My Husband's Still Sick (Long. Wait, huge)

Back in January my husband nearly killed himself due to a long-term addiction and severe overdose of combined Codeine and Ibuprofen. He was addicted to the codeine, but it’s only available OTC when combined with Ibuprofen over here. That’s ostensibly to stop addicts. It doesn’t.

The short story is the ibuprofen ate through the mucosal lining in his stomach and caused an ulcer right on top of a blood vessel. It took 5 units of blood and a week in the ICU to get him back on his feet.

After he left hospital, he spent some time on a maintenance program, taking methadone and trying to stay off the nurofen. He went off the program after a couple of months because there was only one outpatient clinic where he could get his dose before work during the week, and they threatened to cut off his program when he missed a couple of days due to trains being late & his needing to get to work on time.

So since about March he’s been on his own. I’ve been trying to keep an eye on him and keep him off the nurofen, but he’s an adult and I can’t watch him every day. He’s admitted there were a couple of occasions where he started using again, but says to me he was only using a fraction of what he was using before, and no more frequently than once every couple of weeks, whereas before it was every day, up to 36 tablets a day.

In the last couple of months, however. He’s been getting sick again. Not the cramping and vomiting that were hallmarks of the ulcer and bleed last time. Just losing weight, feeling tired and cold, legs swollen, skin dry and flaky, mouth sore and cracked, small injuries (scratches, bruises) not healing properly, sleeping badly. Then in the last 6 weeks, his weight has just plummeted and he has started having gut problems and issues keeping food down again. So about four weeks ago I got him to the doctor.

He saw the doctor at 6pm on a Friday. Had a blood test. At nine am the next morning (saturday) the doctor called us at home and told my husband “You need to come and see me NOW, don’t make an appointment just come in and I’ll see you. I’m sending you to hospital”

It turns out he’s hyper anemic now. The doctor told him his iron count in his blood, which is normally meant to be in the mid-20s IIRC, was 3. But there’s no blood in his vomit or stool, so where’s it all going? So we go to the hospital at lunch time on the Saturday. He gets in to the ER by about 5pm. They do some more bloods and basically say that his kidneys, thyroid and other functions are all fine, he’s just bleeding from somewhere and they don’t know where. His iron and haemoglobin are scary low. So here’s a referral to the Endoscopy clinic, they’ll call you or send you a letter on Monday, your options at this point are a blood transfusion or iron therapy.

The doctor at the time said to us that a blood transfusion would mean a stay in hospital for a minimum of 2 days, so they could watch him for signs of rejection/sickness after the transfusion. And each unit of blood would only really add about 10 to his haem (which was about 70-something), so a 2 unit transfusion would not make him better right away, it would just improve things slightly. So my husband opted to try the iron therapy, and we were on our way back home by about 8 that evening.

So we get home, things go on as normal. He starts taking iron, then starts taking more because the normal therapeutic doses aren’t quite high enough for what he needs. He has an endoscopy and they say that they really can’t see anything apart from a small ulcer that looks like it’s mostly healed. Maybe that’s where all the blood came from over a long time and it’s on its way to getting better now?

Except it’s not. The iron is only just having any effect on his energy levels, he’s still having problems with his lower GI constantly roiling and making noises and cramping any time he’s got food in there, he’s having trouble keeping food down, the edema in his legs is still getting worse and he can’t sleep now because if he tries to lie down at night, the pain comes back. So on Sunday the 28th of September, around lunchtime again, we end up back in the ER. This time we actually got into the ER after only 2 and a half hours in the waiting room, but then there were more blood tests and more waiting. This time the decision was made to do the transfusion. I left him in the ER at about 10pm, just as they were prepping him for his first unit of blood.

Over the next 24 hours he got 2.5 units of blood in total, plus fluids and more blood tests. Haemoglobin levels were up about 35 points on his last visit to the hospital, so the transfusion did something. Just. Monday was mostly blood test and waiting, Tuesday nothing at all happened. Wednesday, another endoscopy.

This time, they said they’ve found a rather substantial ulcer and it’s nowhere near healed. So the gastroenterologist says to us that he’d like my husband to stop the iron treatment, to start taking the biggest PPI (proton pump inhibitor) they can give out and to take anti-spasmodics and antacids as necessary. And then, because my husband was threatening to pull his cannula out and walk, they let him go home with me on Wednesday evening.

So now we’re a week and a half on from that. Husband says for the most part the nexium (the PPI) is stopping most of the pain in his guts. Most of the time. Still can’t eat spicy food. Or acidic food. Or food after a certain time of night. And we’ve had a couple of vomiting instances. And he’s still nearly passing out during the middle of the day at work, he’s so tired. And barely able to eat enough calories in the day to stop him from losing more weight (he’s 6’1" and at one point was nearly 65kg). And the edema in his legs is still so severe he can’t walk up and down stairs properly. And he’s sleeping on the couch all day and all night for most of the weekend. And the house is filthy, dishes are piled up because I’m just too damned worn out to get to them.

Oh, what a horrible thing to have to go through for you both. They say it will be all right in the end, and if it’s not all right, then it’s not the end. Still, that’s not very comforting when things are as scary as they must be for you both right now. My thoughts are with you.

Wow.

Damn, I’m sorry, Sierra Indigo. That last time was very scary, and things just doesn’t seem to be getting any better for you or hubby.

I hope you get some good news soon.

I am so, so sorry for what you are enduring.

i wish i could do more for you than keep you and your hubby in my thoughts and prayers.

i hope y’all turn the corner soon and can see improvement.

:confused: Did they threaten to cut him off and he just chose to stop going? Or did they actually tell him not to come back?

Wow, that sounds absolutely horrible. I am so sorry for your troubles. I’ll keep you both in my thoughts and hope that things improve soonest.

Thanks for all your thoughts and good wishes everyone.

It’s just been feeling recently like he’ll never be well again, and this is just completely shattering our quality of life. We both just want him to be, well, normal again.

It was a combination, really. Basically he missed a couple of days because of the train situation (neither of us drives, so we’re at the mercy of public transport). When he was able to get back in, they drilled him about why he wasn’t there and missed those dosages. Which is fair enough, they’re dealing with addicts after all. And the maintenance treatment isn’t going to work if you go off and get high again. But then they said that if he kept missing the dosages, they would refuse to give him any when he came back, because basically they thought he was going off to get high. He’s addicted to a completely legal substance, and used it to stay feeling “normal” and they were treating him like a heroin junkie. This got his back up but he kept going, until the train was late again another day and he basically just said “Fuck it” rather than going back and arguing with them again about why he missed a day.

I was none too pleased that he stopped, but short of packing him off and involuntarily committing him (which I’m not sure about the laws of over here), I didn’t really have much other options.

Custody and Treatment Orders only apply to the mentally ill and to drug/alcohol abusers who commit a crime while under the influence.

Exactly. So short of giving him my “Disapproving look with understanding that I’ll be here to look after you and love you”, nothing much I could do. Or that I’d want to do. You can lead a horse to water but you can’t make him stay on the maintenance program…

While I can empathise with the frustration of late trains, I can’t help but think that if it was as important as this, I’d take an earlier train just in case. They go every 1/2 hour, after all. You’d make that effort for a job; why not for yourself?

I’m sure it’s hard to deal with being so close to someone who has such a serious problem and isn’t willing to stay with the help he needs. One thing you may want to look into is finding out if there is a support group in your area for the family/friends of opiate addicts. This website looks like a good place to start:
http://www.naranon.com.au/

Good luck to you.

It gets better.

They want us to go to the hospital again because they think he may have a clot in one leg.

Oh, crap. Sorry to hear that, Sierra Indigo. :frowning:

I guess if they give him blood thinners, the ulcer will act up, too?

At this point, we don’t know. We’re waiting for mum to come so she can take us and drop us off at the hospital.

They’ve got his medical history, so they’ll know what not to give him. Hopefully. The ultrasound tech wasn’t sure it was a clot, but they think it is so off we go again.

Oh Ouch, that really sucks. Some thoughts, keep in mind I am not a doctor.

First thought

Is there a possibility that he has been abusing an acetaminophene/codeine combo? That can cause major liver damage and it takes a lot less acetaminophene than one might think.

Second thought

I am torn over whether to post this. I am not a doctor.

But I do know from personal experience that the symptoms your husband is experiencing are consistent with some really serious stuff unrelated to drug abuse. I can’t even bring myself to type the “C” word in this context, but unexplained weight loss, blood clots, edema and fatigue, the feeling cold thing…this is exactly what my SO experienced before he was diagnosed and they are very common symptoms

If you push a thumb into the swollen legs does the skin pop back right away or does a depression remain? If the thumb mark remains the edema is not water based but lymph based…this means the body is not metabolizing proteins properly and it is serious no matter what the cause, it could be liver damage or worse.

Don’t let his drug problems mask the fact that something else could be going on and I wish you the very best outcome.

I have to say this. Are you sure he is off the drugs? He lied about it before, even when he was in the emergency room. I don’t know if you can trust him on this,

Oh honey, I really hate to be the one to say this, but as an addict he will never be “normal” in a sense. When this health scare passes, his crazy brain will assume all is well, and the drug use will creep back in (or roar back in).

Al-Anon or a similar group can be really great in giving you some coping tools. Please contact someone.

I am so sorry. As a clean and sober alcoholic-addict, I know how much hell we put other people through. It’s awful and I wouldn’t wish it on an enemy. :frowning:

I had a patient with a similar presentation. Turns out he was drinking alcohol in large enough amounts to suppress his bone marrow, and his appetite. Weight loss, low iron, low energy.

I’d want to know about his alcohol consumption.

Thanks for support and comments everybody. I know he’s never going to be “normal” in a sense that we’ll always have to be vigilant for the behaviour happening again, but I just want us to get back to a point where he’s not in hospital all the time.

But to address a few concerns…

  1. It turns out that the ER doctors really don’t think it’s a clot, because there’s a record as far back as a few months ago showing swelling beginning in his legs. In their experience clotting causes sudden swelling over a short period. They’ve suggested protein/potassium deficiencies caused by the ulcer bleeding, then by vomiting and anorexia. They’ve given him K to take at home & advice to see his PCP for follow-up.

  2. I don’t know he’s completely off again. I’ve only got his word for it. However, he does work long hours, and I meet him on the train in the afternoon. There’s no pharmacy between his work and the train, to get to one would require him knocking off early or starting work late. And there’s been no change in the money he’s bringing each week. He’s a contractor, so if he regularly was going pharmacy-shopping I’d expect to notice a drop in his income for hours not worked. And possibly threats to fire him, because he’s not working his contracted hours. On weekends I’m with him 24/7, so he’s got no chance to go anywhere there either. It’s not a foolproof method, and he admits that up until he started getting sick again he was using on a non-regular basis, but I do believe him when he says he’s scared enough now that he’s not using, for now.

  3. The swelling in his legs is pitting edema. But in the last 2 months he’s had at least 6 blood tests, all looking at his liver function, kidney function and things like white blood cells etc. The doctors are pretty convinced that the swelling is wholly related to the deficiencies I mentioned above. Everything else in his bloods, apart from a slightly elevated blood acidity, is normal.

  4. He’s never been a big drinker, and at the moment he’s suffering terrible mouth soreness and ulcerations that are bad enough to stop him drinking anything as harsh as a soft drink (soda) let alone booze. Again, he’s really got no time in the day to go and drink, no readily available sources of alcohol, and I meet him straight off the train from work every afternoon and spend every weekend with him all the time.

  5. Acetaminophene + codeine. It’s harder to get that combo over here, the most prevalent one is ibuprofen + codeine. That’s the easiest and most accessible one. But again, with his drug history on file, the blood tests have been very focussed on making sure it’s not his liver or kidneys.

We’re taking him to see his doctor this morning, to hopefully work out a long-term care plan for him, to at least get him back on his feet again. Once that’s taken care of, hopefully we can then work on getting everything “right” so that he doesn’t want to use again. I’m hoping this has been enough of a scare for him (more than the ulcer. That was sort of a one-off, “Shit, if I do this too much this happens” scare. This is a more chronic sort of “Fuck, if I keep this up, at any level, my life’s going to suck hard from here on in” scare) that after this point, he’ll be serious about keeping clean.