Up From Rock Bottom

In case I haven't said it before, hospitals are strange places. They're sort of like airports, or casinos in that they don't have any fixed way of telling the time. You can be in an airport at 3 in the morning and even though the stores and restaurants are all closed there's some buzz of activity. Hospitals are like that too. Sure there are less staff at 2 in the morning but it's a guarantee that someone is going to wake you up at some point.

I had finally fallen asleep around 3:00 after finally getting my record blood pressure down around 170, but exactly at five AM someone came in to get my blood and shortly thereafter the day nurse came in to introduce herself and get my vitals. The word was that maybe I'd get to go home after they ran more tests and I proved I could walk without fainting. This was 6 AM and I had to pee but I was still tethered to the bed and using that bottle so I begged her to let me off my leash. As it turned out the nurse the night before hadn't passed on her comments about letting me off my leash after three attempts at walking with an escort, but Deena my nurse told me that if I promised not to pass out and get a concussion she' let me off. I ran to the bathroom; never has a morning pee felt so good.

Around 9:30 I heard a commotion in the hallway which sounded like Lisa's voice. But it was quickly interrupted by another voice. After a few minutes of whispering Lisa came in looking exhausted and amped up all at the same time. She had a coffee in her hand which drank in her first five minutes and then she asked the nurse for more. 

She was scared and amped up and practically buzzing and it wasn't helping my BP at all. I felt guilty, stupid, tired and feeble and her buzzing was just making me more agitated. It was all very understandable but I think the nurse could sense it and when Lisa went out to get another latte the nurse came back in and said "I know your wife is really upset but I'm here for you. If you feel like you need a break just let me know and I'll take care of it." When Lisa came back Deena, didn't say anything but she did offer me some tips on guided relaxation and suggested Lisa join in.

The wheelie people came in 3 more times for 3 more tests. This time in addition to another CT scan and a chest X Ray I  met with the head of the radiology department who re-did my kidney sonogram. There was a lot of contorting of my body and hmmmming at my pictures and at one point he left to consult someone. He came back smiling and said that it was hard to tell, but it looked like my kidneys were probably okay and it probably looked odd from dehydration.

Around 2 I was told I'd be able to leave once the doctor signed off. I sat there hour after hour in my sweaty little bed, feeling sweaty and disgusting; I hadn't showered the night before this all started and I was really feeling disgusting now. It was apparently a busy day of new patients and I was doing okay enough to drop down the list of urgent need. The one productive thing that happened that day was that Lisa was so jacked up on coffee she knitted my nurse Deena snow hat. 

Finally at 7:00 PM Dr Halpern came in to release me. He did the scary looking behind my eye thing, made me squeeze his hands and then said I was doing okay. The diagnosis was an Extreme Hypertension Emergency. He sent me off with a handful of prescriptions for blood pressure and a recommendation of a low sodium diet and an admonition to see my personal Doctor;  A doctor I had stupidly never seen.

The ride home was almost as intense as the ride home from the street fair. I was very tired and scared, Lisa was scared and still angry. We stopped at Safeway to get some low sodium food. Fortunately I don't like processed meals and food very much anyway, but my big shock was that cheese is loaded with sodium. Well most cheese, for some reason Swiss Cheese is very low. So I loaded up with Swiss Cheese, Tofu, veggies and low sodium tortillas. It would be another month or two before I found a low sodium Soy Sauce that really was low in sodium at an Asian market. To this day I'm still pretty careful about my sodium.

I was terrified those first few days. I was certain that if I sneezed I'd have an aneurism. I pretty much ate nothing and didn't leave the house except to go see my new Dr. I was supposed to be seeing a Dr who had been described as very tough and I wasn't looking forward to it. Both Lisa and I were afraid that that would not help my phobia. But at the last minute I got a call that he was sick and an offer to see another Dr.. Dr B as I call her. She's great. She didn't have any more room on her panel but my case was so extreme that she took me on and I'm very glad about that.

So there I was someone who was certain that I'd completely broken myself. Someone who had developed a horrible Dr. phobia and had record high blood pressure. But that was then. Just like an alcoholic, this was my rock bottom. I have an awesome doctgor. t and I go regularly for physicals and tests. I've been seeing a dentist regularly as well and I even had two sinus surgeries last year to fix a sinus problem discovered by an oral surgeon in an X Ray.  My blood pressure is normal, as is my cholesterol. I even meditate every day which also has a profound effect on my blood pressure and general well being. Even broken things can be fixed with a Little TLC.

You Break it You Buy it

I knew the Telemetry floor well; it was where Lisa spent a week when she had her heart trouble 12 years earlier. Or more correctly it's where I spent a week reminding Lisa, whose memory only existed in 5 minute increments, where she was and why.

So I knew this was some serious stuff. It was serious enough that I was NPO which meant no food, and I was a fall risk because I had passed out so I was confined to my bed. The food wasn't a big deal since I wasn't very hungry. But not getting out of bed was. This meant that I had to do all my peeing in a weired little flat plastic bottle. Between all he fluid they'd been pumping into me and my messed up kidneys I needed to pee a lot. This involved having to figure out how to get the pee into the bottle while flat on my back without making a mess. Even with a full bladder it's hard to get yourself flowing in that position and to negotiate the top of the bottle. But the worst part was I had to leave it on my side table so the tech could measure. I was told by my nurse that if I could walk 3 separate times with someone watching I could be listed as free to walk. Though she forgot to tell anyone else, so I only got one walk before night time and was trapped in bed through the night.

During this time I had yet another Dr.- the hospitalist. At one point he took one of those lights and stared into my eyes making worrying noises. I asked what he was looking for and he said you can actually see brain swelling behind the eyes. He was having a hard time telling if I was having something like that. So I got wheeled for another CT scan and while I was already on the road they also gave me an ultrasound for my kidneys. The only thing the ultrasound lady said to me was that my bladder was really full and I should try peeing when I got back to my room.

That night was one of the scariest nights I've ever had. They'd finally given me some hypertension medicine and the goal was to get my pressure under 180. I'd told Lisa I'd text her when that happened. But the first check at 9:00 PM showed I was still in the high 200's. Robbie, my awesome nurse, came back in around 10:00 with an injection of this medicine and gave me more. An hour later it was still over 200. He called the on-call and she ordered yet another higher dose. Still no change 90 minutes later.

By now I was upset and scared. This idea that I'd broken myself kept playing over my mind. Was anything going to get this pressure down? Was my heart going to get back to normal? Would my kidneys get better so I could stop needing to pee?

 By now it was 12:30 and there was a little drop but still over 200.  Robbie, who is still the nicest nurse I've ever encountered, gave me another dose of meds and came in every few minutes to encourage me. I think he could tell how scared I was. 1:30 still no change and another dose. I wasn't being able to sleep because I was scared and because I knew Robbie would have to wake me up to check my BP. Finally around 3:00 AM Robbie did a check and it was 175. This is a completely terrible blood pressure but I guess half of 300 is an accomplishment. Robbie gave me a high five and I drifted off to sleep.

(Next time the conclusion)

Not Quite OZ

When I was a kid I was fascinated by ambulances; I'd peek in the window and look at the person inside, wondering what they were thinking and what was wrong with them. Now here I was in the back of one feeling very self conscious but also strangely calm. If I hadn't had a million electrodes on my chest, and tubes in my nose and an IV in my arm I might have enjoyed the ride and the view of Mt Rainier. There was something in the IV that was making me a little mellow and feeling like I was sort of watching everything from a distance so the first couple of hours were a blur.

The ER was a swirl of activity and people giving me that odd smile reserved for people that might fade away at any minute. My biggest memory of that part of it is virtually everyone commenting on my record high blood pressure. Most everyone was pretty polite about my stupidity in not having been to a doctor in 10 years except for one intern who didn't quite call me a moron but rolled her eyes every time she came into the room.

You spend a lot of time in the hospital on your little wheelie bed being rolled from place to place. I rolled from the CT Scan, to X Ray back to the ER and finally to my home for the night in the ICU. The ICU is kind of nice in some ways. You get a private room with a comfy bed and a dedicated nurse and tech who dote over you. There was a lot of adjusting of IVs and shaving of body hair to add electrodes. My advice is if you're going to go to the hospital and you're a hairy guy, shave in advance because they're not exactly doing manscaping and you wind up with big bare strips in your chest hair.

My night on-call doctor was a tall lanky guy in his early forties who had a southern drawl that sounded like honey. He managed to tell me that my heart was enlarged, my kidneys were messed up and he was afraid I was about to have a stroke while making it sound like he was offering me a Mint Julep.

There's just no way to fall asleep in the CCU. I was certain that I'd broken myself and I wasn't sure how I was going to fix it and I couldn't relax. But also there's always some noise in the hall, or someone coming in to someting buzz or ring a bell or to take some blood. At one point I opened my eyes to see my doctor just staring at me with a warm smile. He asked if I had chest pain, or numbness and I answered no. He kept smiling and said "Jeff. You are a puzzle to us. From the way your heart looks you should be a man who is having a heart attack. But you're cool as a cucumber and your other tests say you're not having one."   I guess that was comforting.

The next morning I had a new set of doctors. The resident was a spunky friendly woman who did a nice job of keeping  me calm. The on-call was fine but not especially friendly. At this point  I was pretty scared and it didn't help that my room was the one next to the room where the doctors had all their conversations and made calls. It was only separated by a window and a curtain and I could hear everything. I kind of reminded me of the Wizard of Oz hiding behind his curtain. I heard a  half dozen conversations about me. Most of them started with "No that's right 300. That's not a mistake."

The resident came in in what I thought was mid morning; I didn't have my a watch or phone so I wasn't sure. She told me they were doing Grand Rounds with the student doctors and she'd like to include me. She wanted to warn me that I was very unusual so there might be a lot of scary questions, but I shouldn't worry. She was probably afraid that in my condition I'd get freaked out and have a heart attack.

A few minutes later my two doctors came in surrounded by a gaggle of Doogie Howser aged doctors and a pharmacist. The resident started by giving a long, embarrassing explanation of my medical neglect, my vitals etc. Then she explained the mystery of the "not a heart attack". I didn't fully understand it but it had something to with my blood pressure being so high that it had enlarged some portion of my heart which caused it to look like I was having a heart attack.

I kind of knew how my dog felt at that point with a long conversation going on around me and not understanding most of it. Occasionally I'd hear my name and I'd smile or nod my head. There was an argument between the on-call and the pharmacist about what kind of blood pressure medicine to give me. The pharmacist wanted to follow protocol and the annoyed on-call said there's nothing protocol about this  case. They ultimately went out in the hall and argued.

Finally I started hearing phone calls from the OZ room about finding me a bed and me being relatively stable. I kept hearing Telm which I knew meant telemetry which his essentially where hear patients go. They put what's essentially a little radio on you so they can check your vitals continuously.  A few minutes later two transport guys put me on another wheelie bed ready to take me to the Telm unit.

(To be continued)

Face Down in Georgetown

So this weekend is the Power Tool races in Georgetown. It's a lot of fun to watch these dressed up power tools like saw and sanders racing down a Pinewood Derby track and I've been going for years. For some reason it always worked out that Lisa, my wife, was out of town so I'd go myself. But two years ago she was around and we'd finally arranged to go.

That Friday I felt kind of fluish, with a low fever and upset stomache but I figured I'd get better. By the time we got going on Saturday I felt really sick, dizzy, headache, fever, nauseous. But I'd been looking foward to this I put on a hoody for the chills I was having and had Lisa drive. I  felt like I was getting sicker with every mile. By the time we parked I was sweating buckets. We started to walk around the fair that was part of the event and there were a lot of food vendors but I was so sick that the thought of food made me feel worse. Lisa looked for some food and I saw a Vitamin Water booth and got a free bottle of that. I drank a little thinking it would help, but it only made me sicker.

Lisa went to a food truck and I started feeling light headed. I've passed out once or twice in the past and I had a feeling it was coming. I can only describe it as a softening of focus around the edges of my filed of vision, a slight buzzing in my ears and a feeling of coming untethered from the world. While she looked at a booth I found an older brick building that had windows with a little ledge around the base. I sat/leaned on the ledge and felt myself suddenly fading more. It felt like I had just drifted into a deep sleep, when I suddenly started hearing carnival noise and Lisa yelling "Jeff, Jeff wake up,"

I woke up finding myself laying on the ground with a pair of broken sun glasses and a sore face. I sat up and Lisa looked panicked. I was a little disoriented but I've always had this ability when drunk or out of it to sound very coherent. I insisted I was fine but Lisa wasn't having any of it and she made us go home.

Now here is where it gets embarrassing. Somehow over the years I had developed a pretty bad medicacl phobia. I hadn't been to a doctor in over 10 years. I knew that High Blood pressure ran in the family and whenever I tested it myself it was high. I'd been treating myself with herbal medication and had convinced msyelf that my pressure would go down over time; it had already been 3 years of self treatment.

The ride home was tense. Lisa was insisting that we stop at the drug store and take a blood pressure, but I knew that it was going to be high. I tried to persuade her that I didn't need one, that I just had the flu and needed to go home. Fortunately I lost. We went to Bartells and took  a pressure. I thought my arm was going to fall off from how much it had to pump. Finally after a long time, the number came back....300/120.

This sent Lisa into panic mode and me into full denial mode. When we got home I insisted on just needing to get into bed and rest to which, suprisingly, Lisa agreed. I got into bed upstairs and a few minutes later I heard a whispering phone conversation. Lisa was on the phone consulting nurse at our medical center.

The gist of it was that the nurse clearly wanted me in the hospital right that minute. I hollowly argued with lisa and the consulting nurse, but in the end I knew it was time to get some help. I pretty much felt like an alchoholic who had just hit rock botom and had an intervention.

5 minutes later I had a small bag packed and was wearing sweats sitting on my couch gloomily waiting for Medic One two show up. There's something very odd about hearing a siren like you've heard a million times but knowing that it's coming for you. For some reason I kept hearing the lyrics to I heard that lonesome whistle blow.

(to be continued)

Strange Day in Oakland

I had one odd experience while I worked in Oakland (see Last Train Out of Oakland). Most days I didn't have use of a car so I would take a combination of buses and Bart from SF to the school. Some days I would walk from BART but if I was in a hurry there was a bus that I would take after work.

I had somehow gotten walking pneumonia(probably from the stress of the job). It went away after two weeks but I had a really bad cough that hung on. One particularly awful Friday I was on the bus headed back to BART to go home. I was in my usual dark mood and coughing away. It was one of those loud, hacky coughs that drive everyone around crazy.

The bus was empty except for me and a few people at the front. I was sitting toward the back on one of the sideways seats when this down and out looking guy ambled on. He was an older African American guy, probably in his sixties, wearing threadbare clothes. He also had a tall nicely made walking stick. he sat in a seat near the door a few seats away from me.

I was more or less lost in my head coughing as usual, but I did notice him staring at me briefly. I went on coughing, but after a few minutes I heard a humming. I looked up and this man had his eyes closed and he was humming something with an arm wrapped around the stick.

After a few minutes he looked directly at me, then closed his eyes again. This time he rubbed the stick with his left hand a couple of times then put his right hand out flat palm up. He hummed again while waving his left hand over the outstretched hand. Then he acted as though he was pulling something out of the right  hand. Then he’d act as though he was flinging whatever he’d grasped out the window. This stopped after a few minutes and when I looked at him again he was leaning back in his seat with his eyes closed.

After a few minutes I got up to leave. As I hit the top step the man opened his and he stared right at ; I got a chill. Then he spoke in a clear loud voice. “It will be gone.” He smiled at me and I half smiled back and walked off the bus. At the time I just chalked it up to one of those odd experiences that often happen in a big city.

But two days later  I was out with some friends and one of them said “are you feeling better? It sounds like your cough is gone anway.” I realized that not only had I not coughed since the bus but I hadn’t even taken any of the cough medicine I had been guzzling.  And then I remembered the man had started his ritual right after one of my coughing jags. To this day I don’t know if losing the cough was coincidence, some sort of psychological placebo or a mystical treatment but I think about that man often and how much I dismissed him at the time.