It was a normal Thursday evening, 19 June. We were getting ready for dinner. I took one last drink from a can of Diet Dr. Pepper before I shut down my computer just as my youngest daughter asked me a question.
I tried to answer while I was swallowing, which didn’t work out so well. I choked and gagged a little, and coughed a lot, but thought that was it.
I kept coughing through the evening and into the next day. By Friday evening, I was running a bit of a fever, and by Saturday evening, I was starting to move major amounts of mucus when I coughed.
The mucus was red.
Not a bright frothy red, which would have made me very nervous. It was more of a dull brick red. No matter what shade it was though, red mucus means bloody mucus, and that is generally considered a bad thing. There are two main causes: pneumonia, and tuberculosis. Neither is good, but pneumonia is generally less bad than TB. I think.
Since it wasn’t bright red, I didn’t feel like I needed to run to the ER. I felt bad enough (exhausted, really) to skip church both Sunday morning and evening. We planned to have Diana run me to the VA hospital in the morning. The only thing that made us nervous there was that she was planning on driving to OKC that afternoon for PALCON, and if I was admitted, she’d have to stay home with the kids.
When you walk into an ER and say “I’m coughing up bloody mucus,” they get very nervous. See paragraph 6 about TB and pneumonia. TB is ridiculously infectious, so they take all sorts of precautions. You end up in isolation, and all the people treating or visiting you must wear a mask and those cool yellow disposable gowns. And when you get really short of breath changing from street clothes into a gown, you get oxygen (2 L per minute, actually). They’ll draw about half a pint of blood for different tests, and start you on Levaquin, a nice broad-spectrum antibiotic that kills all sorts of bugs. You also get a TB skin test, and you get to stay in isolation until they’ve read that test at 48 and 72 hours. Oh, and chest x-rays.
Where was Diana at this point? On her way to OKC.
Yeah, she went on to the conference. We talked it over for quite a while. I was obviously going to be admitted, but what was there for her to do in Muskogee except watch me sleep? We knew our kids were mature enough to take care of things, as we’ve left them alone for an overnight or two before. Diana called several friends and had them on stand-by for help if the kids needed it, and she headed on west.
And you know what? We were right. Our kids are mature enough to keep things under control in a situation like that. Adam had just passed his driving test the day after I got sick. Without that, things would have been much more difficult, because the younger girls had summer classes at the library, and the older boys were gearing up to work at one of the two fireworks stand our youth group was running. But our kids and our friends pulled it off, and I’m so proud of our kids!
Monday evening, I had some breathing treatments with albuterol, and more IV antibiotics, and more blood draws. They kept asking me for a sputum sample, but not until after they had given me a cough suppressant. Oops. I also started getting insulin. With the infection going on, and my own med schedule way out of whack, my blood sugar went through the roof. Seriously. Medical people get really nervous when they see 325 on the glucose meter. As an old boss once said, nothing difficult is ever easy.
Tuesday, things got even more interesting. I had been moved to ICU, and through Monday afternoon and evening, they had kept a bag of fluids running. By Tuesday morning, I had received 4 bags of fluid along with my IV drugs. My blood pressure was 164/100. That’s high. Really high. Dangerously so. Out came the diuretics, creating a torturous situation.
When a person who has been fairly active gets admitted to the ICU, they worry about blood clots in the legs, since you’re suddenly inactive, and will be for a while. Their choices are blood thinners, or intermittent pneumatic compression hose, AKA Sequential Compression Device. The SCD sleeves go over your lower legs, and are connected to an air pump that inflates and deflates them in a sequence designed to prevent blood clots. And that prevention is a wonderful thing, but the hose connection prevents you from walking any distance. Like to the toilet. Because there is no elegant way to pee 500 ml into a urinal while you’re lying in a hospital bed. There’s just not. Honestly, when I figured out that the air lines were long enough for me to stand by the side of the bed, I think angels sang.
Tuesday afternoon is when things got really serious. I had had an EKG done in the ER, and again Tuesday morning. But they decided to do an echocardiogram as well. One of the things they measure in a cardiac echo test is your ejection fraction, which is a measure of how well your heart is ejecting, or pumping. Normal value for a healthy male is around 58%, and can range from 55 – 70%.
Mine was 20%.
Yeah, I got nervous. My mother suffered through congestive heart failure, and that was probably a contributing cause to her death. My mother-in-law had major heart issues as well, eventually needing a heart transplant.
I got really nervous. Like 911-prayer nervous. I texted the information to Diana, which in retrospect probably wasn’t the best way to break the news. Her response: “Uhhh.” She ended up coming home that evening. Something about not being able to concentrate.
I met the resident working my case, and a cardiologist too. They both said several times that I looked lots better than my test results said I should, and that they weren’t quite clear on everything that was going on. I said, “So I’m this week’s episode of House?” Got a good laugh out of that one. But aside from the low EF, and fluid in my lungs, I wasn’t showing any other common signs of heart failure. My legs weren’t swollen, I was no longer short of breath, and up until a week prior, I was walking 4-5 miles a night at work, and playing flute weekly at church. Neither of those things is commonly done by a person in acute heart failure!
Wednesday afternoon I got moved out of ICU, and I had a nuclear stress test Thursday morning, and came home with a bunch of new meds. They cleared me to go back to work at my own pace, and I decided to go back Monday the 30th. That may have been overly optimistic on my part. Several people told me Monday night that I looked pale, and I ended up feeling winded enough Wednesday night that I left work early. I’ve called the VA and moved my follow-up appointment to this Thursday instead of three weeks later. I’ll get a new post up then to let everyone know what I know. My cardiac followup is still three weeks out though.
When they told me I had heart failure, and I got nervous, I got a little angry too. Seems they start diagnosing congestive heart failure when your EF hits 40%. In 2004-ish, I had a stress test and heart cath done. The stress test results said
“Decreased uptake in the inferoapical and inferior segments. Mild global hypokinesis. Findings consistent with inferoapical and inferior infarct; no ischemia. Ejection fraction is 47%.”
The heart cath was clear, as in no blockages. The cardiologist said at the time that “Well, about 10% of these tests are just wrong.” Wonderful. But I have to wonder why my GP at the time didn’t follow up a little more closely, and maybe order another stress test, or at least an echo at the time later. I was only 7 points away from a diagnosis of heart failure ten years ago, and I wonder what would have happened if we had started me on the diuretic regimen back then, instead of the doc constantly telling me to lose some weight. I did lose some weight under the diuretic therapy: 27 pounds. I’m right at 200 pounds now for the first time in 25 years. I weigh less now than I did when I was discharged from the Army.
That’s where things stand now with regards to my health. I’m moving a little slower than I’d like, and have a couple of issues that I’ll bring up at my next appointments, but I’m vertical and mobile, and those are huge. This whole mess could have been a lot worse. I know I’ve had lots or people praying for me, and lots of people watching out for my family, and I am grateful beyond words for everyone.
Tune in later for the story about my computer. And don’t inhale your food. Really. It’s bad.