This is my account of what actually happened at the end of the race; ( warning: this is another long post)
I think it started around mile 20 as we were descending into downtown Boston. The winds kinda whipped up out of nowhere and within a matter of minutes the temperature must have fallen 20 degrees…. I was freezing! It was then that I started to feel a noticeable change in my breathing . My lungs were getting progressively tighter anyway because it had been more than 6 hours since Id had a neb treatment, but now I was starting to audibly wheeze, which I rarely do, even when I do marathons. I remember I was also air-trapping pretty bad, so I had to purse-lip non-stop for the rest of the race to prevent it from getting worse.
We had now been walking non-stop for nearly 7 hours and as we approached the last mile, I remember telling Mike that my inhaler just wasn’t cutting it anymore and that I would definitely need a neb treatment once we finished the race. No problem I thought, since I had my portable neb machine in my belongings bag, which Mikes crew were holding for me in the finish area. I knew that I was probably in for a long night of bad breathing, but I figured once I got a good deep neb treatment into my lungs, that it would at least take the edge off enough ,where Id be able to enjoy some the post race activities.
30 minutes later at 4:31 pm, we finally crossed the finish line. For a few brief moments I was in heaven. I couldn’t believe what I (we) had just done. We had just finished a race that most runners only dream of…. We finished the Boston Marathon! I was very short of breath and wheezy , but I had finished the race in under the time limit and I was very proud of myself.
Well, not even 10 seconds had passed since we crossed the finish and I was still in a daze on cloud nine, when one of the medical people intercepts me and says ..” You don’t look so good…buddy!”. I told him that we were the two lung impaired guys who did the marathon and that it was pretty normal for me to flare-up a little after a race. ( Mike and I both looked pretty trashed from the race and both of us were huffing and puffing, so I’m not exactly sure why they singled me out as the one who needed medical attention.) So, anyway, this person put his arm around my shoulder and insists that I take a few moments to rest in the medical tent and get checked out by one of the Nurses. I tried again to reassure this guy that it was no big deal and that I would be fine. The guy just wouldn’t take no for an answer. He whispered in my ear ( I’m not sure why) ..” I’m an asthmatic too” ” just let us check you out to make sure everything is OK”. Finally, but reluctantly, I agreed to go to the medical tent to get checked out. By this time, I was starving. I had been awake for 12 hours, and had just walked 26.2 miles with only water and a little Gatorade. All I wanted to do… was eat and take a breathing treatment . He then walks me to the tent , leaving Mike to wait outside.
The scene inside the tent was pretty disturbing. There were runners sprawled out on cots everywhere… some with IVs going! There were people vomiting, others moaning and growning…. some in ace bandages. It looked more like a MASH unit than a marathon medical tent. There was staff running all over the place , bumping into each other, shouting out medical stuff. They had Nurses, paramedics and even Firemen carrying people out on stretchers…It was really pretty gruesome.
The second I set foot there, they took down my personal info and then escorted me to a triage area where they took my vital signs, listened to my lungs and hooked me up to a couple of machines that measured my O2 sats and my exhaled CO2 levels. And that’s …..when the nightmare began!
All of a sudden the triage Nurse who’s taking my vitals, stands up and starts yelling for a doctor. (Apparently she was a little shocked at my numbers). My O2 sat was 85%, my Resp rate in the 30-40’s, My ETCO2 was 45 and I was wheezing up a storm. I tried to tell them , that this was just a minor flare-up, not a big deal, and that the numbers were not that bad for me and could I please just have a neb treatment and be on my way.
Well, from that point on, things just got worse. Before I knew it, a couple of big burly paramedics picked me up under the arms and put me in a wheel chair. They then wheeled me over to a section of tent that was set up like a mini emergency room. From there, they proceeded to CUT ( yes you read correctly…CUT) my shirt off. At this point, I had had enough of all this crazyness and told them, .PLEASE…. JUST LET ME GO..I”M OK! I’ll BE FINE!
Well, that only made things worse. “Let us help you!” they kept saying…. “Your very sick”. I told them again…it’s no big deal! I always wheeze! ” A few minutes later the head doctor comes over and says…. ” your numbers look terrible!”(meaning my vitals I think). And then she proceeds to ask me the dreaded intubation question….”Have you ever been intubated for your asthma? ” ( they always ask you that question if you appear too calm during an attack). I should have said no, but they would have eventually found out which would have made things worse in the long run. Reluctantly I shook my head …yes. Then, at about the same time as they’re trying to put an IV in me, one of the nurses sees the medical ID bracelet on my left wrist , turns to the doctor and starts shouting…. “He’s had multiple intubations!! “He’s had Multiple Intubations !” The doctor then asks ..”How many times have you been intubated?” and finally she asked.. “When was the last time you were intubated?”
Well, that little exchange pretty much sealed my fate.
While all this is going on, poor Mike, he didn’t have a clue what I got myself into . Finally , about 15 minutes into this ordeal, they agreed to let Mike come in to see me. As soon as he came in , they started asking him for my emergency contact phone numbers(mind you, I’m sitting right next to him, but they are convinced that I’m too short of breath to talk.) By this time, the exhaustion of the race was starting to catch up with me and all the drugs that they were shooting me up with, were actually making me feel worse.
The doctor comes back and tells me its too risky to release me, and that I need to go to the Hospital . I tried to refuse treatment, but before I knew it, they had loaded me into the ambulance and I was already in route to Mass general. I could hear the paramedics radioing in my condition to the hospital. The way they were describing my condition seemed to be much worse than the way I actually felt. It was like they were talking about another person and I was just there observing. Don’t get me wrong, the paramedics and doctors were awesome, I just don’t think my condition warranted a code 3 trip( lights and siren) to the ER.
So we arrive at Boston Mass General ER and they wheel me straight into a trauma resuscitation room, where once again, they proceed to try and cut off my clothes off! (What’s up with these scissor happy people?) I did not want my race shirt and Bib destroyed, so I grabbed the hand and told them to stop..”I’ll take my clothes off…thank you very much! “You don’t have to destroy them!”
It was like I was invisible or something. They didn’t listen to me at all. I think they assumed that because of my medical history ,that my symptoms were making me talk crazy. They were convinced that I would crash and burn.
It’s now been about an hour since this nightmare began , and I was pretty much resigned to the fact that they were not going to let me leave , so I basically gave up on trying to plea my case.
I figured Ok , your in an Emergency Room of a very busy hospital . No big deal, you’ve been though this a million times, don’t get overly stressed about it. Just let them do what they think is right.
During my 6 hours in the ER , I ended up getting 10 nebs treatments driven with Heliox ( why they just didn’t put me on a continuous neb, I don’t know), 2 epis, a couple bags of mag sulfate, 125mg Solumedrol and a short stint of Bipap, which I did not want. I hate BIPAP anyway, and for the short time I was on it, it made me feel worse.
I ended up ripping the mask off several times , which pissed off the Respiratory therapist. Obviously annoyed because I wouldn’t behave a like a good little asthmatic, the RT whispers to the ER resident ( right in front of me as if I wouldn’t hear her) …”Can you give him something for anxiety, he keeps taking the mask off” Duh.. of course I’m anxious. You would be too if couldn’t breath and someone was trying to suffocate you with a Bipap mask! She should have known that you never place a tight asthmatic on a Bipap machine unless you bleed in continuous Albuterol at the same time. The airflow from the Bipap can cause turbulence in the airway leading to even more bronchospasm. ( that’s the RT in me speaking)
After a few more hours of back to back neb treatments, I could feel the exacerbation starting to break. I was breathing a little better now and I figured the worse part of the attack was over….but of course it was too late. They had already loaded me up with a ton of IV steroids and I knew from experience , that they would probably admit me to the hospital. The only question was, would it be to the Intensive Care Unit or a regular hospital room. After pleading my case to the admitting doctors, they reluctantly agreed to my request to the lessor of the two evils. They would send me to a regular medical floor for now, but I would have to remain NPO ( nothing by mouth), and if my symptoms flare-ed up again, Id have to go to ICU. They told me that I could start eating tomorrow if my breathing improved.
I then had to wait another 2 hours for a bed to become available, as the hospital was full ( probably from other marathoners…lol). As I waited to be transferred to my room, I remember feeling so alone and so depressed. I felt like I had been robbed of the post race glory. I walked my ass off to finish this marathon, I never had a chance to get my medal….. and now I’m in prison and Im starving to death. Later that night after complaining about being so hungry, they started an IV , assuring me that this would provide all the nutrition I would need.
Try to put yourself in my position. Its 11 pm , 7 hours after I crossed the finish line of the most prestigious foot race in the world. I’m in a dark dingy hospital room . Nobody knows where I am at , except Mike. I’m hesitant to call my partner, my friends or my personal physicians, cuz I don’t want to hear the…I -told-you-so’s . What started out as the happiest day of my life has now turned into a freaking nightmare. I just completed the most incredible race ever, I’m hungry, I don’t feel well, I have no clothes with me except for my shorts and a thin shirt, I have a hotel room that I need to check out of and a flight to catch tomorrow. All I want is to eat, to get my medal and go back to my hotel and forget this ever happened. Yeah, I think this would tend to make anyone a little anxious.
The following morning a wonderful Social Service person by the name of Danielle, came into see me and helped me arrange my hotel check-out and the transport of my luggage over to the hospital. She also convinced American Airlines to waive the $150.00 change fee for my return flight back home. A little later that afternoon, I received a call from a Boston Globe reporter asking me if I ever got my medal. Word must have gotten out that I ended up in the hospital before receiving my medal, and this reporter wanted to know if that was true. He gave me some contact numbers for the BAA, which I had my Partner, Douglas follow -up on .
Within 2 hours, I had my medal. The BAA had it delivered it directly to my hospital room. Finally… things were looking up for me I thought. At least now, I would be returning home with my medal….(Thanks BAA )
Over the next 5 days ,my symptoms would wax and wane from mild to severe , and every morning when the interns , residents and attending physician would make their 5 second appearance, I would try to convince them that I was well enough to travel…only to be told ” No.. you’re not ready”. I tried to explain to them over and over again , that I was not your typical asthmatic and that I was breathing well enough to fly back to California, and that if I had any problems I would seek help at the other end when I arrived in San Francisco. They refused, telling me that not only would I be putting my own life at risk, but also those on the airplane if they had to divert in mid flight because of my asthma….Oh brother, make me feel guilty now. As a consolation though, they assured me that when the time was right, that I would be discharged in a manner that would coincide with a return flight of my earliest choice.
Finally, on the morning of Friday April 24th ( 4 days after I crossed the finish line) they gave in, and deemed that I was well enough to fly home. Their decision to discharge me seemed to be based solely on a single peak flow reading of 300 , that I blew for them that morning, but that was fine with me….. I just wanted to get out of there. So, they gave me approval to book my flight home. Great I thought , this nightmare is finally going to end…….WRONG.
I immediately called American Airlines to reschedule my return flight and thanked them for waiving the change fee that they had agreed to earlier. The only problem was, the only flights they had leaving that day would cost me an additional $450.00 ,bringing the total cost of this one-way ticket to over $1,000. No way was I going to pay this, so I went online to United Airlines ( who I usually use) and managed to get a one way ticket for a $120.00 ,departing early the next morning. By using some of my United frequent flier miles , I was also able to upgrade the ticket to First Class. So, I end up throwing away a $500.00 ticket on American Airlines, but at least I’m going home .
2 oclock that afternoon, a different, not so kind Social worker comes to my room and tells me that Ive been discharged from the Hospital and that I have to get out….pronto! What?? I was told, that I would not have to leave until just a few hours before my plane was scheduled to depart. I tried to explain the circumstances of the past 5 days, but she wouldn’t listen, or she wasn’t interested. I told her that earliest flight I could get was leaving at 6 am tomorrow morning and that, while I was feeling better, I was definitely too sick to be camping out an airport over night. She leaves and then 5 minutes later returns to my room and hands me a list soup Kitchens and Flop houses in the Boston area ! I said..” are you serious?” By this time of course, my blood is boiling and I’m demanding to see the physicians, the Nursing supervisor…anyone with authority. An hour goes by, when the head resident finally comes in and precedes to tell me that he (they), never guaranteed to discharge directly to the airport, but insisted that what he (they) actually meant, was that they would not discharge without a roof over my head. I told them ..” NO! that’s not what you told me” “You assured me I would be discharged at the time of my flight” . Since I wasn’t able to book a flight until you told me I could leave, how the hell did you expect me to get a flight out on just a couple hours notice”
Talk about using loose terms… The bottom line is they flat out LIED to me. They were in need of the bed and wanted me out of there.
Thank god I had a witness (s) to what they had originally told me. After arguing with the head resident for almost a half hour, I finally had him get on the phone where my partner read him the riot act. Doug had reminded him that he had received several calls from the other doctors, assuring us that I would be discharged directly to the airport at the time of my flight.
Anyway, long story short and without admitting that they had lied to me, they did a 360 , and agreed not to formally discharge me until 3 hours before my flight.
The following morning at 2am sharp, the night float came by and formally discharged me. After taking a shower and getting dressed, I was wheelchaired downstairs to the lobby and out the front door, where I caught a waiting cab to the airport.
8 hours later I was back in San Francisco. I loved Boston, but I was really glad to be home in familiar surroundings again.
The physical stress of walking or running 26 miles , can do strange things to ones brain. It could very well have been that I was very sick and didn’t know it. In any event, I know that most of these people meant well and had my best interest at heart. They were obligated to take the actions that they did , but I understand my disease better than anyone, and after living with it for 54 years, I think I know when I require a lengthy hospital stay and when I don’t. Situations like this are very disruptive to my life and cause me a lot of unneeded stress.. not to mention the financial impact. I admit ….I’m the odd one, not them. I’m not your typical asthmatic who plays by the rules. In fact, I’m probably the most unusual asthmatic that most medical people will ever encounter.
Id like to thank the following people who helped me during this unfortunate turn of events:
The Boston Marathon medical volunteers Though I think it was a bit much….Thanks for taking care of me!
Chuck Our spotter during the race. He called me in the hospital to see how I was doing. He also took the time to send my Boston Jacket back to California.
Dani , the social worker who I leaned on constantly and who helped me get through this ordeal.
Veronica, one of the night shift Nurses , who took great care of me during the longgggg nights in the hospital.
Dennis Gaudet , Respiratory Therapist ( yup same last name as mine) who took the time to come and see me and made sure I was well looked after. Thanks Dennis!
A person at the BAA ( sorry I don’t know your name) who had my medal sent directly to my Hospital room. Thank You!
I can’t think of a better person to share this crazy marathon experience with. Thanks Mike!
Last , but not least, to my partner Douglas, who is always my strongest advocate when I’m hospitalized and always makes sure that I’m well taken care of.