Sunday, December 14, 2008

On the 2nd Day of Christmas...




I woke up bright and early. The full moom had circled the house in the night and was stuck in the frosty branches of the tree in my back yard. Last night Liam and I had admired it in the front yard as we sat on the couch and looked out the window at the frozen night sky. It is still cold...-36 Celcius!




But a little bird braved the cold to offer me a reason to be happy with the season. You see, it brings not only cold weather, but pretty, mysteriously wrapped packages! This one is from Penelope!
Oh My! This was totally worth getting up early for! It's a diminutive book, beautifully hand bound. Each page has a tiny pocket that holds a wee little card. Each card is inscribed with magic. It's the secret of Alchemy, that forgotten science that turns the ordinary into gold. It works! Penelope totally made my day golden!
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Wednesday, January 9, 2008

The Results

I'm back from my holiday break. Now for part 2.



Early in the emergency room. The VQ scan was yesterday.

Doctor Hamilton brushes through the curtains surrounding my bed. She holds a clipboard.

"So, we found it."

My insides jump. For the past 24 hours, I've labored under the idea that this could be just a
ghost. Imaginary. No real reason for being shipped in an ambulance, poked and prodded, scanned. I'm not hemolizing, so what else could it be? Really, what is it? Sitting in an emergency room bed does not contribute the a feeling of zen-like calm and well being.

"Bi-Lateral P.E."

Wah?

"We found it, blood clots in both sides of your lungs."

"That sounds serious."

She rubs her forehead. Like in a pain reliever commercial.

"Yeah, problem is, you're not supposed to get this. You're too young. This never happens. Like, never. Maybe a clot in one side, maybe, but not both."

"What does that mean for me?"

"Well, you go on blood thinners. Problem is, you were already on blood thinners, so that really confuses us. We have to draw blood for a real close look. Then we have to look for genetic predisposition to clotting. That will take about a month. Until then, we just give you thinners to melt the clots."

"So I want to pass these out of my lungs?"

"No. Definitely not. We want to melt them. If they dislodge, the next place they end up is in your brain..."

"...which means a stroke."

"...right."

Wow.

"You're just a box of suprises!"

Hamilton leaves.

At least, at the very least, I know what it is. Not knowing is, in effect, a poison. It sticks like a pin in your brain, clouding how you think, how you process your situation. Uncertainty about a dangerous medical condition is like being told, while speeding down an icy freeway, that your brakes might work.

The porter carts in a wheelchair; I have a bed available. It's at the opposite end of the hospital from where I was, on the top floor. On the way there, we wheel directly over the Stollery ward... there's a groovy open-air play area. There's puzzles, books, a crib with a toy doll hooked up to a toy-IV. It's bittersweet and angering to look at.

I flash back to when I was 16, when I first got this.

I was in the pediatrics ward, only a year or two before it was renovated into the existing Stollery. The pediatrics ward is different - nurses are calmer, quieter. They use smaller needles. It's a little more cheerful, also a little more depressing that the rest of the hospital. The image of a five-year-old hooked up to seven IVs is something that doesn't process easily.

Remarkable though, is the resilience of human beings in general - the children in these hospitals, definitely, need to be able to endure a fair amount of sickness and medical-treatment-related traumu. But the parents, who tend to be financially stretched, over-commuted and exhausted, not to mention dealing with the emotional strain of having a child in the hospital, seem to adapt remarkably well to this kind of situation. Life goes on, chemo treatments happen, good news, bad news, wait, wait, wait. It seems to develop into a lifestyle for many parents of children with serious and chronic illnesses.

But, I'm back here. And even though I'm grown, have a child and a wife, I'm still kind of a child when I'm here in these hospital walls. The control of a situation is torn from your hands, and everyone looks at you with sympathy because they can't do anything, and neither can you.

So, back to getting wheeled to my new bed.

Lo and behold! The Urology ward. Once again a ward, having the poor fortune of having nothing at all to do with my condition, but having the merit of an open bed. I will learn more about my bladder in the coming days than I ever cared to know.

I get to my room.

On my left is George, a Scotsmen who wants out as soon as his Chron's will let him keep down food.

On my right, Gary. An aging hippie and former musician, he sings along to 60's rock on his headphones in a broken, wheezy tenor. We'll talk more about him later.

And me in the center. Welcome back to capacity lodgings at the Chez U of A, Nialle.

Friday, December 21, 2007

Voices from the emergency room

Across the hall:

Inaudible. Angry.

"Look! You can't talk to the staff like that!"

Inaudible. Still angry, angry and gruff.

"Look sir, I told you. We've given you your drugs, and that's it. You can't have any more."

"Well I shou... should! I'm in here, an'... an'... aleast I'm not out there! I came here!"

"But you can't talk like that here! You're abusing the staff!"


This nurse is getting loud now. It's night shift and all the nurses are men.

"Whul, all I said was f---!"

"You can't say that to the staff!"

"Well scheeez, Imen pain! Imen in here... Imen in here... I juss sed I's in f---'in pain! Thass all I sed!"

"WE GAVE YOU CODEINE. NOW YOU DON'T GET ANYMORE. IF YOU CONTINUE, YOU'RE OUT ON THE STREET, UNDERSTAND?"

"Iz not henuff! C'mon!"

"You get what you got."

"C'monnnnnn!"

"I'm leaving. If there's any more abuse to the staff, I'm calling security."

The nurse stalks off, grumbling to other staff.

Eventually he relents, the guy gets his codeine. Keep the peace, I suppose.




From under the curtain to my right:

"So you're having heart problems?"

Prim, old lady. Proper British accent. Timid, frustrated, tired, unsure, doesn't want to impose.

"Yes, oh yes, sometimes it gets very tight.. right here."

"Alright, you have previous history of angina?"

"Oh, yes dear."

"Any other symptoms that accompany the chest pain?"

"Well, occasionally, I get a bit of a cough. But it's a silly cough."

Silly cough? I think.

Yeah, we treat that with hilarium.



From under the curtain, later, a lady expounds her tale of woe.

It's a polymorphous account, editing and mutating to extract sympathy from the various doctors and nurses who visit. After spinning her sixth tale, she breaks out the coup de grace to a young doctor who doesn't seem to be buying it:

"But I'm coughing up stuff! GREEN STUFF!"

The doctor parlays back, brilliantly:

"You smoke, right?"


This is what I listen to from midnight to three in the morning.

These are the people filling our emergency rooms.

Wednesday, December 19, 2007

Bi-Lateral Pulmonary Embolism

Whirrrrrrrr.

This room is large. It's quiet, except for soft humming, and bleeps from a computer console. At intermittent moments, the console emits a soft chirp that's almost musical. A technician, female, in her fifties, in a burka, stands in the corner fiddling with controls.

The walls are beige, the machine is white. It's a cage, twelve feet high and more than that wide, with racks and rollers that allow large scanners to float over a long stretcher in the center of the room, where I lay. The is the VQ scan machine.

Whirrrrrrr.

The machine coasts over me. Heavy-looking apparatus comes with inches of my head.

"Breathe deep for three minutes. Don't stop breathing. Deep breaths."

She places a plastic hose in my mouth.

I inhale, breathing radioactive isotopes into my lungs. These have a half-life of six hours. Hear about the controversy on the news about the nuclear reactor being shut down in Ontario? The one the government said would create a medical crisis because it supplies half of the world's supply of medical isotopes? This is one of those medical machines. I'm the one who needs those.

Whirrrrrr.

Coast, scan, coast scan. Listen to my own breathing.

Bleep. Whiiirrrr. Bleep.

"And we're done."

She helps me off the stretcher, back on my wheeled stretcher, and sets my in the hall. This part of the hospital is dead silent, and dark. Because it's the weekend. It's an unsettling change from the noise and pace of the emergency room I was just taken from.

"So... what kind of radiation is this?"

"It's less than you would get from a chest x-ray. Don't worry."




Let's step back 24 hours, to the trauma room.

It's a blur of action. A tech rushes in and takes blood. They want to check my hemoglobin level to see if and how much I've hemolized.

A student nurse sticks me with a IV in my left arm, the only other good spot on my body to draw blood. It hurts like hell and bleeds all over the side of the bed. This is just in case I need an emergency transfusion. The ambulance team already got my right arm, so who knows where the techs will draw from now. A mobile x-ray team wheels in a takes a snap of my chest in less than thirty seconds.

The blood results are back, it hasn't even been ten minutes.

Doctor Hamilton walks in, shaking her head.

"98."

Mom, Vanessa, Me, Hamilton. Our collective jaws drop.

This is exactly what it was when I left. I'm not hemolizing.

"We're thinking it's a clot."

My mind fuzzes. The said something about this prior to surgery... what was it? I can hardly remember.

...I might get a clot in the vein along my pancreas, beside where my spleen was. But the likelihood is a fraction of percentage. Wait... I'm on thinners! I've been in blood thinners since before surgery!

"We'll send for a CAT Scan or a VQ, whichever is available first. That will tell us."

There's nothing else for Hamilton to do. They ship me to emergency to wait for a bed.

Sitting in emergency, I find out that everyone at church was told I'd relapsed badly and been driven by ambulance to the hospital. Great. Then my friend Chris and his wife Jody jumped in his car and sped into Edmonton.

My mom meets him in the emergency waiting room, and comes back to see me.

"Chris is here."

"Really? Send him in!"

"They won't let him 'cause he's not family."

"What?"

"Yeah, he's really shook up. He was shaking and crying."

I'm confused and touched. I don't care that much about my health.


Chris will later come over for dinner after I'm out of the hospital and tell me about that day:

"I was in bad shape. I was driving crazy."

Chris is an engineer who forensically reconstructs car accidents. Chris also drives like an engineer who reconstructs car accidents and looks at photos of people who were involved in those accidents.

"Yeah, I was just thinking about you, and driving, and praying and stuff, and the thought struck me, 'Oh God... I need to have more beers with him!"

Brotherly love works in funny ways.



In emergency, Miles, my father in law, visits for a while, and leaves. He's not doing much better than Chris was. Really, I'm doing fine now. I think.

The clock strikes ten, and my mother leaves.

I'm an expert at this now. I wheedle a sleeping pill and an additional pillow. I convince the nurse to take off my yards of cables and monitoring equipment. I turn, position, don't disturb the IVs. Trust the sleeping pills. Ignore the yelling outside the curtain.

Sleep.

Friday, December 14, 2007

The Ride

"We'll go straight to the U of A. It's going to be busy in emerg."

"....yeah."

Gasp.

This has gotta be hemolysis.

Wait. Hemolysis doesn't act like this.

Gasp.

Blood levels didn't change after surgery... I didn't change my steroid dosage. Nothing could have gone downhill that fast. I've been out less than a day.

Gasp.

Vanessa and I are speeding towards Leduc. I start to sag, sink in my seat. My vision is swimming. I gasp just to get air. My head falls to the window. This is worse than a low blood level. I don't know what this is.

"Screw emergency. Let's go to your mom's and call an ambulance."

We get to my mother's. Within thirty seconds of the phone call, we hear sirens. The ambulance parks on the road, three paramedics emerge, bring the stretcher. I'm helped out of the car. At least the neighbors will have something to talk about. I manage to stand, and I'm piled onto the stretcher and into the back of the ambulance.

My mother calls the on-call hematologist at the U of A.

Liam, looking out the front window of the house, waves excitedly at the ambulance with the flashing lights.

I'm stuck with an IV and gravity-fed saline. I'm given oxygen.

"So, what can you tell us?"

"I was just released from the U of A. I recieved a laporoscopic splenectomy for auto-immune hemolytic anemia. It looks like I'm hemolyzing again."

Insert medical history. Take me to the U of A, please now.

The paramedics, normally confined to taking patients to the nearest hospital, receive approval to transport me to the U of A. Off we go.

Miraculously, within moments I'm feeling better. By the time Vanessa takes a seat in the front and we drive off, I'm having a brisk conversation with the female EMT about her latest practicum.

I chalk it up to lying down. Reclining. It's gotta be the oxygen. Maybe. The saline? This is mystifying.

We get to the U of A. The paramedic looks out the window:

"Uh oh."

"What?"

"We're offloading in the parking lot."

"What does that mean?"

"It means it's so busy, we can't even back in. Like, ten hour wait busy."


My mind blanks. Ten hours in an emergency waiting room?

I'm wheeled in, give my history. We park next to a row of other paramedics, beside other stretchers... alongside a waiting room packed to the gills with coughing, moaning, silent, angry, disquieted people.

In less than five minutes, I'm in a trauma room, being stared down by the same hematologist that discharged me less than a day ago.

Dr. Hamilton, you look very concerned.

Wednesday, December 12, 2007

Home

I'm staring at a plate of curried chicken. My mom stopped by with tupperware and left hastily.

The light is yellow in my dining room. I sit at the table. I'm glad for this food. Not a day ago I forced down gummy, lukewarm pork and tasteless rice from a hospital tray.

At this juncture, homecooked food is not just a luxury, it's an indispensable therapeutic necessity.

I eat.


I don't really remember the ride home. I was in the car, and Vanessa stopped to get my prescriptions. That's all I really remember.

When you first leave the hospital, with all it's dank body smells, the endless pages echoing through the halls, the pulsing of the IV pump and the sickly food, the inclination of your senses is not so much where you are at the time, but where you aren't, namely, at the hospital.

But now I'm here, home, and it's 7pm. My gladness manifests in exhaustion and appetite.

Liam is also exhausted, out of order. He's been displaced at grandparents houses for over a week. For all their love and care and endless doting, the grandmothers can't replicate the routine of home and family. He'll take a while to get back in his toddler groove.

Vanessa, having carried the burden of a sick spouse, long commutes and a first-trimester pregnancy, is just as tired as both Liam and I.

I gobble my food, and bed finds us all at 8pm.

Before sleeping, Vanessa and I talk.

"You know, even if I need another transfusion, or if something else happens, I don't care. At least I got one night in my own bed."

"Yeah, you're right."

She's hesistant. But I'm less hesistant. I'm here, and not in the hospital. Good enough, one step at a time.

The bed is unspeakably sublime. I stretch out under my comforter, feeling the flannel sheets, the forgiving mattress, the warmth of my wife beside me. Delighted that my feet fail to find a footing of molded plastic.

I pop a couple of T3's so I can sleep with the slight burning in my midsection at the area of the stitches.

I sleep in fits, waking during the night several times. Coming cold-turkey off a steady diet of sleeping pills is not conducive to perfect sleep, but it's good enough. A few false starts and I drift off, wrapped in a cocoon.

I'm dizzy when I wake in the middle of the night. My calf hurts. I shrug these things off.

I wake in the morning and I'm dizzier. It's Sunday.

I'm just pushing myself a little too much. These stairs are beating me. Sit on the couch, no big deal.

My heart pounds.

Vanessa, at the kitchen table, lays out my medication, checking off a chart that she has created for this purpose.

"OK... so... come take your steroids, and your antibiotics."

I rise slowly from the couch. One foot in front of the other.

Gasp.

To the kitchen table. I sit.

My vision swims, and I barely get my pills in my hand. I'm hanging onto the table now. I swallow the pills. I need to lie down.

Something's not right.

Monday, December 10, 2007

Insomnia

Finally, I struggle out of bed. Struggle is a strong word.

I wince, roll, shuffle. I unplug my IV. I wrap my gown around me and make my way out the door.

The night nurse crew is still out. Some of them are reading magazines.

"Uh... hey. I haven't slept in forty hours. Really. I'm just out of surgery, and I need sleep bad. Please. I just need to sleep. Isn't there anything you can give me?"

Four pairs of eyes stare at me blankly.

I look terrible, I know. I smell worse. I just watched a wall clock turn from 10 P.M. to 7 A.M.

One pair of shoulders shrugs. I bite my tongue and breathe slowly. Four hours prior, I was given an IV dose of Solumedrol, which pins your eyelids back with violent force. No sleeping pill available.

"Really. Is there nothing?"

I'm clearly agitated.

"We can page your doctor."

More agitated.

"The doctor responsible for my care is Briesboit. I just heard Stars land. I'm not paging him for a sleeping pill. We both know He's operating on some traumu case."

"Maybe we can get you something tomorrow night."

Tommorow?! Are you @%$#! kidding me? When the hell am I going to be able to sleep?! Tell me! I feel like I'm mainlining Redbull!

Shrug. Back to the magazine.

Nothing sets your teeth on edge like this. I give up.

Turns out if your doctor forgets to allow you a sleeping pill or a tylenol, you're not getting it. And there is little worse than not being able to sleep in the hospital.

Tough luck.


I manage a shower, and Vanessa shows up. This calms me down. I manage an hour of blissful unconciousness, and that's it.

Doctor Briesboit shows up later, and I expound my tale of woe. His solution? Send me home. I've been here nine days. Nothing makes a man sleep like his own bed. I like the cut of his jib a little more.

I haven't dropped a single point of hemoglobin since my surgery, so that looks positive, to say the least. The spleen worked. It worked.

However, Wetaskiwin is not so great; I'm over an hour away if I start hemolizing again. He's concerned.

I don't care. Send me home.

Briesboit calls the hematologist and suggests that I leave. Within minutes he writes discharge papers and prescriptions, and sets them on my table. I stare at them like they're Christmas presents. All I need is the OK from hematology.

And three hours later, when Doctor Hamilton does her rounds with an intern at her side, that is what I get.

Get me outta here. This is over with. Home cooked food. Oh, God, home cooked food. Oh, my bed. I won't have to kink my legs to fit. I fit in that bed. My clothing. My couch. My house. My family.

This is over with.

Right.