Saturday, October 12, 2013

"I had no idea you were this tall when you were lying down."

NOTE: This entry has descriptions of an emergency room, blood extraction, and other bodily functions. If that displeases you, please skip this entry.

Tuesday the first of October was an interesting day.

It began atypically: I sat for hours and read article after article about the government shutdown and the date of open enrollment for the Affordable Care Act (Obamacare), both commencing on October 1. So much political theater to slog through. Proposals and counter-proposals, neither one intended to be accepted, but floated solely to allow the originator to prove how "in touch" they are.


After having done some light exercises (push-ups and pull-ups against a doorframe), I sat at the table to make lunch. It was just after noon. Sandwich fixings waited in my fridge. While I was watching a video about a camera I'm interested in, I felt a strange feeling in my chest. It started as a buzzing discomfort, radiating from the sternum. Like prickling or what I imagine heartburn must feel like. "Strange," I thought. "I haven't even eaten anything."

It was almost like I needed to belch, but the feeling didn't dissipate after a few seconds. Worse, it grew in intensity: the prickling was now a spreading warmth. I started to feel clammy and a sweat broke out from my back and forehead. Was this a rupture of some valve in my heart? Was I actually in my last moments?

Was I dying?

I stood, alarmed. I tried to feel my heartbeat in my chest. I couldn't.
I tried to take my pulse at my wrist. I couldn't.

I began to walk towards my phone, hesitating while I decided who to call. Call 911? Call my parents? But then it was too late, I felt the darkness closing in. I staggered into the kitchen, colliding with a chair and knocking it over. I grasped for the counter top and tried to lower myself gracefully to the floor. I imagine it went less than gracefully. But find the floor I did (thanks, Gravity!) and I lay there, breathing hard and feeling my clammy skin stick to the tiles.

How long I lay there, I don't know; probably no more than a couple of minutes. I may have even fully passed out while lying there. But I remember grasping for the sink and pulling myself to my feet, still breathing. My chest no longer hurt, but I was cold and hot all at once. A standing sweat was dripping underneath my shirt and off my nose. I registered I was alive and did the next important thing that came to mind...

I went to my clothes dryer, opened it, determined with a drunken flop of my arm that the clothes I started last night were still damp, pulled the lint trap and cleaned it, then started the dryer.

As I said, the important thing. (I should mention that when recovering from a similar episode ten years ago, the first thing I did was wash my hands. I'm very practical when returning to life.)

I stumbled off-balance to the fridge and grabbed a yogurt, a spoon, and the bag of granola. I sat at the table, tore the lid off the yogurt inelegantly with hands that felt more like insensate clubs than articulate digits, poured a neat amount of granola in, and started to eat. In between bites, I grabbed a glass and filled it with water, sloshing water over the sides in my lack of exactitude.

After finishing the yogurt and starting to think about whether or not to go to the doctor, the pinpricks came again. Not nearly as bad, but I was fearing that I would now vomit yogurt at the next chance. I decided that was a pretty conclusive sign to go to the doctor. Grabbing sandals, keys, and my phone, I glanced at the mirror in the hall bathroom. Pale and grey, even for me. Even my hair looked discolored. Definitely going to the ER.

There's a hospital not far from my home. I noticed it in the first few weeks I lived in Kansas City and made a mental note - if I needed a hospital, that was the closest one. In the subsequent years, I've directed a few people there, always keeping an eye to make sure it was still there.

On Tuesday, I finally made use of the information for myself. I pulled into the parking lot, following the red signs for EMERGENCY. Jam-packed, I had to park a fair distance away, but under a shade tree. As I began walking across the parking lot, I was limping. My left big toe hurt immensely. I probably kicked the chair over with it. Also, there was a pain in my lower stomach on the right side. I must have torn my skin on the counter or a handle or something.

I entered the ER door shortly after an elderly man had been unloaded and pushed through from a private van. The front desk was empty and the triage nurse curtain was just being pulled to. I folded my hands behind my back and stood waiting politely, possibly the least emergency emergency that room has seen in some time. It took seven or eight minutes before a nurse approached the desk and asked if she could help.

I explained that I'd had a couple of dizzy spells this morning. She pointed me around to another non-rectangular cubicle and into a support chair. She reclined it slightly, but I was too long to make it possible for her to get past me, so I was obliged to cross my legs at the shin to allow her to access various machines. After some quick tests and an EKG, she wheeled me down the hall to room 6 in the emergency room.

Four people were waiting for me. I transferred beds and we made small talk, of the kind that allows them to quickly access my information and to simultaneously determine that I am in a state able to give that information. One woman said nothing for the entire duration of my visit. I assume she was a nurse-in-training. A taller man did a good job of explaining what was about to happen and what all the tests were for. A woman with overly-wavy hair started work at my right elbow, inserting an IV and taking blood. Another nurse worked on my left arm and chest, attaching sensors to allow for diagnostic displays.

The woman inserting my IV apparently found it difficult, as there was a fair amount of blood lost in the extraction of the other blood they needed. She said to the head guy, "He's a bit of a bleeder," which I thought most unfair of her. Ordinarily, my blood stays right where it needs to be - it was only her meddling which was putting it over my elbow and down onto the bed and gown.

Time becomes very disconnected in an ER. I have only a vague chronology of order the following things happened:

-A nurse came in to measure my blood pressure in three different states. She must have been newer than many of the others, because she seemed friendlier, less confident, and less quick-efficient than some of the other workers. She took the resting pressure in my laid-back state, then had me sit up on the edge of the bed for a second reading, then stood up. "Geeze," she said as my arm cuff was inflating. "I didn't realize you were this tall." I demurred. "It's the shoes." She looked down at my feet, clad in my thin sandals. "I don't think so."

-A radiology technician wheeled me through the halls to the CAT scan. As I was being loaded on my tray into the machine, it came out that I was born in St. Louis. "I knew I liked you," said radiology tech #1. "Don't even get me started," said tech #2 with an exasperated sigh.

-At some point, a dude-nurse came and used a cool portable xray machine to take a picture of my chest from beyond the foot of the bed. Science! I refer to him as the dude-nurse not because he was a dude, but because that's the only way he referred to me. "Hey, dude." "Sit up, dude." "Put this behind you, dude."

-A blond, petite nurse came in and said that the ER head wanted to see how I did at walking. She disconnected me from various things and I stood gingerly to avoid bumping the IV tap still stuck in my right arm and the uncomfortable stickers still clamped to my cardiologically sensitive areas. We walked down the hall making small talk to the door and back to room number 6. She then commented that she had no idea I was that tall when I was lying down. "But, I'm short," she countered. I inquired how tall she was. "Five foot two." Yep, that will do it.

-The two nurses who had commented on my height helped to get me disconnected and detached as I was preparing to leave. One mentioned to the other that they didn't realize how tall I was lying down. They laughed. Considering I'd been sitting there for two hours looking at my feet dangling off the edge of the one-size-fits-most hospital bed, I don't know if they were really surprised or just making chatty conversation while they removed the surprisingly large IV tap from my arm. That image is going to stay in my head for a while, I think.

-At a certain point, they asked for a urine sample. I trudged down the hall to the bathroom, catching the fragments of conversation "...looks like he can walk well..." I was pleased because it finally allowed me to correct a problem that I had noticed an hour earlier: my zipper was down, and had been since I checked in. That's what I get for leaving the house in a hurry. Luckily, the doctors were too kind or too busy to notice, unless the XRAY tech publishes my photo for everyone to see.

-A lady from the registration office came it during one of the bouts of waiting for tests. Name, rank, serial number? Check. "Are you here today alone?" Yes. "Are you married?" No. "Do you have a partner or significant other?" No. "Do you live by yourself?" Yes. "Well, gosh, somebody needs to find you!" I mumble noncommittally.
I say, "It's because of my pyrotechnic flatulence and extra belly button." She laughs.

After spending my two hours there, I'm released with a clean bill of health. My cardiac exams are negative. My brain waves are normal. My blood tests are normal. My urine test is normal. My blood pressure is low, but normal. My heart imaging is normal. My toe is bruised but not broken. My stomach is bruised but not even abraded. Everything is fine.

Everything seems to be related to the roving problem I have of vasovagal near-syncope. It can be triggered by lots of things, including stress, dehydration, exertion, fear, pleasure, arousal, anxiety, and just plain old being human. There is nothing to do except be ready, in case it happens again. Which could be in ten minutes or never ever again.

When I was trying to decide whether or not to go to the ER, I settled on the idea that even if all they told me was to eat more fruit and bran, it would be worth it to know. As it stands, they now have a great deal of medical evidence that things are well in my body system. No obvious tumors, no hyperactive glands, no disconnected anythings.

On the way home, I went to the grocery and picked up food. Lots of healthy things (as my mother inquired in our phone conversation later) but also butterscotch oatmeal cookies and some "birthday cake" milk from the local dairy. I ate "lunch" and relaxed into a chair to call my parents. Apprising them of the situation and the "nobody can really do anything" parts, I said goodbye and started browsing on my laptop (which is what started this whole nonsense earlier!).

During the ER visit and after I'd called my trombone lessons to cancel, I browsed my phone and contemplated checking in at the ER on social networks. It certainly would have gotten people's attention. But I'd already accidentally given my friends the impression I was depressed a day earlier, with an inelegantly worded complaint about social woes. It was enough that five or six of my close friends contacted me to make sure things were all nice and "non-scary" on my end. And now, if I suddenly checked in from a hospital, I wondered what people would think, despite there not being a relation between the two events (other than stress, perhaps).

So instead, from the hospital bed, I posted this: "Today has already been a most interesting day, and it seems likely to continue to be so." It's very much the truth, and is also very much not the whole truth. When I settled in for an evening of doctor-ordered sitting quietly and not moving very much, I saw that a single friend had liked that status.

Knowing that person had no idea what had made this particular day "interesting," I smiled and chuckled.

And within a few moments, that chuckling had turned to tears. For relief. For exhaustion. For frustration. For being alone. For taking care of this. For the one person who didn't know what I was going through, but somehow made me feel less alone.

I honestly thought I was dying, in that wretched moment. I thought my heart had burst and that I had seconds left of consciousness. And during that time, I had no flash of light. I had no re-visitation of all the moments of my life. It was only the sheer terror of being a body found on my kitchen floor, and the fact that I had dirty spoons on my dining table.

Unlike all the one other syncope episode, I had no one to rely upon. The sound of my body crumpling to the floor didn't bring parents from another room or the neighbors knocking on the door. I wasn't in the presence of medical officials that I could rely upon to "catch" me and deal with whatever was wrong. I was just alone in my apartment.

In my adult life, I've never felt more alone and frightened than I did in that moment. It probably mirrors how a lot of people on this earth die: in terror and by themselves. But it's the realization of just how alone I was that shivered me through the skin and muscle and grated on my bones.

And as I was rising off the floor, white knuckles grasping the stainless sink, I had a dirty and ragged clarity forced upon my clearing eyes and painful breaths. The clarity that stretches the field in front of me and asks, "what now?"

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