Saturday, December 19, 2009

The holidays and hospitals

I'm back. :)

I've had an eventful two weeks. Since Thanksgiving I have been ill. And for the last two weeks, I've been in the hospital with influenza type A, viral pneumonia, and bacterial pneumonia. Yuck.

Can you say thoracentesis? How about infiltrated IV? I'm going to be self indulgent and put down my thoughts about my stay and illness.


I'd been coughing since Saturday, Nov 28. Nothing serious, just a cough. By Sunday, I had a fever of 102 degrees and felt generally wretched. So I stayed home from work on Monday and Tuesday. On Wednesday the fever was almost gone and I felt better so I went to work. BIG mistake. I commute 40 minutes one way. That was one of the worst days of my life. I managed to work eight hours and drive home.

So on Thursday I called in sick and went to the doctor.

Dec 3, 2009:

At the doctor's office, they did a chest x-ray. While we were waiting for the results, my mom leaned over and asked me if I have good health insurance. I asked why. She knew how sick I was and that I was probably going to the hospital. I was clueless.

The results came back, kind of. My left lung had white cloudy stuff, but the doctor wasn't sure because it really didn't resemble pneumonia. So he consulted with his partner and came back and asked me if I had been exposed to TB. At that point, I start to get nervous.

My white blood cell count was elevated, as was my red blood cell count. So they decided to put me in the hospital so further tests could be done and they could administer IV antibiotics. I thought just a few days would get me all better.

We arrived at the hospital and by 3:00 pm I was in a hospital gown and being poked and prodded. I was a bit dehydrated, so they had a very hard time getting an IV in. They actually poked and dug six times. Ouch. They drew blood for general tests, then we had a break for 20 minutes or so.

Then the swarm descended. Everyone gets tested for H1N1 now (the swine flu.) I had a phlebotomist come in with at least six containers for blood. She had to draw the blood from 2 different sites. First site, not so bad. Second site, excruciating pain. Well, second and third sites. Right between my knuckles on my right hand.

Right after she got started 2 guys came in with an EKG machine to take an EKG. Then the pharmacist walked in to ask me about my daily medication. And then the H1N1 team swooped in.

And there was a nurse in the room too. The pharmacist was smart and said he would come back later. The two guys kept trying to reposition me, thus frustrating the phlebotomist. The H1N1 team was busy trying to stick a tube up my nose. The nurse finally restored order and had the phlebotomist finish getting the blood.

Then the EKG guys did their thing. (No heart problems.)

And then the H1N1 team stuck a tube up my nose and flushed it on the way out. Both nostrils. "This will be uncomfortable but it won't be painful." Right. The first time, their gizmo didn't work. So the second time wasn't too bad. The third time hurt. I could feel the saline flush at the back of my skull. They got their samples and left.

I had dinner. Then my parents came with my brother and my dad and brother gave me a blessing, which was very comforting. It really calmed me down and I knew that Heavenly Father was watching over me.

I thought I was coherent, but apparently by this point I was just mumbling. It's weird because in my head I was all there and talking and thinking just fine. Nope. More like hallucinating and out of it.

They came back and stuck a sign on my door. I was contagious. Everyone who came in had to gown up, use gloves, and a mask. I officially had influenza type A, viral pneumonia, and bacterial pneumonia. Offically very sick.

Dec 4,5,6:
General stuff in the hospital. Changing of IVs, doctors visits, etc.

Nights were my favorite though. I'd fall asleep about 10 pm. At midnight they would change an antibiotic. At 2 am, they would take my vital signs and a blood sugar. At 4 they would take blood (the vampires would descend.) And breakfast was at 7:30 am. I hear about those celebrities who check into the hospital for exhaustion. How can they sleep?

However, I was so sick that I would fall back asleep almost immediately. And sleep most of the day.

Monday, Dec 7:

Thoracentesis day. I'd had daily chest x-rays, so the pulmonologist came to visit me. He talked to me, listened to my lungs and heart and then said he was going to perform a thoracentesis on me. Goody.

I signed the papers, then he numbed me. And stuck the needle in. Which didn't hurt until it started drawing the fluid out between my chest wall and lungs. They use a big syringe, then a big jar to collect the stuff. Avert your eyes as I describe it. It looked like gravy or caramel topping. Yikes. He drew almost two liters out, then withdrew the catheter. That hurt worse than anything.

The pain was like a giant L that started at my left shoulder, traveled down to my waist and made a turn over to my right side. Pain meds on the way, which did help. Actually, 1 pill, then no more because narcotics can suppress breathing, and I was having a hard time anyway. But the pain was gone.

I did start breathing easier, a little bit. More mumbling and gibberish from me.

The pulmonologist also ordered a bipap machine for me. I'd heard of CPAP machines, but not BiPAP machines. Here is the description:

i-Level Positive Airway Pressure (BiPAP) machines are non-invasive machines that provide positive pressure while a person breathes in and lowers the air pressure when a person breathes out. Thus, the BiPAP has preset pressures: EPAP (exhalation pressure) and IPAP (inhalation pressure). The machine may also have a timing feature for breaths per minute (BPM). If the sleeping person doesn't take a breath, the BiPAP machine increases pressure, forcing the sleeping person to take a breath. The air pressure then decreases, allowing the person to work less against the airflow pressure to exhale. Because the sleeper's breathing varies, so does the BiPAP's pressure, allowing the pressure drop to vary according to the needs of the sleeping individual. This ability to vary air pressure allows the sleeper to exert less energy to exhale and sleep deeper.

The nurse had come in earlier in the day and found that my oxygen level in my blood was at 37. It should be over 90. Carbon dioxide was at a dangerous level in my blood too. So a couple of hours after the thoracentisis procedure, here came the BiPAP machine.

Oh my. I am claustrophobic, so the mask scared me. But they fitted the mask on and fiddled with the dials and pressure. And I could breathe better. A little bit. It was noisy, but I was fine, no closed in feeling.

I fell asleep. My parents came to visit and I woke up. My mom said I was curled up, and looked up at her. My hair was wild and I had that mask on. Now she says she wishes she'd had a camera, but at the time, they were very concerned. Not me, I waved and tried to smile. (I'm still in the "I'm coherent" mode.) They left and I went back to sleep.

Dec 8 and 9:

I start to feel a little bit better. I'm still contagious, so everyone is in their lovely yellow gowns, gloves, and masks. Each morning I had an xray. A strong young man would come and get me and wheel me down for the x-ray. We'd go down seven floors in the elevator, then they would literally swoosh me down the hall. The wind would ruffle my hair. Seriously. Really nice guys, but I wonder if they timed themselves on the speed of getting a patient to x-ray.

I also had the hospitalist daily visit. A hospitalist is a dr who works exclusively in the hospital for doctors who have private practices. The hospitalist visits the doctor's patients and they work together. This frees the doctor for his practice. I had three during my stay. Not impressed with two of them. One was kind of passive, the other one had no bedside manner. I thought my mom was going to leap out of her chair and punch her lights out. I'm still in the mode where I think I am functioning, so everything missed me.

A hospitalist is a good idea in concept. In practice, in my experience, not so good.

Thursday, Dec 11:

I start to feel like I might live and get over this stuff. My favorite nurse stopped by and asked if I had heard of LTAC. Um, no. LTAC is a long term care facility. I had visions of being sent there for a few months. LOL.

A representative stopped by and talked to us. I was very interested and she left a brochure with me. In the afternoon, she stopped by and said that they had a spot open and they could get me in the next day if my doctor would release me and I wanted to.

At this point, I was moving around much better. They were able to stop a couple of the antibiotics (I was on five.) I wasn't contagious any more. I was feeling a bit better each day. And the level of care wasn't as intense.

So on Friday, I was off to the LTAC facility.

Friday, Dec 11:

My first ambulance ride. Woo hoo! The two guys came up with the gurney and strapped me in, sitting up. Then they swooshed me down seven floors and outside. I had a hospital gown on and a blanket over me. Brrrr. A few moments later I was in the back of the ambulance. Pretty cool, but I don't want to do it again. Ever. :)

The LTAC facility is lovely. My room was twice the size and the bathroom was huge. It was probably almost the same size as the room itself.

I got settled in and they checked me over. At that point, they notice my IV had infiltrated. It was hot and hard above the site. It hurt. So they took that one out and stuck me again. Three times.

My case manager visited me and oriented me. They were going to administer the antibiotics, do respiratory and physical therapy to regain my strength. It was a step down from the hospital care.

I picked out my own meals. They took my vital signs, blood sugar, gave me my meds, and IV antibiotics. And helped me shower. And untangle myself from the tubes.

I was on oxygen 24/7. I had antibiotics five times a day via an IV. At night I had a BiPAP and pulse oximeter on my finger. If I had to go to the bathroom, I had to push the button and shout through the mask that I needed help. LOL.

They'd come down put the machine on stand-by, take the finger probe off, unplug the IV, and I'd do my thing. Put all the stuff back on and fall asleep.

And of course, the nightly routine continued. Midnight IV start, 2 am blood sugar, etc. I finally go to the point where I'd just flop my arm out for them.

Friday, Dec 18:

Home! My doctor released me. My lung x-rays are still a bit cloudy. He said that it can take up to two months for the x-rays to clear up. I'd been on antibiotics for two weeks, and hadn't had a fever at the facility. I'd done physical therapy (riding a stationary bicycle for 10 minutes a day), and even showered by myself. I was ready to go home.

Thursday night was like Christmas Eve. I was so excited. I did sleep pretty well. They gave me one last course of the antibiotic. It finished and I did something. The IV fell out. Just in time. I called my mom so my parents could pick me up and my ID bracelet fell off. Must have been a sign.

They sent me home on two liters of oxygen. 24/7. I can't drive until my doctor releases me. But I am home. And free of all the tubes and poking and probing.

I am grateful to the doctors and nurses at Utah Valley Regional Medical Center for the great care and kindness they showed me. I am also very grateful to the staff at the Utah Valley Specialty Hospital for the care they gave me.

And I am grateful to my Heavenly Father for watching over me and helping me get better.

Part Two to follow. Stories about the patients during my stay.

Nothing about the holidays though. I've pretty well missed the leadup to them. It will be very laid back this year for me. I still need to get in the Christmas spirit of things.

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