Washington DC, Delaware and Extended Hospitalisation

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Well here we are, very thankful to be sitting on a bus, pulling out of Boston South Station. We were still catching our breath as we sat down on the couple of spare seats, not quite used to dashing madly across from the other end of the station, where we had arrived on the Amtrak train only a handful of minutes before our bus departed. I suppose it's all part of the normal travel experience - of course the train would be an hour late, but although I have been taking a brake from the traveller's lifestyle these last couple of months, the adrenaline of just barely making my connection reminds me that I've still got the bug.

It has definitely been a challenging last couple of months, as travel of course always is, although not quite what you'd normally expect on what was supposed to be a brief visit of America. I had originally planned on spending only two weeks in the country, in Washington DC, Boston and New York, before heading over to Europe and the Tour de France. Nothing, of course, goes to plan...

After touching down in Washington DC, after a rather enjoyable flight from Cartagena, the sun was still up high enough to entice me into a spot of sightseeing before I was scheduled to meet up with my couchsurfing host later that evening. Having flown into Ronald Reagan Airport, I was delighted to be able to walk across the street and catch the metro into town, passing stations named 'Pentagon' and 'Arlington Cemetery'. It truly was great to be here after seeing so much coverage on tv, and I was so curious about what I would find in the home of the brave. I headed straight for Washington Mall, the great long stretch of parkland that connects the White House, the Lincoln Memorial and the Capitol, flanked by various museums, with the Washington Monument spire somewhere in the middle. When I arrived the sun was just setting behind the Washington Monument, a brilliant red glow on an otherwise blue sky. On every spare patch of grass surrounding the monument college kids were playing games of softball, while people jogged or walked around the gravel paths that wound around. With my big backpack on and a broad smile across my face, I scampered around taking photos of the scene before heading down one side of the Reflecting Pool towards the Lincoln Memorial.

Being in South America for so long it was a real shock to go to the Lincoln Memorial. It felt like it had been the longest time since I had seen people wearing so many different bright colours! That was the first thing that I noticed, a real change from the familiar neutral tones. I discovered, as I got closer, that the memorial was swarming with bus loads of kids. I soon found out that they were from all over the place, either on summer school or church trips to the nations's capital for some history lesson. My big backpack commanded attention though, and a group of kids asked where I was from, which led to questions about Australia. My favourite was from one girl from South Carolina, who asked me if we had radios back home.

Not realising how late it was now, I indulged myself in just walking around, taking a couple of more photos whilst half heartedly trying to find the Metro station that would take me to the North-West of DC where my host lived. It was only once I had arrived at the station that I realised that it was quarter to ten, that I was supposed to be meeting my host in 15 minutes and that the automatic ticketing machine would not accept my perfectly fine dollar coin. It was from here that one of those other familiar travelling experiences started - where nothing seems to work out at all. I caught the metro to the station where I had to change trains, before racing to try and find a payphone. I couldn't find a payphone, before realising 5 minutes later that they were hidden behind the metro map. Pity that my host's phone number didn't seem to work. I'll go talk to the station manager and see if she can help poor, shaking, desperate me. Where's my wallet? Relieved, I found it on top of the phone booth where I had left it. Why can't even the station manager ring the phone number with the payphone? My host is going to royally pissed for making her wait. Stress.

I suppose this is where I got to learn a little bit more about the people of America. The lady pulled her own mobile phone out of her pocket and rang Jodi, my host. After letting Jodi, my host, know what was happening and that I'd be late (“Oh, that's fine, I'm half an hour from home too - see you soon!”) the station manager wouldn't accept anything for the call. Exhausted, I went and collapsed against my pack on the platform. Once off the metro, walking down the street following Jodi's directions, a young photographer, on his way home from a shoot, started up a conversation as well. I was a little shocked at the station manager's kindness at the time, but I've been getting more and more used to that type of thing recently. Morevoer, I've found people around here really chatty - people actually talk to strangers without any reason at all!

However, it was from the next day that all my troubles in the USA started. I spent the day between lying on the couch in pain and sitting on the bathroom floor, dangling my head over the toilet bowl. Jodi said that there had been a salmonella problem in DC the previous week, and that she'd been royally ill for a good few days, so I didn't think too much of it. As an author, Jodi worked from home, her current project being a book on American politics. When I wasn't in the bathroom throwing up saltines (salt crackers that are supposed to be the age old remedy for all stomach related bothers) I talked to her about Australian politics and the benefits of compulsory voting, which are rather numerous. Jodi really was lovely to me, helping me out where she could, offering to take me to the doctor before she lent me her keys before leaving for a couple of days to visit her parents. I took long shower/baths a couple of times a day which helped ease the pain a bit, and then slept through what I could of the day, forcing myself out of the apartment once a day to the convenience store across the road where I'd buy the ginger ale that was also supposed to help my stomach.

I had organied a week or so prior to meet up with my long lost relative, Malcolm - the brother of Ian who had put up with me in Calgary for a couple of months. Malcolm lived in country Delaware, a bit of a drive from DC, but still came and picked me up on the Saturday after I had been ill for four days. I think I had perhaps mentioned to him on the phone that I had been feeling a little crook, but he seemed surprised as I opened the door to the apartment complex for him. “Malcolm???” I asked, not knowing what this bloke was supposed to look like. “You look like dog shit” came the immediate response as he looked at me, bent over double and supporting my weight against the door. He took me back to his place in Delaware after a scenic tour of DC, the internet directions he had printed providing little help. As soon as we got back to his place I made a bee line for bed, staying there until the next morning. Malcolm had suggested that I go see a doctor, which, after four days of being ill, was an attractive concept. He took me to the local GP, who gave me a bag of fluids before giving me the all clear, saying that I was just dehydrated. I was about to head back home when the fever started, and I realised that perhaps I should go to the hospital instead.

The drive to the hospital was pretty scenic, with the green countryside full of crops and horse studs, the winding road tracing its way through bits of forest before popping out into another stretch of quaint, painted wooden fences. Malcolm took me to Elkton's Union Hospital, across the border in Maryland, where his wife, Terry, has been before . The wait in emergency was pretty quick compared with the old Woden Valley Hospital, and before I knew I was getting another bag of juice and being told to drink two big glasses of foul tasting contrast for the CT scan. It was only late in the afternoon that they told me that I had a ruptured apendix, that I was being taken upstairs, and that I'd be going into surgery in an hour or two. I was pretty cheerful that there was actually something half decent wrong with me, not liking the idea that I had put Malcolm to all this trouble for a stomach bug. Although Malcolm revelled in taking photos of me in the emergency room, he was realy worried about how everyone back home would take the news, and certainly didn't want to share the photos. Beneath his smiling, joking, ball busting exterior he was pretty stressed on the inside - not fair considering it was his birthday.

I can't remember if they had given me painkillers or some other drugs, but I was making jokes and feeling good as they rushed me to surgery, after preparing the emergency surgery team. I signed all the pieces of paper for them, before they moved me onto the surgery bench. The next thing I knew I was back in my private hospital room with a tube down one nostril and pain in my stomach. They gave me some pain medication, and soon I was out of it like a light. I quite enjoyed it really, because you could feel the meds, injected intravenously, immediately - a great surge of pain across the entire width of my stomach, paralysing me for a few minutes, before it sunk back towards my spain, leaving me asleep and in no pain at all. I spent most of my first week like this, asking for my pain medication every two hours as I was allowed, staring into space and thinking for hours in my dark, silent room when I wasn't sleeping. I really quite enjoyed this time, it was lovely to have a break from all the go go stress of travelling for a while, and it was so nice to actually have some time to think. After a couple of days they removed my nose tube, which was connected to a vacuum that sucked bile out of my stomach. I started to eat a little bit and my other systems slowly returned to normal. I had been in hospital for eight days by the time Malcolm picked me up and returned me to his place. He had visited me regularly when I was in hospital - but I wasn't much fun, so I was looking forward to perking up now that I was back with him.

The first few days that I was out of hospital went well. I was eating more and more, and feeling stronger. Although I spent most of my time on the couch watching kitchen and backyard renovations on the DIY channel, I was getting stronger. However, come Thursday I was starting to feel a bit weaker, after leaving hospital on the Monday. Friday was the Fourth of July, American Independence Day, a day off work and of get togethers with friends. I had a good afternoon down the road at Harold's place - they had a bushell of Maryland crabs (famous) which they had boiled up in a special crab pot. A designated table had been set up well away from the main crowd, covered in newspaper, for people to eat the crabs, the shells and bits and pieces built into small mountains on the table. I shied away from trying them, not feeling quite wild about pulling crabs limb from limb, exoskeleton from exoskeleton. We sat around for a good few hours, chatting with Malcolm's friends and other partygoers - though I knew something was wrong with me, a pain deep in my abdomen making it really painful to sit or stand after a while. Malcolm tried to persuade me into letting him take me the 5 minutes back home, but it was only when the rain started bucketing down later that I decided to take him up on his offer and leave the party, which I was really enjoying.

I can't remember if it was the next day or the one after that I asked Malcolm, who had some time off work, every so politely to take me to hospital. This became a bit of a joke between us - he found it hillarious that I would ask him to please take me, when he said that he was more used to a “fucking take me to hospital NOW, bitch!”. Back at Union Hospital in Elkton they did another CT scan on me, discovering that I had developed an abcess deep down in my abdomen. This time though, they didn't act straight away, putting me on painkillers for a day or two before the operation took place. I must say that it was the most painful, unpleasant thing that I've ever had happen to me. I had to lay face down on the CT scan table, so they could take images every so often, my underwear pulled down to expose my left cheek and with a nose tube sucking out my stomach contents. The worst part was how long it took. First was the local anaesthetic needle, through the flesh of my butt, and second came the drainage tube. They couldn't just put one in and be done with it, instead they had to start with a small one, and then expand the hole with a bigger tube, and then a larger one, over and over. To make it more pleasant, the local anaesthetic was wearing off and the doctor didn't want to give me any pain meds. Finally one of the nurses persuaded him to give me some, but the relief the hydromorphone gave sent me into an uncontrollably shaking mess. At the end of the ordeal, which must have lasted perhaps an hour and a half, I went back to my room absolutely exhausted, on my back, immobile with my left leg raised on pillows.

It was once Mum heard of the second admission to hospital that she got more concerned. When I was first admitted to hospital, on a Sunday, with my appendicitis she was in Brisbane. Messages from Malcolm about how I was going where getting passed through Ian in Calgary, which finally made their way back home. The communication line was so long that she and everyone else didn't really know what was going on. It was a long time until Dad discovered that my appendix had been burst for four days before I was admitted to hospital. I passed the message along that I was fine, but being so far away there was still much uncertainty, and after a couple of phone chats with Mum, she decided to come over to help me out.

It was really great to see her after being away for seven months - she poked her head through the door and it all seemed like normal, as if I was back at home. She slept on the couch in my room for days, chatting with me and taking care of me during the day. I was more than happy that she had come over, she made a much greater difference than I had expected. The drainage tube for my abcess ended in a small bag which was tied to my leg, where the chocolate milk type substance accumulated. After being in hospital for 9 days I was frequently doing laps of the ward, trying to build up my strength. I'd of course take Mum along for the ride, probably boring her as we went around and around - the challenge sweeter for me.

I was eventually discharged after quite a long time, but instead of going back to Malcolm's house Mum and I went to the Hampton Inn, just a few minutes drive from the hospital. We had to stay in Maryland because I needed to receive intravenous antibiotics for another 2 weeks after I was discharged, under the supervision of a home care nurse, which for some reason are hard to find in Delaware. The insurance paid for the hotel, which was easily the nicest place that I had stayed in for a very long time. We each had our own room, complete with bathroom and two very comfortable queen sized beds. I needed to take the antibiotics every 8 hours, so at 2pm, 10pm and 6am I jumped into the second bed in Mum's room while she connected me up to the drugs. It was important stuff, and Mum hadn't quite done anything like it before - so we were very careful to swab each bit with alcohol and do it exactly as the home care nurse had shown us.

Because we had to be at the hotel for the antibiotic infusions every 8 hours, our days were a little split up. We managed to get out a couple of times, once going to the C&D Canal, which connects the Chesapeake and Delaware Bays, and Chesapeake City, a small town on the canal. Another day Mum took me into the centre of Elkton for a car show, the streets lined with vintage cars that dedicated people had done up. These little outings got shorter lived though as the days went by, the last one being an exhausting trip to the pharmacy and back which left me rooted. Eventually I went back to emergency - not only was my picc line blocked, meaning I couldn't get my antibiotics, but I was also in more pain than when I had left hospital, leaving me bent forward at an acute angle to protect my stomach.

They let me back into hospital, putting me on the painkillers again. I was also now eating alright, supplementing my hospital menu with food that Mum brought me in from McDonalds and from the cafeteria in the basement of the hospital. The doctors weren't quite sure what was wrong with me, and I ended up spending about a week being tested. I did a number of CT scans and X-Rays, but nothing showed up. After about a week they just sent us away, suggesting that the pain that I'd been experiencing in my right hand side for the past couple of weeks was caused by adhesions between my bowels - something that they didn't want to operate on. So back to the hotel we went, though the next morning after breakfast I collapsed in bed, pain across the width of my stomach and my back aching, nausea not making it any more comfortable. Although we had been out of hospital for less than 24 hours, I convinced Mum to take me back.

By this stage all the nurses in the emergency room recognised me, and when I came hobbling in, blankets around my shoulders to keep me warm, holding a bin to throw up into I recognised them and their sympathetic looks all too well, making me feel like a hospital regular. After I finally got some medication to ease the pain I had another CT scan done, which didn't show anything abnormal. Both Mum and I were feeling frustrated - we had just spent a week in hospital, doing test after test, but with no results or action taken. Back here we were in hospital, but what were they going to do differently? How was I supposed to get better? Perhaps if we had come in on a weekday I would have been admitted back to the same hospital, but thankfully the doctor on weekend duty, Dr Lowe, knew what I needed. She arranged for me to be sent to the University of Maryland Medical Centre in Baltimore, a teaching university where she felt that I'd get people with a fresh perspective looking at me. I was very grateful to Dr Lowe for doing this, who brought it up before Mum or I had mentioned our frustrations with the Union Hospital - she knew I wouldn't get better there. That afternoon was a bit of a blur for me, as I had had some phenergen to help with the nausea - though I found out later that Malcolm and Mum rushed to the hotel, packing everything up, before getting back just in time for Mum to catch the ambulance with me to Baltimore. Malcolm drove with all our stuff, and after an hour and a half on the road we were there.

Again, I had my own private room, which was nice, though not quite as comfortable as the ones at Union. It was a little bit too big for my liking, and the out of control air conditioning vent right over the top of me led Mum to campaign for a new room. The most surprising thing though was when the surgeon came in, flanked by about 6 other doctors. Dr Johnson was the professor of surgery, and these others were his students - though it was kind of strange to be surrounded by people in scrubs all looking at me. Right from my admission, on a Sunday, he said that the plan was that tests would be carried out to see what was wrong with me, and that if they were inconclusive he'd be going into surgery on the Friday for a laproscopic examination. So for a few days I did all the tests I could - CT scans and X-Rays and blood tests and infectious diseases tests and all the rest. The only results that came back were from the blood tests which showed that I was malnourished, so they started pumping nutrition into me, a bag of yellow liquid full of dextrose, amino acids, electrolytes and vitamins, and a bag of white fat which I got at night. I was still taking painkillers regularly, though with the bags of nutrition my energy levels improved substantially, and I was up to walking around and around the ward. Eight laps of the huge ward equalled a mile, and I did my best to do as many as I could each day.

Friday came quicker than expected, with the final decision to operate coming that morning. Mum had arrived extra early that morning, expecting me to be taken down to surgery in the wee hours, though it was perhaps 10am by the time that they took me downstairs to the surgery floor. Poor mum waited in the atrium, with all the other families of surgical patients, while I was taken into theatre. To give you a sense of how big the UMMC is, it has 28 operating theatres - which is quite a few. I was expecting to just have a laproscopy done, where a couple of tiny incisions are made to place a camera into - like I had done for my appendix. I knew immediately when I came round in recovery though, that they had done much more. I was in a lot of pain, my whole stomach keenly sensitive to every touch or movement. I kept on asking the nurse for pain killers, but the morphine that he gave me didn't give any relief. Eventually they hooked me up to a pain pump, a machine that gives out pain meds when you press the button - which finally allowed me to rest. I was glad to see Mum when she came into the recovery room, and she told me about how I now had a mid line incision down the centre of my stomach, and that Dr Johnson had removed two feet of intestine. No wonder I felt like shit.

I recovered from the surgery surprisingly fast though, with the help of the pain pump and the continued nutritional bags. For the first few days I would yelp if anyone touched the blankets near my stomach, an involuntary action, though I still managed to get out of bed the day after surgery and sit in the reclining chair. The next day after that I worked up to going for a walk around the ward, though I was near constantly pressing my pain pump button. In 3 or 4 days I was up to walking around the ward the eight times it took to complete the mile, Mum faithfully at my side as I shuffled along. I still wasn't eating, but I felt good with the pain pump and the nutition bags giving me all the energy I needed, so it was a bit of a surprise one night when the nurse disconnected everything all at once. I was shocked! Here I was, without an appetite whatsoever, and they expected that if they just took all that was sustaining me away that I would just start eating? It seemed like a ridiculous idea, and the next day I felt it. One lap of the ward and I was exhausted, the eight I did the previous day would have taken superhuman effort. We talked to the doctors, we talked to the nurses, but nothing changed. However, after a day or two I started eating more and more without getting nauseous, and I started to build up my activity level, though I still got exhausted very rapidly. So 9 days after surgery they took the staples out of my stomach and I was set free, Malcolm again coming to the rescue, taking us back to his place in exchange for a meaty subway sandwich.

It felt so good to be out of hospital. Now that I've been out of hospital for a bit over a week I've mostly forgotten how down I was getting when I was in, and the elation I felt when we arrived at Malcolm's. I'd spent two full weeks at the UMMC, in the same room, with the same nurses, with the same beige corridors greeting me when I left my beige room. It was only after I left that I realised how much it had gotten to me - although Mum cheered me up considerably, providing 12 good hours of entertainment each day, I was getting depressed there in that hospital. Late at night I'd often shed a couple of tears for myself, unsure about what was going to happen with the rest of my dream trip, tears for what should have been. I was so very grateful to get my daily phonecall from Beth - talking to her made the recovery seem not only manageable but inevitable. Her familiar voice making it clear in my mind that it'd all work out alright. Malcolm's house, in the country, flanked by soybean crops on one side and his huge pond on the the other was indeed a world away from the hospital - I remember telling Beth on the phone that night how happy I was to be out. I was actually smiling for the first time in a while.

The other interesting thing that I experienced each time I left hospital was withdrawal from the pain medication. By the end of my last admission I'd been on and off the hydromorphone for about eight weeks - and every time I left I'd reminicse about my time with the narcotic. As a habit forming substance, you're not really supposed to enjoy the pain medicine that I was given - but I'd miss the way it felt when the nurse would push the syringe, the pain building across my stomach and the way the pain sunk away. For quite a bit of my time in hospital I had been what the nurses call a clock watcher, someone who stares at the digital clock on the wall, counting down the seconds until they could get another dose of meds. During my second and third admissions, and after my surgery in Baltimore, I was given the pain pump machine, where I could press the button and have a quantity of meds delivered as often as the doctor prescribed. However, by the time I was left out of hospital for the final time I was so used to the meds that they didn't have the same effect on me - instead I developed a reaction to them, feeling nauseous everytime I pushed my little button.

It was only once I had got back to Malcolm's that I really got into the swing of my recovery. Although I spent most of my week there on the couch, I'd get up to go for walks around the magnificent pond which frames one side of his house, or down to the mailbox at the end of his winding gravel driveway. I'd been given elastic exercise bands at the UMMC, and I'd lie on the loungeroom floor, watching the olympics while trying to give my limp muscles a bit of workout. I was taking an appetite stimulant, which helped me acccept all the food that Mum was putting in front of me. I'd only finish breakfast until we were onto morning tea, brunch and then lunch following soon after. My diet consisted of everything that we're normally told not to eat, the quantities mutliplied by a factor of four. I didn't mind having thickly spread butter on my bread as I figured having some cholesterol was better than having none.

Up to this point all I had seen of the USA in two months was 2 hours of Washington DC, some highways, Malcolm's house and two hospitals - a point of considerable frustration. As the surgeon dictated that I wasn't to take a long haul flight for four weeks post discharge, my head was filled with options as to what do with this time. The original plan for my trip, before I got ill, was to spend some time up in Maine with Nancy and Sandy, who I'd also met up with in Antofagasta, Chile. I was still really keen to see them and see part of the North-East, Sandy's promise to take me to Nova Scotia on a ferry sealing the deal in my mind. I badgered Mum about it - although staying with Malcolm and Terry in the country was peaceful and relaxing, we only got to see each of them for a few hours each day, while I also got bored of being in the middle of nowhere with nothing much to do - apart from the yardwork that Malcolm frequently reminded me of.

After she could see that my condition had improved, and that I'd survived going to a game of Minor League Baseball in Wilmington, with Ashlee, Terry's niece, she was a bit more open to the idea. We got Malcolm to give us a lift to the Amtrak station in Wilmington from where we caught the train North, the majority of our belongings still back at Malcolm's. I enjoyed the train ride, getting my cheap thrills from the second Harry Potter and the beautiful countryside that whizzed past the window. As I said earlier, we only just made it to our bus to Bangor after racing around the station. Four and a half hours later we arrived in Bangor, where Sandy and Nancy picked us up for the drive back to Bucksport, stopping on the way to get some food after 14 hours on the road. That was yesterday, with this morning spent walking down the main street of this little town and sitting on a park bench overlooking the magnificent river; the civil war era Fort Knox on the opposite bank surrounded by green forests, people washing their pleasure boats in the mariner, the grand bridge that crosses the river downstream. The plan is to spend about a week here with Sandy and Nancy before heading south, possibly seeing a bit of Boston or New York, have another week at Malcolm's place and then fly back to Australia.

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Photos

Washington Monument
College students playing softball covered the grasy area surrounding the monument.

Woodrow Wilson Plaza
It just took me back to the days of Year 11 History.

Office Buildings
The office buildings surrounding the Washington Mall are very grand.

Doctor's Room
After my days of sickness in DC, Malcolm took me here to this Doctor's practice.

Union Hospital
Emergency Ward - Malcolm then took me to Elkton, and the Union Hospital.

Second Admission
After 2 weeks of hospital stay, after getting my abcess removed.

Mum and I
Notice my puss bag on my left knee.

Dr Nguyen
Checking out my lungs.

Elkton Carshow
The centre of Elkton was filled with old cars - but this one seemed pretty fun too.

Elkton Car Show
Mum doing some coordinating.

Chilling Out
On the porch of Cracker Barrel, the country style store and restaurant in one!

Ambulance!
My first ride in the back of an ambulance. Unfortunately they didn't put the sirens and lights on - surely thats part of the deal.

Baltimore
On the road...

My dinner and I
Those bags above my head were all I was eating. A bag of yellow nutrients and a white bag of fat, injected into my blood. Yummo.

Hospital Building
University of Maryland Medical Centre

UMMC
Inside the hospital is this huge open space, with different buildings and wards on each sides.

"After"
After the final surgery.

Meditating
Mum took me for wheelchair rides outside, where I'd sit and think about the world for a little while.

Malcolm's House
It's the nicest one on the street, surrounded on the right hand side by a huge man made pond.

Malcolm's Pond
He goes canoeing in here, while all his relatives come over and fish. He absolutely loves it - even going for a swim once after trying to bounce on the back of the canoe drunk.

Maccas!
It had been too long, so I had to give the dollar menu a second go.

Baseball
National anthem time! I don't understand it really...

Malcolm
On his front porch, watching out over his patch of the world.

Mum and Crabs
She loved it!

Comments

[Emily]

More text!
How are you feeling there, Mark? you look way too skinny in your photographs but hopefully you're back on solids and greasy macca's chips. Write again ...

[Peta]

Ow!
You look completely off your face in a fair amount of those photos - morphine is nice, yes? The hospital is incredible, and I very much enjoyed those half-nude photos. Lightened up my day. How you doing now?

[Penny]

so skinneh! and that grin is getting more and more fixed and scary the most hospital trips there are. feel better.