Back in the hospital

Yea! What fun!

Last Thursday, when the wind was blowing a bazillion MPH and kicking up all kinds of dirt, I started having breathing problems. Fast, shallow breaths. No fun. I took a hit off my inhaler before Mom went to work, and it helped for a little while, but then the fast, shallow breathing returned. I called Mom to see if we had any of P's medicine for the nebulizer, and she said no. She advised me to try the inhaler again or call my doctor. I was a bit nervous about trying the inhaler again so soon (it had only been about three hours since the last hit), so I called my doctor, but he was off that day. I talked extensively with the nurse, explaining I couldn't go see the on-call doctor because Mom was at work and Dad was getting his quad serviced -- no one home to drive me. She told me to try the inhaler again and call her before 5:00 to tell her if it worked. She was very worried, and I wasn't exactly in a cheerful mood about it myself. I tried to call my aunt to get her to help me, but there was no answer at her house. I called Grandma's to see if she was there. She wasn't, and Grandma asked if there was something she could do. I told her what was up and that I needed help with my inhaler. She said she was on her way.

At this point, I was seriously considering going to the Mac ER. The problem was that Dad was feeling worse than I was (he had been off his heart medication for a week but was back on it, and it was kicking his ass all over the place), so I knew he wouldn't be up to sitting in the ER with me. Grandma arrived in short order and helped me with the inhaler, and she decided to stick close until Dad got home. Then she made the mistake of telling me she had driven 70 MPH in a 45 MPH crosswind to get to the house. Short of breath or no, I let her have it.

Me: Grandma, what the hellwere you thinking?

Grandma: You needed help. I wasn't sure how bad you were.

Me: Well, you wouldn't have been very much help to me if you'd wrecked on the way here!

Grandma: Weeeeeeell, I suppoooooose . . . .

That hit of albuterol didn't help for long, either, so I called Mom again at work to tell her I really probably ought to go to the ER. She called my aunt, who was now home, and she took me in. We arrived at the ER at about 6:45 or so. My BP was 185 over 134 and my heart rate was somewhere in the neighborhood of 150. On the way in and while at the hospital, I had a couple of waves of nausea but was able to talk myself out of throwing up. The ER doc gave me three separate breathing treatments, each with different medications, none of which significantly improved my breathing. At that point, she said, "I think you have an inflamed trachea, so I'm going to send you home with some steroids." I wasn't comfortable with that diagnosis and asked her to somehow get in touch with my doc.

While she did some calling and the stupid respiratory therapist kept asking me every ten minutes if I felt better YET, my nausea returned, and this time I couldn't talk myself out of yakking. Through the entire ER process of that night, I threw up three times, increasing in volume with each episode. After either talking to MY doc or the one on call, the ER doc ordered blood chem tests, blood gases, and a CT scan of my heart and lungs to see if I had a clot somewhere. The CT required the injection of contrast solution, so first we had to have fun with starting an IV. By this point, Mom had spelled my aunt (it was now about 10:15 or 10:30) and I had gotten her to lay me down on the gurney because my kidney was really starting to rock and roll. By about 1:30, we had determined I did not have a blood clot, but I DID have acidosis -- so badly that I was admitted into ICU. Well, at least we explained the shortness and rapidness of my breathing -- when you're blood is acidic that means your CO2 levels are very high, and you breathe rapidly to try to get rid of it and put your blood gases back into balance.

I slept fitfully that night, sleeping no more than an hour and a half before having to reposition or pee (I was on IV fluids by this time). Then started fun Friday.

Dr. P was afraid I'd blow the IV that was placed in a tiny vein in the back of my left hand, so he ordered another IV started. My RN tried and failed. Another RN tried and failed. They called anesthesia to get them to do it. He tried twice and failed. Interspersed throughout this were scads more CBCs and ABGs and BMPs and XYZs and such (blood work). Dr. P ordered a central line.

For those of you who don't know, a central line is a small catheter that is threaded through your jugular vein down to about your collar bone. They put a needle in your jugular to where they want the end of the catheter to be, then they thread a guide wire for the catheter, and finally they thread the catheter and then remove the guide wire and the needle. On most people, I'm sure it's easy.

I was assured I would be sedated for the procedure, and that was Jim Dandy fine with me since I was TIRED of being stuck. The guy went to get the materials, and I peed yet again. When he came back, he patiently answered my questions and then broke the bad news.

My doctor would not let me be sedated.

Turns out sedation can mess with your CO2 levels, and mine were already out of whack. I wasn't happy, but what could I do? I said OK, and we started.

Let me just say that a central line placement is in my Top 5 Worst Things I Have Ever Been Subjected To. Those of you who have ever had a PICC line placed will have some idea of what I felt.

And they never got the damn thing in! Forty-five to sixty minutes of work (of which I only started to cry in the last fifteen -- go me!), and they never got the damn thing in. I cried hysterically for at LEAST fifteen minutes after the guy gave up. He and the sweet student who was observing got me settled down, then they turned off all the lights, advised me to turn on the TV, and then left me blessedly alone. I cried a little more, calmed down, called Kender, and cried some more. ::hitching breath:: Man, that SUCKED!!!

Saturday was better. I slept a solid five hours, and the blood work was taken with a finger stick. Then they tried to get an ABG (arterial blood gas). I had already been stuck for it three times in my right wrist and wouldn't let them touch my left because I was babying that hand to keep my precious IV. My right wrist had had enough. The nerves were tender, and the artery was SO DONE with giving blood. They tried FOUR TIMES to get the ABG and failed. The last one hurt so badly and I was crying so hard that I told the lady I'd let her try my left wrist if she'd just TAKE OUT THE NEEDLE!! Apparently Dr. P was outside my room, and he told them no more ABGs for a while. That was the end of the needles for that day. ::sigh::

That afternoon, Mom brought my four-year-old niece Jamie up to see me. She brought me a rock she had picked out especially for me, then she got Mom to lift her into the bed so she could snuggle with me. She was very concerned about the tubes under my nose (I was on an oxygen canula) and in my hand (the IV) and the wires on my chest (the heart monitor), but I explained what they were for and she was fine after that. She even had to give me a play-by-play of my heart rate at one point. "Now it's one-zero-three. Now it's one-zero-zero. Nine-nine. One-zero-one. Nine-eight." Later, she asked me if I still had a rock in my tummy (referring to my kidney stones).

Sunday Dr. P ordered blood cultures because I had run a slight temp Friday night, then he released me to the floor and a regular room. Mom, Dad, and Jamie visited in the evening and brought me a spicy chicken sandwich from Wendy's. Jamie gave me a purple Easter bunny, and Mom gave me a pic of Reba after she and Jamie had been playing dress-up.

Monday afternoon I had another CT scan and an ultrasound of my liver. Someone thought they saw a cyst on my liver on the admission CT pics, but there was none. Since I was going for a CT, I asked them to check my kidney. I still have a 1.5 cm stone. After the CT, I joked with the tech about making me a CD of my pictures so I could look at them. He asked Bruce (the head tech) -- who had done my admission CT and my kidney CT the last time I was in the hospital -- and he cheerfully said he would. Bruce likes me. That evening, I had my CD. Now I need to download some software to look at them. If I can figure out how to post them, I will share with y'all.

Through this time, all the various blood tests were being run to try to determine the cause of the acidosis, and we never did figure it out. I was dismissed yesterday afternoon, and I see a metabolic specialist tomorrow. Hopefully, s/he can get this figured out. Twice in a month is perplexing and frightening. I am also supposed to go to Mac hospital on Mondays and Thursdays for BMPs until further notice so that we can keep an eye on my blood acidity so that, in Dr. P's words, "it doesn't get that bad again."