It’s Me! Ric! I’m Back! (Minus 1x Appendix)

Hey, everyone! It's me! Ric! I'm back! In the US!

...But a bit sooner than I'd have wanted. As mentioned in some of our other socials, my deployment was cut unexpectedly short by an emergency appendectomy! This is gonna be a much longer post than I usually do. I wanted to use this to capture some of my rapid return home. I started it out as a jovial little bump, but it's turned into something a bit longer as I tried to capture this and that here and there. Anyway, here's some things I wanted to share as I mentally transition back to my regular not-deployed self.

OPENING REMARKS

Super grateful to my team and my leadership for the time I got to spend deployed. I feel like we really worked a renaissance in the section (even with Lilliana's early departure and the insane twists and turns of our unit's mission out there). The deployment was everything I wanted it to be as a twilight tour and last "Hurrah!" in the operational force as a more senior officer. (*Knock on wood -- watch a winter deployment to Central/South America happen, lol.*) Our team was exceptionally talented and motivated -- I miss all of you and wish I could have gone the full tour. I'm deeply proud of the work we did; leaving you all as a well-oiled machine is my consolation prize for early departure. If any of you are reading this, I hope that you're all staying safe, looking out for each other, and continuing to crush the mission out there. Also, you didn't answer in the form of a question, so no points awarded.

A life-saving thanks to Pieter and Dr. Alassaf and the Abdali Hospital Staff. Pieter, thanks for talking me out of trying to keep my appendix (even though we all agree that it has value in maintaining a healthy gut biome). Dr. Alassaf, I'm sorry I got medevac'd before you could finish your care for me, but it do be like that sometimes.

I've broken my story into a few parts. Writing this whole thing out is important for me, in part to commemorate for Terra (so she can look back at this in wonder at how huge and amazing her dad's appendix must have been), but also to send to people who like me, as describing my experience has been all I've been doing since I landed in Landstuhl Regional Medical Center (LRMC).

PART I

BYE BYE APPENDIX! The Surgery Part

It all started when Jenny led a super difficult PT session in an attempt to kill me, a fellow coalition member.

Later that Friday, I led a very serious pro-dev session that was definitely not structured in a Jeopardy game show format. I started to feel a little under the weather afterwards, maybe a mild fever. Dawn told me it's because I only eat vegetables. A staunch vegetable eater, I self-denied that I even HAD a fever and chalked my under-the-weather-i-ness up to being a baby. To punish myself, I worked until I was arm-twisted into calling it quits for the day (thanks, Jeannie!).

I got back to my room and called Madonna, but didn't talk long; pressure in my abdomen, a little fever-y wooziness, and lethargy were now chalked up to being a gassy little baby.

Three A.M., horrible pain -- like dull pain, but turned up to 11. If you've seen that video of this ab-strength strongman getting driven over by a truck, I think it was like that, but the truck just parked on my abdomen. I rolled out of bed and thought that maybe I was just about to have to go to the bathroom. I did (and it was excellent, Bristol Type 4, 10/10), but the pain all throughout my abdomen just kept going. Doubled over, I physically couldn't make it back to my bed. I stumbled over to and then collapsed on the couch in the common area, fetal position (shout out to Terra!), just crushing my face and forehead into the cushion and rocking back and forth waiting for the pain to subside so I could go back to bed. It'd probably be gone soon, right?

Four A.M., it was not gone soon -- I start to think that maybe there might be something wrong, but am in too much pain to move to get to my phone, let alone walk to the clinic. Also, I wouldn't want these cool, buff, operator dudes to think I was some kind of Weenie Hut Jr baby over here. (I AM tough enough for the Salty Spitoon -- I'm an intelligence professional!! ...Wait.)

Five A.M., pain can't stop won't stop! I suppose to myself that the pain might not go away on its own after all. I'd been doing modified/light accelerated active labor breathing to deal with the pain for the last two hours (shout out to Madonna!). Between breaths, I think to myself that if, in the insanely improbable case, there actually IS something wrong with me, no one will help me where I am. I muster all my strength and put my feet on the ground. I heave again to stand, then focus through my leg to take one half-step, then another. Taking breaks, I mosey into my room, grab my phone and my room key. I do the foot-dragging arrhythmic shuffle (required in desert worlds) and half-step out my door, then into the night.

It wasn't freezing, but it was desert night cold and there was no way I could change clothes in between -- I just half-stepped myself what would normally be a 3-5 minute walk, but encumbered, it ended up being like... a 30-minute zombie shamble to the clinic, doubling over in pain every 10 or 15 steps. I get there... never having to visit the clinic for an emergency in the dead of night, I'd misremembered that there'd be providers at the clinic 24/7. It was closed. Door locked.

Still thinking I was probably gonna be fine if I gave it another 10 minutes, I thought deeply about just crawling back to my room? What am I even at the clinic for, am I some kinda wuss over here? Jeez. Just to be safe, I didn't crawl back and instead, I opened up chat on my phone. Time was 0527 when I dropped: "Med support please -- outside clinic, severe abdominal pain," lol.

I remember gently kneeling down and holding both arms across my belly, both in an attempt to warm up and to quell the dull, but thundering pain. I remember pushing my forehead into the cement and continuing to breathe sips. I remember looking at the bunker outside of the clinic and thinking that it would be hilarious if I died like this instead of via an adversary's long-range munition, lol. The call was coming from inside the house all along!!

Pieter got there in a flash. I remember hearing the clinic's rear door, footsteps inside the building, and the door clicking open. My face was in the cement, but I saw light spilling out through my closed eyelids. I really couldn't stand up on my own anymore, so I probably looked like an over-dramatic wimp -- he held out his hand and we Predator handshake meme'd. His side was medical provider, mine was dying servicemember, and the grasp was "Being anti-crippling pain."

He helped me up and hobbled me Call of Duty-style into one of their rooms for treatment. The A/C had been blasting all night in that room, which was good, because I was already freezing cold /s. I asked for a blanket, he brought the biggest duvet over and it was amazing. Pieter noted that I was doubled over, hooked me up with some Tramadol, and was like, "We're going to the ER." In my mind, I was like, "Yeah, okay, I guess we can if you want to be extra safe, but this seems super unnecessary -- I'll be fine in like ten minutes and I'm gonna look so stupid." Until then, the meme became:

Smash cut through just an awful, bumpy, terrible ride where Pieter was trying to balance urgent speed with a gentle ride. Each bump in the road felt like getting punched in the stomach. Halfway through, they stopped hurting (as much)! Yay, Tramadol! (Give me a sponsorship and merch! Lifetime supply!) I think it was Tramadol. It was awesome. I thought it was a non-opioid, but am learning now that Tramadol is, in fact, an opioid.

Pieter selected the nicest hospital in Jordan. I was still freezing, wrapped up in the duvet like a white mage. The sun was just coming up, and I was hobbled over into a wheelchair and then wheeled into the ER. So dumb, I don't even know why we're going through all this trouble.

Doctors come in -- PAINFUL tests checking for an inflamed or ruptured appendix:

• McBurney's Point Tenderness: A doctor presses on a specific spot in the lower-right abdomen (one-third of the distance from the hip bone to the belly button) to check for sharp pain.

• Rebound Tenderness: The doctor presses firmly on the abdomen and quickly lets go. Pain that worsens upon release indicates peritoneal irritation.

• Guarding and Rigidity: The doctor checks for involuntary tightening or stiffness of the abdominal muscles.

Super ouchy on the rebound tenderness test which they did like... 5 different times. Ow.

Cart me in to get CT scanned -- big inflammation detected, but no burst! Hearing the news I was like, "Okay, we're inflamed, but maybe I get to keep my appendix!" Some gee-whiz stuff I'd learned way before this horrible happenstance was that the appendix isn't some useless vestigial organ -- it's key to replenishing your microbiome after antibiotics or a purge (via Bristol Type 7). In a tiny chipmunk pushback, I raised my idea to Pieter and after some back and forth, he convinced me to let them take my precious organ. At this point, knowing that I didn't have a burst appendix (just one that MIGHT be ready to burst), I'm still thinking I (and the medical staff) are overreacting a little and probably could have just walked it off. It's not like I had a burst appendix, after all!

I got carted in for surgery; I remember Dr. Alassaf taking mercy on me and not doing another rebound test on me, haha. Kind, professional staff, modern facilities, I woke up minus one appendix, plus three stitched-up laparoscopy holes, and plus one surgical sump drain.

Sometime in the medicated stupor of recovery, Dr. Alassaf came in and told me about the surgery itself. It went smoothly, generally speaking, but the movie-style bomb disarmament of my appendectomy failed to meet the clock and my appendix blew up during the laparoscopy. Dr. Alassaf and the team had to pour liters and liters of saline into my abdominal cavity to try to ensure I didn't get what could be a fatal infection after they pulled out the scopes. He said it really intensely, like I needed to understand how terrible a time he had trying to clean up all the pus, but also probably to convey the seriousness of the situation and the importance of a stable recovery in their facilities. The sump drain was using negative pressure to suck out all the pus, blood, and other fluids collecting at the bottom of my peritoneum to help prevent infection. I carried it around until like... midway through the next part of this story like the character Pustulio from Invader Zim. Or like:

PART II

Let's All Go To Landstuhl Regional Medical Center!

Jeannie took over for Pieter and I did my best to walk around the hospital wing (per the doctor's orders). Jeannie ensured I didn't fall and die on the hospital floor as we did lap after lap around the one floor of the hospital. Bless Jeannie and her patience for my super slow walking and delirious, pained babble. Jeez. Jeannie, thanks for helping with the phone calls and coordination -- this med-evac flight I was supposed to get on cancelled/delayed like three times. Jeannie acrobatically jumped through hoop after hoop to get me all set up to fly away just to be cancelled.

Recognizing the immediate flight wasn't meant to be, Jeannie had to go back to work. I got a visit from the unit's med staff, Pat (my boss), Nate, Kyler, and Jenny (the one who put me in here with her deadly assassination-style PT session). Later on in the evening, DAWN came to visit! Dawn -- It's me!

• To anyone from the team reading this: I launch a one-way attack super gratitude UAS at your faces for the hard work through tough times and the laminated card wishing me a speedy recovery. I love and miss you guys -- it was an honor serving with all of you. I really wish I could have finished the tour with you all; have a safe tour and safe travels! I argued my case to my unit's med leadership and to my leadership-leadership, but understood that their "out of an abundance of caution" was for me potentially posing a risk to the mission and in an effort to try to save my mortal coil. ...FINE!

At this point, it's still not decided whether or not I'll be allowed to recover and return to work at my forward unit or if I'll have to ship off to Germany to recover. Post-surgery, Dr. Alassaf said I should be mobile in about a week, a fact that made me feel like I had the ammunition I needed to not be med-evac'd. Hope?

Nope -- the unit surgeon was stern in his recommendation that he wouldn't advocate for me staying in theater. He apologized (I think he'd had to deliver that news to a couple other people recently), but... he was right... I admit it. Dr. Alassaf's assessment WAS correct, I was able to hobble around (probably at the speed of some of our older contractors at the unit, too! I offered to race those older members if it could prove that I was fit to fight), but even after a couple weeks, my stitches were tight and my organs didn't all start functioning normally until about a week after that, even.

Dr. Alassaf and the Abdali surgical team were extra mad when they found out my unit was shipping me out before the recovery protocol was done. I shared with him that I would have absolutely preferred to stay in the luxurious recovery room with him and the team, but... that was out of all of our hands.

When the med-evac flight finally didn't cancel, it was another horribly painful car ride to the flight line, some painful, labored waiting, a tactical change of clothes, and half-step hobbling onto the ramp of a C-17. Things I'm grateful for:

1. TRANSCOM,

2. my flight nurse,

3. painkillers,

4. traveling without going through airport security or customs.

Arrival in Germany was weird -- I started to feel that "I've abandoned my team!" feeling amplified by Tramadol loopiness and continued pain. Every bump in the road on the way to the medical center was a punch in the gut and the military bus transferred all of them directly up into me. Oof. I sat in the front of that bus and was placed gently into a wheelchair upon arrival.

The first LRMC room was nice, but warm. A new augmenting staff was rotating in and getting spun up from the permanent party there. I shared that room with a dude who was at risk of losing his leg, and the third dude who got wheeled in there had both his legs busted up. Their situations really made me feel like I didn't totally deserve to be there and that I probably should still be in theater. I could have been rotating through and helping out just like the medical staff there; I still had all my limbs and I'm an intel guy! We just need our typies and clickies!

Positive vibes from the staff there, though. Deep gratitude to the nurse team and floor techs at LRMC. Ngi, my nurse really had his stuff together; Ngi, if you're out there, thanks for everything -- you're a real bro! I forgive you for NG tubing me.

There seemed to be a bigger influx of personnel that day, so I got pushed to a second room in another wing, which was nice because I had this room to myself. It was cool and dark and I could control the A/C in my room too. Recovery took a turn for the worse, though. I foolishly tried to eat food like a noob. They brought me an actual hamburger, yogurt, pudding, and all this stuff -- a vegetable eater, I knew it was important to be eating calories and didn't have the heart to push back. I ate that food, but really shouldn't have. And not just because meat is murder.

ILEUS: A temporary lack of normal muscle contractions in the intestines that stops food, gas, and liquids from moving through the digestive tract, without a physical blockage.

My guts hadn't turned back on yet. They tested that hypothesis with a CT scan, but I needed to drink all this oral contrast so the CT scan could show where I was getting stopped up. I really tried to drink this oral contrast, but I really couldn't. I recently saw a video of this dude who was forced to try to eat 50 avocados as punishment for getting caught stealing them. It felt like that.

I did my best, got guilted by my nurse team saying I had to drink it all. I double did my best, got guilted again, failed to finish it, and then got wheeled off to get scanned. I felt terribly overfull. I got scanned again and carted back to my room. Back in my room, I did an Exorcist vomit geyser, but it was like this bright green Ecto-Cooler color? I laugh looking back. The volume of my retches undoubtedly echoed through that wing; if anyone happened to be there and hear that coming from down the hall, it was as bad as it sounded.

CT scan results back, yup -- the food is all just in my upper small intestine and stomach. All just chillin', waiting for the bus, but there was too much traffic downtown.

NASOGASTRIC (NG) TUBE: A thin, flexible tube through the nose into the stomach to drain built-up gas and fluid. It's really just horrible to put in place.

The tube did not feel thin or flexible, but when it was in -- immediate relief. That feeling of being just about to throw up I'd been experiencing for like 24 hours was finally relieved. I was off to the races with just eating ice chips, a race that lasted like three days. Pain meds, antibiotics, and ice chips. I fantasized about Gatorade between slow, horrible walks to the bathroom. I remember one particularly dedicated med tech -- she doted on me with a punchy, light-hearted kind of care that stood out in the dark night corridors and steady beeps of the machines in my room. She had a beautiful hippie name, I think Cheyenne? Anyway, if you're out there, Cheyenne, you're the best! I love you! Thank you!

I think I spent three days at the LRMC? The team there watched my recovery, checked on the work Dr. Alassaf had done, and cleared me for travel, assessing that I'd be best off at Walter Reed.

PART III

Let's All Go To Walter Reed National Military Medical Center!

With the NG tube removed (felt great, thanks Ngi!), my surgical drainage sump out (felt weird -- I imagine like when your dog eats floss and you have to pull it out the other end), and drain sump hole stitched up (by I think an Air Force Academy Cadet on Summer Operations?), I was feeling right as rain!

The trip from Germany to Walter Reed was so much more pleasant than the trip out of theater. A few days into recovery at that point, I started to feel more in control of my body and could start to feel some of my faculties returning to normal. Still grateful for painkillers -- the scars I have now are good reminders of the pain I was in for the last month.

This flight's flight nurse was also amazing and the medical cot on a medical evac flight is genuinely more comfortable than first class, except it was super cold and mega loud.

I think the most striking thing about arriving there from being downrange is that the time in Germany wasn't enough to put me back into a stateside day-to-day everything's just normal here mindset. Everything just seemed normal? Like there weren't munitions being exchanged anywhere? The bus ride getting to Walter Reed had these two kids screaming and crawling all around the vehicle -- their parents just handed them some iPads which they watched at full volume.

Adam from the WWP team wheeled me in and up to my room at Walter Reed. The room was a nice change of pace compared to the bus; calm and familiar from the last few days, I settled into my bed, turned on the TV and waited patiently for Madonna and my parents to make their way up to my room!

• Deep thanks to the Wounded Warrior Project (WWP) team, both in LRMC and at Walter Reed. I was embarrassed when they were referred over to me at LRMC; getting an emergency appendectomy is so far away from the sacrifice I generally associate with the WWP. The guilt of not finishing out my tour is doo doo. While I genuinely feel that Madonna and Terra (and Holly) need me more than my team downrange did, there's just something about leaving early that's still dookie. The WWP folks weren't providing me with any kind of therapy or anything, but despite my embarrassment, they made me feel accepted and welcomed as a member of the community.

I tried to keep the energy really positive and lighthearted when I was texting Madonna -- through the haze of painkillers. Despite my best efforts, Madonna's beautiful face grimaced up into tears on seeing me on the hospital bed. Later she shared that she was just so relieved at me being home safely, and equally surprised at how fragile and thin I looked. After almost a week of throwing up and only eating ice chips as food, I was looking shredded! Appendectomies are a great way to cut weight, it seems. I bragged to my still-downrange coworkers about how beach body I was, but didn't get any takers on the appendectomy training program, even though I lost 15 pounds over the course of just a week! It's true that like... 5 pounds of that was appendix because it was so huge, but still.

A week after arrival at Walter Reed and my subsequent release to the local area, the determination was made that I wouldn't return back downrange. Bittersweet, but definitely in my and my family's best interest. I'm deeply grateful for my time in theater -- deployment bonds are special. Working side-by-side with that team, all focused on the same mission. That particular environment really did feel like a test of character, resilience, and one's sense of humor. Even though the whole time overseas was crazy and it was cut short as just a partial rep, it'll be easy to look back at my time there with nostalgia.

Now that I'm back and not headed back out, I think that ends my VUL. I'd say we should count up Attrition Points, but it seems like this is gonna be an extra-long few rounds. For me, it should be at least a little while before I get shuffled and re-dealt into another match.

Anyway -- I'm back! We'll call it TRANSCOM recovers 1 Attrition Point using Medical Evacuation. That's on one of the cards, right?

- Ric

P.S. PART IV

For Terra

TERRA! We knew you were on the way, but kept you a secret until we knew you were on the way. I've been thinking about you (and Holly and yo mama!) non-stop since I left. I was scheduled to be back in time to welcome you to the world, but you never know with these kinds of things (on my side AND your side), so I'm super grateful to be back mostly unscathed and can't wait to meet you! I love you and am stoked to pick you up and throw you around. ROUGH AND TUMBLE PLAY FTW!

Love,

- Sir King Papa Dad.