometime today and have a new team of docs looking after him. . . and even before the NG tube is inserted, another round of tests were ordered—CT scan, ultrasound, x-ray all on his abdomen. I ask his nurse why this was being done. She pulls up Bob's record on the computer and says, "Well, it looks like the doctors want to look more closely at his abdomen and kidneys, to see if they can see anything physical that might be causing the obstruction." hmmmm. . . .

As of this writing, 10:30 p.m. Bob hasn't left the ICU, nor has the NG tube been inserted (his nurse tried manually, but had no luck. I guess I could have told them that, too, that Bob has a history of not doing well with NG tubes, but I didn't give it much thought, and figured Bob would let them know. . . at some point, interventional radiology will have to do it, if it's going to be done at all. . .)

and to think Bob just wanted to "ride it out" at home. . .