I really don’t think I have done justice to just how bad Jacob’s situation was. Partly because I was just so overwhelmed, and partly because I just didn’t want to think about it. Still, in the interest of full disclosure, and so that there is a written record I am going to do it today.
We had an idyllic weekend. On Saturday we went for a walk in Frick Park. We spent 2 hours just walking along the trails, and discussing our plans for the future. Plans for our next cycle were discussed. The plan was to remove my Nuva Ring a week prematurely so that if I wasn’t pregnant that AF wouldn’t be here for our anniversary. Or if I was pregnant, and subsequently miscarried that I wouldn’t have the memory of finding out I was pregnant on our anniversary. So Yes, we would move things forward a week…by Monday we had already had a full weekend, and weren’t really looking forward to ending it by going back to work on Tuesday…but boy did I wish that were the case.
You already know the story of the original ER visit, so I won’t go into that again…
At 2 a.m., or shortly there after on Tuesday I heard Jacob in the bathroom. His coughing and choking was muffled because he had closed the door to our bedroom. As soon as I heard him I jumped out of bed. I couldn’t find my glasses, but I threw open the door and asked “how bad?” He croaked out “Bad” but in all honesty that was an understatement. Bad would have been the amount of vomiting that had occured at his mothers. This however was life threatening, and I knew it as did he. I quickly threw on clothes. I don’t know how, but Jacob had the presence of mind to do the same. He then lay down on his office floor, while I ran down stairs to open the door and turn on the porch light per 911 instructions. Jacob then crawled down the steps and lay instead on the living room floor. I went outside, and answered the remaining questions to the 911 operator. It is then that I realized how frustrating it is living on a township line. “What is your address?” I told him the mailing city of Turtle Creek, to which responded isn’t that Wilkins Twp? Jake at this point has crawled to the front porch because he needs to vomit again. “I don’t care what you consider this just get here, my husband is dying”
I called my mother in law, and told her Jacob was being taken back to the hospital and she said “I am not going to go, but Dan will” I was angry in that moment, but I didn’t care. Jacob was my priority, she would be dealt with later. I then called my dad and let him know what was going on. When Jacob began vomitting again over the side of the porch I called 911 again, but then saw the ambulance rounding the corner. It was then that my MIL called me back and said she was coming after all. The EMS crew pulled into the driveway and immediately began to assess the situation. I blamed myself for this I knew he vomited blood Monday afternoon, and yet I gave him two Excedrin which have Asprin in them. This was my fault, and I wanted them to know it.
The ride in the ambulance was a blur. What I do remember is that his bp had dropped to 97, and that the female ENT said “He’s vomiting again, and its red. I want to go lights” It was then that the male ENT called dispatch and said his ambulance number, enroute to Forbes “We are upgrading to E1, we are going lights ETA 7 minutes” Normally it takes 20-25 minutes with traffic to get there, and about 15 with none. We made it in 1/2 that time. When we got to the hospital, they told me to go to registration and Jacob was taken to Trauma room 20. It was the largest ER room I had ever seen. There was room for 3 nurses, myself, and his parents once they arrived with room to spare. There was even a crash cart on stand by, but I wouldn’t recognize this until later.
When I went back to his room, he was still profusely vomiting. The ER doctor was in the room, two IV lines were being placed, and his history was being repeated again my me. He was shocked to learn that West Penn had not done an endoscope. He then told me that they were calling in Dr. Patell, and that they needed to put an NG tube down Jacob’s throat. He then advised that he would need a transfusion depending on how his blood work came back. Fortunately, or unfortunately when it did it was normal. Counts were normal, hemocrit was normal, everything pointed to a relatively normal blood supply even though he was vomiting, and was en route to loosing 1 liter of blood (or the equivalent of 2 pints). As they placed the NG tube, I watched in abject terror. I was paralyzed by fear both from watching a tube being placed into his nose, and watching him continue to vomit while trying to catch his breath while the tube was going down. At this point I heard my mother in laws voice–I told Jacob “they are here” The nurse told me “you can stay, but they can’t” I find that odd now. Did they think they were going to loose him and didn’t want me far away? I became angry then as the blood bank person continued to attempt to get a postive ID on Jacob even as he is projectile vomiting. I yelled at him, as did the nurse “Its him” but still they made Jacob spell his name, and give his middle initial. It was only then that I joined his mom and dad in the waiting room. His mom reached out and tried to comfort me, but I backed away. I knew if she touched me I would loose it. If she touched me, this was read. If she touched me, I would crumble and I needed to be strong for Jacob.
It seemed like hours passed, but in reality it was only 1 hour between arrival and the placement of the NG tube, and an additional 1/2 hour before Dr. Patel arrived to do his emergency endoscope. They told me that it would take an hour, and that I would need to wait in the waiting room. That hour seemed like days. Every time I head the security door woosh open I would look apprehensively for the doctor. Once it was the nurse who came out and said “he was doing well” but then nothing. Finally after 50 minutes I had them buzz me back again. The proceedure was over, and Jacob was alive.
His BP had gone back, but still was in the low 100’s. He was going to be taken to the ICU. Dr. P said he was very ill, and that we had a 50/50 chance of this healing without additional surgery. The first 48 hours were critical. If the clot that has stopped the bleeding moved within that time, he could begin to bleed again. If he bled again we were looking at a laparotomy. If things got worse the surgeon told me, they would simply remove the stomach. I wanted to stay with him, but since they were taking him to the ICU I couldn’t. Instead I came home and began making the phone calls that needed to be made, but first I had to hose the blood off the porch, and then deal with the bathroom. I tried to lay down, but I couldn’t get the vision of Jacob with a tube in his nose, and vomiting around his NG tube. My legs were paralyzed.
What you need to know about Jacob is that he is a very active, and independent man. So when I saw him in the ICU, and he could barely speak more than a croak at at time, or raise his hand more than a few inches from his bed I knew how bad things were. He had some color, as opposed to being completely colorless just hours before, but we were still not out of the woods…hell, we had barely begun the trail on the way in.
That day my life was marked by hours. “Its been 12 hours since his last bleed” or “its been 16 hours since.” Yet even though we are talking in hours, it seemed like it was days. Every visit to Jacob i could see he gained strength, but he was still far from coming home. I knew that until we hit the “magic number” of 48 that anything could happen…and so began the week that really has changed my life…