Category Archives: Health care

Free healthcare – in prison

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Medical parole: Hospitalized prisoners costing California taxpayers millions – latimes.com.

I got excited when I read the above LA Times article about healthcare in prison. Here I thought that one day I’d have to kill myself when my insurance runs out, but now there’s a possible light at the end of the tunnel – free healthcare in prison.

Of course, I’ll have to commit some kind of crime to get there, and the healthcare in prison doesn’t sound top-notch. However, that seems inconsequential when it comes to staying alive and getting to see my daughter grow up, though it will be on scheduled and supervised visits at the prison. Will I get to keep my iPad? Probably not.

I think I’ll rob a bank. I can pretend to have a gun in my jacket and ask the teller for unmarked bills and no dye packs. See, I’ve watched enough movies to nail it. Then, I’ll just stand outside the bank and wait for the police to arrest me. Life is simple after all. There’s always a silver lining.

Then I think of the honest, hardworking, taxpaying CF individuals and families on GHPP here in California who are barely holding on to it with the state budget cuts. California will provide medical care to people who have committed the most horrific crimes but cut other programs to the bone. Hmm, something about that bothers me – a lot.

Maybe my idea isn’t so hot. I might get tired of having to file my nebulizer mouthpieces into “shanks” or “shivs” – or whatever prisoners call them – to protect myself. Clearly, there’s a downside. Forget I posted this. Thanks.

Next idea?

Use the Force next time an anxiety attack happens

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After two visits, my new heart doctor suggested I should go on Prozac. “Forget you” very much, doctor. At what point did you not notice my extensive list of medications? The one that comes on a scroll and unrolls onto the floor.

Sure, let’s add another med to the list. Genius idea. Especially a drug like Prozac, which can do all kinds of strange things to your head. May I have a prescription for a .44 Magnum handgun, too? Pretty please with mustard and my brains on it?

How did I get here?

My fantastic regular heart doctor is getting up there in years and is a 60-minute drive each way, plus the two-hour visit. So, every time my heart does its samba, giving up four hours of my day is a real drag just to be told I’m alive. So, I spun the doctor wheel of fortune and picked a new one close by. The five-minute drive rocks. But the new doctor ain’t my old one.

During the first visit he was complaining about his older patients and how slow they moved and how long the visits take. During the second visit, he mentioned how the children of dying patients don’t accept the fact their parents are dying and nothing can be done. He wasn’t making a big production of his frustration, but was whining. And, as I’m the king of whining, I can spot when someone else is stealing my stage time.

I was also thinking he has life pretty good. He’s a doctor, married with kids and doesn’t have cystic fibrosis. Right there he’s ahead of the game. No whining allowed, Doc. What the hell are you complaining about? Where’s the genie that gives you CF for a month to teach you what you should already know? You’re living the high life.

Back to the five-minute Prozac diagnosis.

Along with the suggestion for Prozac came a few suggestions that showed he hadn’t listened closely to why I was anxious, and ended with the simple advice “don’t worry so much.” Oh, doctor, it’s that easy? Why didn’t I think of that? I’m so lucky. You cured me with your brilliant wisdom. May I kiss your stethoscope to show my eternal gratitude? I promise to name my next boa constrictor after you. The one I’ll let wrap me up and squeeze me to death while I’m high on Prozac.

Prozac this. I’m insane, not depressed.

[“Cranky tonight, I am,” as Yoda would say – if he were not on Prozac, though we all know he is.]

In the Cement Mixer

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[adult language and anger warning]

It feels like someone, I mean CF, threw me in the back of an empty cement mixer and turned up the rotation speed to high. Then, as if that wasn’t enough, someone, I still mean CF, threw rocks in the mixer with me. The noise alone hurts my ears and the rocks cause bruising and welts. Then, as if that isn’t enough to cause pain, someone, you know who I mean, adds broken glass to the mixer. The glass cuts my skin and I start bleeding.

Life with CF - some days

Meanwhile, the cement mixer keeps turning and turning and the rocks keep banging against me and the sides of the barrel. The glass keeps cutting.

Then someone pours salt into the mixer, which makes my cuts from the glass burn.

All in all, this is what CF has felt like lately. First, the bleeding two months ago, two embolizations and 20 days in solitary. Fuck you, CF. Then more bleeding the day after Thanksgiving to show me who is really in charge – it’s not the doctors who perform embolizations – and eight more days in the hospital. Fuck you, CF. The hospital kicked me around too. A blown IV puffed up my left hand and I now have a two-inch vein made of rock. During the PICC line procedure my heart went nuts and a doctor actually had to come to the room. When someone was drawing blood, they hit a nerve and now I have nerve pain in my forearm. Then, one day out of the hospital I caught a virus and my white cell count shot up and set back my progress with the IVs. That’s the nutshell version.

Do I need to repeat tonight’s mantra? I think I do – Fuck you, CF, fuck you, because I’m still the luckiest guy in the world.

A Tale of Two Hands

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To the untrained eye, my hands in the following photograph may not seem very different – each has an IV in it. However, to me, this picture represents the two types of experiences one can have in the hospital: excellent and crappy. And so much of that experience comes down to the people who work there and their talent and skill – or lack of one or both.

Which would you prefer?

Let’s start with the image on the left, which is my right hand. This is an example of a beautiful IV insertion with its stat lock and white tape and lack of excess tape. Everything is positioned perfectly. All in all, an excellent job.

The image on the right, my left hand, has no stat lock and looks like something I might do if I had the mind to insert my own IV, which I think I could do if the world was coming to an end and my life depended on it. I wouldn’t like it, but I could do it, though I might need the help of someone’s finger to stop the bleeding when I pulled the needle out. Look at the massive amount of tape used to keep the line in place because the thin white tape and stat lock weren’t used. I lost a lot of hair when we removed it.

Now here’s a question for you: Which site went bad and caused my hand to swell up and turn red? Easy answer isn’t it? I’ve been elevating my left hand for the past week to get the swelling down. The vein is rock hard above and below the insertion site. And it hurts. My medical diagnosis is Puffer Fish Hand.

This distinction between medical excellence and crumminess doesn’t stop at IV sites. It happens daily in the hospital with tests, procedures, and doctors. And for someone who stays in a hospital once in their lifetime, then the IV site on the right might not make much difference in the long run. However, I’ve stayed at the hospital four times this year and spent almost a month and a half there. The difference in the two types of care does matter because I’m exposed to more of these swings in quality the longer I’m there. They add up. And many result in more than a fat, tender hand.

Worst of all, not every difference in care can be photographed. The ones that can’t be seen scare me the most.

Star Date: 120210 – I’m not really here

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It’s day five in the zoo. I’ve been moved from the step-down floor, with its myriad of wires attached to my body and slot machine heart monitor ringing JACKPOT at four in the morning, to the hospital’s CF wing, which makes it sound more exotic than it is. But I am excited to be here and out of the monitored room.

My new room has some choice furniture, including a fold-out sleeping chair and wood chair I can use as a work chair. The rolling table has a pull-out section, which I’m using right now as a workstation. In the previous room I had to sit at the edge of the couch chair to type on my iPad or laptop. It’s amazing how a piece of plastic with fake wood covering can make all the difference. The pull out part is something I missed on previous visits.

The blood has stopped and so far no plans for an embolization. I believe the blood will be back in the weeks when I’m out. I don’t think they caught the correct bleeder. They do and believe this is a new one. Let’s agree to disagree. It hasn’t stopped me from pushing their buttons a little about the fact I’m in again for bleeding. However, they are sympathetic.

Before the visit two months ago, I wasn’t multi-drug resistant. Now I am. Did I pick up something in my 20-day stretch? Who will ever know. I need a rubber suit and mask for all of my stays from this point on – and David Blane’s ability to withstand torture over stretches of time.

I’m on a triple cocktail of cipro, tobra and zosyn. Yum. They infuse zosyn for three hours now. Three f**king hours. I’m on IVs all the damn time. They’ll kick me loose soon to do them at home. I have to admit, three will be a chore. I’m not sure which is worse, the three antibiotics or staying in the hospital. The evening doses are the hardest at home. I like the nurse coming in at night trying not to wake me and giving me a gentle kiss on the cheek to help me sleep.

The hospital has gone Chinese Government crazy with web access and now blocks a ton of sites and most blogs, including mine. I’m using the iPad WP app to get around the censors.

This stint has had its share of mishaps. First, my left hand is swollen and hurts a lot because the IV site went bad. The site looked like I had inserted it when compared to the new site on my right hand, a proper insertion. I took a picture for a future post.

The PICC line placement didn’t go well. It got stuck at the critical juncture of going up or down – down is the correct path. All of sudden I couldn’t breathe and my heart went lottery-winner crazy mad. Luckily, I was on a monitor and the nurse came in and they watched over me. Even after the procedure, which resulted in a mid-line and will lead to me getting a port, my heart wouldn’t settle down because of atrial fibrillation. Bring on the EKG and today’s heart echo test.

One bonus of the failed PICC was a vascular scan for clots. I know the woman who does them after many scans in the past for a clot in my neck. I let her train on me. So, she gave me a gel bath and scanned me with her wand, and no clot – yet.

I told a good friend that CF is not just about surviving CF. It’s also about surviving hospital stays. Bad stuff happens here. You leave with something you didn’t have when you came in. Or they beat the living daylights out of you with tests and procedures. This is a game of Survivor without a safety net.

During this visit and the last few, I find myself escaping into more entertainment – movies and video games – than reality like blogging and reading. I feel like Sigourney Weaver in “Aliens” walking into the middle of dozens of Alien eggs. Luckily, she had a flame-thrower with grenades. I don’t. So, I’m choosing to ignore as much of my surroundings as possible because I know all of this is a bad dream and I’ll wake up at home soon.

(Typed on my iPad. Please excuse typos.)

Life in the wild

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During my last clinic appointment, I told my doctor that being in the hospital is like being in the wild surrounded by lions and hyenas and other critters intent on making me their dinner. That’s not to say the people who work there have the intention to hurt me – or eat me – they don’t. However, mistakes happen and stuff goes wrong. Some people are better at their jobs than others. The hospital can be a dangerous environment and one that requires my constant vigilance while I’m locked up there.

This appeared in yesterday’s Los Angeles Times:

USC University Hospital was fined $50,000 after pharmacists and staff gave a female patient with cystic fibrosis an overdose of medication in February, causing kidney failure and seizures. The hospital has since retrained nurses to verify prescription orders, created a new pilot program to ensure medications are administered correctly and started randomly auditing medication orders, according to a plan of correction submitted to the state. It was the first time the hospital had been fined.

http://latimesblogs.latimes.com/lanow/2010/11/state-fines-12-hospitals-for-serious-errors-eight-are-in-southern-california.html

My best wishes to the CFer. I’m not sure of the outcome at this time, but I hope for the best.

When I was in the hospital recently, they upped my dose of an IV antibiotic I received four times a day. However, the pharmacy kept the 30-minute timeline to infuse it on the label of the IV. Luckily, the nurses caught the mistake, as it should have read 60 minutes for infusion time. They often frowned and raised their eyebrows each time they saw it, letting me know it wasn’t a good thing. I asked them to tell the pharmacy and it took a day to get the label corrected. So, I had to watch over each dose to make sure it was infused over 60 minutes. I’m happy the nurses caught it and told me.

Back to my analogy of the wilderness. I’ve had other incidents, like a nurse telling me at 5 in the morning that they gave me the wrong antibiotic or being given a double dose during a shift change. These are just a few of the events that have happened to me at hospitals. I feel I’ve made a few saves of others by asking questions and staying alert (when I’m not knocked out from being sick).

Here are some of the actions I take during  hospital stays (please note that this is not advice. It demonstrates how crazy I am, nothing more.):

1) I use the high-strength Super Sani-clothes to clean all surfaces I might touch during the stay. That’s right. When I arrive in the room, I put on a pair of rubber gloves and clean the tray table, the phone, the remote, the the bed rails, door handles, etc. Some of the nurses who know me bring me the pads when I arrive. It’s cleaning time.

2) I check all IV medicines they give me  and when they give them to me. I look at the labels and ask questions, and pay attention to the routine. At night, I confirm the schedule with the nurse before going to bed.  There have been numerous times over the years, I’ve called the nurses to give me IVs to stay on schedule. During the last visit, one argued with me over the correct time of the dose. It turned out I had the time right.

3) I try to be proactive. For example, in isolation, I do my best to make sure everyone follows the rules about masks and gloves. I stop people from entering my room, which isn’t always easy and can lead to a hospital employee with “tude,” which I can match. Most of the time, it’s temp nurses and RTs who don’t know the rules and try to sound like they know what they’re talking about when they don’t. Processes can be difficult to train to a staff. Temps don’t always get every memo.

4) I wear gloves in the bathroom (except when washing my hands). C-diff is a killer. Literally. And if it doesn’t kill you, it can make you wish it would. I’ve had it five or six times. I’m doing my best to avoid it. I also take probiotics during the stay and after. My last stay was my best yet for digestion and bowel health thanks to the probiotics. And not contracting C-diff was my reward despite being on three IV antibiotics. I also stopped the Nexium and Zithromax to reduce the risk of C-Diff.

5) Before they remodeled and put a pulse-ox in each room, I used to watch as the nurse cleaned it with a Sani-cloth, not alcohol, and then I washed my hands after using it. Even with one in the room now, I clean it myself.

6) If something falls on the floor, it’s dead to me and goes in the trash. Are there exceptions? Sure. If I dropped my iPad, I’d clean it. Sometimes, my charging cords hit the floor and I have to glove-up and use a Sani-Cloth to clean them. But anything else, it’s outta there.

7) I bring my own Pari Sprint nebs. I hate the cheap-o nebs with the long accordion attachment. I wonder what the particle size is. It doesn’t seem as good as the Pari.

I know I’m nuts. I have other quirks while I’m stuck in a hospital. And after the last hospital stay, I dread having to go back. I’ve knocked out a lot of days there but it’s getting old having to go in three or four times a year. It was easier when I was young and didn’t care as much about living. Now with more to lose, it takes more effort to stay healthy. That’s okay, I’m lucky I have the chance to do it. At least I don’t take that for granted anymore.

Yesterday’s Clinic Visit

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I am so lucky.

Lucky, lucky, lucky. I’m not sure how I’ve lived this long. Better people haven’t.

My clinic appointment went pretty well. It’s funny now my blood pressure goes up during the visit, especially if they take it before I do my PFTs, which make me nervous as I can’t tell which way they’re going to go. They end in happiness or dejection. No in-between for me.

When I was in the hospital for my two embolizations and 20 straight days of partying, my PFTs when down to level unseen since another doctor ruled the clinic years ago. In the span of my hospital stay, I lost over 20% of my lung function. The good news is – and why I am lucky – most of my lung function returned. I worked my ass off trying to get it back over the past weeks, even succumbing to twice a day pulmozyme, a drug has may cause me to bleed and one which my doctor and I discussed for 10 minutes. (Does twice a day make a difference? He says it’s only a 1 to 2% gain twice a day and wants me to take it once a day.) But I was desperate to use any tool in the tool box to get my numbers up. I’ve been doing my treatments three times a day, as always, with more vest time.  Flutter, of course. And I used the big gun of Cayston the minute I got out of the hospital.

Lucky me.

I also had a great visit because the doctor is top notch – outstanding from a medical standpoint – and human, caring and understanding.  It wasn’t a busy day and he listened to me vent about the last hospital stay and we came up with ways that future stays for all CFers can be improved – measured cups for hemoptysis volumes to reduce guessing; faster decisions to embolize. I’ve never met a doctor with a better understanding of what it’s like to stay in the hospital. He’s awesome. Bromance in the air? Kidding.

I’ve avoided a oral glucose test for the past three years. I’ve never had the time to go to the lab for two hours, or I haven’t wanted to take the time to do it. They’ve written me a dozen Rx’s for the test and it’s kind of a joke when I ask them for a new one each time. Tired of that game, they made me do the test at clinic and skip my morning McGriddle, which made me McMad. Not sure how I did, but I know I’ll find out soon. Scary waiting for results for that test, which is why I’ve avoided it.

I hate questionnaires – especially CF-related questionnaires. I’m at the point in my life that if I don’t like a question, I don’t answer it. When they asked me about sexual intercourse and my family history, I said “next, please.” Let’s concentrate on the questions that have some chance of making me well, people. I don’t give a sh** about zoo experiment statistics that you discuss over lunch and have no bearing on my health. Some of what I go through is none of your business. And the less I talk about certain members of my family, the happier I am.

The social worker visit? Hi. Nothing to say. Bye. Don’t take it personally. (They are my dark thoughts. I don’t need to share them with the world. Does a blog count?)

Here’s a mini-story about irony. The clinic visit, which was my “annual” visit even though feel like I live there, went fast. Usually they go slow and I’m there three hours. I could have been out  in 90 minutes if not for the glucose test. ARGH. And I promised to complete a six-minute walking test for a study they were doing, which also included a questionnaire. And I completed that questionnaire while the nurse was asking me questions from another questionnaire. Two birds, baby. I’m the zen master of multitasking questions. Ask away. I won’t answer, but you can ask.

I completed the six-minute walking test, back and forth in the waiting area. 9 complete laps and some extra feet for good measure. A month ago in the hospital my results were not good and I “desatted.” Not this time because I am full of luck to the point it’s falling out of my pants. And I’ll feel that way until the next time I cough up blood on a Saturday afternoon or have to be admitted. But until then, it’s all gravy, baby. Gravy.

Reflections on the ICU and Second Embolization

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(I’m continuing the story where I left off a few days ago)

After the doctors performed the first embolization on Friday, I started coughing up blood on Saturday, which was quite a surprise and a mental defeat. In my mind, it labeled the first embolization a failure, as I shouldn’t have bled again. And I must say the second bleed did seem to stump the docs, who thought they had plugged the leak. My most excellent CF doc explained it as a plumbing problem where pipes of different sizes meet and don’t line up correctly and leaks continue. I didn’t understand his more medical explanation but I had full confidence he did. One of the crazy weekend docs thought it might be from damage to my right lung, my bad lung (I have a good and bad lung), and told me I might need  part of my bad lung removed, which didn’t make me feel so optimistic about my future. Luckily, he was wrong and a stupid MF for thinking out loud in front of me, hence the reason he’s on weekend duty and not scaring the shit out of  patients during the week.

Now if I were completely out of it and in the hospital, the ICU would be the place I would want to hang out. The big glass windows and non-stop, obsessive care sounds pretty good when you’re in an unstable state and hanging on to life. However, when I was moved to the ICU for the bleeding, I was coherent and able to move around. That soon changed when they tethered me to the IV pump on the right side of my bed and the 24-hour heart monitor, oxygen and pulseox on the left side. Frankenstein bound.

As I like to hunker down in my hospital room with the door closed during my normal hospitalizations, this fishbowl of a room where I was the star attraction became my nightmare. When I discovered it had no private bathroom and came with a juice bottle for urine and camping toilet that folded out from under the sink, my bowels puckered up and went on strike. The privacy was one step up from a prison cell. And despite the curtains with partial coverage of the room, I hadn’t reached the point of no shame where I would feel comfortable when a nurse discovered me with my boxers around my ankles, iPad in hand and my rear placed firmly on the toilet seat. I may not take a shower in the hospital, and I may resemble a homeless man with my greasy hair standing straight up, but I’m not at the point where I feel comfortable having a conversation with someone while I’m taking care of business.

And to top it off, the first nurse, who had some a-hole laziness in her, handed me a green box of tissues to use when I asked her where the toilet paper was. These cheap hospital tissues are small and see-through and as absorbent as rock. A much kinder nurse gave me toilet paper when the situation became unavoidable. I made it a point to let the first nurse know about the kindness of the other and to give her a look of “I should strangle you with my oxygen hose right now, but I need it to breathe.”

Thanks to other emgergency IR cases, I didn’t get in for my second embolization until Monday afternoon. At this point, all airway clearance was stopped and they put me on steroids for the jaw pain. Adios morphine dreams, hello steroid hallucinations. Yep, hallucinations. Real ones. Good ones. Like the time I was sitting in bed and the wall moved forward at me real fast, back and forth. Or the time I lay there half dazed driving through worlds painted by famous artists. My favorite was the night I had imaginary friends in my room and woke to find they had abandoned me. What a lonely, sad feeling that was.

Monday afternoon rolled around and my lungs felt congested from no airway clearance. I said goodbye to my wife at the waiting room for a second time, deja vu, and heard the same potential complications speech from the doctor. With no bronc this time, I never reached full unconsciousness. I hung in the misty middle earth of reality and feeling drunk on Colt 45‘s. I do remember them cutting into my groin. I almost said something like “should I be feeling you pinching my private area?” but didn’t care thanks to the fifth beer in my veins. And of course the doctor asked me to perform the same task of a holding a deep breath, though I did have to clarify if he wanted me to start inhaling on 1 or 3. Let’s be clear here, Doc, I’m in an altered state and you’re killing my buzz with these reindeer games and their complicated rules. Is it 1 or 3 when I start breathing? Clarity is the key to happiness.

Three hours later, with Monday Night Football playing in the back room of the IR OR, the team seemed more interested in the game than me lying there on my back with a hole in my groin. Luckily, one doctor stayed behind to seal the leak, though I did think for a moment it would be fitting that I, a lifelong football fan, might die because of MNF. Doctor to my wife: “We’re sorry, we got so caught up in the Bears driving for the score, we forgot to close the hole in his groin and he bled out. But he did lay 100 bucks on them to win the game. Here are the winnings, which I’ll apply to my fee.”

During the three hours, the doctors did a lot of looking around. The area where they performed the first embolization looked much better than on Friday, which was good news. They also found another area that didn’t look normal, probably wasn’t bleeding, but fixed it anyway to help me avoid an episode in the future and help themselves feel better about it not being an unnecessary embolization. It’s hard to say if the second round of bleeding would have gone away on its own without the second procedure. It may have. We’ll never know. The plumbing may have worked itself out.  I was just happy to be done with surgeries that start in my groin.

And can I tell you that the next day when they wheeled me out of ICU and back to the CF floor, my mini-fridge of probiotics on a cart next to me, it was the first time in my history of hospitalizations when I broke down and cried. My CF doctor came to see me and I had nothing left. The energy I used to make it through the two embolizations, and four days in the ICU and three hours of sleep a night (the ICU is never quiet or dark), left me drained by that point and I was very happy to see him. It was the point in a spy movie when the spy, captured and tortured, finally reaches his pain threshold and breaks. That was what it was for me. It was the first hospitalization that broke me. I’m not proud of the moment but I am proud it took me dozens of trips there for it to happen. And I hope I never experience it again, though I have a gut feeling I will. At least I’ll be better prepared when it does thanks to the scar tissue from this visit.

And now for today’s grift

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"Diamond teeth make me feel pretty, oh, so pretty."

 

My wife went to the dentist today – an honest dentist who shares a lot of interesting stories. One was about an elderly patient who brought in his more elderly mother for an exam. The woman was a few weeks out of bypass surgery and didn’t look like she was doing well and might not have much time left. They had gone to another dentist who recommended $35,000 worth of dental work. (It must have been same the diamond package Kayne West recently added to his lower teeth.)

Fortunately, my wife’s dentist did the minimum needed to make her comfortable and saved her enough money to buy a new Cadillac, if that’s what she wanted to do with the leftover money. Whereas the other dentist wanted to buy a new Cadillac for himself or perhaps the Ukrainian mistress he keeps in an apartment in Van Nuys. That’s how I see a person like that who tries to hose an elderly woman in the last stages of her life – he probably cheats on his wife too.

My wife’s dentist shared other stories about the methods dentists and doctors use to bill for money patients don’t owe per the contract of their insurance – if patients pay the bill great, if not and they complain, it’s wiped away like it should have been in the first place. That one really gets under my skin because we get those bills trying to trick us into paying what we don’t owe. It’s unethical.  Yet, it happens. And I wonder who allows it to happen. It’s not some computer that thinks up a great idea to rip people off. Computers aren’t assembled evil and ready to program devious billing practices. It’s a human who thinks this stuff up and somehow finds a way to live with him or herself, along with the pile of money made from the deception.

All of this makes me wonder how ethical we are as a society. Every day I read stories about people skirting the edge of what’s legal and a gray area of almost being illegal, but justified as a billing error or clerical mistake or medical recommendation. This isn’t a robbery of a 7/11 or someone embezzling a million dollars. It’s not an obvious crime that shows up on a grainy video on the 11:00 p.m news. This is a different kind of robbery. It’s not glamorous. It’s not easy to detect. And yet, it feels like it’s happening more often and some justify its financial “cleverness” and ignore it unless by some miracle of detective work it’s exposed.

It’s modern-day grifting and the victim is our bank accounts and faith in others. One’s not so easy to recover.

Highlights from my recent hospitalization: The 1st embolization

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I’m reminiscing about some of my recent adventures in the hole. Here’s the day of the first embolization.

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After six days of coughing up blood in the hospital and playing the “how much blood did I really cough up?” guessing game with the doctors, I won a trip to the IR room for a bronchoscopy and embolization. When I had an embolization in Germany eight years ago, it took the doctors 12 hours to bronc me and 24 hours to embolize me. It was simple and in a foreign language with fewer doctors making the decision. During my recent hospital stay, a lot of doctors were involved in the decision which I can only guess made it easier to delay an actual decision. I knew by day two when the IVs weren’t working their magic that I needed an embolization. But I didn’t have the courage to force the process and expose myself to a procedure where paralysis is a possible complication. But I knew the lung wouldn’t heal without intervention.

By the time I reached the IR room on day six, I still felt in control of my emotions and alert to hospital dangers. My wife was there and I held back the tears when I left her at the waiting room and they wheeled my bed another 100 feet down the hallway, parking me outside the IR while they prepared the room. I signed releases and heard about the risk of paralysis again, thinking that there were benefits to having my first embolization spoken in German. There are no risks when you don’t understand the language and your only goal is to get on a plane and return home. It was annoying when they read the potential complications in English. What choice did I have at that point? Hearing the risks made me wonder how I was going to buy a gun if I ended up paralyzed. How would I pull the trigger? Is that something I could teach my yellow lab to do?

The bronc took five minutes – bleeding from the right lung – and the embolization took almost five hours. They woke me up when they needed me to hold my breath, which seemed like a lot to ask in my drunken state of mind – a sort of breathing sobriety test on my back. Near the end of the procedure, the right side of my jaw started hurting. When I had a chest tube inserted a few years ago, I had referred pain in my back. So I thought the jaw pain was just that, referred pain from the embolization procedure. I didn’t mention it at the time.

The pain got worse when they wheeled me back to my room. They gave me Vicodin, which helped for a little while. That was about when the hospital power went out, including the back up generator at some point. I was in the condition when one shouldn’t operate heavy machinery so it all seemed surreal. The lights went out and the room heated up without the AC. I had to stay flat on my back with my right leg straight to let the insertion point in my groin heal.

Los Angeles roasted that day in the heat when the power grid went out. It happens here in the summer, though I’m surprised it happened at the hospital. It was quite an emergency. One of my friends joked that had I been in the IR at the time, they would have been up my groin without a paddle. Nice. I’m happy I missed out on that experience.

I need to choose my words carefully at this point of the story. Fact: The pain in my jaw went to 10 out of 10. Fact: It took 90 minutes to get pain medicine and only happened at that point because I had to use my loud voice, which shook the windows of the hospital. (Remember, this was Friday afternoon/evening in a hospital when everyone is trying to split for the weekend; charts come first.) A doctor arrived within 15 minutes and there was concern the jaw pain was related to a possible heart attack (thankfully not, the tests showed). They gave me morphine for the pain. And there was concern some of the embolization material broke off and cut off the blood supply to the jaw nerve. I had to smile and make funny faces and demonstrate my facial nerves worked. (Yes, they made me take the bag off my head to do this.)

My wife came back to the hospital and spent the night on the fold-out bed made of rock. I love her for that. It helped having her there. And she was there in the morning when I coughed up blood again (what a terrible surprise that was) and when they moved me to the ICU, a hell of its own I’d never experienced before and hope never to experience again.

To be continued.