The Real Muck

 

Nightside in the ER (photo by FL Ettlin)

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.

Friday MRI fashion selfie

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.

Not rock concert bracelets

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.