Diverticulosis

I unpacked my Zeiss microscope the other day (from my clinic days) brushed it off and oiled it up (or what ever you do to microscopes). I had just added to my collection of tissue sections from my olde pathlab days a few sections from my own large intestine.
But first some background to how I got the section slides of my sigmoid colon and why. Of course the title of this post gives some indication of the 'indication' that lead to 20cm of my intestine seeing the light of day.
H usually brings home from school whatever the kids are coughing up in her presence. I call it the 'flavour of the week'. Unfortunately as H and the primary school kids she teaches are about the same height this can, so to speak, lead them to cough H straight in the face. I get the idea that the parents send their kids to school to get them out of the way even when they have fever!
When the cold or condition is not easily identified from the menu, then it is labelled 'magen-darm-grippe', in other words Gastroenteritis. And that’s what I thought I had at the time, a bout of constipation with cramp like pains.

It’s obvious that it went back further reflecting on it now, with the first signs appearing a month before. It had lasted a few days and I didn’t think anything more about it and didn’t connected it with anything serious but just with stress in general. But more to that later.

In April we were in England to have a break and get probate following the death of my mother. First we stayed a week in the near from Canterbury to visit the couple where H stayed when she was doing a two week crash course in English (see Canterbury: English Lessions). This was a qualification to allow H to teach English to German primary school kids.
The second half of the break we stayed in a hotel in the near of Broxbourne so that following probate, we could finalise selling the house and tie up loose ends.
Although we found someone quite quickly, relation to the woman living next door to mum's house, it took unfortunately about 16 months to finialise the sell (see Home:Paperwork). This delay lead to the house buyers baby arriving before they could move in and not as planned afterwards.
The time lag was due to trying to keep a company up and running here in Germany and kick myself into getting the legal and tax paperwork finished in the UK. Also there was having to tackle the emotional aspect of cleaning things up and not being able to 'pop over' for a couple of hours.
This was also the first time I had to deal with the British legal system and fill out a tax forms for my mother. This was not easy for an 'ex-Brit' not living in the country and having to do it all online. To begin I was in panic mode, but it turned out much simpler that I thought. In comparision, the German tax system is diabolically complicated. It is good to have a tax advisor for the company that can take a look at our private taxes if needed.

This was the last mile stone at the end of a stressful period at work as well as privately. H's parents had died shortly after my mother and we had spent the weekends in the months before driving down to see them. It was a 600 Km (373 Miles) round trip just for a few hours in all weathers. Just no time to relax. And now I was breaking the last ties with my mother and the house where we could stay when visiting the UK.

Of course with this trip I tried to pack all my worse eating habits into the visit by stuffing myself with English breakfast, cottage teas, chish and fips etc. Not a brilliant idea as it turned out.

A few days before leaving for home we were shopping in the Harlow town mall. H knew I wasn't feeling that good, due to a mixture of emotions, as described above, and a general 'unwellness' which I put down at the time to my UK excess eating habits.
As we were passing a small shop for TCM, H saw a sign that they gave a free session of CPD (Chinese Pulse Diagnostic) and so half dragged me into the shop.

It is not that I was against a session as I had practiced Tai Chi for many years and I knew the principles behind chinese medicine, it was just that I wanted to get back to the hotel for a rest.
On entering the shop it was empty until a woman appeared from the back office and greeted us. H asked if we could have a checkup and nodded in my direction. We gave no indication why we wanted the diagnostics but as soon as the woman looked at me a look of concern came over her face and she asked me to sit down. Without saying anything she sat next to me took my wrist and started to take my pulse as shown in the picture. After a while she repeated the proceedure on my other wrist.
When she was finished she said with a concerned voice that I had far too much Yang due to a deficiency in Yin and that I should go immediately to see a doctor. I was a little taken back with how worried she was concerning my health. I thanked her for her time and the results and said I would go to my doctor as soon as I could. She seemed relieved that I took her advice seriously. I didn't mention that we were far from home and wouldn't be back in Germany for another few days.

After returning from England I felt 'better' and pushed the warning I had recieve in Harlow to the back of my mind. I spent a week at home putting my 'Ikea kits' together in the roof, lugging about shelving and screwing tables together. As my gut was still giving me trouble at the end of the week, I had W at work give me the one over.
After I told him that what had 'gone in', hadn’t seen the light of day for over a week, he sent me off pronto for a CT. After having to swallow 600 ml contrast liquid before the CT, everything saw, so to speak, 'daylight' very pronto.

On returning to work I showed W the results. The CT had shown that I had a diverticulosis with a total blockage. I had 'luck in un-luck' that there was no signs of a perforation and the action with the contrast liquid had removed the blockage. If I had left it a little longer the dam would have broke. W immediately rang the local hospital and later that day, after going home to pack a overnight bag, I ended up in hospital.

Two days later on the Sunday before the OP the anaesthetist came to run through the proceedings for the next morning. He sort of mentioned that they would like to use on me a low dose of the standard anesthetic in combination with an epidural anesthesia instead of the standard method for this type of operation.
I couldn’t believe what I was hearing. After working in clinical research for over 30 years, I was being ask, indirectly mind, if I would agree to take part in a clinical trial and one originating in England to boot!
He explained that instead of putting me deep under, which stops peristaltic movement of the bowls, the combination method would not effect peristalsis. For the peridural infusion I would get a tiny infusion needle in the lower spine between L3 and L4 which would keep me out of touch with my body below the midriff. After the Op. the peridural dose would be slowly reduced until normality kicked in after three days. This method would mean a quicker recovery and the peristaltic would say normal throughout the Op.
Not long before the Op. I had, just by chance, seen a program on the box dealing with this method. There were two brothers that had to be “OPed” for the same thing. One got the standard deep sleep method and the other the method offered to me. The latter was up and running five days before the other brother. This was one of the reasons I agreed, the other reason was that they agreed that I would get histological sections of the removed tissue (see top picture).
The Op. went to plan.
It took until the Wednesday after the Op. before I felt and had any control of my lower back and below. I have now some idea of what it is like to be paralysed waist down. I was out and on my way home on the Friday.