A favourite quote and a way by which to approach life.

Today is the tomorrow that you worried about yesterday.

Monday, 19 November 2007

What a 'nana

There has been rather a long time between postings, so apologies for that, though it has been unavoidable.

As an asthmatic, Guy Fawkes Night is always something of a hazard with the fireworks and bonfire smoke-filled air, but I try not to let it rule my life and go out to events with caution. This year (on 5th November) a friend was having a small gathering at her house in Gateshead – just across the river from Newcastle where I live – where we were to meet, then head up to the local park to watch the fireworks display, before going back to Caroline’s for homemade soup and rice pudding. I survived the walk to the park, the fireworks, the bonfire smoke-filled air and the walk back. I survived the soup that Caroline and Andy had made especially for me, catering for my stupidly long list of severe allergies. I was slain by a sip of Sainsbury’s Tropical Fruit Juice. I can’t have juice made from concentrate, and I was so excited by the fact that all four of the juices Caroline had were 100% not from concentrate, that I forgot to concentrate myself and didn’t look to check the ingredients. I wasn’t expecting a fruit juice to have banana in it so was dismayed when I tasted its distinctive flavour in the small sip of the drink I had. I immediately loaded myself up with double doses of two antihistamines, but the tingling lips and fizzy tongue had already started. I took myself off to the bathroom where I was promptly sick, and I could feel my mouth and throat begin to swell. One of my friends, Katherine, came in to see how I was, bringing my EpiPens with her and I quickly stabbed myself with the first. Too late though and I knew that I had to get to hospital, but I also needed just to get away from the rest of the group, because it’s really no fun being watched in horror and fear as you get increasingly unwell. Katherine and Georgina took me down to my car and we set off for the hospital (G drove, not me!). This would’ve been a better plan if any of us had known where the hospital in Gateshead is, but we didn’t and I was getting worse, with my breathing becoming more laboured by the minute. G decided to pull over at a T-junction where there were two clear road signs, K called for the ambulance, and I stabbed myself with my second EpiPen. I have to say that I was very impressed with the speed of the paramedics and we only had to wait about 5 minutes, if that, before they arrived. They were then very good with me, taking full note of all my allergies and medication and treatment protocol, all of which I keep with me on laminated cards so that I don’t have to try to explain it all when I can’t breathe. After several attempts at getting a cannula (needle) in, but failing in part because I was shutting down and in part because my veins are so scarred from over-use, they gave up and whisked me off to the QE hospital in Gateshead. Thankfully, unlike us, they knew where they were going.

The A&E staff were ready and waiting for me in resus with their anaphylaxis kit out and nebulisers at the ready, though I’d already had two more shots of adrenaline and nebs in the ambulance. Unfortunately my breathing was still going downhill and my tongue and throat were still swelling so I was very quickly seen by the intensive care team. Again I was impressed by how attentive all in A&E were to my treatment protocol etc, and how much they asked me what helps in these situations, thereby recognising that I live with this all the time and have a lot of experience of managing it (not all medics/hospitals/places I’ve landed have been like this and it is a very frightening experience). It took the medics in A&E a long while to get any venous access too, but they did eventually succeed and were able to give me the IV steroids I needed and the aminophylline drip that usually helps my lungs. The swelling of my mouth and throat eventually began to subside, but the anaphylaxis had set off my asthma in big style and this wasn’t abating to any degree so I was taken up to intensive care. They explained that they didn’t want to ventilate me if they could avoid it, but that they may have to if things didn’t improve or if I became very tired, which is good because I’ve been ventilated five times and hate it ... understandably. However, things didn’t pick up and I was becoming exhausted so one of the docs got all the intubation kit out and drew up all the drugs to put me to sleep, whilst another one tried to get a second cannula in me so that they had enough venous access to get the drugs into me. He had about 20 goes all together but couldn’t, however hard he tried, get one in. They abandoned ventilation and instead looked at each other, looked at me, and looked scared. This is never good. I knew that all I could do was to battle on with what little energy I had left and concentrate on getting every breath in and then out as best as I could. I was scared. I was beyond exhaustion. I was desperate to give up, but I knew that if I did then I would die. Eventually, somehow, I came through the worst of it, though not without the medics trying again to get another cannula in to put me to sleep for venting. I could’ve cried. It had all started around 9:15pm and it didn’t begin to settle until lunch time the following day. It is like running at full speed up a mountain, whilst breathing through a straw filled with foam, and unable to stop at any point for a rest or replenishing of energy reserves.

I stayed in ITU at the QE until Friday 9th November when I was transferred to my usual ward at my usual hospital (Ward 29 at Freeman Hospital, Newcastle). All at the QE had been great and treated me very well, but it is always a relief to be back where they know me and I don’t have to do any explaining, and they know how quickly things can go spectacularly wrong with me. Indeed, in the early hours of Saturday – 5:30am – it all went horribly pear-shaped again and I was back to square one with the asthma. The Freeman’s ITU team came up to see me, and they wanted to take me downstairs to be with them, but there were no ITU or HDU beds at all so they got the outreach team to HDU me up on the ward, which was a new experience for all involved. Again it was another long hard battle, with the Carbon Dioxide levels in my blood (pCO2) going stupidly high, which is a bad sign, and I wondered if I was going to end up being vented, but at last, at around 1:30am on Sunday it broke and settled. Aching from the effort of trying to breathe, utterly worn out by the huge set-back on top of the exhaustion from the anaphylaxis/asthma attack earlier in the week, I collapsed into sleep. I do Olympic sleeping after bad attacks (I call it The Big Sleep stage), and this time slept from the early hours of Sunday until Tuesday evening. Even after The Big Sleep it takes more time to recover more fully and for my oxygen levels to pick up, and it’s usually not until after The Big Sleep that they try to start weaning down the aminophylline as I have frequently gone splat during the weaning process in the past. Come Thursday afternoon though the aminophylline was successfully down, and by Sunday we’d managed to get me off the supplemental oxygen all together. It’s Monday evening now and I’ve just got home. How lovely it is to be back in the land of the living.

1 comment:

Emily H said...

Hi Becky,

So glad you're home - enjoy your bed and your cat!

Talk soon

Love Em H xxx