Respiratory Distress

Okay…so on my Topic Tuesday post (which I am aware wasn't posted until Thursday), I mentioned the reason for my post being late. I'm in the hospital. Been here since Sunday morning, EXTREMELY early. About thirty minutes before the alarm went off for me to get up and started on day five of an eight day work week, I was holding my rescue inhaler in one hand while I held my chest with the other.

My husband drove me to the emergency room where they took me back and started me on an hour long breathing treatment. I'm accustom to steroids and the jitters they give you. I'm an asthmatic. I carry my inhaler with me always.

Aerosol rescue inhalers are very beneficial. They can be the difference between living and dying. The inhaler administers a puff of steroid medication which enters the lungs and dilates the bronchioles (the air sacks contained in the lungs) allowing air to deliver oxygen to the cells of the body. (It's a lot more complex than I'm making it sound, but this isn't an A&P class, and neither of us signed up for the long haul with this post.)

When the lungs are restricted in some way, the medicine is ineffective and professional health care may be your best bet. As with myself on Sunday, the inhaler was ineffective. I now know the whys, but let's return to the scene of the incident, as it were, and I'll bring you up to speed.

So, I'm in the ER receiving what probably was the equivalent of six tubes of medicine.

**For those not familiar with breathing treatments, the medicine is placed in a machine known as a nebulizer, which turns the liquid medication into vapors. This process allows the medicine to be inhaled into the lungs where the restrictions are occurring. If the planets are aligned in just such a manner, or you aren't apparently as ill as I was, this will do the trick. For the professional-sounding, technical terms, you can go here.

The dose of medication should have been enough to have me back to normal. Unfortunately for me, I was beyond this level of treatment. They administered round one of medication, came back, listened, and ordered round two.

To say I had a "wheeze" when I inhaled or exhaled would be an understatement…an EXTREME understatement. People could hear me in the hallway outside my room. One nurse referred to it as "singing" because she'd barely clear the doorway and I whistled like a freight train.

Next up was round two of ANOTHER shot at stopping this wheeze and getting me able to breathe again. So, there I sat with a mask covering my mouth and nose while this machine turned the medicine into the vapor I inhaled with every miserly breathe I drew.

**If you've never heard someone wheeze, you may be sitting there reading this wondering what in the name of William Thomas Henry I'm talking about. Well, here's a place to read about a "wheeze."

Now, let's jump back for half a second. I said these medicines are steroids. They are. Not like the steroids body builders take, but a steroid none the less. Steroids will hype you up! Some people are more affected by them than others (as with most things, reactions are different for everyone.)

Imagine the shape I was in at the end of two hours of steroid inhalation treatments. I couldn't stay still. I had a twitch in my leg. My hands were shaking. I had energy to burn! BUT…I still couldn't breathe quite right.

After about three to four hours in the ER, they gave me an option.

**People. Take a moment here. Remember this. Medical professionals should NOT give you an option if you don't appear to be well enough to leave. I'm not saying you can't leave against medical advice, but it shouldn't be an option you are given if you don't appear to be better.

My options were:  1) take ANOTHER breathing treatment, 2) stay to get admitted, or 3) go home. Guess which option I chose, people. If you went with number 3, you are ahead of the curve. I was jittery. I don't like hospitals on a good day, and I thought it would get better. I wasn't breathing with ease yet, but I thought I'll be better at home. This will work. I'll have meds. I'll rest.

I must have looked like a hot mess when I got off the bed and into a wheelchair to go out to the car. Every person involved in my care in the ER asked me repeatedly "Are you sure? You really want to go home?"

**<DZS> This one's for Papa Richie. He would've appreciated this. I can appreciate it now that I'm able to breathe again. <DZS>=Dorothy Zbornak Stare  (Lord, I miss the Golden Girls!)

Asking someone hyped up like a Meth-head on crack about anything is probably NOT the wisest move on anyone's part. It was especially true in my case. I got in the car with some tightness in my chest. Not much, but enough. We drove home. I thought I'll be fine as long as I can get home. I can rest and the meds can work their magic and it will be SHUPER! Yeah…'bout that. Not so shuper.

We got home; I got worse. Noticeably worse. I had my inhaler in my hand again. It wasn't working. I probably was working on a nice fat overdose on all these meds. I'm not positive. What I do know is the prescription says two puffs every four hours as needed. If I hit it once, I hit it thirty times in the twenty to forty minutes we were home with me vacillating between going back to the hospital and staying home.

**Once again, people. If you find yourself in a situation where you are having difficulty breathing, don't wait. Don't question it. Just go. Get checked. Be seen. And for the love of all that might be reasonably holy…DON'T GO HOME if you are given an option to stay and be treated properly.

This second trip to the ER was UNBELIEVABLY difficult.

**Let's jump back once again. (I know…I'm flighty. Don't.Judge. LOL) I'm claustrophobic. Not a little. Not mildly. I'm talking seriously claustrophobic. I will fight to get out of a tight place. Injury to myself and others becomes unimportant when I feel closed in.

Now, imagine riding in the front passenger seat of a 2008 Dodge Charger. The windshield slants in. It feels like a cramped space. You feel like you can't breathe. (Do you see where this is going?) I rolled my window down. I needed to feel the wind in my face. It made the close, cramped car not feel so cramped.

It's probably about twenty minutes from where I live to the opposite side of town where our hospital is located. This trip felt longer than the first one. It wasn't. It just felt like it. This happens when you feel as if you are suffocating.

**Let me take a second here to tell you a little about what happens when you feel like this. You panic. Panic is NEVER a good thing in this circumstance because when you panic, your chest tightens and you can't breathe. Being unable to breathe is already the crux of the problem. We don't need to add to it!

So, I'm fighting wave after wave of panic attacks. I'm talkingto myself to keep from crying, to keep from getting out of the car, to keep my head on straight enough to get back to the hospital where HOPEFULLY they will be able to make me better. (Don't say it…I shoulda stayed. I know. I didn't so here we were for round two of You-can't-breathe-and-you-think-you-are-dying.)

This go-around had me in the waiting room while I gasped like a guppy. I had to wait to be registered. I had to wait to have my vitals checked. I had to wait to have my SpO2 checked.

**Quick note…your SpO2, or your oxygen saturation level, is considered normal if you range between 95-100%. My level was hovering somewhere around 92%. Not good. Or at least, not good for me.

I didn't wait long. I mean, I probably could've been left to flop in the floor since it was an emergency room, but I wasn't whisked away by the lovely people who emerge from the hidden areas of the hospital quickly, either.

They re-registered me. They parked me in the hallway to wait for ER personnel to come retrieve me. They were kind enough to put me in the same room I previously occupied a mere hour, hour and one half earlier.

The FIRST words out of the mouth of the woman who retrieved me were, "(Insert ER nurse's name whom I can't remember) called it. She said you'd be back in about an hour." Turned out, I was going to hear this statement a lot over the next hour.

The doctor said basically the same thing when he came back in. The respiratory therapist practically SANG it when she came in. "I knew you'd be back. I told everybody you would be. You're wheezing so badly, I can hear you from the hallway."

**Now, I'm no expert here. Far from it. BUT if you are in an emergency setting, and you have a patient who sounds so badly with a respiratory distress, do you even offer discharge to this patient? I wouldn't. And don't point out that I'm the one who went home. I know what I did. But I also know, I'm not the trained professional. You OFFER me the option to go home…guess where I'm going.

By this point, it's about 10:45 a.m., and I'm getting hooked back up to every monitor they use in the ER. Heart monitor,SpO2 , BP cuff…the whole 9. As soon as all of these minor details are handled, I'm getting another breathing treatment. This one is supposedly the crème de la crème of breathing treatments because it's only a ten minute treatment. Anybody wanna guess what didn't work?

**Let's recap real quick. I've had two, hour long breathing treatments and a ten minute breathing treatment. I'm wired for sound. Guess who can't have any more of these types of drugs for several hours. Bingo!

They drew blood. They called my doctor. They waited for the on-call for my doctor to call back. The on-call ordered a CT scan. They waited for the results of said scan. They called the doctor back. The doctor had them call in a pulmonary specialist. They called the specialist. They waited for the specialist to call back. He was briefed. Then a decision was reached.

**Let me put this in perspective…when I went back into the same room in the ER, the clock read 10:45 a.m. When I went upstairs, it was between 7:30 and 8:00 p.m. I had no further breathing treatments in this time. I received no medications of any kind.

I had been given the most medication I could receive at this point. So, I fought my panic attacks, begged to live and not die slowly as I felt may be happening, and tried my damnedest to not fall apart and make my life worse than it was.

Finally, I was admitted. Now, when I tell you I was admitted, I don't mean the put me in the bed and hauled me up to a floor. Oh no. The nurse came in with EVERYONE else on this team, and said, "We're going upstairs to I.C.U., and I need you to get in this bed."

**I couldn't sit in the bed. I felt even worse in the bed. I panicked when I tried. I, instead, decided to sit in the only place available…one of two plastic chairs. I leaned forward with my back straight, hands gripped around the rail of the bed, and my forehead against the pitiful excuse for a mattress while I spent HOURS fighting with myself.

My only response was "I'll try." I stood slowly, making my way to the bed for the trip upstairs. The nurse told me she knew it wasn't going to be easy. She understood, but they got ticky in I.C.U when you brought them patients in wheelchairs.

I made it. Three hallways and a five-floor elevator ride later, I was upstairs with a new team. Two nurses and a respiratory therapist specific to I.C.U. started working on me practically the minute I hit the door.

Apparently, whatever my problem was it needed to be treated aggressively, and they did. About thirty minutes after being moved upstairs, the breathing treatments they were administering began working. Relief at last!

I spent the next seventeen hours in I.C.U. under the constant watchful eye of the very dedicated, very hands-on staff. Around noon on Monday, they unleashed me on the floor. I was going to a regular room. I'm on a critical care floor, similar to a cardiac floor, because of the severe distress I had been in and the extent of the illness I was experiencing.

My diagnosis, according to my pulmonary specialist (whom I love, by the way), has been 1) acute bronchitis with a touch of pneumonia, 2) acute bronchitis with walking pneumonia, and now, 3) acute bronchitis and acute pneumonia.

My butt was SICK! I'm on day five of my hospital stay with the possibility of going home sometime tomorrow. They are attempting to get me back to what is referred to as "base line". This means when I came into the hospital on Sunday, I didn't use oxygen at home on a daily basis, I only had rescue inhalers for emergencies, and my level of health was on the norm for my age.

This is my goal, what I'm aiming for. I'm hoping to go home soon. Hospitals are not fun, but I want to walk out in a better condition than what I walked in with. More later on this whole process as I process it myself.

Until then,

Peace Up!

***Update:  I forgot to mention one thing.  During the 2nd trip to the ER, they also gave me an epinephrine shot after the breathing treatment. They were attempting to reduce the moisture in my lungs. I had too much fluid, or mucus, and this was causing restrictions in my breathing. Needless to say, that didn't help either.