Shit Just Got Real

A few months ago, I didn’t feel too swell. I had an achy dull spot right near where my gallbladder used to be. It felt worse after I ate, and it didn’t want to go away with a tums or a heating pad or any of the other things that are supposed to make you feel better. I decided to see my doctor about it.

My doctor wasn’t available, so I scheduled an appointment with the physician’s assistant, and then I did exactly what I shouldn’t have done; I looked up my symptoms online. After a quick consultation with both WebMD and the Mayo clinic website, I decided I might just have a common bile duct blockage. Apparently, even if you don’t have a gallbladder anymore, you can still make gallstones, which then can still block your common bile duct and cause some pretty wicked pain.

Maybe you are lucky enough to have a functional gallbladder and don’t really have a reason to know what gallbladder pain feels like. Take two fingers on your right hand. Try to hook those fingers under your rib cage about two inches down and one inch towards your midline from your right nipple. Really dig those fingers in there. That’s where it hurt. Now imagine someone shoving a golf ball in that spot, just under the ribcage. Bingo.

I had my gallbladder removed about six years ago, and before that, I would have the occasional gallbladder attack. I knew this pain. It felt like my gallbladder, my phantom gallbladder. My online research indicated that if I did have a bile duct blockage, I could have it roto rootered during an endoscopy instead of actual surgery with the cutting open of the body and such. It seemed worth investigating to me, seeing as I was uncomfortable as hell and couldn’t bear to eat any more Tums. Tums are just not good enough to pass for after dinner mints.

I met with the physician’s assistant a few days later, who let me know that while she frowns on online self- diagnosis, I might be onto something. She ordered some bloodwork and sent me on to the next level of medical care, the GI specialist. Of course the GI specialist was very busy, which meant seeing physician’s assistant number two if I wanted to get this weird gallbladder-like pain checked out in the next six months.

By the time I got to my appointment a few days later, I was feeling much better. I had decided in my own head that I probably did have a little duct blockage of some sort, but whatever it was worked itself out, leaving me with only some mild discomfort. I kept the appointment more as a piece of mind thing rather than an urgent situation, and in hindsight, I probably should have cancelled it altogether.

This physician’s assistant didn’t really seem to listen to what I said about my symptoms, instead focusing on the fact that I had an upset stomach for a day or two and some nausea, symptoms that would be typical of any sort of digestive thing including a bile duct blockage or a gallbladder attack. She was more concerned about the nausea and upset stomach than the pain that made me go to the doctor in the first place.

Go back to those fingers under your rib cage. Poke them about a few times a day and see if you don’t feel a bit like throwing up or crapping yourself.

The physician’s assistant decided more bloodwork was in order. And an ultrasound to see if there was anything to see. And then, possibly, if all that was bad news, then we would do the endoscopy. But first, because she wasn’t convinced it was bilious in nature, she wanted me to get a stool sample.

No scarier words exist in the English language.

My first thought was I’m not that sick. You can tell when you are really sick because you are willing to do almost anything to feel better. Well, I wasn’t that far gone. I was feeling better, so much better that shitting in a cup didn’t seem necessary.

She asked me what lab service my insurance covers, and when I told her, she sighed and told me that I would have to stop by one of the lab's locations to get one of their specimen containers because they only like to use their own. I don’t blame them, really. Don’t we all have a preferred place to do our business?

I stopped by the lab on the way home to pick up my stool container and drop off my blood work order. The front desk clerk took a look at the order form from the doctor’s office, including the stool sample request, and asked me if I have ever given one before. I told her no, and she had me sit in the waiting room until she was free to explain the process to me.

After about a fifteen minute wait, which was enough time to start a really good panic attack, she called me into a consultation room in the back. I sat down, and she took out a bag containing five prescription bottle sized vials and a plastic tub with ounces marked on it. Oh, and a plastic spoon.

“You've never done this before?” she asked me.

“No,” I said.

“It’s horrible. I’m not going to lie,” she said. “You start with the collection container.” She held up the plastic tub. “This fits under the toilet seat that you sit on. You go in there.”

“Can I, um, urinate in it too, or will that cause a problem?” I did not want to have this conversation, and yet, clarification was needed.

“That’s fine if a little gets in the container. It shouldn't mess up the results. So you go in here. Do not return this. We do not want it back. Do not bring back this container."

I got the feeling that a lot of people try to give back the collection tub.

She lifted one of the five vials. “This one you should do first. Fill this container to the fill mark.” She indicated a line labeled near the top of the vial. “Do not fill it past that line. This vial has to be frozen. Do you know what happens when you freeze a container that is overfilled?”

It explodes?” I asked.

“Yes. It explodes. You do not want to clean this out of your freezer. The next one has red dye in it.” She lifted up another vial. “This one only needs a tiny scoop added to it. Again, do not overfill it. In fact, do not overfill any of these. This one goes in the refrigerator. See the cap that has a little spoon attached?”

I nodded yes.

“If you use that spoon, you will be filling it up all day. It’s like one of those spoons they used to give you at McDonald’s to stir the coffee. You don’t want to be making tiny little scoops all day, do you?”

No, I did not. I did not want to be making plastic spoon scoops, or thinking about McDonald’s coffee stirrers, or having this conversation.

“The other three you just fill up like normal, to the fill line. They don’t need to be cold. Or fresh. They have formaldehyde in them, so you don’t need to be concerned about a time limit.”

I made a “hot n now” joke, to myself, in my head.

“Also, we don’t need the spoon back. Just the five vials, not overfilled, whenever you’re ready. Do you have any questions?”

I did. I wanted to know if they all needed to be from the same stool, or could they be from more than one bowel movement. I wanted to know if they would be able to tell if I snuck something from the litter box and skipped the step where I shit in a plastic tub and used my plastic spoon to scoop and fill five vials. I wanted to know if they had a special drop box where I didn’t have to make eye contact with another human when I brought it in for testing. I had so many questions.

Instead of asking anything, I just thanked her for her help. Then I went out the car and tossed my hazardous specimen bag with the measured container, the five vials, and the plastic spoon in the back,  behind the yoga mats and the extra grocery sacks and the half empty water bottles, where I would never find it again.

Suddenly, I felt much, much better indeed.