Irritable Bariatric Bipolar Bowel Suicide Syndrome
Posted Sep 10, 2014
Think of Ibis, the sacred bird that wades the life-sustaining waters of the Nile. Its long beak penetrates the surface for sustenance. Think of the Egyptian god, Thoth, whose human body carried the head of the Ibis. Thoth was the author of all knowledge. Say “ai”, elongate the consonants “b,” and exhale like you just survived a close call. You are invoking self-knowledge.
Pain makes a person irritable. Irritable people get angry. Anger leads in two directions: determined energy or depleted hope. The hopeless direction descends into depression. Depression morphs into suicidal ideation. Suicide results in a cessation of pain. The path is circular. The syndrome can lead to a fatal closure unless resisted by taking another way; the ibis headed Thoth way of knowledge, because suicide is a short-term solution to a long-term concern.
Near constant pain plagued me for two months. I became very irritable. I was angry all the time. I followed the anger-driven path of hopelessness that culminated in a night where I came closer to killing myself than I have at any time in the past 50 years. In 1965, when I was a junior in college, failing all my courses, becoming increasingly isolated, and seeing myself as a miserable failure, I ingested a bottle of whiskey and 150 aspirin tablets. When the buzzing in my ears and disorientation began, I called out for help and ended up in the hospital medical ward. After a night of terror listening to a man cough, wheeze, and rattle his way to death, I decided I wanted to survive.
For 50 more years so far I have survived, but not without suicidal thoughts because as I found out many years later -- more than a third of a century later -- I am bipolar. I can get extremely depressed and the suicidal ideation begins. After an auto accident where I was whiplashed from behind on the freeway by a distracted motorist my circuit began through pain, irritation, anger to suicidal ideation. The escalating agony was two-fold. My neck, although not broken, was severely traumatized. Turning my head caused excruciating bolts of pain along the spine and into the skull. Along with these agonizing twinges, my small intestine and colon started to ache horribly. Eating anything had me doubled over in unbearable discomfort.
My primary doctor sent me to a gastroenterologist. Several weeks passed before I could get an appointment. The doctor ordered blood tests, which took another week or more to do and to get the second appointment to receive the results. The doctor said my blood tests showed no problems. An ultrasound test would be needed to see what else the problem might be. Again it took more time to have the test and have a third appointment to learn the results. As each day passed I was getting more and more depressed. The results of the ultrasound also found nothing wrong. The doctor said an upper endoscopy was needed to see what my guts looked like. I foresaw that this test and re-appointment would take more weeks while my pain, irritation, and anger grew more intense. I descended into hopelessness. I started to think seriously about killing myself.
Another upper endoscopy would be the third in less than a year. None of previous two showed any major problems. Redoing the test made no sense to me. Why was it taking so long and how could they find out what was troubling me by reiterating the same tests done before? I was very angry with the medical establishment that operates by the method of exclusion. By subjecting a patient to batteries of successive tests, the doctor eliminates all the possibilities or finds the cause. If the doctor concludes there is nothing amiss, the problem must be something else outside his or her particular slice of expertise, the patient will be forwarded to the next type of medical expert, who will require his or her own kind of tests. I couldn’t see the point of more expensive and inconclusive tests. I had nowhere to turn for relief. I wanted an end to constant misery. Suicide seemed the only answer.
One night I wrote in my journal that I could not go on. All I could think about was ramming an ice pick into my heart. I wondered if I could survive the night. Ruminating very late in this night of desiring death, a thought came to me that the doctors hadn’t a clue what is wrong with me. Another doctor I respect highly said exclusionists are good at treating problems that are potentially fatal. If you have heart disease, they can find and treat the cause. Exclusionists are not so good at treating conditions that aren’t fatal. My condition didn’t seem organically fatal, but it was fast approaching psychologically fatal. I had to find another path if I wanted to survive.
As exclusionist practitioners, gastroenterologists, urologists, cardiologist, and other medical specialists do not think as a general rule holistically. Their concern is one small, granted important, part of the human anatomy. They don’t treat a condition as if influenced by other factors, like the brain. I intuitively sensed there was something else afoot, and the G.I. doctors could not help me. I speculated I had to heal myself. I needed to become my own Thoth with the head of an ibis plunging my beak into the river of information to find answers. I began with my own record of information.
I keep daily dairies each year. Perhaps I could find a clue in reviewing these dairies of what or when this problem first started to appear. Discovering that similar stomach pains occurred in November of the previous year starting on Thanksgiving one month after bariatric surgery to lose weight, improve my breathing, and evade diabetes, was a revelation. Because of the increasing abdominal pain, I could eat or drink very little. Even water made me miserable. The episode culminated with admission to the hospital for dehydration, and "a million dollars worth of tests" (my words) including an ultrasound test and an upper endoscopy. These tests and procedures showed absolutely nothing wrong with my body.
Rehydrated and released from the hospital, I was enraged at the doctors who couldn’t resolve the problem, but there was nothing to do. After a time, the pain went away, and I could eat again. Five months passed almost pain free. In early July intermittent stomachaches reoccurred and diarrhea began. I went to my primary doctor and she said I might have an intestinal infection and recommended two over-the-counter medications, which did little. On July 15 I had the whiplash auto accident and everything got worse. I now had severe neck pain and abdominal pain at the same time.
My neck wasn't broken. That was a good thing, but the stomach pain steadily increased to an intolerable level. First I went to the bariatric surgeon, who did the sleeve operation for weight loss last October. He said there was nothing wrong with the surgery. I revisited the primary doctor and she referred me to the G.I. doctors and my whole sorry saga began.
The alternative was clear. I needed to advocate for myself or slide down the angry path of exhausted energy to death. I had to stop feeling sorry for myself. I had to get up off my butt and follow the other path of anger, the kind of anger that motivates a person to overcome everything, like the athlete, who pumps him or herself up for the big game. This is my big game of survival.
The research began on the Internet looking at what my symptoms indicated. I found IBS (Irritable Bowel Syndrome). My complaints mirrored the symptoms of IBS, which is characterized by terrible stomach pain, gas and alternating diarrhea and constipation, and lastly, depression, that can leave a person so hopeless as to commit suicide. There is no simple anatomical causation of IBS. It is a diagnosis that relies on various indicators defined by the Manning or Rome III criteria. I fit most of their benchmarks. Making this diagnosis requires a holistic look at the sufferer. One factor in making the diagnosis is the occurrence of stressful life events. I had two stressful life events. The first was the bariatric surgery and the second the auto accident. Research has found that there is a brain-to-bowel connection to IBS. I sensed I was on the right track.
IBS can be controlled by a combination of things. There is no known cure. There are no miracle drugs. Diet, psyllium fiber, peppermint oil found in peppermint tea, and probiotics, can lessen and even eliminate IBS. Armed with this knowledge I refused another upper endoscopy and proceeded on my own self-defined path to healing. It is too soon to know if my personal prescription will work, but I am no longer the passive depressed patient. Unless in a crisis with fatal potential, I am finished with narrow exclusionists doctors, who will never wager a guess that strays outside their expertise. Only with a conclusive test will they make a diagnosis. Without anatomical verification, they prescribe nothing. Legal liability issues are probably the reason. I contrast that with the professions of psychiatry and psychology, which make diagnoses on the basis of symptoms. (Being bipolar I have a lot of experience in diagnosis based on symptoms!)
Acting like the Ibis headed Thoth knowledge provider, I am making a plan to heal myself. Making this decision has made me feel better. I refuse to kill myself. The path is not myopic, it follows all things: biological, psychological, dietetic, allergic, looking for the interrelationships. My declaration is to heal myself following the IBBBSS diagnosis that seeks solution by examining the factors indicated by the defining alphabet letters. Knowledge is the path, Energized anger is the propellant. I will survive this big game.