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Nightside in the ER (photo by FL Ettlin) |
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A bloody story:
My big and scary (hemoglobin) adventure
Not to overstate the situation (keep in mind that I am back
home, writing this), but my body has tried to kill me -- again. In 2019-2020 it
was MRSA/sepsis, this time a more subtle attack in what appeared to be
gradually diminished red blood cells.
More than a month of incessant headaches prompted a brain MRI
a week ago... the results negative. Not even sawdust. Then things got weird.
Dizziness, loud thumping sounds in my left ear in tandem with my pulse, blurry
vision, an almost comedic spin and fall on Monday amid a cascade of bathroom
cleaning products (no head impact), and then nearly flying backwards down the
living room stairs on Tuesday morning.
Barely able to stand, I called my primary care doc, and she told me to call 911. What ensued was
two days at University of Maryland BWI Medical Center, where I arrived with a
hemoglobin level of 4. (Normal for men is a range of 13 to 17.5, women slightly
lower.)
Hemoglobin is a protein in red blood cells that whizzes
oxygen throughout the body and to such innocuous places as my brain. I was
nearly running on empty. When I moved, I could feel my heartbeat and the thumping
speed up as my brain demanded more oxygen. The hospital hematologist told me of
a patient she had with a level of 2, who had arrived still conscious and
talking... but that case was a rarity.
I'm sharing my story because, from this experience, it might
help folks pay closer attention to persistent headaches and worsening neurological
symptoms -- but also in a wider view to offer a sense of the wonderful people
whose daily work is saving lives, including (cue the dramatic background music)
mine.
The headaches behind
my left eye and near the sinus cavity had seemed at first possibly from an
infection, but 10 days of amoxicillin did nothing to help. I began to worry
about the next most obvious act of hypochondria -- brain cancer! Thence my
doc's order for the MRI, which took a
week to schedule. Evidently they're very popular.
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Friday MRI fashion selfie |
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The MRI
was last Friday.
I was still quite functional. Went to the 210th birthday celebration of
Baltimore's Peale Museum that Saturday afternoon, and a house concert Saturday
night. On Sunday, the annoying thumping began.
I thought a neighbor might be doing some work, even drove around looking
for its source. There was none. It was, so to speak, all in my very own head.
On Monday I took that spin onto the bathroom floor, reaching
to the countertop for balance too late. Items there landed on the near side of
the toilet as I spun around the bowl, knocking a line of cleaning product
containers down like a row of dominoes and landing between the toilet and wall
in a cascade of plastic... stunned but barely hurt. Just a bruise on the
back of my left hand.
I stood, tried to put
objects back in their place, and used walls to steady myself in heading for the
living room couch. I'd had lunch, but couldn't stand to fix dinner, and just headed
to bed to sleep it off that evening.
Then came Tuesday morning. I awakened hungry, but dizzy. The
thumping was incessant. As I turned from the hallway into the kitchen doorway,
I sensed I was tilting backwards with the stairway behind me and grabbed the
top railing for balance just in time to avoid a header crash landing.
My wonderful doc had messaged me on Monday that the MRI was
negative and ordered other tests. Now I called her office with urgency, and
within minutes she called back. I told her there was no way I could go anywhere
for testing -- that I could barely stand. And she said to call for help.
I was hungry, though. The Lake Shore Volunteer Fire Co. is across
a patch of woods less than a block away from my backyard, and just two blocks and
barely one minute from the house by road. I was hungry, dammit. I worried about
my blood-sugar levels. So I steadied myself to fix up a bowl of fruit, a slice
of toast, and a quickee scrambled egg that I managed to overcook. I sat on the
couch with my phone and food and dialed 911.
"I'm OK," I told the dispatcher. "The
firehouse is just around the corner. They don't need to panic anyone with the
siren." I didn't want to alarm the whole neighborhood. And I started
eating to the sound of the ambulance siren ... a piercing wail that only seemed
long enough for the crew to turn onto the main road from the firehouse
driveway.
Two young men -- paid Anne Arundel County paramedics based
at the volunteer station -- arrived and made a quick assessment. I told them
they didn't have to carry in the cumbersome stretcher, just to keep me steady as
I held the iron rail on the way down my nine curving front steps. (Was it stupid male pride, or emotions channeling the last time anyone was carried down the steps... the morning my wife died in 2021?) They lowered the stretcher
by the curb, helped me recline, lifted me up and in, and off we went. The
hospital is nine miles away, and I relaxed as best I could amid the thumping in
my head.
I was checked in quickly, had blood taken and given an
immediate CT scan. The ER was crowded, and I was conscious and lucid, so I was rolled
in a wheelchair out to the waiting room -- requesting a spot as far as possible
from the roughly 18 other people waiting for treatment room space. I sat there
for close to 90 minutes of thumps, head down, trying not to think.
Hospitals are busy places these days, especially in emergency
services. Beds for admitted patients were full. I spent the next approximately
22 hours in an ER treatment cubicle, on a narrow and uncomfortable bed never
intended for lengthy stays. And over the course of the ensuing night, I was given
a transfusion of two "units" of packed red blood cells and closely
monitored by its caring team of nurses, physicians and aides.
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Not rock concert bracelets
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My older daughter, FL, who is a nurse at another hospital,
joined the party. She took a few pictures with her cell phone to record how
pale I had become -- about as white as Casper the Friendly Ghost but not ready
or able to float through walls.
Nearly at noon on Wednesday, patient escorts arrived simultaneously
to take me to a cozy private room -- and to an MRI of my brain, head, neck and
vascular system, in search of leaks that might account for blood loss or a
carotid artery problem. The MRI escort got first dibs.
And I noticed something remarkable as I was wheeled on a
gurney through the bright corridors: The thumping in my head had stopped. The
transfusion had upped my hemoglobin level to 7.8, close to a targeted stabilizing
measure of 8.
The MRI took 23 minutes. In case you've never experienced
it, you are most often moved into a circular chamber... in my case, with my
head padded snugly in place and earplugs to temper the sounds of this amazing
machine: clangs, clicks, and -- what else? -- thumps.
Twenty-three minutes
of thumps, the last 22 of which featured an itch on my rose and chin that I
could not touch. I focused on the sounds, counting sequences of the noises, with a woman's voice occasionally piped into the chamber
that was as inaudible as a bad day in a crowded subway car. I think it was offering updates on the timing
for me, but could just have well have been saying, "Approaching Ritchie
Highway Station," or "Next stop, BWI Medical Center."
I've told friends that I hope my sense of humor is the last
function I lose. I did my best to be kind and funny to the hospital staff, even
an aide who came by to check my blood sugar with totally no expression on her
face. I gave her a hard time, sort of
-- elicting a tiny smile, maybe even a
twinkle in her eyes, and as she departed wished her a great rest of her day.
I am in awe of hospitals. But I don't like being in them.
I've had more than a few long stays over the course of my life -- longest among
them a time in 1971 when I nearly bled to death from an intestinal rupture, and
at this particular hospital for a week of body repairs after a nearly deadly
head-on car crash in 1983, and the five weeks I stayed there between two visits
for the life-threatening infection in the autumn of 2019 and February 2020.
Each situation was unique. Four of them featured ambulance
rides. Through all of them, people who I mostly did not and likely will never
know kept me among the living.
I am grateful to them way beyond these words.