"It would be more worrying! But having agonizing cramps isn't a great sign - don't tell me they're not that bad, I know what your pain tolerance is like, and you're not objecting to getting pain meds." She refreshes the screen again. "...They're not seeing anything overtly worrying on the scope, but the large intestine sometimes tolerates a period of limited bloodflow better, and we won't necessarily be able to see damage to the membrane lining directly. They're getting a biopsy to send to pathology and they can test if there's a little bit of blood in your stool – though if there's a small bleed higher up, we might only see that on imaging, because nothing is moving very much." 

Kalorm gestures impatiently. "Already...did imaging!" 

Merrin sighs. "The ultrasound isn't that good for seeing small local bleeding – it doesn't really distinguish blood from other fluid, we know there's more fluid in your small intestine than there should be but not exactly what it is. It would let us see a huge bleed, or a hole in your intestines, and it lets us check the circulation - at least on the level of arteries big enough to show up with this resolution, there could be microvascular dysfunction that we're not seeing. What we really need is a high-resolution MRI to check for any subtle structural changes, and a sort of CT scan that we do by injecting you with a radioactive isotope solution and watching where it goes based on the decay, so we can tag and follow your blood specifically." 

They're going to inject him with WHAT. 

"It's a very standard diagnostic test! You wouldn't want to have one every day, but it's not that much radiation exposure, and it could be life-threatening in the short run if we miss something wrong with you." 

....Kalorm is maybe not listening to this very closely because he is having another round of HORRIBLE CRAMPS, and a very slight but still pretty alarming wave of nausea from deep down. 

"- That looked bad, I'm giving you drugs for it." Pain medication button. "Here, and this is really supposed to be for you to hold onto, right? ...Are you okay, your blood pressure just did a thing." Not a very major dip, and it was starting from a baseline of 120/70, but it shouldn't really be doing it at all, he's on the maximum dose of the standard vasopressor and still getting a sniff of epinephrine. 

Kalorm swallows. "Fine now. Was - nausea -" He gestures at his lower belly. "But - weird. Far down. S'gone now." He tries his best to do a mental inventory of his body's current state. "...Bit dizzy. Cold." 

(Treatment Planning wants to give him more atropine. He responded well to it before, and unlike epinephrine it won't try to pinch off the microcirculation to his gut. Aaaand they should try to wrap up the colon irrigation, for now the priority is getting him decompressed in there, it doesn't need to be totally clean or anything. They're looking at a pretty high chance of doing a diagnostic scope later anyway and can work on it more then.) 

Merrin squeezes Kalorm's hand reassuringly and turns up the heating blanket another notch. 

"We're going to scoop you up once this is done and transport you in the bed," she says after a moment. "You're not stable enough to sit up in a wheelchair right now, and I think you wouldn't like it anyway." 

The medtech doing the irrigation does one final suction run, making the horrible sound, and then shuts the machine down and carefully slides the tube out before wiping the area. 

"Done. Got - adjusted output nearly 1700 ml, wow, though nearly a third of that was just the enema. Imaging was guessing 800 or 900 ml of stool in there before, it could have been underestimated or the excess could be water that was drawn in from the surrounding tissues by the hypertonic solution. - Do we think he needs more fluid replenishment? I think the vena cava is looking slightly flattened. I know we want to be careful with his kidneys, but he just had dialysis - did they take fluid off -?" 

"Not much, but some. He also just lost a bunch via gastric fluids. If Treatment Planning agrees, I think we should give him some colloids or albumin." 

Questioning look? 

He's so much more alert and communicative today! It's really good! 

"We think you might be a little dehydrated," Merrin explains. "Or it's possible you're losing blood - we'll get the results of your last blood panel back any minute and we'll have scan imagery to check for that soon. But we maybe just weren't quite staying even with your fluid needs - if you're sweating a bunch, it's harder for us to estimate how much water you're losing that way - and then you lost a bunch of gastric contents and the enema pulled in some water from the rest of your body. We gave you IV saline and electrolytes, about 1.5 liters total, but we're thinking now we maybe want to give you some fluids with colloids in them, maybe the proteins from blood - those are bigger molecules that don't cross the vascular barrier, so the water will stay in your bloodstream better." 

Kalorm nods. "And - fix - blood pressure?" 

"Yeah! That's the hope." Merrin pats his shoulder. "All right. Ready for us to put you in bed? I'd like to put you in clean pajamas first - I can get ones right from the warmer, how does that sound - but it's going to be more comfortable and ergonomically easier for me from there." 

Kalorm rolls his eyes. But nods. 

It's kind of a production! But he's at least hooked up to fewer things than when they transferred him to the floor in the first place, and one of the backup-response medtechs manages his IV tubing (it's pretty important! they were able to stop the epinephrine entirely but he's still maxed out on the standard vasopressor) while Tharrim and Merrin manage the mechanical lift equipment and his oxygen tubing. 

Kalorm tolerates this. And then lets Merrin unfasten all the various detachable seams of his pajamas (held in place by tiny hidden magnets) and put on a clean, dry new pair, MRI-safe without magnets - slightly less comfortable since it needs to use Velcro instead - and, as promised fresh from the warming cabinet. 

One obvious effect of stopping the epinephrine: the other drugs in his system are hitting harder, and he's so sleepy. He's finally stopped shivering or shaking, though he still protests drowsily when Merrin has to briefly remove the blanket and leave his skin bare to the air, and he requests his heating-pad pillow to hug. It's such a good concept. 

His temperature is up to 37.1, but this is not a fever yet, so she'll let him have his warm blanket and pillow (though only set to a moderate heat level).

Aaaaaaand time to go on an ADVENTURE to the imaging suite! 

Tharrim accompanies her, along with one of the other medtechs. It's not a long trip, but they have a ton of emergency equipment and drugs in the storage space under the bed, just in case, and sensor data plus markets up on a portable LCD screen at the foot of the bed. Which practically drives itself, but they still arrange to have one of them at the head and one at the foot in case it tries to veer into a wall. 

However, it's an uneventful trip! 

Kalorm apparently manages to fall asleep, going by his EEG. 

Well, the ultra-powerful anti-nausea drug they resorted to was noted to be very sedating; it's impressive he kept himself awake this long. His oxygenation is fine, and his blood pressure is a little more labile, but Merrin has a finger hovering near the button on her portable console to push another dose of atropine if he drops outside parameters. 

They reach the imaging suite, and spend a minute or two checking all the room equipment - it should have been checked by the on-site staff this morning but you still always check it yourself too - and while someone brings over a prepped syringe of a special radioactive isotope solution to inject. 

The top of the bed slides on rails, and can be unlocked and slid directly onto the waiting empty rails on the scanner bed without jostling the patient much. Kalorm doesn't even wake up. 

Unfortunately Merrin is going to be MEAN and BOTHER him, because she's feeling pretty on edge and paranoid right now. She nudges him. "Kalorm. Hey. Need you to wake up for just a minute."