Tuesday, May 7, 2013

Prologue to Change: Crappy Year - Part 1

As some of you may know, this year, so far, has not been much fun. It started the first week of January when I caught the flu. I called it the "Special Express" flu since it traveled to me from Virginia via Kellie, Dmitry and Mathilde. When it's the holidays, and one of your best friends in the whole world comes to visit with her 18 month old daughter, you don't worry about the germs. You want to hug and kiss everyone and munch on the baby as much as possible. And, Mathilde is very munchable.

So, I got the flu and was down for 8 days straight. Under my down comforter, shivering and sleeping. For 4 days, I didn't even go downstairs for food. I did a short cost/benefit analysis in my head and concluded it was not worth it. On the 9th day, I was feeling better, though still coughing. I got up and got dressed and went downstairs to take a walk to Bartell's Drugstore for some more cough medicine, and, oh maybe some chocolate. When I hit the cold air, I started coughing. Then I couldn't catch my breath. I waited a bit until I could breathe again and continued down the street. Within half a block I was completely out of breath and sucking air. No matter how much I sucked the air I couldn't catch my breath. It was scary. I tried not to panic. I leaned against a building gasping for about 5 minutes. When I felt better, I looked down the street - 4 more blocks to go…Fuck it. Not worth it. I turned and headed back home. By the time I got there and up the stairs to my building, I was sucking air again and my hands were getting tingly so I knew I was hyperventilating, even though I still felt as if I could not get enough oxygen. I found a bag to breath into, got back to normal, but I didn't want to even think about the stairs up to my bedroom. I watched some TV and eventually went back upstairs and back to bed. If I wasn't moving around, I could breath fine. If I moved, even to get up and go to the bathroom, I couldn't catch my breath.

Now, I am not the person who runs to the doctor for every little thing. The more I can avoid it, the better. I took my usual, "let's wait a day or two and see what happens" approach. Two days later, no improvement and I am at the doctor's office. At first she thought I had pneumonia, however, I had done some research on-line and I doubted it was pneumonia, but I didn't really want to consider the alternative. The doctor gave me a nebulizer treatment. She said it would open up the passageways in my lungs and make it easier to breathe. Then the nurse came in and put a pulse/ox monitor on my finger and said, "Let's take a walk around the clinic." Three quarters of the way around (and it is a small place) I was gasping for air again. The doctor said it isn't pneumonia, but having ruled that out, she feared it was a pulmonary embolism. She said I needed to go to the emergency room immediately and she sent an email to the Harborview ER and followed it up with a phone call. She wanted to be sure they took care of me immediately and I wasn't sitting in the waiting room for hours. I appreciated that, but it also scared me. This is worse than I thought.

I called 4 friends for a ride to the hospital - the first 3 went directly to voice mail, but my friend Trout answered and said he would come and get me right away.

In the ER, the first thing they did was start an IV and draw some blood. I was so dehydrated that the blood clotted up before the lab could do anything with it. They started an IV saline drip. In all, I got 3 liters of saline. I knew I was dehydrated because every time I peed it was dark yellow, and I was trying to drink water - it felt like I was pounding it down, but to no use. Then they started tests. Xrays of my lungs, Ultrasound of my legs. I had two DVT's (deep vein thrombosis, aka blood clots) in my left leg and something indeterminate happening in my lungs.

I was admitted to the hospital and a different team of doctors took over. They ordered a CT scan of my lungs, but not until I had the 3rd liter of saline, which was finished about 2:30 AM. So at 3 AM they wake me up and send me to get the scan. I got back to my room about 5AM, wide awake, nothing to do. Then I remembered that in Florida it was 8 AM, and I called mom.

The doctors came in later and told me I definitely had a PE (Pulmonary Embolism, aka blood clot) in each lung. Hence the breathing issue.

They said that the clots were the result of my complete inactivity for 8 days and my extreme dehydration and perhaps there is some vein or muscle scar tissue in my left leg from a reconstructive surgery I had in 1980. Moral - even when you feel like crap, get up and move around. Also, try not to wreck your knee whilst skiing.

The treatment for DVT and PE is blood thinners. Thin the blood out and the clots will eventually dissolve. Blood gets thinned with Coumadin or it's generic, Warfarin. To dissolve the clots you need an INR between 2 and 3. A normal INR is 1. Until your INR gets up there, you are also given anti-coagulation shots as a "bridge". These are not fun. You give them to yourself (unless you have someone who will do it for you) in your stomach. They leave giant bruises and hard lumps. Both eventually go away, the bruises first, the lumps later. They are also extremely expensive. I was shooting up twice a day for almost 2 weeks. A 4 day supply was over one thousand dollars. All I can say about this, is: Thank you Harborview and your sliding scale for those of us who are underemployed, poor and uninsured.

The other thing they did was insert a vena cava filter into a vein in my abdomen. This is a tiny device that looks kind of like an umbrella - closed, they slide it into place and then tug on the release and 4 prongs open up, like the ribs of an umbrella. This is a preventative measure; the doctors feared that in the process of dissolving, parts of the clots in my leg would break off and travel north. The filter was there to catch them and prevent further damage to heart, lungs or brain. Fortunately, for me the damage was only to my lungs. It could have been worse.

I was in the hospital for 3 days, released on January 21. I am still recuperating from the clots. I want to thank the support of friends and family for their assistance, phone calls, visits and after-care. Especially Juls, Trout, Mel, and Kellie. And mom and dad of course.

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