Diverticulitis: A diary of my first bout with diverticulitis (symptoms, testing, and treatment)

After my first-ever bought with diverticulitis, I wanted to make notes about what happened over the last five days. This is a little diary of those diverticulitis notes and my experience.

Monday, April 7, 2015 (diverticulitis begins)

On April 7, 2015, I woke up at 3:30am with pain and discomfort in my lower-left abdomen. I knew something was wrong, but I didn’t know what it was. It felt like a golf ball was lodged in there, and after several enemas, it was still there several hours later.

I couldn't get in to see my primary care doctor, so I went to the emergency room (ER), which was fortunate, because as I would learn, (a) proper diagnosis of diverticulitis requires a CT scan, and (b) diverticulitis can be very dangerous, because if your colon ruptures it can lead to sepsis and death.

The ER nurses and doctors asked me to rate the pain on a scale of one to ten, and I answered it this way: “The pain is only a five, but the discomfort is a 9.” If doctors ever ask you to rate the “pain,” I encourage you to differentiate between pain and discomfort as well, because when I first answered that the pain was a “5,” they seemed to handle my case very slowly. Once I made this distinction they moved faster.

CT scan with contrast

The doctors drew blood and did a urinalysis, and after those test results looked okay, they sent me for a “CT scan with contrast.” One of the reasons they did the blood work was to make sure my kidneys were functioning properly, a precursor to having the CT scan with contrast. (It sounds like you can’t have the contrast if you have kidney problems.)

The CT scan showed that the problem was most likely diverticulitis in the lower-left abdomen, the sigmoid colon to be specific. It looks like there may also be another problem, and I have a followup appointment to have that checked out.

The ER doctor suggested that I take an antibiotic named moxifloxacin. Moxifloxacin has a lot of side-effects, as I would soon experience.

Tuesday, April 8: allergic reaction to medicine

Early in the day Tuesday I seemed much better, and thought that how surprising it was that I could rebound this fast. But starting Tuesday evening at 7pm -- one hour after I took the second dose of moxifloxacin -- my heart rate accelerated and I began to have burning and tingling in my feet. Until this point the moxifloxacin had been helping with the colon discomfort and pain, but at this point it also seemed to stop helping.

I lived with all of the side-effects Tuesday night, and by 3am they had all subsided except for the burning and tingling in my feet (what I would learn is called peripheral neuropathy). Note that I don’t recommend living with these symptoms; I was just exhausted by this time, and didn’t have anyone to drive me to the hospital.

Wednesday, April 9

On Wednesday morning I returned to the ER with the peripheral neuropathy, hoping they had a different medicine I could take. The new ER doctor took me off of that and started me on amoxicillin, a much safer medicine which, according to other doctors, they should have started me on to begin with.

Wednesday through Friday

I was still uncomfortable on Wednesday and Thursday, and when I woke up at around 2am on Friday morning I woke up with severe cold chills and was close to passing out, a phenomenon named syncope that I learned about last year. The ER doctor on Wednesday suggested a liquid diet for 24-48 hours, and some part of the illness, the drug, and not eating had me close to passing out. (I should mention that starting some time on Thursday I had a very bad case of diarrhea, either a result of the liquid diet, the drug, the diverticulitis, or all three.)

I was shaking quite a bit, so I went into the bathroom and turned on the heater. At 2:30am I took four ibuprofen, and at 3:15am I took the next dose of amoxicillin. Some time later, I don’t remember exactly when, but probably around 4am, I began to feel well enough that I went back to bed.

Saturday, April 11

Finally on Saturday, April 11, 2015, I began to feel normal. I could feel the diverticulitis pain if I poked on it directly, but otherwise I didn’t feel it. I’m writing this on Sunday morning, and I still need to take the antibiotic for a few more days, but I began eating some crackers last night, and everything seemed okay, so I had a little bowl of oatmeal this morning, which also seems okay.

Thursday, April 16: Cold chills, shaking

I’ve been trying to eat semi-normally lately, with mixed results. The biggest problems are pain through most of the colon in my lower abdomen, and the chills, which usually happen at night.

I had a bad case of the chills last night, so I got dressed, drove up to the store and bought two thermometers to check my temperature. (As part of my personality I don’t trust one thermometer in a case like this, lol.) My temperature wasn’t high, and in fact it was a little low, in the 97 degrees Fahrenheit range.

As I write this on Thursday morning I’m still having a little pain in the lower-left abdomen. When I talked to my doctor two days ago she said if the pain/discomfort persists we should do another CT scan, so I’m guessing that’s what will happen next. At this time my plan is to go back to a liquid diet again for a few days.

Sunday, April 19: ER trip and hospitalization

After more pain Thursday morning, I called my doctor about the CT scan, and she suggested I go to the ER instead. At the ER they did another “CT scan with contrast,” this time after making me drink two bottles of fluid that would help show the diverticulum more clearly. That scan showed that this is indeed what I’m dealing with.

I got to the ER at about 1:30pm, and at 7pm they told me I would have to stay in the hospital for a few days. Because I had an allergic reaction to the moxifloxacin, and then the augmentin didn’t help, an “infectious disease” doctor started me on a new antibiotic named “Invanz” that would be administered intravenously. So they put an IV in my left arm, started me on the Invanz, and then admitted me to the hospital.

I stayed in the hospital until yesterday afternoon (Saturday). However, before doing so they installed a “PICC Line” in my right arm, as I’ll need to keep injecting myself with the Invanz for two weeks. A PICC Line is an intravenous line that goes in your arm and runs about two feet into your body, ending up somewhere near but above your heart. (See that link for graphic picture or two.) A nurse came by last night to show me how to administer the antibiotic.

Unfortunately I still have some pain in the lower-left abdomen. It went away for a little while when I wasn’t eating, but now they want me to eat a low-fiber (yes, low fiber) diet while I’m taking the antibiotic, and I started having pain again a little while after I started eating. I have eleven more days of the antibiotic, so hopefully it will be better by then, as the next step is probably surgery to remove that part of my colon, not something I’d be looking forward to.

Wednesday, April 22: PICC Line and Invanz

If you had asked me yesterday how I was feeling, I would have told you I was feeling much better, and that now I just needed to continue taking the antibiotics for the next eight days. Unfortunately if you asked me that same question this morning, I would have told you that I was back to square one. I’ve been eating almost exactly the same thing every day since I got out of the hospital, but this morning the pain came back, and that made me pretty sad.

As for that PICC Line, this is what it looks like when I hook up the Invanz antibiotic:

That little bottle that looks like a hand grenade contains the Invanz antibiotic, and it’s like a compressed balloon, and squeezes the medicine into my system over thirty minutes (sometimes a little faster, sometimes a little slower). Once that’s finished I flush the line with the saline and then the Heparin, which is a blood thinner.

Thursday, April 30, 2015: Reaction to bandage

I had the bandage and PICC Line removed yesterday. The nurse put a new bandage on the area after removing the PICC Line, and for some reason I had a bad reaction to that bandage, or the chemical she used to clean my arm:

The little darker red spot on the left side of my arm in that photo is where the PICC Line was inserted. As the nurses said, removing the PICC Line was painless, I didn’t even feel it.

The doctor thinks that my current digestive issues are due to the medicine, not the diverticulitis. About 95% of the time I agree with him: the pain and discomfort is in other areas of my digestive system. But about 5% of the time the pain is still there in the lower-left part of my abdomen.

I still can’t eat normally. Every time I try to, it makes all of the digestive problems worse. I’m on a borderline liquid diet at this point, eating only scrambled eggs, chicken with rice soup, and canned peaches. That’s pretty much my diet every day, with a little apple sauce, jello, or crackers thrown in for variety.

Sunday (evening), May 3, 2105

Over the last three days I kept having chills and felt like I had a cold, but that seems to have passed now. I have started to eat a little more normally during the last two days.

Thursday, May 7, 2015: Blood clot

About four days after I had the PICC Line put in, my elbow got very swollen and a little painful. My hand also swelled up a little bit, but by taking ibuprofen and keeping my arm elevated, the swelling went down in a few hours, and then next day it was better. But the pain in my elbow persisted.

Early yesterday afternoon the pain came back much more severely, and when I looked at the elbow I noticed that a vein on the bottom of the elbow was standing out a little bit, and when I pushed on it, it was more stiff than usual. Instead of just being able to push it down, it felt more like a string under my skin that I could push around. I also noticed that the pain was not in a muscle, but ... it was somewhere else.

So I went to the hospital again, where they did another ultrasound and found a blot clot in my arm. Fortunately it’s in an outer vein, something they call “superficial thrombosis.” This isn’t a great concern, and they have me treating it by taking aspirin and applying heating pads to it four times a day. I thought all blood clots were bad, but apparently this one is not a problem because it’s in a vein near the skin, and that vein doesn’t feed into any other veins. (I think that’s what the doctor said.) The doctor said the blood clot formed in the vein that had the PICC Line in it. When you hear that a blood clot is a problem, the doctor said that is called “deep vein thrombosis.”

Friday, May 15, 2015: Another ER trip and “epiploic appendagitis”

I woke up with severe abdominal pain again this morning (just like appendicitis, but on the left side of the abdomen), so I took a very fast shower, grabbed my pre-packed suitcase, and headed to the ER once again, assuming I was headed for emergency surgery.

At the ER the doctor ordered another CT scan, and to my great surprise said that I do not have diverticulitis, but I have something else called “epiploic appendagitis”:

(I was “received” much earlier than 13:06 (1:06pm). That was the time the doctor typed up this doc.)

Epiploic appendagitis is described like this on Wikipedia:

“Epiploic appendagitis (EA) is an uncommon, benign, non-surgical, self-limiting inflammatory process of the epiploic appendices. Epiploic appendices are small, fat-filled sacs or finger-like projections along the surface of the upper and lower colon and rectum. They may become acutely inflamed as a result of torsion (twisting) or venous thrombosis. The inflammation causes pain, often described as sharp or stabbing, located on the left, right, or central regions of the abdomen. There is sometimes nausea and vomiting. The symptoms may mimic those of acute appendicitis, diverticulitis, or cholecystitis.”

I can confirm the nausea/vomiting part, as I walked around the hospital yesterday with one of their “barf buckets,” and nearly passed out later in the day (probably due to the morphine).

Here are two good links about epiploic appendagitis, if you’re interested:

• http://en.wikipedia.org/wiki/Epiploic_appendagitis
• http://radiopaedia.org/articles/epiploic-appendagitis

Fortunately the treatment for this is not surgery, but only involves taking NSAIDs until the pain goes away (I hope). I sure hope this is nearing the end of this adventure.

The question now is whether I ever had diverticulitis. Did I go through the “Initial pain > ER > CT scan > moxifloxacin > allergic reaction > ER > augmentin > ER > PICC line > Invanz > blood clot dance > ER dance” for nothing? I plan to meet with a GI doctor to see what they think. I’m not into suing anyone, I just want to know if I ever had diverticulitis, and since there is “ischaemia and necrosis,” I want to know what happens when the necrosis (tissue/organ death) part runs its full course.

Update: June, 2024

As an update many years later, in 2018, because of the diverticulitis, I had a partial colectomy. The surgeon told me that the radiologist saying that I had “epiploic appendagitis” was a “brave call,” meaning that he thought it was a very poor/dumb call.

After the surgery he also told me that there were four things wrong with my colon, and none of them were epiploic appendagitis.