Monday, February 16, 2009

Miracles IIX: Doctors Let Me In The Door!

After Ruth's wild ride, I was ready for almost anything but what really happened at the ER.

It was almost a major anticlimax. Turns out, the attending who saw me almost immediately was one of the staff neurologists. That was great, I thought. She bundled me up quick and sent me down right away for an MRI. I thought, we're off to a so much better start than at either UVRMC or Mountainview, this has just got to turn out so much better!

Things went downhill pretty quick, and were looking like combat for a few touchy minutes. The neurologist took a quick look at the MRI scan and declared that she could find no evidence of brain stem stroke since November. She turned to interogative, demanding why we had not sought a clinic appointment, since there was obviously no stroke or neurological problem that constituted emergency in her estimation. Some other emergency patient was threatening immediate demise without her quick attention, so she ducked out to take care of that situation, after exchanging a few terse words with my mom, who defended her bring me to the ER, saying that the telephone assistance had instructed her to bring me right in. Ruth had her fight reflexes fully aroused, and was ready to pounce with all her fury, but was throwing verbal jabs too fast to make any comprehensible impression. When the doctor left, we reigned in her leash a bit, but I was resigned, and ready to get my clothes on and go home. My dad was trying to help get Ruth to settle down -- I'm not sure what else he was thinking at that moment. I'm sure, saying a prayer of desperation in his heart.

When the doctor came back, we all unloaded. Ruth reasoned that there were obvious neurological deficits that could not be ignored, and they were getting worse by the minute. Mom said the guys on the hot line told her to bring me, not schedule a clinic appointment, and we lived hours travel away. I said I did not care what the diagnosis was -- I just knew something serious was wrong, and I NEED HELP! Every other place we have gone said there was nothing wrong, or gave me SSRIs. Please HELP! Dad tried to inject at logical quiet tone of reason, saying we came there for help, and trusted the doctors to do their best.

The doctor finally listened, I think most convincing to her was Ruth's argument about neurological deficits. She started to administer what I have come to refer to fondly as "stupid pet tricks" because I have now performed them or variations of them so many times. They are as familiar and tiresome and tedious to me now as doing household chores. At the time, some of the tests were very frightening, because I was suddenly confronted with the stark truth -- I failed. I was failing to perform some of the simplest cognitive and physical tests, things I have know how to do without effort since I was a grade school age child. I could not memorize a series of words, and the effort to remember caused a cold sweat to break out. How could I forget something so easy? She gave me easy reminders, and still, I failed!

She finally conceded that something more serious must wrong, and I thing against her better judgement, decided that further inquiry was needed before they let me go home. As a last test, she asked me to show how well I could stand with my eyes closed, and I tried to plead that I couldn't do it at all, but she thought I was just stressing out or something, so urged me to try anyway.

Well, I shut my eyes, and I'm pretty sure I toppled like a felled tree. I couldn't stand up for hardly a second without my eyes opened or else some other support. I fell over against the gurney, and that pretty well concluded the "stupid pet tricks" for that session.

At that point, there was continuing argument about the need for immediate admission, or whether I should come back for clinic exam by her referral in the next day or two. Of course, Ruth was arguing for immediate admission, but the doctor was sceptical. In an inspired idea, Ruth suggested that they ought to perform an immediate lumbar puncture, to examine cerebrospinal fluid pressure and content for abnormalities. In order to defend her great professional skill and proficiency, this neurologist agreed that it was an easy procedure, and that she could just go ahead and do it right there, as if she performs dozens of spinal taps every day. Anyway, whatever Ruth said somehow stroked her professional ego in just the right way to get her to go along. She arranged to perform the LP right away.

That is where complications started. I don't know what. It hurt me more than LP normally does, according to what I understand. It is normally a painful procedure, but this was PAIN to the MAX. I felt like I was having electricity connected to my body directly through my back. And supposedly this was while I was heavily sedated, and supposed to be aware of almost nothing. It was hurting me badly, and it went on for and inordinate length. Apparently, the neurologist had difficulty tapping a spot with enough pressure to provide sufficient flow to fill the test vials. And when she did finally settle upon a spot, the vials filled excruciatingly slowly. I surmise that the doctor was used to tapping patients with high cerebrospinal pressure, from whom the fluid literally squirts generously. Mine was a miserly sluggish slow drip, by comparison. I know not why, nor can I explain why mine would be different than any other. But I remember the pain.

After the LP, I understand I was admitted to the neurology ward at the U hospital. Ruth stayed in the room with me and slept on the foldout bed, while mom and dad went to camp out at Aaron and Michelle's place. I don't remember, but Ruth says one of the nurses was changing my gown or something, and I woke up enough to be convinced that it was the coroner, preparing me for the autopsy. I think she was doing something like shaving my chest, to place electrodes for the remote sensors of the cardiac telemetering device. Anyway, Ruth says I was trying to convince the nice hispanic-looking woman that I was not dead yet.

Thus started an interesting few weeks at the neurology ward.

Next instalment:  Friends, Doctors, and Sharks


Anonymous said...

I think the LP didn't go so well because of the tumor in your spine. From what I can tell, she was probably trying to draw CSF from the area where your tumor was, if not from the tumor itself. It wasn't normal at all. That's why I think it might be beneficial for you to have another one. Sorry. But I don't think it would be a repeat performance the second time around.

Anyway, the nurse you accused of trying to autopsy you was very good natured about it all. We had a good laugh about it afterward - you too! LOL

Jim Cobabe said...


I'm suffering from acute performance anxiety. This is a much scarier ride than the first time.

I will do my best.