I’ve been sipping strong coffee for about 90 minutes now, munching pistachios as I take my morning beta blocker. I have been trying to get my meds to 6 a.m. and 6 p.m. I don’t want to take them at the time I get up for work, because who wants to wake at 4 a.m. on a day off? The hospital gave me them at 9:30… but in the evening I’m usually asleep by then and working on a typical day. 8:30 a.m. is my morning break at work, so that would make sense from a practical point of view, but it would also mean having a snack at 8 p.m. and not getting to sleep until 9 which means the most sleep I will ever get is 7 hours. 6 a.m. and 6 p.m. sound ideal because I usually arrive at work at 6 a.m. and have a small breakfast and 6 p.m. is dinner.
But today I slept until 7.
Oops.
But when I got downstairs, my legs felt persnickety and my blood pressure was perfect if not a little low– so I went ahead and made the strong coffee. And I took my baclofen for the first time since before I went into the hospital.
One of the generalist’s at the hospital thought the baclofen might be causing some of my issues. Which makes this a test? Maybe?
But this is not a post about my Zio heart monitor or my scabs slowly crumbling down my face, though those things are fun. My gash is healing rapidly and well. I wanted to talk a bit about my weekend and what’s up with the publishing company.
Many of these thoughts will be further explored as part of the Parisian Phoenix blog and Substack newsletter. We’ve migrated from Mailchimp to Substack for better visibility and the prospect of building more paid resources and services for writers and readers. If you didn’t read this week’s recent release, check it out here.
Friday night, a journalist friend and her partner came to visit. I had planned to go visit her, but this close to my hospitalization I wasn’t sure driving on the highway by myself for an hour was a good idea. They have also been involved with cat rescue, so she’s offered some support on realigning the cat book. I’m helping her (I hope) with some of her goals and we’re both trying to help people find ways to publish their books.
My unsolicited submissions pile is growing rapidly.
Meanwhile, the dog is keeping an eye on me.
In the afternoon yesterday, I visited my “office” at Panera where our photographer Joan touched base with me regarding her activities at the Greater Lehigh Valley Writers Group conference this coming weekend. She’s not fooling me– I know my friends are doing wellness checks.
But I had the most amazing meeting with the duo behind Echo City Capers, and we have a handshake agreement to launch some projects together which will allow Parisian Phoenix Publishing to kickstart Parisian Phoenix Kittens with a second edition of an Echo City Capers Jr. book, a children’s book from Darrell Parry (and maybe someday a puzzle book/older kid story– hint hint Darrell) and perhaps event a story in the vein of Eric Carle from Larry Sceurman.
It’s thrilling to watch a simple “let’s introduce ourselves” coffee meeting can explode into ideas and mutual support.
That little meeting went two hours and when they saw our physical books, they were pleased. They immediately saw the love and attention we give to our titles at Parisian Phoenix, and without even meeting Gayle yet, I think they “know” and trust her.
I ended my afternoon romp with a visit to Larry, to deliver some publicity materials and give him and his wife, Barbara, a copy of Thurston’s book.
When I left, I felt like my blood sugar was dropping. I found a cherry Pop Tart that the Teenager had left in my car more than a year ago and came home and made a lovely lamb dinner. (The teenager saw lamb and potatoes in the skillet and immediately claimed the leftovers.) My blood pressure was high, but it was also time to take my beta blocker.
Finally, I slithered to my bed– exhausted, when I didn’t even do much– in great anticipation to finish Katherine Ramsland’s I Scream Man and Echo City Capers YA Graphic Novel printed in Canada, Who Turned the Lights Out?
I was so tickled and delighted to read the wit, the humor and the “smarts” in this little volume, which the type is uniquely done and the paper quality gorgeous. It made me very sad to put the book down to sleep.
Are you sick of hearing about these nuisance trials and tribulations? I am a tad tired of living them, but sometimes health problems force us to pause, reflect, organize and refocus. That’s how I prefer to look at it, and since I can’t change the circumstance, what I can do is use every moment to my advantage.
Somewhere in Thursday afternoon, I realized that I would not be at work on Friday for the release of Thurston Gill’s book, The Phulasso Devotional. I had scheduled a Facebook event for the launch and planned on recording him opening the box of books at 6 a.m. and then posting it as part of the event.
But now, I was home sick, and my employer most certainly does not want me on site while I am even more of a fall risk than I normally am. I opened the box of books at home on Facebook live and while I was recording, my Zio heart monitor arrived. (if you want to see that, click here.)
The day prior, the company had contacted me that they were having problems with my insurance company, which turned out to be because they spelled my name wrong (memories of Valentine’s Day in Mrs. Sanders’ second grade class serviced, my earliest memories of “Angel” becoming “Angle”) and they were missing a digit from my member number for my insurance company.
The Teenager assisted me in applying said device, after shaving my chest, sandpapering it, and then wiping it down with alcohol. She’s nervous it’s not quite straight and left enough, and the device itself doesn’t give you much indication how or if it is working so I guess we wait and see. I figure if the placement had to be exact, they wouldn’t let you do it at home. I would assume that most medical professionals think most people are idiots who don’t follow directions. Because really– aren’t most people idiots who don’t follow directions?
Now, my friend who had the heart attack on February 15 had a heart monitor. Not this one, but similar of course. She had a thing she had to carry with her. All I have is what is on my chest. I remember my friend saying that she didn’t know if she should hit the button or not. Because the idea is, if you feel a symptom you hit the button and log the symptom in the provided booklet or in the app. But when symptoms are things like “heart racing” or “anxiety,” it’s hard to quantify that.
Compared to how I feel right this second, my heart was racing all day yesterday. But I also know my blood pressure when I got up today was 97/56. Once I got moving, it increased to 101/67. After strong coffee, black licorice, cantaloupe, a big glass of water and my beta blocker, it ended up 110/66.
In other news, my stitches have rotated a bit and don’t poke me in the lip anymore and I think the swelling has gone down. That makes life more comfortable. I’m not doing enough hand rehab, but I’ve been using and bending the fingers in ways that mimic the exercises without sitting down and making a formal effort to do them.
I return to the gym Monday, to do what I would refer to ask a gentle workout, to get back in the swing of things and see how it goes. By Wednesday I hope to do closer to a real workout, because the heart monitor has to get a good replication of my life.
Luckily, if such a thing can be lucky, one fall happened before the gym and the later one occurred after. Based on that, it looks like exertion in the gym has nothing to do with it. Unless of course, it turns out that exertion at work is equivalent to exertion at the gym, which we won’t know unless I manage to stand at a table and fold clothes for eight hours. Who has that many clothes?
I do have to clean my closet and weed out old clothes, but I don’t want to fold all my clothes.
TRIGGER WARNING: This blog posts contains descriptions of a fall and medical treatment.
Listen, this one is going to be long. I spent almost a day in the hospital under observation on the general med-surg floor without my laptop or my phone charger. And the special type of not knowing in the hospital means you can’t trust them when they say you’re going home until they pull the IV out of your arm.
I’m going to use subheadings and break it up with photos. Gayle says I need to start writing a television sit-com. I would– but I’m not a screenwriter. Maybe I’ll change this into a play at some point.
The Unexpected End to the Evening of 3/13/23 (the fall)
It had been a busy day– maybe too busy: work, hand occupational therapy, a killer chest workout at the gym– but it was a good balance day. I could stand on one foot, I felt myself, and I was jovial. The only weird thing was on the 13th rep of every set of barbell bench presses, my right pinky would tingle. I even mentioned it to Andrew, and in the back of my mind, I was concerned because when my blood pressure spiked in early February, my right hand tingled.
I got home, had a lovely dinner with my daughter that included a massive bowl of brussel sprouts (which are one of my favorite things in the whole wide world) and made a cup of valerian tea to take to my room because I felt a little hyped up and it was almost bedtime.
I had the tea cup in my left hand, and my buddy straps for my sprained pinky on my right, and I was probably using the banister with my right hand. Three-quarters of the way up the steps, probably where the banister ends, I felt myself falling backwards. Just like a tree swaying in a storm (which considering the weather we’ve had recently sounds like the right metaphor). My normal falls start from my lower body. This did not.
I made a sound and started dropping f-bombs as I cascaded, according to the Teenager, sideways then straight out and dropped at a ninety degree angle onto the air conditioner. The Teenager ran to me. The air conditioner knocked the wind out of me, seriously knocked the wind out of me and now judging the bruise on my back it might have been a kidney punch from the stairs. I slowly rose and sat on the bottom step.
As I did so, I saw a frightening look on The Teenager’s face.
“I’m fine,” I assured her.
“No, Mom,” she said. “You’re not.”
Later she explained to me that blood was “pouring from my mouth” and she worried that I knocked teeth out. Honestly, from the pain in that moment, I feared I had broken my jaw (in part because in my chin-meets-sidewalk accident of spring 2010, the ER staff and the dentist marveled that I had taken enough impact to spit out teeth but had not broken my jaw).
The metal frame that holds the air conditioner in the window had sliced open my face under my lip. The tea cup had ended up between my breasts and smashed into pieces. I looked at my hands. They were covered in blood. And the floor. And the wall.
My pajamas were wet. And most of me had driblets of blood here and there. The Teenager got me a rag and a bag of frozen peas and we sat on the stairs for a minute and tried to stop the bleeding. The lightheadedness, feverishness and sweating started. I handed The Teenager my phone and told her to call Sassy, because she witnessed the last fall and this felt identical. I also checked my blood pressure: 106/81.
Sassy answered despite being at a restaurant with her family. It passed and I promised to keep an eye on myself and call my doctor in the morning. But when I looked in the mirror, I knew what my daughter described as a cut was a gash and it needed stitches.
I peeled off my pajama top. Blood streamed across my chest, perhaps from the tiny pricks made by the broken ceramic but more than likely from my face. I left on my fuzzy Cat-in-the-Hat pajama pants, threw on a tiny yoga tank and a Stitch Fix t-shirt and zipper hoodie and headed out the door in dirty slip-on sneakers and no socks.
In the Emergency Room: When the doctor listens and the patient acts responsibly
My daughter took my car and drives me to the hospital literally 600 steps away. She didn’t trust me to walk. It’s literally half way between our house and her high school, but she doesn’t know how to drive there so we wiggled around the neighborhood. We wandered in, registered, and were taken right back. 8:20 p.m.
The Teenager did have time to buy refreshments from the vending machine.
Once we got into our room, we saw nurses and a doctor very quickly. Our Emergency Room physician was amazing. I explained what happened, including my description of how my falls have not been normal, and he gave me three options.
He could stitch me up and send me home and I could be home by 9 p.m.
He could order bloodwork, fluids and an EKG, but then I would be there an hour or two.
He could go all out and order CT scans and all the things, but then I’d be there for hours.
I chose option 2. I already felt something was off, and I thought bloodwork would give us a starting point without going crazy like some sort of hypochondriac. (Speaking of hypochondriac, my current favorite podcast is Hypochondriactor with Sean Hayes and Dr. Prianka Wally.)
They even allowed me to throw out my rag and get a big old pack of gauze.
The nurse hooked me up to an IV of fluids just in case the incident was amplified by dehydration. Here is the first mistake we made, not putting on the hospital gown until after my IV was installed. So when they came in for my first EKG, I had to shimmy my shirt and tank down the IV line to the bed.
The poor technician with the EKG machine had a terrible time getting it to work and she was so close to the end of her shift and tired. The Teenager had her intrigued that she had found a half-iced tea, half-lemonade Monster in the vending machine. The technician ended up getting a second EKG machine and the doctor came in to do the stitches but decided to come back later.
That’s about when The Teenager almost sent Sobaka’s mom a text that I was in hospice, thanks to auto-correct.
And the blood pressure and heart rate go crazy
You know that look you never want to see? The one where the doctor almost gets an “oh shit” expression? Now remember– I came to the hospital for stitches. And I’ve been monitoring my blood pressure for six weeks. And maybe it had been a day or two since I checked it, because we went to Waffle House, had margaritas and ordered Dominos in the same weekend.
I was informed that my blood pressure was high and they were going to administer a beta blocker through my IV line. After it kicked in, I looked at the monitor and it said 150-something over 90-something. I’m glad they had it turned away from me before giving me the medicine.
The second EKG revealed I was in atrial fibrillation. And as my blood work started rolling in, it should my white blood count and TSH was high.
Meanwhile, I am texting my travel companion M, because he’s a medical technologist by trade and loves numbers.
They also asked when my last tetanus shot was, to which I responded, “two weeks ago.”
When the doctor came in to do my stitches, I asked if he could unhook me from the IV so I could use the restroom first. Because I don’t know about you, but I find it horribly difficult to handle pain when I need to pee.
The doctor finally had his chance to shoot up my face with lidocaine (that second shot was a bitch) and sew up my lip. We irrigated the wound by me holding a basin under my face and him pouring the solution over my face so I ended up with quite a bit of liquid and a little bit of blood on my gown and down my chest.
I got three stitches, and he did a nice job. Not that I have a whole lot of experience. I’ve only had stitches once before.
And then I got a third EKG from a new technician also about to end his shift.
That’s when the doctor said I was still in A-fib and he’d like to admit me for observation. If that was okay with me. And if the hospital administration would allow it. Which probably means if the insurance company would allow it.
Admission
At 11 p.m., I was wheeled into some narrow elevators and transferred to room 353, which had to have made M happy. All prime numbers. I was admitted to the med-surg floor and I think I might have been the youngest person in the hospital. As we rolled along, I noticed they have a whole lounge of the chair I love that the dog ate!
The nurse had some situation going on so it took us until 1:30 a.m. to finish my admission survey. I had fun with some of the questions: “Are you safe at home? Do you face any physical or verbal abuse?”
“Only from my cockatoo,” I replied.
They had to take photos of my bruises, too, and take my cardiac enzymes, blood work and vitals every few hours. And the floor seemed to be crazy until 2 a.m.– and remember, I had gotten up for work at 4 a.m. I managed to take two naps each about 45 minutes.
I thought I had turned off my work alarm, but I had not, so it went off at 4 a.m. and then the nurse started her rounds at 4:45 and my work friends started texting at 5. So I was up for the day, with no phone charger and a book by Katherine Ramsland as my entertainment. I read 150 pages.
I was delivered the most boring, high carbohydrate breakfast I have ever seen.
And the staff kept offering to bring me water, and when I said yes, they would disappear forever.
I met with the cardiologist, the occupational therapist, the physical therapist, and the hospitalist (who needs a caretaker for her beagle when she visits India for a month this summer).
By morning I was allowed to move independently, which meant I could use the bathroom without someone watching me walk. The staff quickly learned that although I have cerebral palsy, I am adequately mobile.
The cardiologist explained that we would start a beta blocker, as that is the easiest form of management, and based on the echocardiogram and the information from the heart monitor I will be soon wearing, we can determine if different or more aggressive treatment is needed.
Often, A-fib raises risk of stroke so patients often take blood thinners. My cardiologist and I agree that will my tendency to fall, those medications would do more harm than good.
Echocardiogram and therapists
The echocardiogram was fascinating. To see an ultrasound of my heart in motion was truly an amazing reminder of what a complex and marvelous machine the human body is. My mitral valve regurgitation did show up on the test, but even with that my heart function was normal. That was great to hear, because lord only knows I didn’t want to hear that the mitral valve was failing and confusing the rest of my heart. I have never had medical surgery and would like to keep it that way.
The occupational therapist I met asked me what my everyday challenges were. I answered that my biggest challenge was dealing with my socks and shoes. She showed me an extended shoe horn and a sock aid. The sock aid is basically a big piece of plastic pipe with a jump rope attached to it. You put the sock on the end of the pipe, stick your foot it and pull the tube away from the sock with the rope.
I think you probably kill the life span of your socks by stretching them out, but if it means you can put them on, that’s cool to know.
And the physical therapist okayed my gait and my walking, especially knowing that I was already scheduled to start fall prevention therapy on Monday.
I was able to order my own lunch, but even though I ordered the entree salad, I got something much blander. But compared to breakfast it was delicious.
The Teenager came around one, because the hospitalist said I would soon be discharged. The hospitalist had declared the fall was mechanical, even despite my protests it was not. She told me to follow up on that with my neurologist. And I plan to. The poor neurologist has been getting so many portal-based text messages from me.
The head nurse came in and gave me a gift blanket— that would have been nice to have the night before.
The nurse removed my IV and 2:30 and we left the hospital about 3:30. I filed my short term disability claim, made an appointment with my primary care physician and took my first set of meds. The Teenager made dinner and I was in bed, asleep by 5:30.
My bruises hurt. My lips are dry and sore but finally the cuts are healing enough that food doesn’t burn them.
I have proposed to my employer, and plan to bring paperwork to my doctor tomorrow, to leave me out of work for at least three weeks. I have six weeks of leave left. The three weeks would give me time to see if the medicine is working, finish hand rehab, participate in fall prevention, wear the heart monitor and take ALL that information to my neurologist.
Because no one wants me having another episode at the warehouse.
The cardiologist assures me that I can’t blame this on Waffle House, margaritas and Dominos, but how can we know that when the last fall down the stairs happened after Little Caesars, Taco Bell and Diet Coke. Coincidence? Do my overbooked days add to the triggers? The risk factors for A-fib include anxiety, being overweight, alcohol and caffeine. That’s my life in a nutshell.
I’m going to see Nicole today, not sure I need a chiropractor right now, but I had the appointment already and I like the idea of her checking my post-fall body.
Angel Ackerman 