Wednesday, July 30, 2008

Late Entry: A Visit to the ER

For various reasons, I've been off line for several weeks.
It didn't stop me from writing, though.
So the next few posts are "late," "late, late," and "late, late, late" entries.
It's a good excuse for catching up--as some of these entries are far later than just "a few weeks."
Hope you enjoy.
________________________________
July 30th

Went to the ER last night.
In fact, just came home from the ER and it's 6:15 in the morning.

It's not something I wanted to do.

Going to a Level 1 Trauma Center late at night, gumming up the works, when what the Trauma Center really needed from me was to stay away, so they could do their real job.

I went because somehow, while eating / slurping a brothy noodle bowl, I swallowed something that lodged in my throat.

It's a strange feeling, to be thinking, "Uh-oh. Something hard and not noodly is in my throat, And I can't cough it up and I can't move it down."

I tried.

At first it just felt funny, but there was no pain. But when I swallowed, it went deeper, and my throat started to hurt.

Since it was 10:00 at night, and I was home alone, I started to worry.

What if this worsened, and I got into real trouble or incapacitated. Then, what would I do?

I didn't think the object in my throat merited an ER visit, but where else was I supposed to go?

Meanwhile, the pain was getting worse.

I stopped swallowing because each swallow HURT.

I figured if nothing else, I could sit in the waiting room (since I knew it would be an extended wait), try to swallow, and hope the object would work it's way down--with emergency services nearby, in case of a bad outcome.

By this point, I'd become fairly paralyzed from the neck up, afraid to swallow—almost afraid to move in any way. So, I mobilized my legs, got myself dressed, and drove myself to the ER. Which, despite the continued increase in pain, and my rising hypochondriacal concerns about what the heck I had swallowed and what kind of damage it could cause (read "perforation"), made me feel better.

You know something is not right when sitting in an overcrowded ER waiting room, with the clock approaching midnight, makes you feel better.

The ER was a slice of city life in the middle of the night. Fluorescent lights eliminated the dark. It was crowded, but surprisingly quiet, except for the loud blare of the TV and miscellaneous coughs, sneezes, and muted conversations. Those in most need were already laying in an ER bed. Those of us in the waiting room were low on the triage list—with a long wait in front of us.

It turned out that, on this particular night, the hospital was under a "code purple." All hospital beds were full, and new admissions were being lodged in the ER, reducing the number of ER beds available, and increasing the wait time in the waiting room.

My x-rays were done before midnight.

My complaint was listed as "minor soft tissue trauma".
Minor soft tissue trauma? I was definitely pretty low on the triage list.

The wait continued AND my pain increased.
A lot.
Swallowing was excruciating, and sent my throat into spasm. The pain would increase in waves after each swallow. When I turned my head to the right, it hurt more. I clutched numerous wadded-up damp-with-spit tissues and tried to avoid swallowing.

The worst was a minor post nasal drainage that I couldn't control, leading to several involuntary, painful swallows.

Sometime after 2 am, I swallowed involuntarily, and something moved, painfully, lower into my throat. And then stuck. Or, so it seemed.

I considered going home, but since they had already taken x-rays, I figured I should see if anything showed up and, besides, I was still having excruciating pain with each swallow. I was getting tired..

At 3 am I got a bed. My resting BP was 150/90. Heart rate 55. My normal BP is something like 117/70.
I propped up the bed, so I could sit up and close my eyes without saliva running down my throat.
I still had an extended wait, so they turned out the lights, and I actually dozed a little.
I think this allowed me to finally relax, because when the doctor came in, the pain, although still strong, had eased a bit.

Dr. C. had a great bedside manner, especially after a night treating life and death and now being tasked with treating a "minor soft tissue trauma." He said my x-rays were clear, but he still wanted to take a look.

By inserting a scope.

Up my nose.

This is what I learned: When you're in a whole lot of pain, you will do anything on just the promise of making it stop.

He said he would insert a numbing gel into my nose, then a numbing spray into my throat.
I tried to sound like this was OK with me.
But what I was really thinking was of the story of a friend, who had been in a terrible hang gliding accident (now recovered), and who had told me that having an "NG (naso-gastric) tube" dropped down her nose while she was conscious, was one of the most awful experiences she could remember.

Dr. C began squirting all kinds of things up my nose and into my throat. Gel and Liquid things. He was extra solicitous—making sure I felt no pain: nose-throat-nose--uh oh—better have you gargle. Those of you who know me, know I panic in water. Having all this liquid inserted into my breathing pathway was getting in the way of oxygen acquisition. The amount of gel and liquid going into the back of my throat made me swallow, which hurt. I started to tear up, which, of course, further clogged up my nose with mucus, so that when Dr. C sprayed liquid into my throat, I felt like I couldn't breathe.

It was not a happy time.

Then, Dr. C showed me a narrow black instrument, with a lo-o-ng tube, and said he would put it up my nose.

I immediately closed my eyes.

Even with all of the numbing gel, getting that tube up my nose still hurt. I didn't feel the part where it dropped into the back of my throat. Dr. C could only insert it so far and then directed me to make certain noises to open my larynx and improve the view.

The view was obscured by "a lot" of mucus.

Dr. C said I must have an irritation in the area with all the mucus.
My take on it was that 7 hours of swallow avoidance coupled with allergies and post nasal drip had allowed a pile of mucus to build up—(hypochondriacally) maybe even on top of whatever it was that was in my throat.

When the smoke cleared, Dr. C said he couldn't see anything, but thought that whatever had been in my throat was gone—and gave me a prescription for narcotic pain killers, lidocaine numbing gel, and anti-reflux medication The pain was so severe I really didn't believe that whatever was in there was gone, but once the doctor said there was nothing as far as he could see, I felt I could go ahead and REALLY swallow.

I left the hospital at about 5:30 am, picked up a large cup of coffee, headed for home, made cheesey toast for breakfast, swallowed through the pain, and fueled by the pseudo-adrenaline of an unusual experience, went to work. All the cheesey bread swallowing must have done the trick, because by this time my throat wasn't hurting so bad, and in fact, less than an hour later the pain was essentially gone.

Initially, I didn't talk about my night, but wondering how I might appear, asked a co-worker what I looked like. She said "Great! You're wearing makeup today."
When I looked in the mirror, I realized that the rosy red lipstick she saw was really the raw bloody skin of lips that had been roughed up by spitting into hospital paper towels all night long.

I made it until 2 pm then, tired of looking good at work, caved into an impossible fatigue, went home and slept.

I didn't fill my prescriptions. I've had too many close encounters with people addicted to narcotic pain medication to ever think of these as anything but a last resort. The doctor assured me that everyone has reflux, and that I would feel pain from it--but I didn't. The lidocaine numbing get? Well, I immediately thought, "Would this be good for sore muscle recovery?" and stashed the syringes in my fridge.

Over the next few days my lips progressively scabbed over and peeled.

I chalked up my NG tube experience to learning something new: one last thing I would worry about if it ever came up in the future--and a whole lot of empathy for those who have one.

You know what they say—I'll try anything once.

Saturday, July 26, 2008

Chiaroscuro

It's 11:00 Saturday night, and I'm standing in the dimly lit, cavernous, cement underground tunnel of the DC metro.
I'm by myself.
A few moments before, Mark had been next to me. Now he's just a shadowy figure back lit against the solidly shut doors of a train, receding smoothly into the distance at an ever increasing rate of speed.

I imagine an expression of whoops!-amazement on his face, which now I can no longer see.

There's a blank pause as the world slows down and I take it all in--then an uh-oh, now-what-do-I-do moment, as I realize my guide is disappearing down the tracks, I don't know where I'm going, and I'm alone, late at night, left behind in the DC Metro.

I think about calling him on the phone, but at almost the same time, realize I don't have service in the semi-bowel's of the city ("semi" because I'm sure there's another shadowy layer beneath me, peopled by who knows what).

I wander over to the direction sign, and realize it was a good thing I had pestered Mark so much on the way out about where we were going. I recognize Metro Center, the name of the station where we transferred earlier and reason that Mark will either 1) get off at the next stop, and come right back for me, or 2) wait for me at Metro Center.

Well...maybe.

What if he comes back, and I've already gone?

His phone doesn't get reception in the tunnels, either.

A few people start to trickle in to catch the next train, and that isolated feeling of being in the underworld starts to abate.

I just have to have faith that he'll do the right thing.

And so I sit and wait for the next train, and almost begin to laugh.

The movie scene pathos and poignancy of it all.

We had run down the steps trying to catch a train before it pulled out. The train was sitting there with the doors open, and as Mark leaped through, one step ahead of me, I thought "uh-oh, how long have these doors been open?" What flashed through my mind was Mark's story of his first day on the Metro, shoving a large bike box ahead of him through the open door of the train--and having the doors close and clamp halfway down on the box. He said the feeling was one of "horror and embarrassment," as he envisioned the train leaving and taking his bike, so he frantically pulled, and hauled, and tugged to get the box back (it was commute hour and people on the train were watching--hence the embarrassment). What he marveled at was how quick and hard those doors closed--and wondered if anyone ever got caught in them.

And so, as Mark leapt onto the train--thinking about what he had said about the doors, I may have hesitated for a moment--and the doors closed.
Just like that.
Mark turned, saw me, and reached for the door. I reached from my side. And for a long moment, we were a tableaux, he in light, me in shadow, reaching, yearning, on either side of this immovable barrier--then the train began to move.

Later, at Metro Center, disembarking into a sea of people, Mark found me, relief in his voice, and we continued home, together.

You never know when you'll have a movie moment,
and,
it might not be the movie moment you want.

Finally,
what do you do when the cell phones don't work?

post script
The thought of Mark running around looking for me on the railroad tracks reminded me of an early sci-fi short story from my father's bookshelf, "A Streetcar Named Desire," about a ghost car that ran the tracks and would disappear, than reappear. I believe it was the D line. And it ran on a mobius. I tried to locate the story online to share with Mark, but couldn't find it. Not sure if I have the correct title. Anyone familiar with it?

post, post script
The post title is dedicated to Mark.

Wednesday, July 23, 2008

What The Doctor Would LIke For Christmas

I hate going to the doctor.
I always feel that I'm whining about what's wrong with me.
Someday, it would be nice to go in and give the doctor a break.

"L! I'm feeling great, and I just wanted to stop by and tell you the good things!"

I'm sure the doctor would appreciate it.

Instead, we took care of my unexpected belly button puka, then went over all the numbers:

Cholesterol is looking good in the 130's:
  • HDL running happily high in the 60's
  • LDL happily low in the 60's

Triglycerides are a trace in the 40's.

As L. puts it, I don't have a trace of carbs left over in me.

If that's the case, then why do I keep packing on a pound a year?

Sunday, July 20, 2008

Green It Is

Put "driving green" to the test these past few weeks.

Fill-up today told the story.

10.28 gallons

411.9 miles

40.07 m.p.g. !

Since I already get something over 35 m.p.g., the jump up isn't nearly as significant as it sounds.

Still, the last time I got 40 (actually 44) m.p.g. was last year, when I incidentally drafted a large truck to get out to the Gallup Triathlon. It was night, and I was using the tail lights as a driving guide.

Today was a surprise.

But that driving green, sometimes, just takes the fun out of things...
I never thought I'd feel guilt for driving 70 m.p.h.

Saturday, July 19, 2008

What, again?

Killer swim.

Still would be considered slower than a floating iceberg by some of my triathlete compatriots.

But it felt good to me.

I didn't feel draggy and didn't waste energy side to side while wrastling an alligator.

I didn't have that dead in the water moment with each stroke.

I felt aggressive and strong.

I was able to dig in, raise my torso, follow through with acceleration.

All week I had felt tired.
Last weekend's unexpected killer bike and run left me with oh so sore leg muscles. I didn't realize how hard I had worked and didn't eat enough to recover and felt tired all week.

Took rest days on days I normally don't take a rest.

My legs felt heavy.

My brain felt heavy.

My sore muscles hung in for most of the week.

Wednesday, I stopped by the store and bought meat. This is what I do when I'm feeling run down. The meat is a psychological magic pill to help me get back on my feet.

I took way too many rest days, so of course, along with feeling heavy, slow, sore, and unmotivated, I started to feel that universal (at least in my household) I'm-used-to-being-active feeling of "I'm getting fat" and "I'm not doing enough", but I still stuck to my rest, because it does no good to train when I'm not feeling well---it just exacerbates and extends my malaise.

On Friday, I toodled around at work. Wasn't motivated. Didn't have any plans. Stayed late and was the last to leave.

On the way out the door, I figured, even though I didn't feel like it, I should try going up to the pool and do a few short, easy laps. I bargained with myself: 10 lengths would be OK, maybe 20, well that would be 500, so look at doing 400. Pause. Or maybe 800. 800 is a metric half mile, so why not round it up to 1000 like you used to do. No, the way I feel that might be too much, and I don't want to do a swim just to tick off the distance when I'm not feeling good, so maybe 800.
Or 400, to make sure I don't over extend myself and feel draggy.

Etc.

In the back of my mind, I gave myself permission to do nothing. To lazily, languorously move slowly and just enjoy the water. Because what was really getting me up to the pool, when I didn't feel like swimming at all, was the thought of how good and cool and refreshing the water would feel for those first few laps.

So that's how I got myself to the pool.

But, then, what a swim.

Monday, July 14, 2008

The Beauty of an Unripe Pome

I hate fruit.

But, not really.

I love kiwi's, unripe nectarines, cantalope melon, apple bananas, and wild-picked blackberries and raspberries.

I used to like mangos, but have had rather too many of these to like them anymore. When they're ripening and dropping everywhere, and there's that sweet, mushy smell, and swarming tiny, ripe mango loving fruit flies are subtly flitting around, and you can pick and eat just bags of them...well, at some point, you finally have enough. Still, every year that we go back to Hawaii, I'll eat a few--but only if they're tart and almost unripe.

Same goes for papaya's. Mmmm--firm, not mushy, with lime. Yum!

And, I love avocados.
Did you know they are a fruit?
We used to pick bags of these, too.

I guess I don't really hate fruit, I just don't like soft, ripe, mushy fruit textures (think mealy, mushy red delicious apples -ugh!).

I don't know how people eat mushy banana's, mushy grapes, or mushy cherries.

And, since it is extremely difficult to find fruit just at that peak that I like.
And, since I generally don't like fruit and am just not in the mood.
And, since if I do like fruit, it might just be for a fleeting moment--so that a bag of apples ends up sitting for 6 months in the fridge.
I generally hate, and generally don't eat, fruit.

But, this summer, I'm practically drowning in it.

1 green apple, 2 nectarines, 1 cantelope melon, and 5 bananas so far.

I have a small watermelon in the fridge.

And, today I bought raspberries and blueberries (along with a lot of vegetables--because that is what I really do like).

Fruit.
Regardless of what appears to be a genetic component to my dislike (shared emphatically by my sister).
Or, the plethora of soft, mushy fruit choices in our food markets.
Or, that it just might be the anti-oxident secret ingredient to last week's run.
For some reason, this summer, I like what I'm eating.

I never thought I'd say this, but...

... fruit just might be here to stay.

Sunday, July 13, 2008

8 Hours Later and My Face is Still Pink...

What a run.

I have no idea how long it is, but it's become my regular weekend route.

3 hours out and back, through the neighborhood, past the university, across Menaul and Candalaria. The turn around is at Montgomery.

I started June 15th, taking the levee paths along the arroyo, seeking extra mileage.

Whew (!)--were my legs sore after the first day, so I decided to keep on doing it.

I went again on the 22nd and 29th of June, and this morning was my fourth time.

I'm consistent at 3 hours--almost right to the minute.

But today, I reached the turn around in an hour and 11 minutes, and sailed back home for a total time of 2:29. That's 30 minutes faster than my regular pace. Over (what used to be) a 3 hour run, that is pretty significant.

I'm not sure what was different today, but it's probably a combination of multiple factors:

The weather was certainly cooler. After many a Sunday morning returning hot, sweaty, and cooked, today was a delight.

I decided to use my new shoes. They're Asics. I've been wearing this brand for a long time and they always work for me. I transfered my orthotics to a brand new, unused pair, and took them on a 2 and one half hour first time break in run. That's how much confidence I have in them--and, of course, they did the job.

Finally, I only had 4 hour of sleep two nights ago, so last night I went to bed early, slept deep, and woke up feeling great.

But the real kicker, at least to me, is my unconstructed, do-whatever-I-feel-like brand of training these days.

Unless the streets are shape-shifting.

Shhhh...

Saturday, July 12, 2008

The Unplanned Athlete

A raucous and rollicking karaoke dance party, followed by 4 hours of sleep and a killer ride up Tramway--

(--mostly because I wouldn't let the cyclists that passed me on the hill go by without a fight--I was just in that kind of mood. I dogged one poor guy all the way up, and he kept working harder because he didn't like me there (which made for a great sub-anaerobic climb), then caught up with another on the flats who did everything he could to drop me, which of course he eventually did. I can't figure out if these guys drop anyone who comes up behind them, or if they see a little female, so they try extra hard. I mean, initially, they're obviously not going that hard because I catch up to them...in all my years here, the only one who ever sat up and beckoned me up to say hello and give me some good advice was a former pro member of the Shaklee team--a very nice guy.)

A perfect cap to an unprogrammed but spot-on "my-muscles-are-sore-but-I'm-feeling-stronger-every-day" training week.

Now, its time for a nap.




Happy sigh :)



Monday, July 7, 2008

Swim Session

I swam for an hour and fifteen minutes today and my nose won't leave me alone.

I am stuffed up, sneezy, and runny.

The skin under my nose is sore.

I'm not sure if I'm going to be able to sleep tonight.

The water was cool and mildly murky.

Some giant guy got into my lane and kept hitting me.

The little girl in the next lane swam by me like a mermaid.

The guy next to her just about emptied the pool with his 'fly.

I pooped out in the middle, but picked it up when the water got choppy and to try to get out of the way of the flailing limbs in my lane.

I think the little girl may even have kicked me.

When I exited the pool, I ended up in a conversation with the little girl's mom who told me about her 30 pound weight gain after a car accident two years ago, and a sad-eyed pregnant woman who said that all the women in her family had a hard time losing the weight after the baby was born...

Once I extricated myself, I ran out the door, went home, and stretched.

It was a good swim.

But my nose still won't leave me alone.