This is a very long post. I’ve attempted to keep it down, but want to tell the whole story. You can always delete it, if it’s too long for your patience.
Choices
You may know that for the month of April, I’ve been a participant in a workshop provided by Authors Publish, The best laid plans of mice, men … and women … often go awry.
My plans for approximately April 12 – 15 were to attend generative workshops for the Authors Publish experience. Write the poetry prompt each day. Have lunch with the retired teachers’ organization and take minutes during the business meeting. Attend the presentation by the invited speaker for the workshop. And, go to a medical appointment. WELL! THAT DIDN’T WORK! As a patient with AFIB, it had been four days of an over-100 heart rate event. And during those days of fluctuating heart rate, I really didn’t feel well. That means no driving anywhere – I believe it’s not safe for me or the other drivers during these times. So, I stayed at home, waiting for the HR to do what it usually does – last four to eight hours and drop to my normal of mid-sixties. It didn’t.
Tuesday, after a call to my cardiology office with my cardiologist’s PA, it was decided that a decision would be made the next day. My next appointment with MY cardiologist was scheduled a week away – what was I going to do with elevated HR between “now” and then? On Wednesday, I was told to report to a local hospital. So, I did. Report to the ER, where tests were taken and plans were made for me to be admitted. By 11:30 that night, I was in a room for my first stay.
The cardiology unit staff were incredibly professional, caring – GOOD – just plain good! Decisions about what to do with this old lady were in flux; finally it was decided that on Friday, I would be in the cath lab with two possibilities. The first was to have a TEE, a transesophageal echocardiograph. I had to look up that, I can tell you. Turns out it’s when a camera that can see through tissue (like an ultrasound) is placed into the esophagus, in my case, to see if the heart has any blood clots that may have escaped the Watchman. And, if everything is okay, there would be a shock (cardioversion) to the heart to get my heart back into its proper rhythm.
That was to happen in the afternoon on Thursday. Which, of course, means NPO after midnight. Now, I’d been in the hospital since Wednesday, with the idea that all of this might happen on Thursday. And even though I’d had some nourishment earlier on Thursday, by ER time, I was ready to eat. The ER nurse brought a cold turkey sandwich. I was grateful to have it. Then, it was up to the cardiology unit with nothing after midnight.
Thursday morning came and went. It flowed into Thursday afternoon – no food. Into late Thursday afternoon – still no food. Hunger was really setting in; if you know anything about diabetes, you know we need regular food input. Then, the decision was made that nothing was going to happen “today.” Food was on its way – salmon plus other good stuff. BUT, Friday would probably bring those procedures so nothing after midnight.
Here was Friday morning, medical people came and went. Finally, a decision was made that the procedures would happen in early afternoon. Time came that I was taken down stairs to the cath lab. I told the lab doc that he was very tall to which he replied that in the cath lab people are either very tall or very short. He was right – everyone is either very tall or very short.
But, I digress. He also told me that he’d reviewed my history about the Watchman, it was doing its job perfectly, there were no clots, SO no TEE was necessary. However, the shocking would definitely be done. “But, don’t be concerned. You’ll be asleep for about ten minutes and, then, it will be done.”
I signed the permission slip – well, actually the electronic thing that was brought for my signature – and went to sleep. True to his word, it was a short sleep, and I woke in the recovery area with a very short technician assisting.
Back up on the cardiology floor, I rested during the afternoon, talked with Daughter #1 who had been assisting me with this (getting to the hospital and all). The doc came in, looked at the machine that was recording my heart rate and saw that it was back into the sixties. So, I could go home.
Hooray! For the next week, I felt really normal. Up and down the stairs for laundry. Food to eat. All of those normal things that one does at home. I caught up writing all of the poems I needed to write for the daily prompts for the workshop. I took care of the 166 e-mail messages on my computer.
Suddenly on Monday, next, I could tell that something was again wrong. My plans for this week were to write more poems for the daily prompts, make more food for myself, etc. The most important plan, however, was to have Paisley (“my” Australian shepherd) come to my house for a week while her mom and dad went to Mexico. I knew right away that that could not happen. Fortunately, her mom and dad had a friend who could take Paisley. My HR was fluctuating between the thirties and forties according to my oximeter.
I called my cardiologist’s on-call folks, we discussed the history, and they said that if I wanted to, I could go again to the ER to have an EKG. Also, I was informed that the “home” oximeters weren’t really accurate. Wait a minute – if the home oximeter is giving an inaccurate HR reading, what about the oxygen percentage? Is that inaccurate, also? Am I not sitting at between 90 and 95 percent without oxygen. And, wait another minute! I thought! Isn’t it your job to give me your recommendations and strongly insist that I follow what you think is the best – I wanted to yell at the on-call people. I’m supposed to guess at what should be happening? I’ve lived in this body for eighty-six years. I already made the decision to call you. What is the best procedure? I decided to go to the ER and did so. Again, Daughter #1 took me.
This time, the ER folks didn’t seem as efficient. I was told later that on that night of the week, they get a lot of university students in trouble for several reasons, causing a log jam in the ER. Again, all of the tests were run, showing nothing was wrong. I, however, knew something was wrong. In the ER, I was told that I could decide to go to the cardiac unit to be observed. Or, I could go home for the same reason. Wait a minute! Didn’t I come here to get some recommendation from y’all in the ER? How would I possibly be able to do observation at home? What equipment for that process would I have at home? I’m not a medical person.
I, again, made the decision. I would be admitted to the cardiac unit on the fifth floor. I KNEW SOMETHING WAS WRONG! It was about 11:30 pm that night when I finally made it upstairs. This time, again, I had something to eat. I was told that the wait was not because there was no bed, but because there was not enough nursing staff to accommodate me. That gives one pause!
I was able to sleep some the rest of the night. Not comfortably, but one does not expect hospital mattresses that must bend and twist, up and down, to be comfortable. And, the morning came.
The doc who saw me that first morning did, actually, believe that something was wrong. Finally – someone is listening to me! There was a wobble in my HR. Yes, it was not as high as one would expect. And, so more tests began and questions. No, I never have chest pain. Yes, I have a Watchman and three stents. Yes, when I usually have AFIB events they last from four-to-eight hours. Yes, this week since the shocking of the heart, everything has seemed fine – really fine. Life was back to normal. None of the recent blood work indicated concerns, x-ray concerns, etc. So, again, what to do with this old lady. But, something was wrong. More observations of HR, oxygen, etc. During the day, my oxygen levels are between 90 and 95 most of the day. With no oxygen added. What, indeed, was going on?
The good news is that the medical staff decided that my current dose of the drug metoprolol (meant to keep the HR lower) was too high at 200 mg a day. Meant to lower the HR in AFIB, now that my HR was back to its normal, 200 mg was way too much. Taking me completely off of the drug for a few days allowed my HR to rise to its normal. So, home again, I went on a dose of 50 mg daily. And, I have felt basically well. While in the hospital, doing nothing is really tiring. There is a lot of down time while waiting for tests and decisions. Exhausting.
Downtime can be a really boring experience in hospital. Even though there is a television attached to the wall. I must say that the television in that hospital is NOT GOOD! It appears black and white. Images are smeared and non-existent. So, the question is, what to do with that much down time? Because I didn’t know how long I would be at the hospital, I had brought a couple of books. The Sirens’ Call, by Christ Hayes. Very interesting. And, my book for writing poetry thoughts; it turned into a book for recording my experiences while in hospital. After a day, I asked Daughter #1 to bring me one of my sketchbook and some soft pastels. I was able to lay in color on the sketches I made during our trips to Texas and to Seattle.
Fun? Probably, it would not call any of these experiences fun. Interesting – definitely. Here I am compelled to say that the hospital staff, to a person, were knowledgeable, considerate, helpful, careful, compassionate – I could go on. From the admitting, to house keeping to the phlebotomists to the nursing staff (floor nurses, nurses aides, charge nurses, nurses in charge of the entire nursing staff), the food service personnel, chaplains, and the docs are are all great. And, of course, there are the “hidden” workers that we never think about: the pharmacy staff, those who process the blood sample. The cath lab people that we don’t see who work to make our lives healthier.
You can tell that I am more than a little loquacious. That’s me. So, I ask the care givers about themselves. “Your voice definitely has an accent that is not common to my state. What was your home country?” “How long have you worked here?” “Do you like working here?” “Do you really know that this organization can’t really operate with all of you at your posts?” Great conversations will arise if you only show that you care about those workers and appreciate their help. And, with good luck, you may make new friends.
But, this article is primarily about making decisions. During these past weeks, I’ve had some great help making the decisions I needed to make to improve my health at that time. I’ve had some very weak responses, as well. This really brings home my thinking that WE are in charge of our health. WE need to be asking questions. WE know when something is wrong and need to keep insisting that someone needs to help. WE have lived in our bodies all of our life, and we know it.
I wish you the best possible help situations. I want you to receive the best possible care in times of need. And, in between times, I want you to do those things that make your health and life the best it can be.
Be Safe and Be Well
The Cranky Crone
Thoughtful comments are greatly appreciated.
And, PS. Thanks to Nancy for taking over the minutes for the meeting I missed. And, to Robert for being so quickly willing to have Paisley come for a few days and live with him while Mom and Dad are in Mexico.