Tuesday, May 26, 2009

One year ago


It was just a year ago, and yet it seems longer. A year ago my sister got up out of her hospice bed and did her first round of chemo. A year ago another sister had a heart attack on the heels of a traumatic experience. And a year ago, I almost died.

Of the 17 days I spent in the hospital, I only remember the last week. Which disturbs me. Clarity of mind is important to me. I rarely drink and I don't do drugs because I'd rather experience the world authentically, awake to the moment. And yet I lost 10 days. I remember bits and pieces. I've made a patchwork quilt of memories, trying to cover my hospital bed in a security blanket. Odd, how insecure I feel about that drug-induced fuzziness. Odder, still, to realize that there are people who would envy me the blissful void that comes with dilaudid-on-demand, people who seek out that oblivion every chance they get. And having experienced it, I am both glad to be alive and saddened by the awareness that there are people who would rather sleep through life than live it. Because after being trapped in a hospital bed for 17 days, I understand the escape that drugs can be.

Within a week, a small infection turned to cystitis turned to septicemia. I'd gotten the 'flu and was working long hours trying to get caught up before I took a few days to be with my sister for her first chemo treatment. I really wanted to be there with her. I felt like hell but I got on a plane, determined to be there. I'd spent hours sitting by her bedside telling her to get up and fight and I wanted to celebrate the victory that starting chemo was for us both. I had terrible chills that had me shivering for hours. I thought it was the flu bug, but it was the first signs of septicemia. Her immune system was compromised and I didn't want to make her sick. So when I arrived at the airport, I knew I couldn't see her, not right away, so I stayed with a friend.

In the morning I told him I was sick. I called my doc and her office called in a prescription for an antibiotic to a local pharmacy, with instructions to seek medical attention if the infection didn't improve in 48 hours. I should have gone to the hospital that day, but I didn't. I thought I was getting better because my temperature had dropped. I didn't know that meant I was going septic. I was in a lot of pain, so I spent the next two days in a haze. I just withdrew my consciousness. My friend did what he could to make me comfortable there on his couch, bringing me my antibiotics and my aspirin. By Friday morning, the pain was beyond level 10. I had to fight back the constant urge to vomit. It was 48 hours since I'd started the antibiotics and I was no better. I called my sister the nurse, the one who'd just had the heart attack two weeks earlier, and she told me, with a tone of voice that brooked no argument, to get to the emergency room for IV antibiotics. So I went.

I remember that the first dose of morphine didn't do anything for the pain. Neither did the second one. It took 4 doses of morphine to get me to lay still enough for them to do a CT Scan. I remember after the scan the doctor asked me how long I'd had kidney disease. I told him I'd had a full physical 6 months earlier and was in perfect health. Apparently that information, combined with my low blood pressure and falling body temperature, was what they needed to know for them to realize I was in septic shock--the infection had gone to my organs and in a few hours I'd be dead. 30 minutes later, I was in surgery.

I remember the anaesthesiologist was a woman with a compassionate demeanor. I remember her asking me questions, but I don't remember what they were. I remember them moving me to the surgery table, and the mask, and then nothing. The next thing was a moment of panic when they brought me up to consciousness while still attached to the respirator--they wanted to make sure I could breathe on my own. Then blackness again, and the next thing I remember is the anaesthesiologist saying, "I need you to remember one word. If you ever need surgery again, tell your anaesthesiologist 'anterior'. Remember. Anterior." Apparently, they'd had a hell of a time intubating me for the surgery.

From then on, it is a blur. There was a rhythm to the days in the hospital. They gave me antibiotics via IV twice a day at first. I remember it because the bag of vancomycin was cold and a disgusting greenish-yellow color. I remember endless blood draws. Change in antibiotics to three times a day. The CNAs putting the nasal cannula back in place because my oxygen levels were low.

And I remember the twice-daily ordeal known in my mind as The Cleaning Of The Wound. It was a 20 centimeter incision that they did not stitch closed -- it needed to heal from the inside-out the surgeon told me -- and it needed to be cleaned often. I don't remember the early days as they did it for me and they usually gave me a dose of dilaudid first. But at some point around my first week there they decided I was healing well enough that I could move around without damaging the wound on my thigh. And then the fun started. I got my first shower, and in my first shower, they cleaned it with a water wand. The pain was so sudden and so intense that I lost my breakfast. And after that, they were all too happy to let me clean it myself. I got two percoset an hour before my shower to take the edge off the pain without making me too drowsy. Then they wheeled me to the little tiled room and I would spend 30 minutes cleaning up. When I was done, I was shaking so badly they had to dry me off and help me shift from the stool in the shower room to the wheelchair. When I got back to my room the nurse was always waiting with a dose of dilaudid. I would slide into oblivion for a couple of hours and wake after the worst of the pain was gone.

I always had another person in my room with me, and the first one was very quiet. I only remember her as a face saying goodbye. The second one was a Filipino girl who watched Catholic services on TV, and whose family brought her food in the afternoons. The smell of the food often hit me like a wall and made me physically ill. I have a memory of vomiting with enough force to hit the privacy curtain 6 feet away. I remember that after that the CNAs started giving me the towels I begged for instead of the little basins. I remember my friend calling and asking permission to visit, which he did every day. And I remember talking to family and friends on my cell phone, though I don't remember what was said. Ten days passed like that.

And then Mrs C arrived Memorial Day Weekend. I could tell she was elderly by her voice, and her tendency to speak loudly. That is probably all I would remember about her, if it hadn't been for the fact that the battery in her hearing aid went out. Her deafness meant that one day I woke up in my own Personal Hell.

The nursing staff always thought there was something wrong with my TV because I didn't watch it. Apparently I was the only person on the floor who abhorred TV. And Mrs C not only watched TV, but needed the volume turned up VERY LOUD because of her hearing loss. I lost my mind. I kept my sense of humor during my ordeal, I made the staff laugh with my story of the ingrown hair turned killer hair, but the endless hours of unremitting babble emitting from Mrs C's TV reduced me to tears. My friend called to ask if he could come by and I told him only if he brought ear plugs and chocolate. Which he did, and thus saved my sanity.

I hated the dilaudid, and yet I started asking for it even when my pain-level wasn't high. I hated that feeling I got in my chest when they pushed it through my IV. It felt like anxiety hitting my heart. I begged the nurses to push it slowly, extra slowly, and they'd laugh and say I'd never make a drug-addict, and yet there I was, asking for dilaudid to escape the misery of my existence... an existence that had narrowed down to the agony of my twice-daily showers and 18 hours of too-loud TV that the plugs in my ears cut down to a just-bearable level. The staff, bless them, tried to find a replacement battery for her hearing aid, but could not, and with it being a holiday weekend, her family didn't bring one in for her until Tuesday afternoon. Three and a half days of hell.

It got better after that, but now I was awake to every moment and the agonizing rhythms of my days. I'd been getting a new IV every other day because the meds were so hard on my veins, and it got to the point that I cried whenever they started thumping my arms and hands looking for a new site. I was healing fast but I still had an open wound and as long as it was more than a few centimeters, I required IV antibiotics. My sister suggested a PICC line and I requested it, which made everything from the blood draws to the IV meds painless. And it turned out that the PICC line was my ticket out of the hospital. My step-mom was once a home health nurse supervisor and between us we convinced the hospital that I could go home with the PICC line and administer my own IV meds. I studied molecular biology, I told them. Running an IV is simpler than running PCR.

And so I went 'home' to my friend's house, and spent another 3 weeks on home health care, running my own IV three times a day.

All this was just a year ago. And perhaps it seems to have happened so long ago because so much has happened since, and perhaps because I still feel Tammy's loss so keenly. It has been 16 months since she died and sometimes I think of her and smile. And sometimes I think of her and ache. And for some reason, the memory of her pain hurts more than the memory of my own. Funny, how life works.

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