I noticed recently that we have a lot of systemic problems in our society right now. We have systemic governmental problems. We have systemic financial problems. We have systemic problems with the distribution of truthful information. And we have a systemic problem with me writing these posts because when I end up in the hospital no one provides an update!

The funny thing is, back in the middle of October I was thinking about what I could provide as an update. Things were progressing nicely. The wounds were healing (albeit slowly.) Didn’t have any respiratory issues. I was generally in good health and felt pretty good. As such, there really wasn’t much to update. So I was thinking perhaps I should write about the accident, or about what I was doing in my life before the accident. But those ideas will have to wait for another time. Because right now we have other things to talk about.

It was Wednesday, November 1. Feeling good – and generally positive – we took a trip downtown to Shirley Ryan for an evaluation on being included in some of their clinical trials. That was kind of a cool experience. They hook up electrodes to different muscles and then put this thing on your head which causes an electrical shock to stimulate the brain in the right spot to activate said muscles. They’re testing to see if there is any connection between the brain and the muscles. The results were in-line with what we already knew: decent connection to the upper arms, some connection to the lower arms, fingers and legs are “inconclusive” (whatever that means.) So there’s that. At least now I’m in their research system for consideration.

That was a good day, and it’s always nice to have a good day.

Thursday afternoon I started to not feel well. Over the last couple of months Suzie and I have figured out that when I’m freezing cold but sweating from the back of the neck it means I’m having a bout of autonomic dysreflexia. It’s a strange gift of the spinal cord injury. The body is in pain somewhere, but the nerves that would tell the brain exactly where are severed. Nevertheless, the bloodstream is flooded with enzymes and neurotransmitters telling the body that something is wrong. So the body reacts.

Laying under a pile of blankets, freezing cold, sweating, temperature of 103.2, blood pressure of 212/160… something ain’t right. Now a person in my condition can basically get whatever pharmaceuticals are requested. I’ve never taken advantage of that; and by and large I have never needed any of the hard-core pain relievers (read opiates.) But there have been a few times when 10 mg of oxycodone would’ve come in really handy. This was one of those times.

Instead we make a cocktail of tramadol, Tylenol, and Advil. While not perfect, it certainly takes the edge off and brings the temperature down. Follow that a few hours later with a double Ambien and 12 hours of sleep, and Friday morning I’m feeling much better. We chalk the whole thing up to being overtired from Wednesday’s trip downtown and maybe I caught a bug or something.

Friday I’m good all day. A little bit of pain in the evening. But nothing like the day before.

The weekend passes with more of the same. Chill. Sweating. Temperature. Thankfully the pain has subsided. So we just figured I got the flu or a cold or something. Although, Suzie does observe that I’m acting a little “goofy”.

On Monday, Bob stops by as he was rolling through town on his way home from Ohio. We have a nice visit. By all accounts I was lucid and holding it together. A little tired perhaps, but nothing out of the ordinary. After Bob leaves I take a well-deserved nap and wake up speaking gibberish. Suzie calls 911.

I don’t know what it means, but Suzie, Clara, and the fire department are pros at getting me out of the house. Clara knows the dog and the cat go in the basement. Suzie puts the ramp in front of front door and moves my bed over to one side of the room. CFD knows that they have to send the engine company with the ambulance just in case they need a couple extra hands. By the time they show up everything is ready to go, which means we can proceed directly to introductions and catching up. “Hi Mr. Bosco. Good to see you again. So what’s going on with you today?”

Here’s a medical fun-fact: high temperature + low blood pressure = infection.

I don’t remember exactly – and I certainly wasn’t thinking clearly – but my recollection is that in the ambulance my temperature was >103 and the blood pressure was around 64/42. While it’s true I don’t remember the exact numbers, I do remember having a conversation with the paramedic about how that blood pressure is actually not terribly uncommon for me. I may, or may not, have said something about just taking a Midodrine and going back home. He may, or may not, have very politely indicated that was not a good idea.

When you roll in by ambulance, you (thankfully) get to skip the waiting room. Suzie tells me that’s a good thing as the waiting area is filled with people who think the Emergency Department is a clinic and that the whole place smells like weed. And the place is busy. So busy in fact, they don’t have enough rooms for all the patients. So they have several positions marked in the hallway where they can keep an eye on you.

I got assigned to position “E” which is in the hallway between Rooms 8 and 9. A nurse comes by, takes vitals, puts in an IV, and hangs a bag of saline running wide open (pushing fluids trying to keep the pressure up.) As Suzie and I are sitting there enjoying the natural chaos of the ED, I notice a security guard slowly pushing a long stainless steel cart. I get Susie’s attention and say, “Hey, you see how that cart’s not a gurney but stainless steel?” Suzie gives me the side-eye as we watch the security guard slowly push the cart into Room 7. As if on cue, the nurse walks up and excitedly says, “We’ll be moving you out of the hallway shortly. We just need to clean up Room 7.”

The goal in the ED is to prevent you from dying. Period. Full stop. The gurney is incredibly uncomfortable, and not at all good for my wounds. There’s a serious lack of pillows and blankets. There is no TV. The monitors are constantly alarming and the room is illuminated by lights which I believe are called the “Face-Melter 3000”. As a result sleep is next to impossible. The best thing you can do is catch 20 or 40 minutes at a crack in between someone coming in to run some test or to tell you that the EKG telemetry is not working right and they need to rip all the electrodes off your chest and start over.

Despite being exhausted I was kind of curious when I awoke to nearly every staff member in the ED shouting, “No. No. No! Sit down! Tina SIT DOWN!” My vision came into focus just-in-time to watch a woman on the far side of the ED standup, take 2 steps forward, and fall forward on her face. As interesting as that was, I was grateful for being able to quickly drift back off to sleep.

However Tina was not done interrupting my sleep that night. It was some time later when a, now restrained and clearly agitated Tina, was shouting “Let me go!” and “Get these restraints off me!” That was followed by an interesting string of profanity. The staff was doing what they could, but it was no use. The more they tried to calm her the more agitated she became. At one point she starts screaming, “I need to get it out of me! I need to push!” The staff was very encouraging, saying things like, “Okay you go ahead and push.” Now I know I was sick. But I know what I heard. It was at this point when Tina shouted, “I’m having a lion baby! I AM HAVING A LION BABY!”

Well, congratulations Tina. I hope you and your lion baby are both doing great. (Now I did fall back to sleep, so I don’t know if any local media showed up to record the momentous event. Maybe it was on WGN or something.)

C’est la vie in the Emergency Department.

My condition was stable but not improving. I was diagnosed with sepsis, an infection in the blood. They suspected it came from a UTI which, again, is not unusual for a person in my condition. They sent urine and blood samples off to the lab to see what would grow. In the meantime they very carefully selected (they guessed at) an antibiotic which should have a high likelihood of success in treating my infection. But they wouldn’t know for certain until the stuff in the lab started growing. That could be 3 or 4 days.

Now because I’m a chronic overachiever and I like to keep things interesting, my belly was distended and hard, and there was a little bit of swelling in my right leg. A few x-rays and a Doppler ultrasound later… it was confirmed that I had the beginnings of a bowel obstruction and a blood clot in the right leg. However those were low priorities compared to the sepsis. They had to take a backseat for a few days while we focused on the infection.

The original plan was for me to move from the ED to the ICU. But I guess no ICU beds were available, so in the emergency room I stayed. Eventually, although I was not feeling any better, I guess my condition stabilized enough to be moved into a regular room. At 6 o’clock on Tuesday evening, 22 hours after rolling into the emergency room, I got to a room on a floor.

And that my friends is how I began my 11 night extravaganza of medical care.

However right now, I’m exhausted. And I won’t be able to get back to this for a couple of days. So I’m afraid that’s just where we have to leave it for right now. But trust me the story is far from over. In our next episode we will cover more about infections, CT scans, night nurses, kidney stones, and other exciting topics. I for one can’t hardly wait.

I’ll try to get the rest of the story done sometime next week.

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