I usually don’t post about my hospital experiences because its not a subject I like to re-live. Its an unwanted , terrifying , but necessary part of my life. When it happens , I just try to get through it and then I try to blank it out . Its the only way I know how to cope with it. Since this BLOG has as much to do with my asthma as it does with my walking, I think its important to include what a typical prison stay for me is like. I think a lot of my fellow asthmatic and CF readers can probably relate. So , here goes….
Wednesday of last week, I noticed I was having more hay fever symptoms than usual. In addition, I was having way too many fluctuations in my peak flows.
It had been quite warm and windy that week and I’m pretty sure the air was full of pollens as my eyes were burning. As a precaution, I started taking Claritin and it helped a little ,but by that following Saturday my asthma symptoms were also starting to act up. I was definably experiencing a downward trend over the previous week.
On Sunday morning , Mothers Day, I did a stupid thing. Despite having a post treatment peak flow of 350, I took a 5 mile walk anyway. I guess I was just trying to be defiant and see just how far I could stress my lungs . I think I just got pissed off at the fact that my lungs were constantly interfering with my life.. I mean everyone was walking that day. Heck, Dave was in spain walking 30 miles! The least I could do was a measly 5 miler. Anyway, the entire walk was brutal and totally pointless , I couldn’t racewalk any of it . By the time I made it home ,I was completely exhausted and starting to get “that feeling” — the feeling I get when my asthma gets out of control . For the rest of the day, I felt like crap.
Later that night I started myself on 80 mg of prednisone ….always a last resort for me because it always signals the beginning of a spiraling decent down the asthma toilet.
By Monday morning the prednisone had not kicked in so , in a last ditch attempt to bring my breathing under control , I increased the Albuterol treatments to every 2 hours and just propped myself up in bed and tried to conserve energy. I kept this routine up for nearly 16 hours ,but I was starting to feel fatigued and sleepy from the work of breathing. It was at that point that I knew I had to go to the hospital or risk possibly dying at home. Believe me, I almost chose not to go in. If it weren’t for the people who cared about me, I would have just as likely stayed at home and let nature takes it course.
At 3 am on Tues morning my partner took me to the ER. From the triage desk they whisked me immediately into one of the observation rooms, a room with windows on all 4 sides and a TV camera pointed right at the bed. Then they began to do their thing. The first thing they always do is slap some oxygen on and then start probing for veins to fill with IVs. They wire me up from head to toe and plug me in. Then they took some xrays and a slew of blood tests. After everything was in place, they started me on the usual 3 single neb treatments back to back to see if that would break the attack, but knowing my history , they decided to stop those and go directly to the hardcore continuous neb of albuterol at 15 mg per hour delivered with “Heliox”(a mixture of helium and oxygen which tends to get the medicine down deeper in the lungs in severe asthmatics.)
By the way, 15 mg per hour of Albuterol is equiv to 6 neb treatments per hour CONTINUOUSLY, so it tend to to make your heart go really fast.This is just the first step in a series of long wait and sees.
So, with the nebulizer mask strapped to my face, I just lay there hour after long hour and do the best I can. I usually try to focus on an object in the room or eaves drop on the conversations of the nursing staff. If you’re lucky, occasionally someone will come into the room and ask ask how your doing. Other than that, it gets very lonely in that observation room.
Well, 7 hours had already gone by on the continuous neb and my peak flows were still dropping ( now in the mid 200s). So, they packed me up, transported me to the Intensive care unit and placed me on the Bipap machine where I stayed for the next 36 hours.They took periodic blood gas samples ( ABGs) to make sure I wasn’t progressing into full blown respiratory failure.
Mind you an intensive care unit is not really conducive to healing .Its an incredibly noisy environment with alarms constantly going off and people being paged on the overhead. You have people milling around, technicians poking and prodding you, and an endless parade of interns and residents asking you the same questions over and over again, ” don’t try to speak–just nod your head for yes or no”
In case you don’t know what Bipap is, its a machine ( or actually a type of therapy ) that helps push air into your lungs with each breath you take . Its basically does the same thing as a ventilator , but its non -invasive, as its attached to you via a mask that they strap to your face.( instead of a tube in your throat) The theory is that it can reduce the work of breathing by doing most of the work for you. By reducing the work of breathing , you can hopefully prevent respiratory failure. But, it doesn’t always work the way its supposed to . Sometimes, if you fight it or work against it, or if its not set up just perfectly by the therapist, it can actually make you more tired. It can also be very uncomfortable and once you have the mask strapped on , its very difficult to communicate .But still, its better than the alternative, which is having a tube placed in your windpipe, being paralyzed, sedated and then artificially ventilated on a machine until you improve.
By now it had been 2 full days since this exacerbation started and it appeared that I was strong enough to avoid the breathing tube. I was holding my own and my blood gases were improving.
That evening they finally took me off the bipap and the continuous nebs and transferred me to the regular medical floor.
I did fine for a while, then later that evening , out of the blue ,I suddenly became extremely short of breath, my peak flows dropped below 100 and my O2 saturation dropped into the 70s. Well, I had all the staff in a panic so they immediately had me transferred back to the monitored unit.
I spent the next 12 hours sharing a room in this “so-called” monitored unit , with a patent who required 24 hour assistance. The lights were on in the room all night , the TV was blasting and there was almost a party atmosphere by the some of the hospital staff just outside the door.
I was so sick at this point, I just wanted to scream , but didn’t have the strength or the lung power. Actually, I just wanted to die. Its a feeling I can’t describe. You can’t sleep because you cant breath . They wont give you anything to help you sleep because they’re afraid that you’ll stop breathing. Your heart is pounding from all the medications they’re pumping into you, and your emotions are wide open . You cant even cry because your just too short breath.
Finally I managed to call Douglas on my cell phone and he was able to contact the head nurse to try to get me moved to a different room.
The next morning they finally transferred me to a private room where I received the best care of my stay. The room was quiet , the staff was excellent and always came right away when I needed them. I was breathing better, my peak flow was up to 400, my oxygen level was almost normal. Douglas made copies of the emails that friends and readers had sent me , I cant tell you how good that made me feel. Finally, I was relaxed enough ( probably through sheer exhaustion) that I was able to sleep a little.
The following morning, I convinced the attending physician that I could take care of myself at home and they discharged me.
I guess by comparison this was a modestly short and easy stay. Ive had some that lasted nearly 3 weeks. But, as
I get older, even the shorter stays have a lingering effect on me. It will take me weeks for the all the drugs to leave my system and for the bothersome effects of the steroids to subside , ie ; the acne, the crepe paper skin, the insomnia, the manic mood swings , the GI problems, the muscle cramps, feeling like your head is in a vise……. strange shit like that.
With a little luck and lot of rest, this regularly occurring nightmare will be over and totally forgotten until the next signs of “that feeling” start to surface again.
There is one bright spot to all this, I still have my walking to look forward to. Right now it means everything to me. I’m glad I’m able to do it as well a I can. It takes me as far as away from my asthma as I can get.
Another side effect of prednisone, is uncontrolled babbling and blogging.