Tag st Luke’s Easton

Colonoscopy

Angel Ackerman 2 Comments

Yesterday I had a colonoscopy, which means that I went 36 hours without food and experienced my first bowel prep. As with many things, I approached it with the same curiosity I would other aspects of life. Like how long does it really take to clean one’s colon? How does it feel to fast for an extended period of time? Can I find a broth or a gelatin dessert I like?

I’m not a big meat eater, and was vegetarian for eight years before my daughter’s birth. So the clear liquids diet seemed abhorrent to me, and the fact that they asked you to avoid nuts, seeds, whole grains and vegetables and fruits with skin for five days also troubled me.

The directions for the prep said I needed a 64-ounce bottle of Gatorade, but not in red, orange or purple as those colors could look like blood in the colon. I didn’t know if blue were okay. I looked at all the flavors in ever store and it looked like yellow was the only color that was safe. Except Gatorade is gross. And it’s hard to find a 64-ounce bottle of Gatorade, so I had to hit the grocery stores. That’s a LOT of Gatorade.

I told myself– find a small bottle of a flavor that might work and taste test the Gatorade. But even then I could not do it.

I looked at this logically. The whole point of the Gatorade is to suspend the Miralax powder into a liquid and to offer the body electrolytes so you don’t end up horribly dehydrated. Gatorade is not the only electrolyte drink out there. There’s also Propel, G2 (okay so that’s just diet Gatorade), and high-end products like Liquid IV. I’ve been down this rabbit hole before with research when my primary care provider suggested I drink more electrolytes to treat my orthostatic hypotension. I already had a favorite.

(Here’s an old blog entry about the cardiologist I now refuse to see who thought he knew better than my primary care provider. Smug little doctor man. And here’s another that mentions electrolytes.)

I ordered myself some of my favorite electrolyte powder (Powder Vitamin Plus), in lemonade, unflavored and ginseng green tea. No colors.

As for clear liquid diet… I made chicken stock and froze it. But, I don’t like chicken broth and I could not convince myself to thaw it out and drink it. I found some gelatin that expired in 2022 from when I promised I would make Eva finger JellO, but I couldn’t find the JellO. Eva also brought home a bottle of Sprite.

I used the Sprite and a random can of Beetlejuice spiced apple soda from Fanta to make one batch of finger JellO but the color of the soda was bright green and I expected it to be golden. I also made a batch with white grape-strawberry juice (and that was diet).

Saturday morning I had a big salad, removing all the items from the “avoid list.” Then I had a decent dinner, and a few homemade Christmas cookies. Lately, if I have more than three Christmas cookies, the sugar makes my belly feel wonky and this night was no exception. I stopped eating at 6:30 Saturday night (and didn’t eat solid food again until 10 a.m. Monday).

On Sunday morning, I made some electrolyte water and a hot ginger drink. Midmorning I made black coffee and laced it with a little chocolate chip cookie dough Torani syrup. For lunch, I had a heap of finger JellO and a small cup of vegan soy ramen broth. In early afternoon, I drank a cherry Coke zero.

I took my first set of laxative pills at 2 p.m. and an hour later, well you can imagine the results. I already had no stool left in my colon, but as most of my intake had been brown liquid…

At that point, I filled a glass jug with 64 ounces water, and a scoop of lemonade electrolyte powder and a half scoop of the ginseng powder. I shook and started to add the miralax powder. Except it didn’t fit. Even with me stirring with a long spoon as I added it slowly.

I poured it all into the blender, which resulted in about 72 ounces of final mixture.

I put it into the fridge, with the overflow in a mason jar so that I could track how much I was drinking.

At 6 p.m., I started drinking. At first, it tasted good. The directions said to drink half. Now, at this point, it already looked like my colon was clean. And I was supposed to drink it in about an hour. A glass every ten to fifteen minutes. I managed the amount suggested in an hour and twenty minutes. By the end, I never wanted to see the mixture again.

The final set of laxatives were at 8 p.m. I went to bed about 8:45 p.m., but my lingering cough kept me up, and every time I coughed I had to use the bathroom. I finally dozed off at midnight, only to be scared awake by my alarm at 3:45 a.m.

My procedure was scheduled for 9 a.m. and the directions said to finish the prep mixture four hours before the procedure. I went downstairs and poured a glass, drinking while I watched the Apple TV program Trying. I made it through almost two glasses. Then the drink started to gag me. And I used the bathroom and saw that my waste was still as clear as my urine so I returned to bed.

Around 6:30 a.m. I woke again and took a shower. Checked my blood pressure and my weight. Blood pressure up, weight down by 3 pounds.

Eva took me to the hospital at 8. They had asked me to arrive by 8:15 a.m. Now, I schedule a lot of these procedures at St. Luke’s Easton Campus as it is about 600 steps from my house. It’s usually empty, and the doctors and medical professionals there always seem to take good care of me. I used the self-check-in kiosk and went up to the Lotus waiting room.

That waiting room is full of the chairs that I love. We had a teal chair that we called “the throne” that I bought myself when I found it on clearance. I loved that chair, but in its first few months of owning that chair, we got a puppy who ate the chair. We tried several times to fix it, but she repeatedly ate the chair until there was nothing left. For a while, we took the legs off and set it on the floor with a slipcover over it and just gave it to the dog, but eventually, we gave up and threw it away. Which broke my heart. Because she also ate holes in my couch.

When I ended up in the ER for stitches in March 2023, after the fall that left the scar under my lip, I noticed the Lotus waiting room was FULL of my chair. Half of them in the color I had purchased, half in St. Luke’s blue. I had been admitted to an upper floor, perhaps the third. I looked down upon the chairs as I headed for the door.

It’s an ugly waiting room with a collection of my chairs.

They took me back to the unit at 8:40. Eva had to leave to feed some clients breakfast and the nurse told her to come back to this waiting room. The unit looked the emergency room from every television medical drama made in the last thirty years. There was another person there getting prepped for something. And maintenance men changing the lights which technically put them at an angle where they could see through all the privacy curtains from above. Not that I care.

Two nurses started prepping me and the doctor and the anesthesiologist lined up for my consent and the consent of the person next to me. The whole process was a very efficient assembly line. I mentioned that during my prep all I could think about was saltines. And the staff laughed and said they could handle that. The nurses took one look at my tiny veins and I think they panicked. They got a third nurse specifically to start my IV.

That IV was beautiful.

She was like an IV angel.

Normally IVs are a tumultuous experience for me. When I had my tilt table test, the man who administered that IV dug around under my flesh for what felt like an eternity and left bruises all over my hand and arm from his failed attempts.

I have never had blood draws as smooth as what this nurse did yesterday. I included a picture: If you see the three dots on the top side of the frame in the middle of the edge of my hand and think of them as Orion’s belt (they are from an old cat scratch) and travel to the middle of my hand slightly to the left, you will see a tiny pin prick– and not the one between the two lines on my wrist– that’s where my IV was. There is no bruising. At all. I had an IV in this hand and there isn’t a single piece of evidence that it was there!

As the placed an oxygen mask over my face and told me to turn to my side, someone else gave me an extra pillow concerned for my comfort. My last thought as I watched the nurse or whomever finish pushing the plunger on my medicine was “Why do I need to be comfortable? I’ll be unconscious.”

It was 9:20 when I woke to a small bottle of water and a pile of saltines. I texted Eva and she was almost to the hospital. The doctor told me he did find and remove a polyp. And I was home by 10 a.m. And the saltines were delicious.

The Rocket Ship Construction Zone

Angel Ackerman 1 Comment

I had an MRI this morning.

It was my first MRI, to monitor an aneurysm in my brain discovered last year during my random heart issues. Last year they did a CT scan with contrast as I did not know if tooth implants would count as metal. (It does not. They are non-ferrous. I learned this as a more-or-less universal fact from the radiology tech. And to think I made my poor dentist research the screw in my mouth.)

When I called to schedule a few weeks ago, they asked where I wanted to receive an MRI and I chose the hospital that is 600 steps away from my front door. They offered me an appointment at 7:15 a.m. on a Sunday. I agreed.

Roll out of bed, wander to the hospital, get an MRI, and be home while it’s still early for a cup of coffee.

And that is indeed how it played out, and I had my coffee in my hand before 8 a.m.

On the walk over, I noticed this Subura station wagon from Vermont with roses on the hood. Now, between the apartment building across the street and the hospital itself, one finds a lot of out-of-state cars and doctors-in-training. And while I did not linger long enough to read what was written on the windshield, it said something like “you and me forever” and someone had laid a wrapped bouquet of roses on the hood. A marriage proposal? A stalker? A farewell from a lover returning to a place far away as a promise to come back?

I surely hope they aren’t roses, because leaving roses on the hood of a car in the middle of the city in the rain, especially if it’s a marriage proposal is certainly both romantic and stupid.

I arrived at the hospital around 6:50, in part because I know they ask you to register at the front desk and then meander through the facility to reach the waiting room of your particular appointment where you start the registering process again. There are usually insurance card checks, and headshots taken to prevent fraud.

I walk in the front doors and there’s one person, in a hospital t-shirt, sitting right inside. Before I even have a chance to pause or plot a course, she greets me with, “Are you hear for an MRI?”

I say yes, and then she follows with, “Is your name Angel?”

I again say yes.

Now, I know this particular hospital doesn’t do much hospital-ing. They literally only have one floor of inpatient services, and I experienced that last year. I must say the renovations are looking gorgeous, again, nothing like the room I stayed in last year straight out of mid-twentieth-century Americana. At this early hour on Sunday morning, there is no one in the hospital but me and this employee, Rose. No one.

“As soon as I clock in, I’ll take you back,” Rose says. “But we have a few minutes. So have a seat.”

I sit behind Rose in the waiting area in front of the not-even-staffed-yet registration desk.

“That’s fine,” I say. “I’ll read my book.”

I have a lovely conversation about Rose, her retirement from one of the larger hospitals in the network, and how she has really enjoyed reading again since her retirement. She clocks in and escorts me upstairs and down the hall to the MRI suite where I sit in another waiting room and Rose greets the staff who are arriving with us for their shift.

I sit and read my book, and the techs come for me. For the first time ever, I am given hospital pants. I peel off my civilian layers and tie on my gown and pants.

Much to my relief they have a metal detector as the final phase of the pre-MRI adventure. I am pleased to report I am not magnetic.

So many of these tests come with so much hype, and I have to say, I think I prefer the MRI to the CT with contrast, because an MRI doesn’t make me feel like I’m about to or in the middle of urinating in my pants.

And they tell you to stay as still as you can– which always makes me super aware of every twitch in my body.

They warn you that the machine is loud and they give you ear protection. If I had to describe the experience I would say space rocket meets construction site. And so many different types of squealing, clanging and banging.

And the latest medical stuff…

Angel Ackerman 2 Comments

7:30 a.m., Wednesday, April 5: Yesterday I was discharged from hand rehab with John at The Institute for Hand and Upper Extremity Rehabilitation. My hand strength in my right hand is stronger than my left hand, so even though my pinky doesn’t quite have all the functionality it should, John thinks with proper use and exercise at home I can handle recovery.

As John said, implying that he could trust me to monitor and invest in my own hand health, “with everything you have on your plate, this is a mere flesh wound.”

Indeed.

With that, I had my last session of rolling and smashing silly putty and twirling balls in my hand. Really, hand therapy is not that far from children’s play. As an adult, there’s not enough activities that involve silly putty.

After a weekend of high blood pressure, my body suddenly feels low– and my blood pressure is on the low side, even after coffee, and I’m light-headed and feel as if my blood sugar could be low, despite snacking on a slice of fresh pizzeria pizza (I found that real pizza versus Dominoes or frozen varieties does not have the sodium and preservatives that impact my numbers) when I took my evening dose of Lopressor. I ate breakfast, and that helped some, but not enough. I also had an 8-ounce glass of water.

So, as my primary care doctor is signing off on me returning to work on Monday and we’re still waiting for my cardiologist’s report, I’m terrified that something might happen today. But I don’t want to manifest my own misfortune. It’s interesting to note that today was supposed to be my first day back to work, but I still have physical therapy during the day this week, and I felt better knowing my cardiologist should have the info he needs by then in case we need to make adjustments to my treatment plan.

The manufacturer of the Zio sent a push notification to my phone that they received my device and will have the data to my doctor soon.

My left hip, according to my physical therapist, was tight Monday, and now my right hip is giving me issues, the kind of issues it often has when compensating for the left hip.

I should have taken a shower last night, but I thought it would be nice to shower in the morning, but then I remembered I have physical therapy and the gym today… but I might have to take two showers today. I need to see if I can shake this feeling of brain fog and lightheadedness. By then, it will be 8 a.m. and I can call my doctor’s office. They are next door to physical therapy so maybe one of the medical assistants can take my blood pressure. Because my neurologist would be mad at me if I ignore this.

8:20 a.m. After a hot shower and exposure to The Teenager’s work drama– not being able to get into a client’s house to feed the dog– my blood pressure is now high. So I don’t know whether to call the doctor or not. I put on my sports bra inside out and my shirt backwards.

8:30 a.m. I called the doctor’s office. They won’t let a nurse or medical assistant take my blood pressure because they would like a doctor there because of my history. I have an 11:15 a.m. appointment, directly after my physical therapy, with one of the residents, I think, because it says my doctor’s name but that’s not what she told me. But it usually shows the resident’s names so we’ll see.

9 a.m. I decide to play with the Stitch Fix style algorithm before leaving as I only have a couple minutes. This will be important later… because brain fog. That was another symptom I’m struggling with– I put on my sports bra inside out and my shirt backwards.

Brief interlude while I am thinking of it. My hospital EOB came yesterday, as did updates as to some of my other medical visits. It’s obscene to see the battle between medical providers and private insurance companies. When did this become an acceptable model of business? The hospital charged my insurance company almost $18, 500 for one day of services. The insurance company pays a pre-negotiated rate of $2,500 and I get bill about $300.

In a similar fashion– the medical office billed the insurance company for the resident who so patiently spent 30 minutes removing three stitches from my face. It was itemized as “surgery” and the provider billed $66, of which the insurance company paid $13. And left $1.50 for me. So this poor resident, who worked her way through medical school and had to dig the stitches out of my scabby face, isn’t even worth $30/hour?

9:40 a.m. I arrived at Physical Therapy to sit and read my book until my appointment. Yesterday, I finished Susie Bright’s How to Read/Write an Erotic Story and I have every intention of finishing Suzanne Mattaboni’s Once in a Lifetime today.

10 a.m. or there-abouts: physical therapy with Jimmy, instead of Eric, because it’s Eric’s birthday, and his colleagues suggest that this might not be his first thirtieth birthday. I am also informed that the goal today is to poke fun at Eric as much as possible because he’s not there to defend himself.

Summary of Physical Therapy: I worked hard and found myself pushing and having good balance despite the issues with my quasi-lightheadedness. As usual, my left side is tighter than my left, but I notice as the day goes on my discomfort on the right seems to be correcting itself.

I also told my physical therapist about The Institute for Hand and Upper Extremity Rehabilitation and my mallet finger that I did last year, right before Easter. I explained how I ruptured the tendon pulling my socks off. He’s now afraid to take his socks off.

10:40 a.m. I stop at the car to update my notes and drink some water. This massive Audi SUV is parked next to me, requiring that I turned sideways to slip into my car. I take my blood pressure: 122/71.

10:50 a.m. I walk down to the primary care office, and finally put the facts together that between the physical therapy office and the family practice, there is a pediatrician. That’s why I always hear screaming children though the wall. I use the rest room and open my book.

11 a.m. My doctor’s assistant takes me back to the exam room, and confirms that I will be seeing my doctor. She’s the same person I correspond with through the portal, and who fills out all my paperwork with the patience of a saint. She doesn’t weigh me and this disappoints me because I think all this healthy eating has resulted in a smidge of weight loss.

If we’re honest, I feel silly. My head still doesn’t feel right, but I’m fine… I mean I’m going to be cautious but it could be so many things: blood sugar, blood pressure, the beta blocker, allergies or even the pollution from the major industrial fire a mile away yesterday or heck even stress… but the neurologist said… Everyone in the office, including the doctor, reassured me that I did the right thing since no one wants me to fall again.

My blood pressure was 120/77, which is pretty darn close to my car reading so that proves that my monitor is reading my blood pressure accurately and the presence of the doctors does not cause my blood pressure to increase.

Alpha Books J Journal

11:10 a.m. the assistant leaves and I open up the final pages of my book. And I finish it in five minutes.

11:30 a.m. the doctor arrives. He sees my Alpha Books J journal in my lap and starts asking questions. Then he asks why I am there– that my chart just says “high blood pressure.” I explain that no, it’s actually lightheadedness that started with low blood pressure but hasn’t abated since my blood pressure returned to normal levels, and that the neurologist made me promise not to ignore symptoms like lightheadedness.

I explain that I got out of bed a tad clumsier than usual, after ten minutes of trying to force myself up despite 9.5 hours sleep, and I just attributed it to stiff cerebral palsy legs. But as I went downstairs and turned the lights on, I realized I was a tad lightheaded.

I poured a glass of water, took my blood pressure and my meds, and made a cup of weak (for me) coffee and finished my water and had fruit and toast.

I pass the doctor my list of blood pressure readings and tell him my first of the day was 102/68, followed by 108/65 an hour later.

He peruses the list I gave him and asks, “do you have some fancy blood pressure device that takes your blood pressure every hour?”

“No,” I say. “I’m just neurotic.”

He chuckles. “It’s not bad,” he says. “It gives me data to work with. I have patients I can’t get to take their blood pressure once a day.”

“I know you’re going to ask me what happens in certain situations, so I just want to see if I can anticipate the questions so I have the answers. Like there’s definitely a difference when I eat pizza from the local pizzeria that uses real ingredients versus Dominoes.”

He mentions I should track my pulse. I told him I look at it when I take my blood pressure because the neurologist mentioned it but I haven’t written it down. I haven’t noticed anything. And I didn’t tell him about the symptom diary I started. But I did come home and add heart rate to my iPhone tracking info. I really need an Apple Watch. Okay, I want an Apple Watch, but I refuse to consider buying one until my business computer is paid off and I replenish my savings and pay off the credit card bills I ran up during this hiatus from work.

He performs some basic exams, and has the nurse take my blood pressure lying down, then sitting, then standing up. If the low pressure is caused by gravitational pull on my body, or something like that, my blood pressure will drop as I quickly force myself upright.

My blood pressure spiked (142/100) suggesting that I tensed, which I did, because the sudden movement made me feel like I was swaying. And I braced my muscles, afraid I might fall.

So, the next test in our journey through Angel’s recent career as a face-diving professional, is to half the dosage of my Lopressor. My doctor thinks he found a note made while I was in the hospital that the IV medication made me dizzy and that’s why they switched me to the oral tablets. I don’t recall this, but a lot happened that night… so I asked The Teen much later, and she said no, my memory is correct. I read the note the doctor found, and I believe, though I could be wrong, that the real problem is doctors have no skill at writing and this leads to misinterpretation. Ooooh, maybe I need to start a “Clearer Writing Styles for Doctors” workshop.

And since my echocardiogram was perfect, and he reviewed it there with me, but I’d already read it, he wondered if the beta blocker was necessary at all (ironic since he was trying to get me on blood pressure medication for the last two-plus years) and/or if the Afib was an isolated incident. I dispute this theory, because I had two unexplained, nearly identical falls within two weeks.

My doctor reduced my beta blocker in half, which meant I had to remember to go buy a pill splitter because I already have the tiniest pills I ever saw. And he also suggested taking some sort of hydration beverage into my bedroom– a G2 gatorade or a Propel– to drink before getting out of bed.

And he closed with something like, “these are the kind of things I have to tell my patients who are 70 or 80, but unlike them, you’ll listen.”

Then he asks, “when is your next appointment?”

Not until August, I reply. He looks to me in disbelief. “I want to see you before that.”

And he sends a note to the cardiologist that he reduced my beta blocker and asks him to review the data from the Zio patch. The same Zio patch that just returned to the manufacturer yesterday.

I mention I will see the cardiologist May 5, if that matters when scheduling our next rendez-vous.

“I want you to check in in the next couple days,” he directs me, “and I want to see you next week.”

“How about April 20?” I ask. “It’s in the middle of now and April 5 and I already have to take the day off for some CT scans at the hospital and physical therapy.”

I’m going back April 20, at 8:30 in the morning, to meet with one of the residents. I didn’t think to check which one.

12:10 p.m. I leave and head to my friend Maryann Ignatz’s house to bring her some books she ordered and visit.

2 p.m. CVS. The computers have gone insane. I don’t think this will impact me as I peruse the aisles. My list is simple: a better lotion for scar care, an electrolyte drink, a blood pressure monitor, and a pill splitter.

Now, I have a borrowed monitor and I’d rather have an Apple Watch connected to a wireless monitor cuff…

And the only thing on the list today I need right away is the pill splitter.

So I find one for $8.49 and I have a 40% off coupon that expires today. I also find Propel dry powder packets that go into a water bottle– I think $3.49 for ten packets. On Amazon, the already constituted Propel Water in the same flavor costs $8.38 for 12 bottles, which is 70 cents a bottle or twice the price. I even placed one of my reusable water bottles by my bed, and I picked one with a screw-on lid designed for my bike so it’s less likely to spill.

The blood pressure monitors start at $62, and the $62 one provide $10 in Extra Bucks, but I don’t want to spend that much now.

And the only lotions “better” than the ones I have at home start at $10 and the ones specifically for scars are $20.

And on top of all that, the system doesn’t really register my Extra Care card, so it says I was logged in, but it didn’t use my coupon.

I never pay full price at CVS.

And we’re not going to talk about the fact that they were sold out of jelly beans.

3:30 p.m. I make a run to the bank and take the dog for a trip to Dunkin’ for Munchkins. Oh, and the teen. I eat too many jelly munchkins, drink a cold brew and eat one of their salty processed sandwiches, their completely not-a-Grilled Cheese with their sun-dried tomatoes. Not worth the money I paid. My blood pressure does not change. I cancel the gym for tonight because I still don’t feel stable.

I come home and I cut a pill. The Teenager then insists she can do it better and that I’m sloppy.

vegan tofu salad with lime dressing and cucumbers

4 p.m. I spend some time with my cockatoo, and tend to some self-care details and start laundry.

6 p.m. The Teen and I make salads with tofu nuggets and romaine and cucumbers. The Teen devours heaps of romaine and cucumber. With a homemade fresh lime dressing.

I mention to the Teen that KFC has nuggets now.

“Really, Mom?” she protests. “You expect me to eat tofu after mentioning KFC?”

And then I proceed to drop the knife several times while chopping vegetables. I’m amazed I still have all my toes. Brain fog is so real.

6:45 p.m. I text the neurologist just to update her.

7 p.m. I place my last load of laundry into the dryer and find a half pill of my beta blocker on the table.

I call the teen’s name.

“Did I not take this with dinner? Did I miss my mouth?”

“I doubt you missed your mouth,” she reassures me. “It probably just slipped out of the bottle.”

“I could count them,” I say.

“And if there is an even number, you fucked up,” she says.

It was an odd number.

7:30 p.m. I finally retire to my room hoping to start a new book as part of my pre-bed, no screens ritual. I make the bed, feed the cats, put my Propel packets in my drawer and organize my lotion (for scar massage on my finger and my face) and my water bottle. But first I have to finish this blog entry. And I notice– to my chagrin– that somehow this morning I changed my next Fix from May 18 to April 18. Hopefully I can change it back before the stylist grabs it, because my charge card needs to take a little vacation from my wallet until I rebuild my rocky finances.

And that, friends, was my day. Louise the Tripod is snuggled against me, kicking me with her back feet and snoring. I still need to give the bird water, make my Propel, brush my teeth and massage my scars. So, if you think I’ve been over here partying during this short-term disability leave, I have not.

Not the vacation I asked for: Went to the hospital for stitches and ended up with admission for atrial fibrillation with rapid ventricular response

Angel Ackerman Leave a comment

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.

  1. He could stitch me up and send me home and I could be home by 9 p.m.
  2. He could order bloodwork, fluids and an EKG, but then I would be there an hour or two.
  3. 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.

So I think that’s everything.

It’s good to be home.

My heart monitor is on the way.

Waiting for my ambulance

Angel Ackerman 8 Comments

If you look at my last few entries, you will read about the tiny, little cat bite that sent me to urgent care and then to the ER at St. Luke’s Easton Campus. I never expected what happened next,

Right away, at 6:40 or so a.m., the doctor in the emergency room explained my options. They preferred to start IV antibiotics, then transfer me to one of the larger hospitals in the network.

Which would require an ambulance.

So I asked, “Could I just go to the hospital myself?”

And he explained I could, but he would be discharging me against medical advice, and then I would start over in the other emergency room. Which might mean two separate emergency room charges. And not being monitored. And losing my spot in the triage line.

And he recommended asking for removal of the transfer charges.

Now they have drawn on me with surgical marker at this point and i can see my finger swelling and my infection spreading. Two knuckles are completely swollen and angry.

I want to get this treated ASAP. So I agreed.

I’ve seen every episode of House MD, I know infections that spread are bad.

That was an attempt at levity. I don’t think all doctors are like House.

This is only my first real hospitalization— unless you count childbirth.

Now, Easton Hospital has a long history in the small community where I live. When I moved here, Easton Hospital was still a small, independent hospital. A few years ago, the Steward Group bought it and made it a for-profit hospital.

Which, for the sake of trivia, increased the tax base in our borough.

But over the course of the last year, Steward closed down entire departments. When Covid-19 hit, Steward threatened to close the whole damn hospital if the state didn’t offer massive financial support.

In May, St. Luke’s University Health Network bought the hospital. My doctors are all affiliated with this network so when the urgent care suggested going to the emergency room, this one is about 600 steps from my house.

I didn’t know that in the transition, the hospital has not fully rebuilt its services and wasn’t equipped for my care. I would have gladly driven to the larger hospital. Oh well.

By about 10 a.m. my ER nurses have given me a second antibiotic (the urgent care had given me oral Bactrim), hand x-rays, and fluids. They also swab me for Covid as a safety precaution prior to transfer. That was squiggly. The hospital where I must go is full, so I have to wait for another patient to be discharged.

And it is the full moon.

I have my own triage room in the ER. At about 11:30, my neighbor, Sarah, comes and brings my phone charger, iPad, teddy bear and my favorite sweat shirt.

We talk, play cards, watch TV and learn that I am not allowed to eat. My hand may need surgery. The nurse apologetically offers me clear fluids but also offers me a milk. I ask for the ginger ale.

Lunch was Shasta. It was a perfectly tasty and cold Shasta that hit the spot.

Sarah and I play cards as I drink my Shasta

The Easton squad arrives at 2:20 p.m. for my 2:30 transport. I am happy to report that my blood pressure has been good. I joke around as they strap me on, which this is really the silliest medical transport ever.

It’s almost 9 p.m. I’ll finish this tomorrow.

The wound at the time of transfer