Storyline: Thinking in Autumn Colours
From the horse’s mouth
Tuesday September 7 was mostly a blur. I was given more saline, but I wasn’t much with it. At one point I was told that I’d be getting a CT scan. Radiology was just down the hall and I followed a PA (Patient Assistant) to the waiting room. Had a CT of my head and shuffled my way back to my welcoming bed and to sleep. My voice by then was not much more than a croak.
Later in the afternoon a porter came and wheeled me in my bed to have the gastroscopy. I was in and out before I knew it. Frankly I think they could have done it without anaesthetic since I was still living in a semi-conscious state. Anyway, it was end of the workday for this area, and I was one of the last patients through. As the waiting area quickly emptied and staff were saying their “see you tomorrows”, I lay there, waiting for a porter to wheel my bed and I back to my cubicle in Emergency. But there was a backlog of requests. One poor nurse and her supervisor were well past their end of shift with no porter in sight, so they decided to push me back to Emerg. Problem is that there was now another patient in my place. They went off to find someone who could tell them where to take me. The Emerg nurse saw me in the corridor and said, “Hi. What are you doing back here?” “Um, they’re just bringing me back from the gastroscopy”. “Oh, you’re not coming back here, you’re going to an inpatient unit.” Confusion reigned for a while as the nurses put their heads together to find out where I was going, but they eventually found my place, called up to the inpatient unit and got me to my room.
During Covid times, new inpatient admissions are put in isolation for at least three days, notwithstanding three negative Covid tests. I’m not complaining because I had a private room. But any time a staff member entered my room it was fully gowned and gloved. And finally, Diana would be able to visit me (gowned and gloved like anyone else).
Transferred to my new bed, adjustable air mattress and all, I spent a few moments of wakefulness checking out the controls available to me which were head, knee and foot angles plus the firmness of the air support. The mattress was comfortable, but strange at first. Once I settled into a position, the bed would seem to think for a while then with a soft whirring adjust to my position by deflating a little under pressure points and distributing my weight more evenly. Heavenly. My exploration didn’t last long. A friendly nurse breezed in, introduced herself and started asking questions. Details of my condition, pain and pain severity, allergies, history of falls (to determine falls risk – I later learned that one of the bed’s functions is to sound an alarm, with a repeater at the nursing station should I sit on the edge of or get out of bed), etc.
On the wall at the end of my bed was a glass-covered whiteboard-like template. The nurse picked up a marker and started by filling it out: today’s date, my name, her name, my current doctor’s name, allergies, meds…There were other sections for planned discharge date, actions to take before discharge, etc. – these were left blank for me.
It had now been five days since I’d eaten anything substantial. But I had no appetite. Settled in and IV dripping, I slept.
By now, you might be wondering how I was feeling about all this. It was now a week and a half since we, or more accurately Diana, had pointed Doranya south-west and started our journey home. Well, that’s an easy answer. I felt that I was in good hands, despite the odd little procedural hiccup. The medical staff I had interacted with were communicative and sincere. I knew that I needed them and needed them to figure out the cause of my symptoms. Beyond that, I was really not well enough to care. At this point I was just happy to fall asleep. And wake up.
Wed Sept 8
The gastro doctor visited me the next morning. Other than a minor swelling in the esophagus, he could find nothing wrong with me. So, he was passing me off to an ear, nose & throat (ENT) specialist for more tests. I was put on a clear liquid diet, and he told me that he was prescribing hydromorphone for me on demand once every four hours. “Well, I’m not going that route”, I thought. Well, I’ve been wrong before, and will be wrong again, I’m sure.
Breakfast came. 113 ml of apple juice, 113 ml of apple sauce (clear liquids?) and black coffee (no thanks). I managed to get the first two down without too much choking and spluttering. Same again for lunch and dinner, with the added benefit of 125ml of vegetable broth. Those who know me well are aware that I’ve not been a soup fan since I was a child, and although Diana has patiently trained me to have and even enjoy soups now, I still like to pretend I eat them most reluctantly. Well, that stopped there and then. I really enjoyed that broth. And the hospital’s veggie broth turned out to be the last thing I successfully ingested for a long time.
Thu Sept 9
I was finding it difficult to speak, and was going through a large (Costco) box of 150 facial tissues every day to get rid of the saliva that I couldn’t swallow. Once again, I was presented with apple juice and apple sauce. I asked for tea instead of coffee, and managed to choke everything down, although with much coughing and even more saliva to spit into a tissue.
My first visitor! Diana was able to finally get permission to visit, although I was still in isolation and she was admonished for not gowning up before entering. Nobody had told her she had to, but I guess there were signs outside the door. Anyway, It was great to see her and have a nice hug. (Also not allowed, but what the heck.)
Later, I was seen by a speech-language pathologist (SLP) who told me that my left vocal cord was not vibrating, and that was the cause of my vocal problems. She gave me a swallowing test: water, apple juice then apple sauce… Only the water went down without problems. I couldn’t get the others down. Her conclusion, I should stop taking anything by mouth. The risk I faced, she explained, was that bits of what I swallowed could end up going down the wrong way and cause pneumonia. Which I definitely didn’t need on top of everything else. So, I was NPO (nil per os, or nothing by mouth) from then on.
I also felt that my heart was in arrhythmia. Not unusual for me as I have periodic episodes of atrial fibrillation and am on medications to minimize the occurrences and protect me from stroke. But this arrhythmia felt different. I couldn’t get anyone interested in my concerns. The heart issue was minor compared to the other problems I had.
By day’s end the headache, which was focused around my left temple and ear, was much worse. So one day after I naively thought that I’d never ask for the opioid, I was asking the nurse for a dose of hydromorphone. It wouldn’t be my last. Things were progressing…in the wrong direction.
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