Know the signs-just in case part 2

I lay on the gurney alone thinking about whether I had done the right thing - by coming there.  The ct-scan was fine, but the doctors wanted to perform additional tests.  I turned my head around and looked at the monitor, which keep beeping from time to time.  My pulse was around 47 and my blood pressure was 96/57.  Low, but normal for me.  I figured that was good, because if something was truly wrong the numbers would be significantly higher.  I flipped through my iPhone playing one game of sudoku after the next waiting for something to happen until finally the doctor - the short one - came into the room.

Doctor: You wanted to see me?

Me: Yes, I wanted to know when I can go home.

Doctor: Well, we still need to run a few tests, so you are going to stay the night.

Me: Well, I do not really want to stay the night.  Plus, I have my groceries in my car.

Doctor: Well, it would actually be considered a danger if you went home since we still do not know what happened to you. 

Me: Well, can't I just come back tomorrow?  I would really like to go home.

Doctor: I really think that you need to stop worrying about your groceries and focus on your health.

OK, now if she had offered to go and get my groceries that I had purchased at Whole Foods earlier that day and that were presently sitting in my car in the late July sweltering heat, that would have been one thing, but that was not an option.  So I really did not have too many choices in front of me.

Me: Um, ok, so what is the room situation?

Doctor: Well, that is what we are waiting for, ok? (and then she showed me a big smile as if she knew something that I did not know). Oh, and we are going to give you some ativan once you get to your room.

Clearly, they did not want me to talk any more and were convinced the medicine would take care of that. I really have nothing to do but wait, and shortly there after the nurse came in to tell me that my room was ready.  He announced it almost as if I was in a hotel, which of course I was clearly not!

On my way up to my room I texted Kerry, on of our best friends, and she offered to come by and visit and bring a phone charger and a sweatshirt to wear.

I got to the room, and navigated my way off the gurney with my IV in my right arm, and my computer bag over my left shoulder.  I carefully walked into the room and past an elderly woman who looked me over as I walked towards my bed, which was located by the window.  The woman looked at me as if I was intruding and I did not belong.  I felt like telling her I could not have not agreed more, but instead offered her a slight smile and walked to my bed.

An orderly started to take my vitals - and this included my weight.  Seriously?  It was about 8:30pm, I was having a really shitty night, and she seriously wanted my weight?  Unfortunately for me there was no getting out of this one as the bed actually contained a scale.  Like or not this WAS going to happen.  After those unpleasantries, I asked her for some scrub bottoms to put on, and then went to change (I was still in my work pants).  And that was it. When I emerged from the bathroom I just stood there and looked around.  I was alone and in the hospital for no apparent reason.  The bed was as flat as a board - there was only 1 pillow and one of those moisture resistant pads on the bed for unmentionable problems.  The bed was too close to the woman's part of the room - even though the curtain was closed.  I started to move the bed - one inch at a time pushing all of my weight into my legs. There I was - in my hospital fashion wear, with an IV drip, moving around the room.  Lovely.  However, I needed to do something to keep me busy while I just waited, and waited.  I put the bed into a place that gave me some sense of satisfaction.  Then I did some more waited, and while I did I lost it.  The tears started to roll down my cheeks, and I seriously contemplated leaving.  I took the moisture pad that lay on the bed and through it across the room since it represented everything to me that I was not - sick, unhealthy, and not well.  My IV line kept getting tangled and due to its position, I could not comfortably bend my arm.  I called the nurses and asked for my IV to be moved to my hand.  More waiting.

As I lay there with mascara unevenly streaked around my eyes, Kerry walked in, and for the first time in several hours I felt a sense of relief.  Not only did only she bring a charger for my phone and a sweatshirt, but she also had a box of Belgian chocolates, which inevitably put a smile on my face.  She helped find out where my medicine was (by this point I decided I wanted to go ahead and get the ativan right away).  After another call for the IV change and an inquiry for my medicine, the IV nurse came in to relieve the pain in my mid-arm only to instill some pain into my hand.  A mere several minutes later, the nurse came in with my medicine and I quickly took it all anticipating the ativan to take effect.  Kerry sat back and watched, waited, and after about an hour of keeping me company saw that the ativan was taking effect.  She graciously left me to drift into some kind of sleep.

Voice: Lily, Lily, wake up.

Me: Wha...? Is it time for my MRI?

Voice: No, it's me, wake up.

I opened my eyes and Jarrett's face was right in front of mine.  Jarrett - one of our best friends had managed to talk his way past hospital security after midnight and woke me up from my ativan-induced sleep.  At that moment it hit me that Hector and I are two of the luckiest people ever. Between Kerry and Jarrett (and so many other people) we have incredible friends, and having good friends makes all the difference.  For about 40 minutes Jarrett paced the room, ensured that my car would not be towed from emergency parking, suggested that the overhang outside the window be used for overflow beds, and reassured Hector via multiple text messages (since he was away in D.C. for a conference) that I was fine.  Jarrett also witnesssed the moment that the nurse gave me an additional dose of ativan via IV.  Now this was new to me - something I had never had before.  Apparently the doctor had decided this would be a good idea prior to the MRI, which was finally ready around 1:00am. 

As I got up to walk to the MRI, I kept my computer bag by my side.  The ativan had a mind-numbing affect, and little bothered me at this point.  Jarrett followed behind, in line with the gurney, until I got to the MRI.  We said our goodbyes and then the testing began.  The knocking from the magnets were louder than normal, but this was not like the 10 or so other MRIs that I have had.  The ativan started to take its full affect, and as they explained the MRI to me, and I nodded in agreement informing them I had undergone almost a dozen of these tests, my legs started to bother me.  Restless leg syndrome is the only side affect I have following my stroke, but it came on in such full force while I lay there during the test that I could not stay still.  I kept shaking my legs - one after the next in an attempt to dull the aching and restlessness  that took over.  Through the intercom the doctors repeated several times to stop moving.  Impossible.  I could not stop my legs.  I started to hallucinate.  Orange fuzzy-like things were all over my legs and I kept trying to shake them off, on after the next.  I could not even remember where I was and I felt as if I was drifting in and out of consciousness.  Shaking, one leg at a time.  The orange fuzzies would shake off and then jump right back on.

Me: I need more ativan.

Them: You need to stop moving.

Me: I can't.  My legs.  I can't stop them.

Them: You need to stop for 10-20 more minutes.  We are not done.

Me: I can't...

Tears, again, started coming down my face.  I wanted it over.  I wanted to go back to my room.  And before I could go through another series of shaking my legs, it all stopped.  The banging was over, I came out of the machine, and the test was done.  My computer bag was handed back to me, and we started to go back to my room.  I have no recollection of getting into bed that night.

I woke up around 6:30 am (4 1/2 hours of sleep) to another set of vitals and the hustle of hospitals.  I called Hector in tears (I have a lot of them, so no chance of ever running out!) just wanted to leave.  I wanted to go home.  I could not believe that less than 2 months into my new job I was out of work for something so stupid.  As always, he took the time to talk me down from my hysteria, and bring reason into my head.  Several minutes later a nurse came in to tell me it was time for my ECHO.  Great, another test, and this time on my heart.  I contemplated asking for ativan...

The ultrasound wand ran around the outside of my chest and there it was in black and white on the screen - my heart.  The one organ/muscle that caused all my problem in the first place, but the one I would never ever want to do without.  I watched it quiver as it brought blood in and send blood out.  Flaps and valves moved, and I waited in antipation for the "Bubble Test".  This test would confirm whether the hole, that was sewn shut on December 12, 2006, was still closed.  The doctor agitated the saline and injected it into my IV line.  Instantly, the bubble reached one chamber of my heart.  We all watched and held our breathe.  Nothing.  Nothing happened.  No bubbles escaped and went to the other chamber.  It was good, closed, the thread that tied it together (so to speak) had not come unravelled.

And that was that.  Back in my room my mother waited for me with one of those smiles only your mother can give that makes everything seems alright.  Unfortunately, some young neurologists also waited.  I dreaded having to answer more questions, and I glanced at my mother who sat in the chair reading a book.

Doctor: Do you mind telling us what happened?

Me: Actually, I do.  I am tired of telling my story, and I really do not want to go in to it any more.  It should all be written down in the chart.

Doctor: (looking rather taken a back) I understand, but it would be good to hear you go over it.

Me: I really do not want to.  I am fine now.  I want to go home.

Doctor: Well, it seems that you had rather large migraine, and that could be what led to all of this....

I tuned him out.  I was not going to go over my story again.  I knew that it was a teaching hospital, and I was not helping the cause, but I was exhausted, annoyed, and hungry.  I wanted a coffee (which my mother managed to get for me) and I wanted my own bed.  A migraine.  I came all the way in here for a migraine?  That was it?  I was done.  The fear still danced in the back of my mind.  What if...what if it was more than that?  Well, then it was, and it was over now.

The doctors released me shortly before noon, and I walked out of the hospital in a sweatshirt, scrubs, dress shoes, and carried my computer bag over my shoulder.  I looked anything but fabulous.  But I was ok.  Deep breathes, and I drove myself home.

I supposed if it happened again, I would have to do the same thing.  There is no way of knowing whether the outcome would have been different.

Thank you to Hector, Kerry, Jarrett, my mom, Steevy, & John.

Know the Signs - just in case part #1

July 30, 2009

4:00pm - I sat at my desk and with in minutes started to feel weird - this was not like the first time.  My left arm started to go numb and feel weak, I felt nauseous and a gradual headache made reading and focusing on my work almost impossible.  I ignored it at first.  I get headaches - they happen.  I work out all the time, so I am used to aches and pains, but this felt different.  So different in fact that I thought of my neurologist and called my neurologist's office a few minutes before 5:00pm to make my annual check up.  5:15pm I took 2 baby aspirin, again just in case.  My arm got weaker and pain started to radiated in the upper part of my arm.  I pulled out some post-it notes from desk and wrote "I might be having a stroke, only take me to the Beth Israel". I slipped the note back in my desk drawer so that I would not raise alarm for anyone, but that it would be accessible just in case I needed it.  After speaking to Hector, and telling him how I was feeling, he urged me to call my doctor.  5:50pm, I called my doctor's office, and the nurse  - after reading over my medical history - suggested that I go to the emergency room just to be safe - she said that she would call ahead and tell them about my situation.  She asked me several times if I was able to get to the hospital safely, I felt that I was, so off I went.

Driving though Boston can be a challenge at any time of day.  Driving through Boston an hour before a Boston Red Sox game is misery.  I navigated along the Charles River, past Boston University, around one side of Fenway Park and finally got myself to the Longwood Medical area.  Tears started running down my face as I remembered the last time I went this route was when I actually experienced a stroke and rode in an ambulance.  This time was different - I was by myself, and no one really knew where I was going.  I maneuvered through traffic and finally got myself to the emergency room parking lot.  

As I starting to walk in, two women were in front of me on their way into the ER, one of which was in a wheel chair.  I needed to get in front of them, so I started quickening my pace.  Now perhaps this was not very nice of me considering they were significantly older, but at this point I did not care.  I was alone, scared, and needed someone to give me some kind of reassurance.  This was not going to be a moment for pleasantries or manners, and I did not want to wait in line.  When I got into the building their was a triage receptionist taking "orders" and a really tanned couple was giving their problem in extensive detail.  Although there were three other windows for people to go to, there were no nurses behind the windows waiting there.  To my left a receptionist sat reviewing various bits of paper and looking at her nails.  That was my ticket - I was not going to wait in line - regardless of the octogenarian duo in front of me.

I walked to the receptionist on my left and explained my situation all the while trying to keep it together.  She gave me a blank stare not really getting it. I told her again that my doctor's office had recently called over and that three yrs ago I had a stroke.  Several hours ago I started feeling odd, seemingly having stroke-like symptoms.  I wanted to see someone straight away.  She pointed me towards a chair to sit down, and a triage nurse came over to take over to ask me some questions and take my vitals... Blood Pressure:  110/70, pulse: 56. Time: 6:30pm.  Another nurse came over and asked me to follow her back to the ER, she led me into ER room #17 and asked me to undress from the top down -with that she left the room.

I changed into the johhny and pulled my iPod and computer onto the gurney and started to get ready to do some work while I waited, because I knew that there would be a great deal of waiting ahead.  And so it began - the tests.  I knew what to expect, I am all too familiar with neurological testing, and in fact when I was back in my office a few hours earlier, I did some tests on myself - I stood in front of the mirror in the bathroom and smiled to see if the smile was even.  It was.  But the doctors asked me to smile again, and touch my nose, raise my arms up, squeeze their fingers.  The tests went on... and on. There were two neurologists there - both women, one tall one short - and they both wanted to ask their own questions and conduct their own series of test.  While one of the nurses impressed upon them that it was time for my MRI, the shorter of the two neurologists quipped "Well, we better follow you" and they quickened their pace to follow the gurney down the hall - the little one practically ran she was so excited (if I could have read minds, I would bet that she wanted to find something on the ct-scan...).

The scan came back normal much to my relief - they did several scans in fact, with and without contrast.  I was brought back to my "room" and left to wait.  At this point it was around 7:00pm, which mean shift change for the nurses.  The new nurse, a young man, came into the room and took my vitals and again I was asked what happened.  I suppose that reading a chart is out of the question, and each person needs to hear the story on their own.  By this point I was tired, and I felt alone, and I was sure that my story was not sounding exactly the same from one version to the next.

After making several phone calls to tell key people (boyfriend and mother...) where I was, I pressed the call button and the nurse came in.

Me: Um, what is the situation? (I lay there with one legged draped over the metal bars on the side of the gurney)

Nurse: Well, I looked at the computer, and they want you to stay the night.

Me: Well, I do not want to stay the night.

Nurse: Well, we can't make you, it is your body, and you are of sound mind, but that is what the doctors are ordering.

Me: Well, I have my groceries in my car.  Is there a place I can put them?

Nurse: ????

Me: Well, can I go out there and get them?  I am hungry.

Nurse: I do not think that you can eat. 

Me: Well, can you get the doctors?  I really do not want to stay.  This is not in my plan.

Nurse: OK.

(stay tuned for part 2...)

Home is Where the Heart Is

I am an avid tweeter - you know, Twitter?  I love it, and in fact have 2 separate accounts to match each one of my blogs.  It is not always easy staying on top of all of the info, never mind remembering to be engaged and provide updates and info that seem to be "worthy" of reading.  There is a lot of fantastic information on Twitter - likewise, there is a lot in MISinformation as well.  In my attempt to look for all things heart related, I came across HeartHub for patients, which is part of the American Heart Association (AHA).  The site is great - it is a site for patients and caregivers and it is affiliated with the AHA - who better to back a patient website with all things heart related?  You can check out your risk level for heart disease, your BMI, and review various treatment options.  But as the index page of the site came up and I started to look a bit deeper, that feeling of disappointment that so often follows every time I look at most heart and or/ stroke related material emerged.

There were no young people (that I could see anyway).  When I say young, I mean people who appear to be younger than 40-45 or so.  Speaking from personal experience, I know that strokes can and do happen to anyone no matter what you look like, what your age is, or your ethnicity.  The site reminded me of a brochure I received upon being discharged from the hospital after my stroke.  An elderly couple smiled back at me - they were sitting outside in a chair and had their arms around each other.  The heading on the brochure read "Sex after Stroke" and the couple was probably in their late 70s - early 80s.  How could I (33 at the time) possibly relate to the couple on the brochure?  I did not think that the brochure would provide alternative birth control methods since I could no longer take hormones following my stroke, and somehow, I did not think that the elderly couple would need to worry about such issues. 

The situation is similar with HeartHub .  While the information is fantastic, I would love to see someone (other than a health care professional) who is at least near my own age.

Now, don't get me wrong, there are  campaigns to which I can relate.  As I was on my run yesterday, I ran my an American Stroke Association "Choose to Move" poster.  A young healthy woman - probably in her late 20s - mid 30s - was wearing headphones, had a smile on her face, and looked as if she was dancing.  She could have been me - and I could be her.  This I related to.

In the end I suppose what matters the most is that the information is there-  people see it and remember what kinds of resources they have access to.  My only concern is that if people do not see individuals "like them" on health-related marketing materials, they may ignore the resources and think "This could never happen to me", when it fact it can, and it can hit closer to home then they could possibly imagine.

Work Your Heart Out

Last week I started posting about the American Heart Association's Go Red for Women: Better U Movement.  This 12-week program is a way to take steps - one at a time - to understand and learn about the importance of heart health.  The steps are literal, as they should be when one is talking about heart health.  You can make over your heart, make it stronger, make it work more efficiently, and make yourself healthier.  You might ask me how I know this information, and my first answer would be that I am a fitness instructor.  However, the more important and even relevant response is that I suffered a stroke in July 2006 and underwent open heart surgery several months later.  Because my heart had been worked, running up stadium stairs, the 1996 Chicago Marathon, hundreds of step aerobic classes, laps around tracks, hours on a treadmill, and years perfecting squats and bicep curls, I recovered from the stroke and from the heart surgery and found myself back at the gym, back to getting my heart beating like it once was, less than two weeks after the stroke and less than two months after the heart surgery*.

Yes, years of working my heart actually saved it.  Every single day that I decided to exercise and to work out, I made a decision to save myself.  Yes, the stroke happened after I taught a step aerobics class (irony at its best...) but due to previous training, and a conscious decision to take care of myself, I emerged healthier that I was before, stronger than I was before, and more aware of what I needed to do to ensure that I could forever choose to make a difference in my life and the lives of others.

*While this time-frame worked for me, it might not be the most ideal time frame for all stroke / heart surgery patients.  It is always best to check with your doctor before starting / resuming any kind of exercise program.

Through the eyes of a 7 year old

"What would you do if you had a stroke in Africa?" He asked me.
"Try to get to a hospital." I answered, even though I knew so much of it depended on where exactly I was when in Africa.
"What would you do if you had a stroke in Morocco?" He knew I spent almost two weeks in Morocco last summer.
"Well, I would try to get to a hospital." I answered.  And in fact, I almost did have to go to a hospital when I was in Marrakesh since I got serious heat stroke (after decided to work out everyday in the 115F weather).

But his questions started me thinking.  I had my stroke in Cambridge, MA.  In fact, it happened on the Harvard Business School Campus (I suppose if you are going to have a stroke, that is as good of a place as any...) Once we arrived at the hospital, I received immediate medical care and now have minimal, if any, residual affects from the stroke.  But this is not always the case.  What if I did have the stroke while traveling?  Would I be ok?  Would the care have been as stellar?  I honestly cannot say.  Perhaps, is my answer.  However I am only familiar with Boston's medical hospitals and research capacities.  I have had great experiences.  I am lucky.  I can only hope the same is true for others.

Grey Matters

I finally watched the Season Finale of Grey's Anatomy.  Yes, I am a fan, and I love the show.  I remember the fall before my heart surgery I recorded every episode so that I would have something to watch as I recovered.  It so happened that some complicated heart surgeries were being conducted that season, so I was particularly interested in the shows in 2006.  But back to the 2009 Season Finale...

Izzy Stevens was getting wheeled in for surgery - a risky one - and while I am not here to write about the tear jerking ending of the show, the topic of DNR (or Do not Resuscitate) emerged several times throughout the 120 minute episode.  This is a topic I became quite familiar with as I prepared for open heart surgery in 2006.  I would be willing to bet that most healthy 33-year olds are not spending a lot of time thinking about DNRs.  Perhaps I am wrong, but until I was told on August 12, 2006 that I would be having heart surgery 4 months later to the day, I spent little time thinking about the "what ifs".  I had undergone three knee operations and one back surgery (yes, I am like the Bionic Woman...) prior to my heart surgery, but I never took the time to think about what might go wrong.  The knee operations seemed too benin, and the back, while serious, occurred when I was 19 years old.  Although 33 is young, 19 is almost infantile (in a good way of course) in respect to 33.  So at that point in time I worried not about a DNR but instead about when I could get back to the gym etc.

But for my heart it was so different.  It had to do with being put on heart-lung bypass (Cardiopulmonary bypass), which literally takes over the job of the heart and lungs by circulating the blood throughout the body while surgery on the heart is taking place.  In my instance an incision was made in my femoral artery and the machine was attached there.  For the surgery, the doctor had to go into my heart and quite literally sew the hole in my heart closed (blue nylon thread in case you are wondering... I asked).  I could not stop thinking about something going wrong.  The doctor - incredibly well respected not only in Boston, but the field - put me at ease, but that did not stop me from conducting multiple web searches on an hourly basis to find out the pros and cons of heart-lung bypass, open heart surgery, and side affects after the surgery.

So this brings me back to Grey's Anatomy.  Izzy was getting wheeled down the hall, she lay on the gurney, and her husband of several hours stood by her side angry with her for signing a DNR form.  I listened to her reasoning, and it resonated a little too much.  Having the man she loved by her side as she was wheeled into surgery also resonated a little too much, as that was the last thing I remembered before my surgery.  I thought long and hard about the possibilities of not waking up or if I did wake up, not being me, being someone else entirely.  Perhaps someone who would be unable to recognize my friends, family, and even myself.  Prior to my surgery, I had already suffered a stroke, which is what brought me to the point of heart surgery in the first place.  I certainly did not need another major medical episode.

Yes, I thought long and hard about what the DNR would mean - for me and for my family.  It was not an easy decision, but it was the right one for me.  So as Izzy, from Grey's, was wheeled down the hallway and she raised all the reasons for her signing the DNR form, I related.  I felt like I was right there by her side, and that December 2006 was yesterday.  These seemingly far away decisions, the ones you think that you will never have to make, the ones that other people make, you might have to make those decisions one day.  They might be staring you in the face.  The writers at Grey's do a great job - it is entertaining and allows me to shut off after a long day at work.  However this particular episode was real.  It was like "real life" (at least the DNR decision making).  So think about all of those things that you might think do not matter... They do, and so do you.

Stroke Awareness...What would you do?


It happens suddenly, out of the blue, from nowhere.  You know that you want to talk, the words are there, somewhere, but they just cannot come out.  He starts to ask you questions: what is your name, what is his name, what day is it.  Really, you  know that these answers are somewhere, but you are unable to find them, and even worse, you know that you are unable to get them.  One or two letters might float around in your head, and somehow they relate to the questions being posed to you, but you can't reach them and pull them to your mouth in order for actual sense to be made.  It is as if someone shut off your ability to speak.  A switched went from "on" to "off".

Suddenly, you are brought to the hospital, and there is a flurry of activity around you.  You are rushed into the nurse's triage room, and as your right arm is being prepared for a line to go in, the nurse is asking you questions.  Basic questions,  However, you cannot answer as the words are gone.  Your blood pressure starts to raise as you being increasingly upset, and begin to understand that something is seriously wrong.  The IV is in and you see the dark ruby color fill up have of the line.  The nurse asks your name. You cannot answer.  Your age, nope, and hopefully you look good enough that she will guess lower than it actually is... Your address... Luckily H knows these answers, and he fills in the blank when needed.

Again, more activity, and you are placed on a gurney and brought into the CT-Scan room.  The test occurs, but no one gives you any information.  In your head you try over and over again to talk, and try to make sense of words, it all begins with the alphabet.  Maybe you can do the A-B-Cs?  And just as you try and get the first 6 letters out, you are asked to stop, and rest. They insist that you try to relax as you need to decrease your blood pressure.

As you lie on the gurney, with H by your side after the first test, the ER doctor walks in - tall, blond thinning hair, angular face, creases around his eyes.  And his eyes are kind, probably due to his job.  He pulls up a stool and sits down one your right side.  His face is merely inches from yours.  He starts to ask you questions: your age, what activity you did that day, have you taken any medication, specifically, have you taken cocaine?  You desperately shake your head no, and can hardly believe the question.

He tells you that he sees something that he does not like something on the CT-Scan, and he would like to do another one, this time with contrast.  You look into his eyes and nod.  What else can you do?  Your options are not very plentiful.

A nurse comes in and takes you back down the hallway and in to the CT-Scan room.  She explains that the contrast is going to warm you, even make you feel hot. No one really lets you move, and you are limited to that gurney.  She leaves the room, and there you are alone.  With your thoughts and nothing else.  Still no voice to explain your fear, frustration, or the beginning of a massive headache that would be more painful than you could possibly explain.  Following the nurse's cue, you feel the warm rush of the contrast liquid pour into your vein and spread out into your chest, pelvic area, arms and legs.  It does not last more than a few seconds, but for some reason feel like a lot longer.

She takes you back to your room, and after a few minutes the doctor reemerges.  His face is grim, and there is a shadow sadness over his eyes.  He pulls the stool up again to your right side, and he sits down.

"Lily, you've had a stroke. You have a 1.5 cm blood clot in your head." And after hearing those words, your life is forever changed.

May is National Stroke Awareness Month.  Be Aware. Know the Signs, the Symptoms.

The 10th Floor

She stood in the elevator today on her way to pick up a rx from her doctor.  The elevators were all too familiar to her as was the scent of the hand disinfectant dispensers that were located strategically all over the hospital.  Each floor has a different purpose, and a little sign inside and outside of the elevators reminds people where they need to be going.  Some floors for general practitioners, others house doctors that will sort out your bone and other ortho problems, optometry is on floor 4 or 5... and then there is the 10th floor.  As she rode the elevator up to collect the prescription, she remembered her visit on the 10th floor.  Almost 3 years ago she to make a trip to this floor.  Shortly after her stroke, she saw a lot of specialists and those on the 10th floor were no exception.  However, they did bring a shocking reality to her situation.  You see, the 10th floor was hematology and radiology.  She suffered a stroke, so she did not understand why she needed to be seen by anyone on this floor.  She quickly learned that she needed to talk to a hematologist before going on prescribed blood thinners.

It was not so much the appointment that shocked her, but the severity of what else was taking place around her as she waited for the appointment.  She needed to have her blood tested to see if it had made her sick. Perhaps it was indeed what caused the stroke, but until further tests took place, she had no way of knowing.  As she waited for 2 hours (no, she was not early, but the doctor was very, very late indeed...), she had a great deal of time to absorb everything around her.

Oh, the 10th floor also has the Windows of Hope shop.  She glanced into the window of the shop from time to time, but felt as if she was trying to gain access to something that she did not have an invitation to...  As the carts of cookies and juice were wheeled around, she started to feel sick.  Her life took on a new meaning, she started to realize it importance and beauty.  Guilt ran through her entire body as she looked into the eyes of the patients.  In a room to the right were the chairs with patients receiving their chemotherapy treatments.  She felt so out of place, and had seen too much - too much pain, too much suffering, and too much pretending, and not enough beauty.  She whispered a quiet "I'm sorry" to herself and anyone and everyone who could her hear.  And in her mind, she gave them all something beautiful.

Nuclear what???

Tests, medical ones.  All kinds.  I have had them  You want to know about them, well, in my 36 years, I have become quite the resource:  ACL surgery, laminctomy (back surgery on L5-S1), stroke, open-heart surgery, TEE test, multiple CT-Scans, MRIs, endoscopy (2 times, and the drugs given for this, well let's just say that they make it all better), and that is just a few of things.  You would think that I am about 30 years older than I really am.  Nope.  You would think that I am unhealthy.  Nope - I exercise, eat an extremely healthy, clean, additive-free diet.  But none-the-less, I have had these test for real problems, and the last was a gastric-emptying study. 

In my experience, when doctors explain tests, they do so in a very "laissez faire" kind of way.  For me, I tend to look up as much info as possible, and sometimes that is not a good thing.  So when one of my doctors mentioned a gastric emptying study, and I started the searching on line, I was not thrilled (to say the least) to see the words NUCLEAR MEDICINE.  I am not a doctor (although in another lifetime, I would probably like to be one), but the thought of something nuclear going into me just did not seem right.  Upon further research (on line mind you, important to know this) I starting reading about "fried egg nuclear sandwiches".  Not exactly what I imagined, especially considering that I do not order fried egg sandwiches on a regular day.  So, a few days before the test I called the office and asked many questions.  The tech, very nice, gave me some info that I would not have otherwise had.

1. Bring an IPOD.  I would be lying still for 45 minutes for the first series of images.  This came in very handy...

2. The test could last up to 4 hours.

3. The substance (Tc-99m) is in an egg substitute mixture, and this is eaten along with toast.

Well, I figured that the hospital was going to have some kind of processed white bread, so I brought my own toast.  The tech looked at me like I was a bit odd, and I told him he could discuss it is with all of his friends, I did not care, but I was not going to eat processed white bread - the nuclear eggs were bad enough.  He complied, and went off to make my sandwich.  When he came back, the eggs were in a little paper bowl, and my toast was burnt.  Not the fanciest breakfast, but I was hungry, and I ate it even though the eggs left a metallic-like taste in my mouth.

The first set of images were fine.  The table was fine.  The test is really quite simple, and since I had to be there for the entire 4 hrs, I finally asked if I could just sleep on the table in between the pictures (each break was for an hour).  No one had a problem with it, so I got to rest, and they received their images. 

Seriously, I mean let's hope that something comes out of this test.  It is comical that I had nuclear eggs for breakfast.  However, it is certainly not something that you will see posted on the Queen of Tarts!

On Waking Up: December 12, 2006

I remember waking up.  It was hazy, and while there were people there, and I could hear their voice, I do not clearly remember their faces.  The monitors were to my left and the door to my right.  The door stayed open since it was on the ICU floor.  From time to time the window to the outside would come into view, and the dark December afternoon was reflected back to me.  I was safe inside.  But the sounds, the noise, and the sensations were overwhelming.  A man was leaning over me instructing me not to talk.  I was intubated, and he told me it would be impossible to talk. Don't bother he said.  I could not move my arms.  My wrists hurt.  Were they supposed to hurt after heart surgery?  Why did they hurt, why couldn't I lift my arms?  They were strapped down to the bed.  Tied down, so that I would not wake up in a panic.  Well, being tied down and intubated - that was causing a slow and deep panic to set in.  The man told me not to fight it when he pulled the tube out from down my throat.  It will not hurt, he said.  It will be fast.  I gagged and choked as it came up from my insides.  Things faded away...

My mother finally helped to untied my wrists.  I looked down.  Not my wrists.  They were bloated with all of the fluid in my body.  I tried to bend my fingers, but it hurt.  More pain.

One of my friends told me that my father was coming in to say goodbye.  He had to get on a flight that night. She picked up a washcloth and started to wipe the blood away from my mouth so that my father would not be more frightened.  I do not remember him coming in to say goodbye.  They day went on like that.  Time did not matter.  I watched the afternoon sun turn into evening as I drifted in and out of consciousness.  On several occasions, one of the nurses would come by my side and tell me that I needed to breath, that I was not breathing enough.  Every breath took all of my energy.  My entire torso felt as if a sledge hammer had been driven through it, and breathing took too much effort.  My pulse was too low, she said.  And handed me a device to practice my inhaling.  No... it hurt.  Knives in my chest, my throat, and side where the chest tube was inserted to drain the fluid so that it would not build up in my lungs.

The pain medicine only lasted so long, and when it wore off, they put me on a morphine drip.  No, she cannot take morphine, my mother told them.  It does nothing for her pain.  She was right, and so was I when I watched the nurse write this detail on my chart only the day before.  The morphine made my sleepy, things became hazy, and the pain in my chest more intense.  It felt like one of those chefs from the Ginzu knife commercials testing out his products on my insides.  I drifted again, and in and out.  And heard a lot of commotion about making sure that they could find pain medicine.  I tried to call out to someone, anyone.  It hurts, I whispered in a voice that I do not think anyone could hear.  It hurts...  I tried again.  Later, much later they found it.  The new medicine.  Better, and it took the pain away.  The drip went into my IV.  I drifted out again...

That was the day I had my heart surgery.