Nothing Like a Pulmonary Embolism to Ruin my Day

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Actually it was a cluster of small to medium-sized pulmonary embolisms.

I had gone in the morning to the Brookwood Hospital outpatient to have a CT scan and a bone scan to check to see what my cancers were doing.

First I was given an injection of radio isotopes for the bone scan to read. That would take a while to course through my body.

While the isotopes were doing their thing, I was scheduled for the CT scan. I drank two coffee cups of a lemonade-like mixture that didn’t have any sugar in it and waited for a short while. That concoction had a tracer in it for the CT to read.

Just before the CT scan, a nurse drew my blood to see if my kidneys were normal. As it turned out that was the only thing that was working normally for the next two days.

During the CT scan they do inject you with a substance that’s about like hot bbq sauce coursing through your veins. I had the CT scan and wasn’t due back for the bone scan for about an hour and a half, so off to the cafeteria I went. That’s where hospital personnel and people visiting hospital patients eat. Contrary to hospital food for patients, the food in the cafeteria is quite good. I took my time with a turkey sandwich and sweet tea. Most places where I eat don’t sweeten the tea enough but this was very close to Southern, sweet tea, and passed my taste test.

Then I went back to the outpatient waiting room for a brief period before they called me for my bone scan. They do place the bone scan within a few inches of your face, which might be claustrophobic for some, but didn’t bother me that much. The bone scan finally moved off my face and down my body. I don’t know whether it was looking for my brain and found it, or just gave up. It sorta hesitated momentarily, which I think was meant as an insult to me.

After about fifteen minutes, the bone scan had worked down to my feet. The next step was to rotate it around the hip area which didn’t take that long.

It was early afternoon, and I thought I was ready to go home. I called my daughter and wife to pick me up. My daughter, sounding calm, cool, and collected so as not to scare the dickens out of my wife, said that  my buddy over at Urology Centers Ashley had called, and told her the CT scan may have revealed a pulmonary embolism in my lungs, and that I needed to call my Internist sooner than soon. The scan had been positioned primarily to check my main organs, but the very upper tip had picked up the possible embolism. Dr. Poole at Urology Centers had ordered the CT scan and bone scan.

Here’s a bit of information which might be of use to some older people. My wife and I had previously given a power of attorney (POA) to our daughter, our son as well, and it was this that allowed Ashley to give my daughter the necessary information. Had that not been, my daughter could have only told me Ashley called, and I needed to call her at work. Considering Ashley’s normal schedule, it might have taken me a while to reach her.

I called my Internist and spoke to triage. The nurse there spoke to my Internist once he was finished with a patient, and my Internist said if I had thoughts of continuing to live I needed to go to the ER immediately.

As it turns out, ER was just a short walk from the outpatient waiting room. I went in and told them my CT scan that morning may have revealed a pulmonary embolism. Those who have been to the ER might think they move at a slow pace sometimes, but this was like calling the fire department when your house is on fire.

They had me an ER patient room before I walked away from the desk to sit down.

My nurse in ER Kelli was a true blessing, one of the nicest people I have ever met. The hospital staff had me in X-ray in short order, and another CT scan followed in the same place I had had my CT scan that morning.

The tech and I laughed that I liked her so much I had come back to see her again. She ran the test, and then they wheeled me back to my room to wait for the in-house ER doctor.

They re-hooked me for various tests they were running, EKG, oxygen, and an IV, to name a few.  They also had me hooked to a monitor for BP, O2 levels, temp, etc.

It was some time, but when the doctor came in, he told me I had a cluster of pulmonary embolisms in my lungs. Although I was hooked up to wires and plastic tubing, my initial reaction was to jump up and run out of the hospital. Then I got to thinking Medicare might not pay for all the detachment of the machines I was hooked to, so I decided to hear the doctor out.

In passing he did say the radiologist had read the bone scan, and it had revealed that I still had the cancer in my right hip that had been there before. There was a confirmation of a cancer on one of the ribs on my right side, but that was no surprise. The bone scan about a year before had determined it was either scar tissue from a previous rib break or cancer. This was saying it was a metastatic cancer, a second confirmation in my body. That is important. I’ll tell you later why.

It was already late in the day that had started out early, and I could see the chances of eating some homemade lasagna my daughter had made evaporating before my very eyes. I would spend the night in the hospital and maybe beyond. They would start me on a blood thinner. They did that before I left the ER.

I always assumed blood thinners dissolved the blood clot, but the LPN who came in later to give me a full rundown, pointed out, among many other things, that a blood thinner does not dissolve the clot or clots. It stops the growth of the clot, and the body itself is actually responsible for dissolving the clot or embolism. I wish I could remember that LPN’s name. She was great.

I had to remain in the ER a while longer because they had no bed available in Brookwood Hospital, but it was a somewhat enjoyable time. My family all were there by this time, except our son, and Kelli and I were joking back and forth.

The kitchen that prepares patient food had closed for the night, and I thought the turkey sandwich I had for lunch was my full fare for the day, because I could not eat before I came that morning.

The doctor finally gave permission for food, the only problem was where was the food? Fortunately my son went for a Subway turkey sandwich on his way to the hospital.  The sandwich looked like it was about 2 feet long, but might have only been 1 foot.

They came to take me to my hospital room while I was still eating, and I took it with me. I bid farewell to Kelli but not before I filled out an evaluation card and then called the supervisor into the room to tell him what I thought of Kelli and the service. He thanked me and away I went, well sorta. Away me and Zac went because he was taking me to my new room.

When I got there the nurse to greet me was Billee, who seemed to be cut from the same mold as Kelli.

I always find people’s life’s stories much more fascinating than mine, and all my stops along the way with nurses, techs, other personnel, I always tried to find out theirs. With Kelli and Billee it was no different.

If you are ever at Brookwood Hospital, and are fortunate to have Kelli and Billee as nurses, you have found the very best, and Jennie who took over for Billee the next morning, after Billee ended her 12 hour shift.

For those lucky enough to have not been in the hospital, let me give you an overall view of the night there. The night is not a time to sleep in the hospital. People are coming in and out of your room all night.

Perhaps the most unusual was Dr. Saleti about 2 in the morning. We reviewed all of how I came to be here, and she was quite thorough in her conversation. What surprised me was the time in the morning. I was used to seeing nurses, but not an in-house doctor at that time. She did concur in what other doctors had said that the clots or embolisms probably occurred as a result of the cancer. We did discuss the treatment I was taking for cancer, but the likelihood of those treatments causing the pulmonary clots was minimal.

She, as other doctors, was convinced the clots were originating from a DVT (deep vein thrombosis) in my lower leg, breaking off, and moving up to the lungs.

I was connected to so much med equipment I was afraid to move for disconnecting them.

Every once in a while my monitor would start beeping, and Billee would sail into the room to check on it. Most of the time it only required a reset.

I was scheduled for an ultrasound (a Doppler) the next morning to check on the DVT. Although the test showed nothing, when Dr. Bell came in the next afternoon, he said it was still possible that is where the clots came from, and just were not showing up at this time.

Dr. Bell is a big fellow about the size of an NFL lineman, not fat, but big and muscular.

When he first came in the room and had not introduced himself or I had not seen his name tag, I thought he might be the bouncer, and I started recounting the last 24 hours to see if I had been a model patient. I wasn’t sure. I knew bars had bouncers, but I thought he was about to toss me from the 7th floor, and I was hoping I would land on a couple or three box springs on the ground that would propel me back at least to a room on the 2nd floor.

Dr. Bell is a gregarious-type. After we finished the necessary info, we talked about his med school and his parents. It’s these types of conversations that make the hospital visit a lot more tolerable.

Dr. Bell and Dr. Saleti are in the same group of doctors who provide an in-house doctor’s presence 24/7/365 at Brookwood Hospital.

Dr. Bell said because I had not experienced any prior pain, and didn’t even know I had pulmonary embolisms, or being asymptomatic as he called it, he saw no reason why I couldn’t go home. He went and signed the discharge papers.

He did do me one big favor. He saw that I received a free 30-day supply of Eliquis to get me started on the blood thinner at home. Eliquis is quite expensive.

While I was waiting for the discharge nurse to come for the final step, my Urologist Dr. Poole came by. I thought surely one of us would say, “And, oh by the way, the reason I was here in the first place………”, but we didn’t. We just talked shop.

He did point out one major factor which I mentioned slightly before with an explanation to follow. Because the place on my right rib had been confirmed as cancer, the cancer was now technically metastatic, which meant Medicare would pay for the new drug which Dr. Poole was adding to the ones I was already taking. A minor, but major point, turning on the technicality of the word metastatic.

I am sure I have left out names of those who served me well, and for that I hope they will forgive me.

I did have to take a detour on my planned trip home, but one only a few feet away from where I was at the moment. Some people don’t get to make that trip, because a large pulmonary embolism blocks the lungs, and the next trip that person takes is in a hearse on the way to the funeral home.

It wasn’t quite my time, but, as for me, it was close enough for all practical purposes.

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