Damn it I am sick again.

Damn it I am sick again. This time It is a GI thing. It is one of those, "if i'd just vomit I'd be OK" things.


So dehydrated. This is the worst I have seen in a long time. I am forcing fluids but am not able to keep them down. I was very near heading to the hospital then I decided to try proctocysis therapy.  It did the trick. 


I woke with a markedly dry mouth, moderate grade nausea and a headache as a pain grade 6.  I knew the dry mouth was more than an effect from the C-PAP.  When I stood, there was the dizziness.  I drank about fifty ccs of water and went back to bed.  The emesis came later when I got up a couple hours later and tried to drink. I knew I was in trouble then. I took my blood sugar. I was twelve hours fasting. I came in at one seventy. Something was wrong. I have not had a significant cold or flu since I started monitoring my BS, so I am not sure how I respond to illnesses. I do not believe I have an infection, a reason that would cause a spike in the BS. There were only two choices left and one could be done at home and on in hospital with IV therapy. Best to try the home option first.


As I was rehydrating, I felt my mood change and the nausea ease. The warm shower felt good also. Afterwards, I was able to take in a steady amount of oral water.   Around three pm I started with the chicken broth.  It has stayed down and has eased everything except, my head is still killing me.  How I hate h/a's. I am up to a 7 now, it was an 8 earlier. I haven't had a 9 in many years, and they have all sent me to the ER as well. Fortunately I stopped having them in my twenties.


But, life is good.  My stomach is back to the low grade nausea I have had on and off for the past couple weeks. I can control the slight dizziness that occurs on standing, by standing slowly. I am going to try some solid foods here in a bit. And, I am reading a good book. I know this is a cheeky excuse for a blog, but I am too tired to write and this will just have to do for today. Besides, I cannot WAIT to see what JaJa has to say about this one. [I am feeling better]




OK, Wait a min..... I am feeling better.  As I was researching for a pic to find I ran across this story in the 

Journal of Indian Association of Pediatric Surgeons

I will publish only the xray here, but provide the link if you wish to see the related photographs.


I publish this not to make fun of anyone.  This is an illness that can have fatal effects.  The child needs, and hopefully received, significant mental health guidance. I am simply fascinated by what the human body can stand and by what we humans try to do with that body.

Sheikh MS, Hilal RM, Misbha AM, Farooq AR. Colorectal lithobezoar: A rare case report. J Indian Assoc Pediatr Surg [serial online] 2010 [cited 2011 Dec 2];15:62-3. Available from: 

http://www.jiaps.com/text.asp?2010/15/2/62/70642

Journal of Indian Association of Pediatric Surgeons Official journal of the Indian Association of Pediatric Surgeons           Users Online:18

Click here to download free Android Application for this and other journals       Click here to view optimized website for mobile devices       Journal is indexed with PubMed   CASE REPORT Year : 2010  |  Volume : 15  |  Issue : 2  |  Page : 62-63   Colorectal lithobezoar: A rare case report Muzamil Shafi Sheikh1, Rizvi Malla Hilal1, Afsheen Malla Misbha2, Ahmed Reshi Farooq3 1 Department of Surgery, Sheri-Kashmir Institute of Medical Sciences, Soura, Srinagar, India 2 Department of General Surgery, SMGS Hospital, Jammu, India 3 Department of General Surgery, SMHS Hospital, Srinagar, India Date of Web Publication 24-Sep-2010 Correspondence Address: Muzamil Shafi Sheikh Nawab Bagh Baghwanpora, Lal Bazar, Srinagar, Kashmir India DOI: 10.4103/0971-9261.70642 PMID: 20975785    Abstract   We report an unusual case of a giant lithobezoar that was extending from the caecum to the anal canal, and the patient had no features of absolute constipation or peritonitis. It is believed to be the first such giant colonic lithobezoar in the literature. Keywords: Colon, lithobezoar, pica, rectum How to cite this article: Sheikh MS, Hilal RM, Misbha AM, Farooq AR. Colorectal lithobezoar: A rare case report. J Indian Assoc Pediatr Surg 2010;15:62-3 How to cite this URL: Sheikh MS, Hilal RM, Misbha AM, Farooq AR. Colorectal lithobezoar: A rare case report. J Indian Assoc Pediatr Surg [serial online] 2010 [cited 2011 Dec 2];15:62-3. Available from: http://www.jiaps.com/text.asp?2010/15/2/62/70642    Introduction   Bezoars are rare foreign bodies in the gastrointestinal tract. The stomach is the most common site. Primary colonic bezoar is an exceptionally rare situation. Colonic lithobezoars are very rare findings in children.    Case Report   A 9-year-old male child was admitted with a 3-year history of pica, recurrent constipation, abdominal pain, failure to thrive and painful defecation. Abdominal examination revealed moderate distention with multiple palpable intraluminal masses along the rectosigmoid, descending colon and the ascending colon up to the illeocaecal region, with no features of peritonitis. Anal inspection revealed stone pellets protruding through the anus. The rectal examination revealed hard, prickly masses filling the dilated rectum. It was impossible to negotiate and pass around the masses occluding the rectum. A plain radiograph of the abdomen showed numerous opaque shadows of different sizes scattered throughout the colon [Figure 1]. Under general anesthesia, following anal dilatation, 1,025 pieces of stones were completely recovered manually, with a diameter ranging between 5 mm to 2.5 cm [Figure 2]. He had uneventful recovery. After evacuation, the patient was given laxatives as well as proctoclysis enema and he used to pass 40-60 pieces of stones a day for 7 days. On the 8 th day, another radiograph of the abdomen revealed no residual stones. Mental health assessment by the pediatric psychiatrist did not reveal any gross abnormality. The patient was subsequently discharged on day 9 and was followed-up for a period of 6 months and was put under strict parental supervision. He had increased appetite and gained weight. Figure 1: Abdominal X-ray at presentation Click here to view    Discussion   Pica is persistent eating of nonnutritive substances for a period of at least 1 month. It is considered normal for children <2-years-old to put anything in their mouth. After this age, eating nonfood items is thought to be abnormal. The cause of pica is unknown, but multifactorial etiology is suggested. Some causes include iron deficiency, psychological factors like poverty, maternal neglect and abuse, lack of parental supervision, disorganized family situation, mental retardation, autism and brain behavior disorders like  Kleine-Levin syndrome More Details.[1],[2],[3] The various nonfood items include amylophagia (laundry starch, corn starch), geophagia (clay, sand and dirt), lithophagia (stones, gravel and pebbles), pagophagia (ice), trichophagia (hair) and coprophagia (feces). [4] Bezoars may be composed of hair (trichobezoars), vegetable matter (phytobezoars), milk curds (lactobezoars), sand bezoar [5] and, very rarely, stones (lithobezoars). Twelve children with primary colonic bezoars were reported in the literature until 2004, of which only three had colonic lithobezoars. [6],[7] Up until 2007, only four colonic lithobezoars had been reported in the literature. [8] All the previously reported cases had lithobezoars confined to the rectosigmoid and descending colon. Clinically, these patients often present with signs and symptoms of bowel obstruction. A palpable abdominal mass is occasionally found. On rectal examination, the presence of the "colonic crunch sign" can increase the suspicion of bezoar obstruction. The colonic crunch sign is defined as the palpation of a prickly mass on digital rectal examination and can be found in sunflower seed bezoar and lithobezoar. [9] Plain abdominal radiograph is especially important in the diagnosis of this kind of colonic intraluminal mass. The scattered radioopaque nature is typical of lithobezoar. This unique appearance on plain abdominal radiograph was called as "corn on the cob." [10] Anal dilatation under general anesthesia also helps in the dislodgement of the mass. [11] We conclude that pica is not as rare as once thought, and can lead to an array of surgical complications if left untreated. These patients can be managed conservatively in the initial stages, but frequently need surgical intervention if complications occur. Finally, these patients should be kept under strict follow-up and psychiatric assessment should not be forgotten. Strict parental supervision is the single most important factor to be considered if the disease incidence is to be decreased.