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15 September 2015
A note to the old soldiers on my email list (more inside)
I don't know what went wrong. Here's what I thought I posted
Here’s what happened:
Those who track these things may remember that I got a pacemaker installed a few months ago, which I’ve been enjoying immensely. We all realize that when the time comes to have an appliance like that installed, the recipient has stepped up to the edge of the pit for yet another moment to reflect on the joys of survival. In the case of old souls like us, I could say we dodged another bullet. I’m getting used to it by now. Then my stars lined up and I got a titanium hip joint implanted. After a couple of months of physical therapy I am ready to toss away the walking cane and revisit my pole vaulting career. Well, the cane is about ready to be cast aside anyhow.
I had some issues with my PT, though. The strength exercises were getting harder, not easier. I figured it was maybe the smoke from all the fires lately. Last month the sun was pretty much just a theory, little red thing somewhere up there. I hit the inhalers and drove on, as they say. Breathing got worse, I would wake up gasping. I charged up my nebulizer and drove on.
Anyhow, to make a long story shorter, after my PT last Wednesday I headed out to my car, becoming more short of breath with each step. My drill here is to sit quietly and breathe through pursed lips—this is how I pay back the oxygen debt—stay calm, breathe slowly. It helps to lie back. I got in the car that did that. The problem was not in the oxygen debt, though. I was not having a COPD issue, or an issue regarding the heart blockage that had earned me the pacemaker.
I was drowning. Water was filling my lungs, and when I lay back in the car seat, the reservoir of liquid that was pooling in my legs rushed to my lungs. Each breath I took reduced my capacity by exactly half. In five breaths I could neither exhale nor inhale. I began to drown. I went into slow time, figured I had at least a minute or so left before I blacked out. I honked the horn in groups of three, and my PT, Mary Ellen, came to the door. I saw her turn back inside, heard her say “Call 911.”
She stood by the door of my car and talked to me... the EMT are on the next block, Mark. Call my wife, please. Yes. Stay with me, Mark. I’m losing it. No. Stay with me, Mark. I nod in slow time. I know she means well and I am entirely grateful to have her standing at the car window, holding my hand, to usher me across to the other side. I think that this isn’t quite what she had in mind for this afternoon. I think something else, something something. I may be looking in the wrong direction. I can see around the corner.
Then it was busy. They were moving me. Fucking stretcher. Don’t bother, asshole, just let me be still. The EMT brought the CPAP to my face but I could not yet bear to have it over me, because of the irrational notion that it would suffocate me. I became polite, too weak to struggle, but not too week to resist. We negotiated—the EMT and I—and when he brought the cool pressure to my face and when it sealed, I could feel cool damp air pushing into my lungs. I stopped fighting him. Maybe I stopped before. Somehow I was in the ambulance. He said I got a vein. I was looking between my feet, through the open doors of the ambulance at my wife standing among the EMT, firemen, and PT people, working it out that I was in good hands. Mary Ellen had her hand on RedBud’s shoulder. RedBud’s face was grey. No, I’m grey, I heard them say that. The ambulance doors became closed—I didn’t see that happen, but by now I was getting used to gaps. Now we were out on Hwy 62, on the way to the hospital. There goes the Apple Peddler Restaurant, Taco Bell. Some gas station I should recognize, but don’t. I missed the ER entrance somehow, going inside. I was inside, being manhandled from one stretcher to another. A woman’s hand held the CPAP in place. I made myself busy working its rhythm. It’s really easier if you work with it, like a SCUBA. Otherwise it jams the air in anyhow, and makes unflattering noises that alert the medical people that you are not trying to cooperate. I wanted to be good. I could almost ... something … something.
Then it was quiet. Just the CPAP and me and the table. People talked. A very pretty woman asked permission to cut my shirt off. I declined, and leaned forward so she and her helpers could slip it over my head. I was sweating. I remembered, now that I had some air in my lungs, that, back in the car, just before I took that last breath, I had voided my bladder. I didn’t care. I think I napped. Lights came and went. People asked me questions. I don’t know what I told them, but I suppose it was all right. That night was all CPAP, and I was okay with that, but by the next morning I’d had enough. Yeah, said one of the doctors. Six and a half liters of fluid. Imagine that.
When you have congestive heart failure, the drill is just the opposite of oxygen debt. Don’t lie down until you absolutely have to do so ... buy more time for the EMTs to get to you by remaining in a sitting position. Then let them do their job. Don’t fight the CPAP. Don’t worry about pissing in your pants—that’s just your body trying to save your life by dumping extra fluid, so go with it.
They took good care of me. I got there Wednesday afternoon, and Sunday I came home with a list of instructions and some water pills. Okay, a handful of other pills, too.