Riding a Cross-Country Health Roller Coaster

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 14^th.. 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 30^th 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. 5^th, 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.