Yup, it all went pear-shaped and the day after my last entry I ended up back in hospital. To be honest, I wasn't feeling dreadfully awful most of that day ... just pretty rubbish, but I was short of breath and did have some pain in the base of my right lung, which I thought may have been infection. Since the previous week I'd been planning to meet up with one of my OU friends and his wife for lunch on the day that ultimately went pear-shaped, and I managed to convince myself that I was okay to do this. Actually, I felt quite ill in a general 'I think I've got an infection and my temperature is a bit variable' kind of a way, but I enjoyed meeting up with D and his wife C and we had a lovely lunch down at Peppy's. However, once we'd 'done' lunch and they'd headed off back home after a short stop at my flat before going, I flopped and I gave into the 'I'm not well' thing that my body was telling me. I called the doctors' surgery to see if by any slim chance they might have a free appointment, but was 99.9% sure that they wouldn't as it's usually a case of having to ring up at 8:30am for an appointment and they're all taken by 8:31am. It being around 2pm, I wasn't surprised when the receptionist said that they didn't have any appointments other than emergency ones, so it was either take one of them or go to the walk-in centre. I um-ed and ahh-ed, saying (in part sentences, because I couldn't actually breathe enough to speak in full sentences - oops) that I didn't think it really was an emergency, but I was short of breath, had some pain in my lung, thought I might have an infection, but didn't think it warranted taking an emergency appointment ... on the other hand, with my medical history I wanted to see a doctor who knew me, rather than a random one at the walk-in centre. In the end I asked if it'd be okay if I took the emergency appointment for 5:30pm, and was immediately told, very warmly, that of course it was okay and not to be daft :o) End of call ... except that five minutes later the receptionist phoned back to say that she'd spoken to the doctor, explained what I'd told her and he'd said he wanted to see me straight away, rather than waiting until 5:30pm. Clearly we have different ideas of what constitutes an emergency ... or maybe it's that my emergencies tend to be critical situations these days. Anyway, feeling a little surprised by this turn of events, I put on my coat, picked up my bag, gave the cat a quick stroke and set out to the doctors' surgery. Now the surgery is only four parallel streets away, but I had to keep stopping to get my breath so it took longer than usual and more energy than usual to get there, but in the end I did and the receptionist on the front desk had been forewarned of my arrival and instructed to tell the doctor as soon as I arrived. He had someone in with him when I got there, but I only had to wait five minutes or so before I was called in.
The walk to the surgery (no, for some stupid reason I didn't use Taz to get there. Don't ask me why - I have no clue) had not only made me feel more unwell, but also made me realise that I wasn't well, so that by the time I got to see the doc I felt quite lousy. At this point I still didn't consider myself to be in a state of emergency, but the doc wasn't so convinced. He got me to do a peak flow and wasn't impressed with my grand score of 80. Actually, I was surprised by this as only an hour before hand it had been 130 (still completely rubbish, but a whole 50 better than it was by now), and I'd had a nebuliser since then too. Oops. He looked at me and said, 'For any other 'normal' asthmatic I'd expect them to be on the floor with a peak flow of 80. Can I listen to your lungs?' He did. His response to having listened to them was, 'Hmm, well I can sort of hear some air in the top of your lungs, but nothing in the bases.' Bugger. I knew it was coming - I knew he was going to send me to hospital - though he did first ask how I felt about it. I said that I had too much work (study) to do to be going into hospital, which prompted a somewhat incredulous and exasperated look of despair on the doc's face, and with that he rang my consultant at the hospital. During their brief conversation I could actually feel my lungs getting tighter and knew that I was now heading downhill rapidly. All of a sudden I didn't feel so bad at having taken an emergency appointment. Despite all this, I can't deny that I was disappointed at the docs' joint decision that I should get to hospital asap, so with a quick check that Ward 29 had a bed, a blue-light ambulance was called.
Usually when I'm ill enough at the doctors' to need an ambulance then I'm kept in the room with the doc or with one of the nurses, but for some reason on this occasion I was to go and sit back in the waiting room for the ambulance. A little irregular, but I didn't think much about it and started my breathless trek the twenty yards up the corridor ... in stages, like an expedition up Everest. I was on the third or fourth leg of my assent up the hall when I saw the FRU paramedic at the front desk asking where he could find me, and I heard the receptionist say that she thought I was in room 5 (where, indeed, I had been). I raised my hand and said as best as I could, 'I'm here.' To say that the paramedic looked aghast would be putting it mildly. He took hold of me, said, 'Bless you, you're really tight there,' and then turned to the receptionist saying that we needed a room now. There's a treatment room just off the waiting room/area that's used by the district nurse etc and this was immediately unlocked for our use, so I was guided into there, sat on a chair, and supplied with oxygen while the lovely paramedic called Dave (so his uniform told me) got a nebuliser sorted for me. During this time the ambulance crew arrived, and were shown in, whereupon Dave told them how he'd found me struggling up the corridor on my own even though I was clearly very ill. I could see their point, but I have to say that on the whole my GP practice are superb, and this is one slip in years of fantastic care from them so I don't hold a grudge.
Anyway, they got my history from a combination of a print out sheet (or four) the doc had handed me to give to them; all my cards and laminated letters; and an increasingly breathless conversation/gasping of words. Dave was pretty keen to get some hydrocortisone into me, but this required a cannula and after two attempts he'd had no luck so instead he and the ambulance crew decided just to get me into the ambulance and on my way to the Freeman Hospital. Once in the ambulance, he actually tried to cannulate me a further three times, but my veins are so over-used and scarred from hundreds of past cannulations that it's not at all easy to get venous access in me these days, which I have to say is something of a concern. There was no success in the cannulation department so we sped off up to the hospital, Dave having left his FRU car outside the GP surgery so that he could accompany me in the ambulance as he 'didn't trust [me] not to go off.'
On arrival I found my consultant had come up to the ward to see me as I came in (very nice of him, I thought ... though also rather an indicator of what shape he thought I was in). The ambulance crew and Paramedic Dave handed me over to the nursing staff, and then there was the swarm of medics ranging from F1 (previously known as House Officers) to consultant with everything in between, all of whom were desperate to get a cannula into me. I had an F2 at my left hand, an SpR (registrar) at my right hand, and the consultant at my feet, and a small cheer went up when the SpR (S, as there was more than one SpR there - also V, Re and Ri) eventually got access in my right wrist. Then it was time for blood gases (horrid things), followed by a quick injection of hydrocortisone before my usual aminophylline infusion was started, and the ITU team were called to come and see me.
It was a fight. It was exhausting. I went into acidosis - both metabolic and respiratory, so I was told. I did something new too - I managed to get dangerously dehydrated, which was all a bit weird, and I ended up needing so much IV fluids that they called it 'resuscitation'. I'm not quite sure how, but some how I managed, by the skin of my teeth, to avoid going down to ITU, although the anaesthetist was up to see me four times in the first night alone, so it really was a close call. After about 38 hours or so things started to settle and they all got ever so excited when I finally had enough breath to create a small wheeze, as up until this time I'd had a silent chest. Some time after that I finally had enough breath to sleep, and sleep is something I do very well after a long exhausting battle with asthma, so I stayed asleep (being half-woken briefly and intermittently for nebulisers to be given, bloods to be taken and gases to be checked) for 48 hours. It took a long while for me to get through the sleepy stage this time, and although I was more awake than I had been after this initial 48 hour sleep, I remained very sleepy-tired for a number days. It also seemed to take longer than usual for things to really settle, which is most likely why I was still so tired I guess, and I ended up needing to stay on the aminophylline for eight days, when I'm usually on it for more like four or five. I don't know why this is - whether it was just this particular attack, whether it was down to how acidotic I got, whether it was the queried infection (as indicated as a possibility from my blood tests, though my x-ray was clear for infection), or if it's just that I'm getting older and recovery is slower. Whatever the reason, it took time for me to get my bounce back, but eventually it returned and I was well enough to resume my study worries. I actually ended up writing my final assignment for English Literature course whilst in hospital this week, at a point where I was still on the aminophylline infusion and on oxygen! I'm not sure if that's dedication, foolishness or the effects of hypoxia ;oP
I finally got home yesterday mid-afternoon, although this wasn't without it's complications. Sometime earlier in the week my dad had visited and had brought with him my foldy-uppy wheelchair (not Taz, the other one) so that he could take me for a trundle in the park over the road from the hospital :o) Now there isn't usually any problem whatsoever about getting me, my stuff and my foldy-uppy wheelchair back home from hospital, but most bizarrely there seems to exist such a thing as an ambulance that doesn't take wheelchairs! Excuse me, but huh?! I've got foldy-uppy w/c in a micra before, so how come it doesn't fit into an ambulance? It was all very weird, but the guy who initially came to take me home insisted that this was the case so went away again without me :o( This meant that my ambulance home had to be re-booked for the afternoon (I'd previously been told to be ready to leave at any time from 9:30am) and that I was put on the bottom of the list :o( However, a nice guy with an ambulance that did take wheelchairs came fairly quickly, picked me up, brought me home, carried all my bags into my flat and left me with a smile :o)
Home at last :o)
(Oh, and I've lost any trace of guilt I had about taking that emergency appointment at the GP surgery)