Thursday, March 17, 2011

BMC ICU

My mother drove down to Springfield at 4am to meet the ambulance. As she drove down the empty highway she saw a large dark bird flying beside her car for a while, then after a while it veered off into the woods. An owl? She was horrified. "Is that Kat's spirit? Is she leaving?"

Meanwhile the EMTs and nurse bumped and rolled me down the halls in the stretcher up to the ICU. I had never been there, even working at Baystate OB for 4 years after graduating from nursing school I never made it over there. I was brought into my own room with a big sliding door and a curtain a young nurse who was very gentle and kind with me. I got warm blankets, ahhhhh. My mother got lost at all the different ambulance entrances, but finally found me in the brightly lit unit.
On entering the room we were greeted by four different doctors in full gown and mask, each asking specific questions. I might have been getting a bit more with the program. Just before we got into the ambulance to leave Franklin I had remembered my children were ages 5 and 8. I still couldn't remember their names, but it was an improvement. At Franklin they had started me on IV antibiotics, antifungals and antivirals along with lots of IV fluid. Now at Baystate they continued all that therapy. When I first got there, a doctor spent alot of time listening to my heart. I fell asleep and woke up and he was still listening. I got hooked up to more monitors and had more blood drawn.

They did a electrocardiogram in my room of my heart that took forever and made me very nervous, my heart sounded so swishy. (They still didn't know what germ was causing the infection and some germs, once they get in the blood, attack the heart.) They were waiting for blood cultures to come back, and clearer spinal tap results They asked so many questions. We (my mom) told them Strep was in our kid's school, that we had a new puppy, and we had a pet rat and some chickens. They took it all in like detectives.
They asked over and over what other medications I was on. I didn't think I was on any, but they didn't seem to believe me. My mother told them, "Just vitamins." Then I heard my nurse say, "She's only 40. She's healthy. She's not on any meds!" and they stopped asking. I was not their usual customer.

My sister was there by now and she was very focused on me. She is seven years older than me and very protective and loving. She looked very regal at the foot of my bed, she kept her hand on my leg repeating, "We love you so much, Kat. I am sending you healing energy." She gave me ice chips and a cool cloth on my forehead. She also hung my parent's Christmas card on my wall and made me a little altar on my bedside table with some battery lit candles I'd given her when she was in the hospital. She brought recent photos of the girls with the puppy. It was wonderful to see when I opened my eyes.

When my sister asked my nurse about my fever and my delirium the nurse's response was serious. "There is a war going on in you sister's her body right now. We just have to support her so that she can win, but there is a war going on. Her body is working very hard."

While I was in the ICU Rob, my mom and my sister took turns sitting with me. My sister and Mom got a bed and breakfast across the street and took turns on night duty. I would wake up and someone would be there. I felt so lucky and watched over.

The nurses were smart, supportive and kind, The doctors were polite and thorough. During the whole experience I felt extremely well cared for. Amazingly, there were no rouge bitches or jerks, everyone was amazing.




Mysteriously, I wasn't really scared.
Maybe it was the delirium?
Maybe I knew I was going to be OK?


The blood pressure cuff went off every 15 minutes, but I slept.

Rob said, that next morning, "I couldn't get out of the house. Everyone was calling."
"What do you mean everyone? How would they know?" I asked. I felt like we were all alone on the moon, so far away from everything.
"I told them at your work, like you asked me to, so Patti called people and Nooni sent an email to everybody, so now they're calling me." He was overwhelmed with everything; the phone calls, the kids, and fear of widowhood, but I was deeply excited that some people knew I was there. It made me feel much less alone in this weird place where I was laying in bed all day, getting really puffy all over, while my ear drained yellow ooze onto my pillow.

My mother said someone had brought a spinach lasagna to our house. She and the girls had eaten it! And it was delicious! I was so moved that someone was caring for my family when I couldn't. "Already? A lasagna! I just got here."

My sister also emailed her friends and old family friends so all those people also were praying for me and thinking of me and my family. I felt like George Baily in "It's a Wonderful Life," There's that opening scene above the house where all the frightened and loving prayers go up and up to the twinkling black and white galaxies. There the angels gather and hear everyone praying for him on his rough dark night.

I felt like I was being held by all the love and concern, which relieved me greatly because I couldn't seem to do it for myself. I couldn't focus on anything long enough to get through it. I couldn't meditate, pray, tap or send Reiki. I was out of it and mostly sleeping, drooling open-mouthed sleeping.

The nurse and aide washed me up head to toe with warm soapy water, changed my bedding under me, rolling me back and forth and then boosted me up in bed several times a day. I have given that kind of basic care to so many, mostly elderly, patients, it was surreal to be the one in bed with the sweet women chatting over you. They were glad to have me as a patient because I could actually talk with them and they don't usually get that in the ICU.

At one point later in the day my nurse came in and announced cheerfully, "We can all take off our protective gear! She doesn't have viral meningitis!" Hooray! Everyone took off their gowns and masks happily. They could breathe and stop wearing the hot plastic gowns.


The blood culture had come back positive for what could be Strep A so they picked the antibiotic that would kill both the possible bacterial meningitis and the Strep A. I am allergic to many antibiotics (Penicillins, Sulfa drugs, and Biaxin) which can be a problem. They chose a new one for me, Ceftriaxone, which I got every 12 hours. I didn't know any of this, but everyone seemed a bit lighter and things certainly looked much better with everyone out of their protective aprons and masks. We asked the results of the echo-cardiogram (when we asked the tech performing it if it looked OK, she said, "I can't tell you anything. The doctor will read it soon") So we asked the nurse, who hunted down the results and popped her head in to say, "Heart looks good, Katherine." Good words to hear.

I lay on my left side so my ear could drain a straw colored fluid onto my pillow. Nasty. Lots of pillow case changes. I was really puffy from all the fluid and the left side of my face was bigger because I was laying on it all the time. The Franklin nurse had thought to had thought to take off my rings before I got in the ambulance. My hands had been getting tight and big from all the IV fluids and the nurse didn't want them to be cut off later. It had felt creepy pulling them off and handing them to Rob. I never take them off. My angel necklace was taken off first thing in the ER when they first put the monitors on me.

Coming down the highway to see me that next morning, Rob got a call from Georgia's school that Georgia had a rash. My mother had to go pick her up at school and take both her and Lily to the doctor. Georgia had scarlet fever (a form of Strep A with rash). Both the girls were started on antibiotics. We had been getting newsletters and even an automated phone call from Lily's school saying that strep was in every grade and to monitor your children carefully. But I didn't have a sore throat or patches or swollen glands, neither did Georgia. She just had a cough and now a rash. I never would have thought to get either of us cultured until the rash hit.

My blood pressure started to improve, maybe the medicines and the fluids were finally catching up with the illness. At some point I stabilized enough to be transferred to another regular floor. I didn't have a fever. My heart was OK. The antibiotics were working. I was very nauseous and vomiting and they were giving me meds for that, but nothing seemed to really help. I hadn't eaten for three days so I would dry heave a couple times an hour when I wasn't sleeping. They thought it could be either the antibiotics, the sepsis (the actual blood infection makes people feel terrible for a while), or the ear infection/rupture (may have messed with my inner ear, which can take a long time to resolve) Great. So even though I was happy to be doing better, I felt worse. My family looked exhausted but relieved. We were firmly told the children were not allowed to visit. No one under 12, for their own safety.
I had no sense of how much time had passed, what season it was, really what my life was like. I loved my mother's detailed updates about who stopped by and left bread or a casserole. It helped me remember and imagine normal life.

I didn't want to leave the ICU. I loved the nurses, having a private room and the attention of a sea of skilled doctors. We had settled in. But my nurse said, "You don't want to need us. It's good news, Katherine. It's a good thing." They found me a room on Springfield 2 and we packed up my stuff and I rolled down unfamiliar corridors once more.

Sunday, March 13, 2011

FMC ICU

I spent the day in the ER and then they admitted me to the hospital in the evening. They rolled me into the ICU. I knew enough to know that was serious place and thought, "Maybe the other floors were full?"

The nurses settled me in to an actual bed. I recognized these ladies. I had floated down and helped them on busy nights as a nurse when it was quiet upstairs where I work. They treated me with great kindness. I had lots of monitors, cuffs and IVS but I got cleaned up. I had my period and had pajamas from the night before and she put all new clothes, underwear and pads. I was so thankful to have a soft bed, new blankets and a very tender nurse who watched me closely. There was alot of beeping, but mostly I slept.

Earlier when I had been brought into the ER, I apparently told Rob that he had to go upstairs and tell them I couldn't come to work the next evening. He was appalled! I could not remember his name! or my children's ages! or that I had children!! but I remembered to make sure not to inconvenience work. But he went up and told my dear co-workers that I had a high fever and was getting a cat scan for a confusion. Later my sweet friend asked if she could come down and give me Reiki and they said, "No visitors. She's too sick."

My mother came in when Rob got home to get the girls to bed. I must have been high in my bed because she looked small and cold with her winter's hat on.
"Hi Mom" I said.
They asked me quickly, "What's your mom's name" and I replied "Mom."

It seemed worrisome that she was there in the night.

She told me later that when she got there, they told her I was speaking less and she thought, "Oh my God is she is a coma?" but I greeted her with the "Hi Mom." She noticed my blood pressure was low ("the bottom one in the 40's") and they were giving lots of IV fluid and the blood pressure wasn't coming up. I was on antibiotics and still had a fever. My lumbar puncture had come back preliminarily positive. My mother also noted that on my chart it said "Patient condition: Poor" I've never seen that. She's never seen that and she was scared. (I was completely out to lunch dozing and hating the Foley catheter to drain my urine that felt burning and uncomfortable.)

The hospitalist came in. I saw her nice worried face and she was talking to me, but I had no idea what she was talking about. They were calling anesthesia for a central line, a sort of IV access in the chest to give me more fluid. That anesthesiologist was driving in from home. My mother says the hospitalist said to her then , it was about 3am, "We're treating an infection but it's not working and we don't know what else might be going on. We're going to do a central line, but if it was my daughter I'd send her to Baystate (the big teaching hospital 30 minutes away) My mother said, "OK let's go, then." She was so anxious and was scared to move me, but didn't want to wait to long. My poor mother. She called Rob to make sure she wasn't being a renegade and he said yes, crying in bed.

They made my mother a nest down the hall and let her nap while they waited for the ambulance. It came and they got me moved with all my wires and monitors onto the stretcher and out into the cold world. My nice nurse was coming with me. The sirens were on and down south we went. Even then I didn't really feel fear or the gravity of where I was. I was thankful for my family, for my mother and her night duty (Rob is incapable of staying up after midnight) thankful to all the concerned skilled care. I still felt so much better than when I had when my ear was in such horrific pain. I slept most of the 20 min ride there. I don't remember the sirens.

Saturday, March 12, 2011

ER

By the time I was at the ER my temp was 105. I did not know my name, Rob's name or if I had children. They kept asking me over and over. It became annoying. Like they were asking me questions they knew I didn't know the answer to. They asked my birthday and I remember thinking it was so strange that they said 1970. That was so long ago! I didn't know the nurses or doctors that came and went.

Everyone wore gowns, masks and hats.They did alot of handwashing. I recognized my husband and child, was glad to see them, but could not identify them. I thought Rob looked so handsome in his blue plastic gear. I was sleepy and cold and no one would give me more blankets, which I didn't understand (they didn't want my fever going higher.) I slept and then people asked me questions, took vital signs, looked me over. I actually don't remember much but I remember wondering when I would go home.

Rob said once when they asked me his name I shrugged but then leaned forward earnestly and asked, "Did my book ever get published?" He said there was alot that would have been funny if he wasn't so scared I was dying or going to be forever mentally deranged.

Two nice women came and put my head in a cat scan machine and I didn't know why (They thought I had a brain tumor causing the sudden confusion)
A nice doc came and did a lumbar puncture a couple times to see if I had meningitis.
I'm sure they did lots of other things. Lots of blood drawn and antibiotics running.
I don't remember.
Rob was stoic and calm. He and Georgia watched Tom and Jerry in the waiting room. Came and went.

Here's Georgia geared up


He called my mother two hours away.
"Kat's in the hospital. She has a high fever and she's incoherent. Can you come out and take care of the girls?"

She came and took Georgia home and met Lily at the bus.
Rob came and sat with me.

Friday, March 11, 2011

Well then.

What a very strange two weeks I have just had.
I will tell my story as best I can, both for you and for me. I'm still trying to figure out what happened, why and when.

Somehow I ended up very very sick on Wednesday 3/2 at the local ICU getting transferred with sirens blaring to Baystate ICU at 4am last Wednesday night. My chart said "Condition: Poor." I did not know my name. They did not know why I was so sick.

Several days before, I had a cold and chose to work overnight anyway. I felt achy and gross, a bit of a sore throat, but not bad, just a cold. I drank lots of fluids and slept well when I was home during the day. Sunday I felt nauseous and under the weather but not so bad we didn't drive to Keene and buy a puppy training book, all stopping to eat burgers and fries at 5 guys burgers. I was fine, really and glad I'd get to sleep in on Monday.

Monday I slept most of the day and got to bed early. I thought I had fought it off.

The next morning I woke up with an ear ache in my left ear. It hurt! I woke Rob up crying in the morning and told him I was going to butt in front of him in the shower, hoping the steam would relieve the pressure. It didn't. I got the girls to school and went to see my doctor.

When she looked in my ear she said, "Oh you poor thing!" because it is was so inflamed and irritated. She recommended fluids, sleeping upright, heating pads to the ear and ibuprofen.
It hurt so much I couldn't imagine not getting something stronger.
I asked for codeine cough syrup. (As someone in the medical field I am loathe to ask for narcotics because you don't want anyone to think you've got some drug addiction, but I asked anyway.) I was hoping it would knock me out and let me sleep. She told me to call if the eardrum ruptured, they'd want to look at it after and make sure it was healing.

I went to CVS to drop off the script and the pain got worse while I waited. The line was long, people smelled like smoke and they asked 10 questions of the tech then rummaged forever for their card. I was losing it. Once my script was dropped off, I was hungry so I drove to Mesa Verde to get a nice lunch but there was no where to park and I started to fear that I would start crying in public and wouldn't be able to stop, so I drove through Wendy's. Disgusting. I ate french fries, a fried chicken sandwich and a chocolate frosty. I wouldn't' usually eat that, especially if I was feeling sick, but was feeling felt stuck and worried.

After eating my weird meal and whimpering in the car I went to stand in the always enormous line of CVS drug pick -up and waited and waited. I started to squirm, wasn't able to sit still, squirm, twist, sigh. It was agony. The ear was throbbing, sour, aching sharp pain all at once.

Finally I got my script and got to my car using my frosty spoon and getting everything ready to give myself a dose of the codeine when I got halfway home. I figured I'd get zonked out and wanted it to kick in just as I was done driving.

I cried in the car.
Cried really loud with lots of tears.
(Looking back this seems like an obvious warning sign that something was not normal, but at the time I thought, "It's an ear infection. I guess they really hurt. No wonder my kids fuss and scream when they've had them.")

I downed the pink codeine half way home. When I pulled in I let Cookie out as fast as I could and then lay down, but it hurt to lay down! Hurt! I was horrified. It hurt to sit up! It hurt to do anything. The hot-pack didn't help at all. I whined and paced and poor Cookie stayed quiet back in her crate watching me roam back and forth. I kept waiting for the syrup to kick in and it never did. The family got home, did homework, ate dinner. I was kind of out of it in the other room, pacing around. I took one of Rob's last vicodin from his back injury a year ago and that didn't help either.

Just before 5, I called the doctor back and told the receptionist,
"This is too much. I need something. I'm doing my labor breathing. I can't sit still. Can somebody just poke a needle in my ear and release the pressure?" She was startled, "I've never heard of that." long pause.
"I need to talk to the nurse. I need to do something."

She put the nurse. I cried. "I am tough. I'm really tough and I can't do this all night. It is killing me. It feels like my head is going to explode!"

She said sympathetically, "It sounds like you're in alot of pain, let's see. I'll talk to the doctor and get back to you."


I paced and waited. I waited. I finally was able to sit down in the lazy boy upright and doze for a moment. The family went to bed. I was downstairs. I waited. No one called back, but the pain was slightly less and there was ooze coming out of my ear. I didn't have to pace anymore. Then I started to puke every hour. I could sleep between puking. I had to sit on the toilet to vomit because I had diarrhea, so after 15 or so minutes of retching I'd head back to sleep sitting up in the chair.

While I waited I looked on-line and in my alternative healing books for any remedy that might help.
I tried warm olive oil with pressed garlic dripped into the ear "instantly soothing!" Not for me.
I tried putting Sodolite, a blue stone against the ear to pull out the inflammation. Nope.
I tried two homeopathic remedies, Chamomila and Pulsatilla which didn't seem to do much.
Olive oil and apple cider vinegar warmed and dripped in ear. "My daughter's pain instantly went away!" Not mine.
I tried acupressure and massage around the ear "creates drainage and instant relief." Uh Uh.
I tried to do my tapping on the pain but the pain and nausea were so powerful I couldn't focus on anything.
I walked around saying "Help me help me help me."

I could have called an ambulance, woke up Rob, called a friend but I just thought I was having ear pain. I thought it would pass. Everyone seemed to think it was fine. No one was worried enough to call me from the doctor. I was also confused, felt stuck in a cycle of pain and puke.


The night was long. I was getting a bit confused because I put some logs in the wood stove and shut the door, touching the burning glass and frying the skin on my wrist ending up with a band-aid sized burn on my inner wrist, which started to throb. I remember being puzzled that the door would be hot.

It was morning and Rob was handing me the phone. The doctor's office was calling back at 8am and Rob was heading out to work. I told whoever was on the phone my eardrum had ruptured and she fit me in at 9:30am. I hung up and told Rob he was taking me.

He was dressed for work and exasperated. "I don't have any time left, Kat. I can't"
I sat up and said, "You have to take me."
I was very calm and distanced. I knew he had to take me.
"Kat, I have no time. Can you bring yourself?" He had no idea what was going on.
"Nope. You're taking me."
"Where is it? Which doctor?"

I had been there the day before. I knew where it was, but I could not tell him. He looked at me, getting exasperated. "Where is it Kat?"

"Take a right at the bank."

He and Lily looked at each other. Puzzled.

He asked me again, probably more gentle this time. "Where are we going?"

"Through the window." was another reply.

I got dressed and he took me to the doctor.

I saw a lovely woman I knew from work who started talking to me, not only could I not hear her (my left ear was so very plugged) but I also just could not answer her. Could not find the words, the connections the noises that would just let her go on with her day. I just said random things or maybe smiled silently. Then I brought Rob over to a more private area and we waited.

When they called me it was the same tech I had yesterday who did not seem to get the gravity of my pain. She stared at me. Yesterday I had told her, "My ear hurts so much, I cry when I burp." I suppose that was a weird thing to hear. This morning she had me lay down on the short paper-covered table and I slept while Rob and the doctor talked, all the while Rob must have entertained Georgia. The doctor asked me questions. I remember her face near mine. Rob took me out of there to the hospital. My doctor had said I could get a Tylenol suppository to get my fever down. I could get that at the ER. She would call ahead. I was confused when he brought me into the waiting room. What could they do for me there?