Riding
a Cross-Country Health Roller-Coaster (and still smiling)
I
was very tired when I arrived at my son's home in Santa Cruz, CA late
in the evening of July 14th.. The next few days I didn't
feel quite myself. I noticed I had less than normal confidence when
climbing the unstable steps in the backyard. I wondered if my
brain's balance mechanism was suffering from oxygen deprivation. I
also had a “frog in my throat” at times, and my voice did not
have its customary timbre.
These
symptoms vanished in a week or so. I felt normal at my grandson’s
wedding July 30th and then fit enough to keep pretty close
to my two sons as we rode motorcycles up the coast and over twisty
mountain roads in California's Tiffany Alps for four days.
Two
weeks later, when up in the Portland, Oregon area, I noticed that at
times, when I breathed deeply, I heard a faint rasp in my chest and
occasionally coughed. In a few days my throat became sore. I
visited a Doctors Express location for an exam. The assistant nurse
confirmed right lung congestion with her stethoscope. An X ray
alarmed the attendant doctor for she felt it showed a greatly
enlarged heart. She referred me to a cardiologist. However, her
written report indicated possible pneumonia and she gave me a medium
strength antibiotic to take for it.
I
saw the cardiologist the next day. She looked at the Doctors Express
X ray CD and found the heart was only moderately enlarged. Her EKG
proved normal but she got me an appointment the next week for an
Echocardiogram.
I
have had a heart murmur for 15 years. It and the moderate
enlargement, are caused by stenosis (calcification) of my aortic
valve. Other than an occasional echocardiagram, I have paid scant
attention to it as I have been asymptomatic (no chest pain or
shortness of breath). Now the cardiologist seemed to ignore the
“pneumonia”. She evidently felt the congestion was caused by
heart disease.
The
echocardiogram diagnosed acute aortic valve stenosis. The
cardiologist said she agreed, and while the AMA guidelines would
suggest I now wait for stronger symptoms or an “event” before
taking any action, she favored an aggressive posture – replacing
the rusty old valve.
So
I stored the bike with accommodating friends and flew into Islip,
Long Island, on Sept. 5th, Labor Day. The next day my
brother-in-law, Buz Murray, drove me to see Dr. Berke, his
cardiologist at St. Francis Hospital in Roslyn. Dr. Berke asked
perceptive questions and examined me. He had me take a deep breath
and exhale hard, as if I were blowing out a birthday cake. He later
told me I failed that test miserably, (at least now, no one can ever
call me a blowhard:). He doubted the rusty valve was
life-threatening but said there were tests he could run later to
assess its true condition. He suspected I had pneumonia and sent me
downstairs to the ER for tests.
There,
a doctor on the floor asked what they were supposed to do with me.
He then glanced at a paper in his hand and said, “Oh, a CT Scan.
Okay, go in the bathroom, strip to underwear and socks, and put this
on like so”. With that, he unfolded one of those skimpy
gowns, spreading his arms wide like a department store clerk. Once
“gowned”, I was directed onto a gurney and pushed into one of the
alcoves which bordered two sides of the room.
All
the alcoves were occupied and more gurneys lined one wall. All bore
patients and many had doctors, nurses, or family members sitting or
standing alongside, making for crowded aisles. Personnel garbed in a
rainbow of colors hurried about. Others sat and stood before work
stations which paraded in a double row the width of the room.
Gurneys and equipment carts moved slowly through the crowded space
like storm debris helplessly caught in the current of a swollen
river. Wow!
I
was well-attended. I was wheeled out to exterior locations for a CT
scan and X ray, had an EKG and a blood draw. Two antibiotics were
subsequently intravenously administered for 90 minutes. My coughing
ceased and my head began to clear.
At
around 6PM, when I had been in the ER four and a half hours, I asked
a passing asst. nurse if any further tests or procedures were
scheduled. She looked at me quizzically, smiled and said, “You
weren't thinking of leaving, were you? I'm sure you'll be here all
night.”
I
was dumbfounded! The cardiologist had said I was going down for
tests, not an overnight. And poor Buz, standing by my gurney or
sitting out in the reception area for all this time, waiting to drive
me home. And then I needed to sleep!
Sleeping
here was impossible. With so many people and so much activity, the
large room was plain noisy. Then there was the other patient in my
alcove. Like me, he had been wheeled in and out several times,
jostling my gurney due to the tight space. His gurney also had a
Vital Signs monitor mounted on a pole which frequently emitted loud
electronic signals and alarms that would shame a Big Ben. And the ER
elevator, a major traffic breeder, was immediately adjacent to my
alcove. Down by the foot of my gurney, its tuberous CALL button
protruded from the end of the partition separating my alcove from the
elevator. Personnel would often bang on the switch to activate it,
calling my attention as well as the elevator's. Sleep? –
Not a chance!
I
slipped into my street clothes. I told another passing asst. nurse
to tell my nurse (I had learned each patient was assigned one) that I
wished to leave. A half hour passed. Finally my nurse came by. I
told her I wanted out because I couldn't sleep, my coughing had
ceased, I felt good, and I needed rest but couldn't sleep there. I
suggested she take my vitals and bring me any papers I needed to
sign. Twenty minutes later she took my vitals, which were good, and
quickly departed. After another ten minutes I told a passing
attendant I wished to talk to my doctor, who was behind the nearby
row of work stations. Time passed. Finally, I walked over to work
station row and told my Doctor, standing on the other side, I wished
to speak with him at my gurney.
A
few minutes later the doctor came over and I told him my situation.
He said he would have to talk to my referring doctor, Dr. Berke. A
few minutes later I saw him exit the room with cell phone to his ear.
A half hour later he returned to tell me Dr. Berke was tied up but
might get free in 30 minutes to an hour. He suggested I wait. It
was now after 8:00. I said I really wanted to leave. He said,
obviously now feeding me morsels of information he had obtained from
Dr. Berke, I needed to stay because I should see a pulmonologist in
the morning. I told him I would be happy to return in the morning
after I had been able to get some sleep at home. He responded by
saying that there was something else – a suspicious looking spot
had been detected on my X ray. Instead of caving at this piece of
news, I told him to please, just get me the release papers. It was
9:00 before I and poor Buz could depart.
Dr.
Berke called early the next morning to chastise me for leaving the
hospital ER where he said tests and procedures were so convenient.
He went on to say the CT scan had shown swollen lymph nodes and the
chest X ray revealed a possible lesion (said almost
reverently). I assured him I was calling the pulmonologist when her
office opened.
Twin
Carol and I arrived at the office of Dr. Janus, the pulmonologist,
at noon that day. Because of Dr. Berke's “lesion” and “swollen
lymph nodes”, we fully expected that, before the day was over, I
would be back in the hospital and this time not just in its ER, but
also the OR. We were ready!
While
in the waiting room, I was summoned by a technician to get X rayed.
When stripping off my shirt, I casually said that I had also been X
rayed the day before. The tech left the area, returning in a few
minutes to say I should stand down and return to reception. (How's
that for an example of medical inefficiencies, etc.!)
Dr.
Janus saw both of us. She was refreshing! She asked me to relate my
recent travels on the West Coast and history of symptoms (I have
logged them daily for almost two months). Then she said that she had
already studied my hospital test results the evening before, courtesy
of electronic wizardry (and no doubt thanks to a heads-up from my Dr.
Berke).
She
said I had a good case of pneumonia, but doubted there was even a
hint of the big “C”. However, to verify that, she asked me to
return for another X ray in two weeks when the lungs should be clear
of pneumonia. She felt the lymph nodes were enlarged solely due to
the pneumonia, but that it would be three months before they returned
to normal size and that a CT scan should be taken then to prove this
was the case. Dr. Janus gave me prescriptions for two antibiotics
and told me to rest at home for two weeks. Earlier, I had told her
of my exploits with my Oregon forester grandson, and now she shook
her finger at me and said, “And no chopping down trees!”
Once
I receive the “all clear” from the “lung lady”, I'll go back
to cardiologist Berke to get an accurate reading on that rusty valve.
If it ain't totally broke, I 'spect I'll soon be back in Oregon to
again mount my steed and get her back to her deep-south barn, 'fore
the weather window closes.