Punctuated Equilibrium
Punctuated Equilibrium
Hiatus
Sunday, February 22, 2009
Well, if you’ve visited here lately, you know that things suddenly went quiet towards the end of last year. I got quite busy, had other priorities, etc. (excuses, excuses..) and I stopped posting.
It was not that there wasn’t anything new or interesting to write about, just that I didn’t feel motivated. I made note of some things I wanted to address, and added them to the list of things I would get to....someday.
The winter solstice holiday break finally arrived, and I fully intended to catch up on many things. While the two weeks would not be sufficient to knock everything off of my to do list, I was going to try.
I got off to a good start -- began with some studio upgrades, recabling my Pro Tools rig, reorganizing my racks of gear, and so on. So far, so good.
Naturally, running cables, crouching under tables, behind equipment racks etc., is not so pleasant. It always seems that I stretch a muscle or something while in an unnatural position. This time around, I noticed a strange pain in my lower abdomen, right where my right thigh and abdomen meet. Odd, I thought. Perhaps it will go away.
It didn’t. The day after the traditional solstice celebration, the pain was such that I decided I should not wait until after my doctor was back in the office. So I made a Friday night trip to the Emergency Room at my local hospital.
And what a trip it was.
First of all, since most people’s physicians were off celebrating the solstice, the emergency room was packed. They were in Triage mode, and determined that my pain was not as serious as the broken arms and bleeding fingers, so I ended up waiting for over six hours before I was even examined. During that time, the pain grew more intense, and I felt a little feverish. I brought a book along with me, but neglected to bring along my reading glasses, so suffice to say...I was quite miserable.
FInally I was called in. They had me lie down on a stretcher in a ward with six other patients, the sole doctor shuttling back and forth between them. It took another couple of hours before he finally got around to seeing me. I guess they felt that the woman next to me was suffering more than I was -- she complained of having a headache (migraine). I could hear the conversation between her and the doctor.
Doctor: “Do you drink coffee or any other caffeinated beverages?”
Patient: “Yes....coffee and some coke”
Doctor: “How much do you drink?”
Patient: “Oh, only five or six cups from Starbucks, and maybe four cokes a day”
Doctor: “I see....how many glasses of water do you drink?”
Patient: “Oh, maybe one. I don’t drink much water.”
...and so on. After explaining that she shouldn’t be drinking so much caffeine, the doctor wanted to give her some morphine to alleviate the pain from her migraine. The woman shrieked, “No! I don’t want to take any drugs!” (Of course she apparently didn’t have any issues taking the drug know as caffeine...)
After the doctor finally got the woman next door calmed down (after much argument, she eventually agreed to take some Tylenol), he came over and began to examine me.
Now I have to back up for a minute....I had surgery to repair a hernia around six or seven years ago. Since the pain I felt was in the general vicinity, I had been thinking that what might have happened is that I simply ruptured things again (this is quite common - an astonishingly high percentage of hernia repairs have to be done repeatedly). I figured they’d just examine me, tell me I needed hernia surgery again, and to go home, take it easy, and schedule an appointment with a surgeon.
I was wrong.
The exam revealed some very swollen lymph nodes in the area in question. They sent me in first for an ultrasound, and it showed some extremely large, swollen lymph nodes. This was cause for concern. But that isn’t what ended up putting me in the hospital...
They took some blood samples, ran some tests and discovered that I also had an extremely low blood platelet count. The normal range is between 250-300 (in thousands), and mine was coming in a 40. Suddenly the focus switched from my lymph nodes to my blood.
The doctor ordered a CAT scan. While they were dancing around, trying to avoid brining up the obvious (lymphoma), it was clear to me that the CAT scan was being performed to see if they could see any evidence of cancer.
While waiting for the CAT scan results, the doctor ordered the nurse to get me ready.
“For what?” I asked.
“To go upstairs”
“What’s upstairs?” (another test?)
“We’re going to admit you to the hospital”
“Wait a minute....I don’t feel so bad. Can’t we pursue this on an outpatient basis?”
“While I can’t force you to go into the hospital, I highly recommend that you do so, until we figure out the cause of your drop in platelet count. We need to figure out what is going on.”
<gulp>
Since I hadn’t expected anything more than to be told to go home and schedule an appointment to have my hernia surgery redone, I was not prepared to go into the hospital. I had nothing but my book (no reading glasses) and the clothes on my back. My dogs were cooped-up in the house, and I was worried about them.
“How long will I need to stay?” I ask the doc.
“Oh a few days, a week or maybe even more....we don’t know.”
<sigh>.....Oh, no. Here we go.
They wheeled me upstairs and put me in a room with another patient (I get to him in a minute). Peeking in the rooms as I passed by, it quickly became apparent that this was the area of the hospital where they sent the gravely ill or terminal patients. Oh boy.
The sun was coming up (and naturally, I could see from my window that it was a beautiful day). I hadn’t slept, so I tried to get a little shut-eye. An exercise in futility.
It was now Saturday. A weekend. A holiday weekend.
The hospital seemed to be running with minimal staff. No doctor came to see me until Saturday evening. All I could think of was my dogs, and that I wanted to get out of there.
I called my Animal Nanny. They take care of my pets when I go out of town, and have key to the house. Thank goodness. They said not to worry (I did anyway), they’d take care of the dogs.
Now, about my roommate.
My roomie was a poster child for every lifestyle ailment known to mankind. He was maybe in his 60s or early 70s, and I saw he was hooked up to every monitoring and life-support system known to modern medicine. He had more wires going into his body than the Frankenstein monster just prior to re-animation.
I talked to his wife, and found out that he had had a couple of heart attacks, and a stroke had left his left side partially paralyzed. He had extreme difficulty walking on his own, so he was mostly bed ridden. From overhearing his conversation with the nurses, I found out that he was being treated for diabetes, high blood pressure, high cholesterol, and was often taking oxygen. They hooked him up to a c-pap machine at night. He had a pacemaker, ad later a catheter was installed so his urine could drain.
On the next night (Sunday...yes, I wasn’t out yet), something happened and my roomie became delirious. He was thrashing about, trying to get up, and shouting insane things to his wife. It was clear he was out of it -- when asked he didn’t know he was in the hospital, he thought he was at home. The guy had choked while drinking some water, and the nurses thought this might be responsible for his delirium, but I don’t know. He certainly had an incredible mix of chemicals going into his bloodstream.
Visiting hours were just about over, and his wife was clearly worried. I asked if they were going to let her stay. “No” she said, “But the nurses say they’ll keep an eye on him.” Knowing that the hospital was running with minimal staff, I did not think this was likely. I said that being out of it like he was, he out to have someone watching him around the clock. His wife responded, “Well, I suggested they move him to the ICU, but they don’t think it’s necessary.”
Visiting hours were up. His wife left. I looked forward to an evening of being nurse to my roommate.
Sure enough, his wife wasn’t gone for five minutes before there was trouble. I heard the guy thrashing about again, moaning. I got up to see what was going on only to discover that he was siting up in bed trying to remove one of the IV’s in his arm. “Don’t do that!” I shouted, and buzzed the nurse station. But no one was coming, so I got up ran down the hall and grabbed the first nurse I could find.
By the time they made it to the room, the guy had succeeded in decoupling himself from his heart rate monitor and an IV or two. The nurses were scolding him, asking him why he was getting up. “I need to go to to the bathroom” my roomie says. They take him to the facility, but he is unsuccessful, so they hook him up, tidy up, and slip him back under the covers.
Again, they weren’t gone for more than five minutes before there was trouble. I could hear the hissing sound from his respirator mask that he had removed. He was trying to get up again. Once more I hailed a nurse.
I mentioned that he had wanted to go to the bathroom during the last episode. Well, this time he was successful, although no bathroom trip was necessary. He had shit his pants.
The nursed again, cleaned him up, put on a new diaper, hooked him back up to the machines and IVs, all the while scolding the guy.
This went on all night long. Someone was coming in to draw blood (which was quite an endeavor, since they had great difficulty in finding a vein, and even then his circulation was so poor that they had problems drawing blood out), change his diaper, give him a pill (he was taking meds practically every hour or so, often not aware of what meds he had previously been given), change his IV drip, give him his oxygen treatment, help him eat or drink, and if he choked the swallowing therapist would come see him.
Needless to say, sleep was not an option.
The next day (Monday...yes, they still had not figured out what was going on with me) my roomie’s wife came back. She thanked me for flagging down nurses all night, and we chatted. She told me her husband had been this way for 26 years. That’s right 26 years of bed ridden misery, and when things got really bad they’d shuttle him into the hospital, sometimes for a stay of two months or so.
I am at a loss to know how she could have put up with this for so long, because in addition to being a basket case, her husband did not appear to be a very a nice guy.
To make a long story short, my lymph node swelling disappeared with antibiotic treatment. My platelet count rose daily, and on Tuesday (the fourth day of my stay) I was released from the hospital. My platelet count is back to normal, but still, the doctors have not been able to explain why this happened. And once they wave the magic wand over you and pronounce you “cured”, the want nothing to do with you.
One thing is for certain, however. If you have a patient who needs to clean up his act -- need to eat healthier, drink less, get more exercise, etc. Try room number 4A on the fourth floor of Washington Hospital in Fremont, CA. Maybe my roomie will be back for another stay.
No, sorry....that’s not me on the table.