's hospital stay--fire up the printer!

[Guest guest]

I was in the hospital June 28 to July 4; In the month previous I had

pretty much become a shut-in. My activity was down to throwing a

stuffed animal for my dog in the yard for five minutes a day.

Prodigious (up to 480 mL) dark-colored sputum production began going

down, under 240 mL, and I began to feel that my left lung was turning

from a sponge to a stone. " Ballooning " pain in my left shoulder

suggested heart problems, too. My peak flow dipped under 400, and was

at 350 just before my in-laws drove me to the hospital.

A bed opened up at 6pm, right around nursing shift change, so I didn't

get hooked up to IVs until 10pm. Blood draws kept me up 'til

midnight--I don't think I slept more than 20 hours total in the six

evenings of my stay. I was on big bags of IV potassium chloride with IV

antibiotics of Amikacin (also known as Amikin) and Meropenem (AKA

Merrem), as well as 2x daily IV shots of Solumedrol and the oral AB

Rifampin, best known as a TB drug but used for other infections.

I impressed the night nurse with my knowledge of bronchiectasis and my

dogged attempts to get well--so much so that she got me a private room

the next day (a good thing; my roommate, whose stay appeared to be

drug- or crime-related, had bad taste in afternoon TV.)

Care of me started in earnest in the private room; respiratory

therapists showed up every four hours with SVNs and percussion therapy;

where the one first-night RT used her hands, I had a string of folks

who used a clear, soft-plastic mask with a rolled edge, beating me with

it. That was just okay--the best RT's, I found, are slightly-built

women with light hands and arms, who can let the " pop " of cupped hands

mobilize secretions, as we euphemize it. I forgot how violent RT was; I

could only take 10-15 minutes of it before I was dripping with sweat

and gasping. Then again, I am in a weakened state, having lost 5% of my

body weight in a month. Also, I have used the Vest for 7 years now,

exclusively. With a new health insurance plan, I am going to look into

having a home RT person pound me every few weeks to a month. My wife

would do it, for that matter. The RT people aren't the resource they

were my last hospital stay, 8 years ago--those folks were full of

concern, sharing therapy ideas--indeed, a young woman RT with

bronchitis had sampled the Vest the morning before she pounded me 'way

back then; it wouldn't be too much of a stretch to say she saved, or at

least greatly altered, my life--the RTs this time were quiet,

overworked, working 8- or perhaps 12-hour shifts. Older nurses will

tell you how task-, rather than patient-oriented new nurses are; I was

just another gross container of phlegm for too many RTs--most didn't

bother to introduce themselves. Like nurses here in the USA, there is a

shortage of RTs; I felt this most when I had neither pounding or SVN

for a 15-hour stretch; I finally had a nurse find vials of ipratroprium

and albuterol and figured out the wall air spigot. A couple of RTs gave

me oxygen after rougher post-pounding coughing spells. I shied away

from oxygen, fearing it'd be like an instantly-addictive drug,

remembering long-ago ice-hockey TV broadcasts, the fleetest players

coming off the ice and just whiffing away like the oxygen was something

savory and delicious. I strapped the stuff on and said, " yeah, so? " I

guess I've got good SATs, is that it?

On night number 3 I was watching TV (I am the only person left who has

neither dish nor cable; viewing cable only confirms how easy it is to

save $40-$50 a month) when a pain began in my right lung, mid-front.

Coincidentally, my brother came to visit and the night nurse came to

check my vitals--maybe start an AB IV, and an RT started an SVN. The

pain began rising, like a bubble in a Lava Lamp, slowly moving up my

lung. Nurses ask what pain is like on a scale of one to ten; I said

this was a nine. Did I want a pain pill, she asked. I rolled my eyes.

" Pain MEANS SOMETHING, " I said--either infection, or...I went on to say

that this pain was like pneumonia pain, but it was up high in my lung,

and it was sudden. The nurse left and returned. Here, take this nitro

pill under your tongue. " My heart is GOOD, " I thundered. " 140 over 100

is my 'hospital' blood pressure--I'm stressed because I'm here. " (My

brother stood a couple steps from the bed, watching bemusedly.) The

pain kept rising, pushing up, up. The RT offered another SVN and oxygen

and I took him up on both. After a few minutes the pain lessened and

became less frightening; the nurse went and called my doctor as I asked

her. The RT left and my brother and I had a talk. The next morning the

crack-of-dawn RT let slip that charts on my room door suggested I had

TB (I didn't) and had had a pleural infusion (the source of the

pain--opinions vary.)

Earlier day three I was seen by a very-well-regarded infectious disease

specialist; he confirmed the move to a private room by putting me in

isolation, closing the door and having everyone entering wear a mask,

(and sometimes a gown) and having me wear one on trips for x-rays,

echocardiogram and PICC line installation. The ID doc was terrific; our

talk was as substantial and thoughtful as those with my lung doc, whom

I've known for 15 years or more. The one IV drug, Amikacin (pronounced

am ih KAY cin) evidently is an older drug that has been shown to be

recently successful in (I think it was) some journal article.

As kind of a terrycloth bathrobe takeaway gift, my last and best RT,

Vicki, gave me a disposable, single-patient-use " Vest " --I use quotes

because it's more of a flat shape, 8 inches by about four feet. You

wrap it around yourself like a big bandage and affix it to itself with

Velcro. Hoses insert into soft-plastic/clear latex openings, rather

than fitting over nozzles. So you have sort of a disposable

paper-plastic life preserver around you, more or less only around the

bottom of your ribs; then you turn on the compressor and adjust

pressure and frequency. Another difference is a small vent that bleeds

a bit of air near the hoses. The big advantage to me over the full Vest

(which resembles something a SWAT team member wears) is that this band

would work on pleuritic pain/congestion, at least in the lower lung

area where i have to resort to a hand-held G5 percussor. The all-white

strip is labeled Single Patient Use The VESt Airway Clearance

System/Hill-Rom A Hillenbrand Industry. I don't know if the Vest folks

sell this; given their rebuff when I asked if they'd sell me a

custom-made vest (with rear-mounted hose nozzles), I'd suggest asking

an RT or hospital if they'd sell you one.

I felt my lungs clearing; they worked silently. My mind had thoughts of

working around the house, painting, outdoor work--surprising, alien

ideas to my long-sick self. Hospital food was delicious, ordered by

phone, showing up bedside an hour later. I had liquid supplements at

every meal. My legs made me think of concentration-camp survivors; I've

never had body-image problems, but I hated the feel of my leg bones

jarring together at night when I tried to sleep. I was too embarrassed

to ask for a second pillow.

By day six my lung doc said he wanted to get me out of the hospital

before I caught something; the next afternoon I was home, a nurse

waiting for me to teach me how to self-administer needleless IVs.

Squeamish as I am (I hide behind a pillow watching TV medical dramas) I

have done all right for a week now--though I am waiting for a nurse to

come and open a blocked line. I am home all alone as wife and daughter

cool off at the beach five hours west. The IV schedule doesn't allow

much sleep, as one AB is every 8 hours, the other every 12, and sputum

color indicates there's still a battle going on down there. Volume is

down to 60-120mL a day. I am still somewhat exhausted, but a tiny bit

less each day; took the dog out in the back yard last night for the

first time in 2 weeks. I have the feeling if I just can get enough

rest, I'll feel better--I look forward to getting out of the house,

getting some exercise. My doctors and a bunch of nurses and respiratory

therapists, as well as dozens of people praying, have pushed back death

for me; I have great hopes all their hard work was not in vain.

Speaking of Vests, I have to go shake. Hope I haven't bored you.

55, Bronch 20 years, Arizona USA