Well I lasted about an hour after my last post before I really couldn't do anything except press my community care alarm for help. I did actually phone ward 29 at Freeman (my second home) first, but they had no beds so I knew that I'd have to go to A&E and then end up in the RVI, which isn't my favourite hospital in the world. Consequently I sat at home that little bit longer battling with myself about whether or not to hold on and see if I could last until the next day when ward 29 might have a bed, or if I'd be better off going to A&E all the same. Ultimately my choice was made by my peak flow becoming unrecordable (the lowest on the meter is 60 and I couldn't get that), so I contacted my friend W who was kind of expecting to hear that I was going in, and she met me at A&E. She actually got to A&E before me, because the ambulance took a little longer than usual to get to me and then they spent a bit of time trying to get me breathing a bit better before we set off. It was to no avail though, so I had a rather speedy, blue light trip to A&E, where the medics were all ready and waiting for me. The doc I saw was nice enough, cheery and had a fairly good bedside manner, but he was a bit remiss in forgetting to do any blood gases, and only remembering to get a chest x-ray as the paramedics were waiting to transfer me from A&E at the General to the Emergency Admissions Unit at RVI. Oops. It also wasn't great that he had a medical student try to get venous access in me, as my veins are so damaged and scarred from overuse that even the most experienced doctors have trouble getting access, and any veins I do have left need to be treated very gently so that they don't get damaged too quickly. Needless to say, the medical student wasn't successful, another vein was knacked (not her fault, just lack of experience) and the doc had to step in and give it a go so that they could give me the aminophylline I needed, but couldn't have until venous access was achieved.
After a while I was transferred, again by blue light ambulance, to EAU at RVI, where I was successfully ignored for quite some time (they're too busy there and not terribly organised so that everyone seems to be doing the same thing, meaning that not everything is done). The doc there did do my gases though, which he wasn't terribly impressed with so the anaesthetic team was called and I ended up on the High Dependency Unit again. Thankfully, one of the SpRs was someone I knew very well from her year spent working on ward 29 at Freeman, so I felt safe enough while she was there and knew that she knew what I needed and would give it to me. This is always a concern as I've had one or two experiences of 'doctor knows best' in which doctor didn't know best and I've ended up much more poorly than I would've done if they'd just done what I told them needed to be done. Ach well, such is life.
Sometime around 4.30am/5am things began to settle a little bit, so that by 4pm the following day I was well enough to be transferred to ward 29 at Freeman (they had a bed by this time), although I was still struggling and far from well. The problem was getting an ambulance as the city had been hit by a sudden onslaught of snow, and the hospitals had apparently received telephone calls from the met office giving severe weather warnings! Anyway, an ambulance eventually got through the snow and after a rather slippery journey across the city I arrived at my second home where I eventually managed to get my breath a bit better after several more hours of trying. Then I fell into that ever-welcome, all-consuming sleep that is restorative, yet somehow exhausting ... I'm not sure how that works, but it's how it feels.
There were one or two hairy moments when we lost venous access again, and on one particular occasion there was a real question of how they were going to get it back, because all my veins were either hiding or collapsing. I still needed the aminophylline infusion so it was imperative that a vein be found, and eventually one in my foot made an appearance long enough to be spotted, stabbed and maintained. Feet really don't like have needles in them, and it doesn't make standing easy (I wasn't doing much standing, but a certain amount is required to get onto a commode), but it's better to have a slightly sore foot than to be dead or not far off dead.
I seemed to need the aminophylline for quite a long time this time round, and was on it for about 7 or 8 days. I've had some difficulties with coming off IV aminophylline and onto oral theophylline before so it can be a rather anxious time trying to swap over, but thankfully there weren't any hitches this time and it all went smoothly. I came off the oxygen on Friday morning, and managed to get home yesterday afternoon.
I usually have a day or two in hospital when I feel a little overcome emotionally and have a bit cry. It didn't happen this time, but seems to be catching up with me today. I know it's just the fear of the attack catching up with me, and that I'll be fine tomorrow or the next day, but it puzzles me why it's come later than usual this time. I won't bother analysing it - it's not worth it - but it's curious. Anyway, I'll go to church this evening and I'm sure I'll feel better for seeing people.
It's so good to be home, but however many times I go through this it never stops surprising me just how exhausting it is to suddenly have to do everything for myself again. When I'm in hospital I don't have to do anything, so it's quite easy to think that I'll be perfectly fine when I'm home, which I am, except that even getting up to make a cup of tea is something I haven't had to do for 11 days and it takes more energy than I anticipate. I'll get my energy back eventually, but for now I'm just enjoying being home, being with the cat and having my own things around me again.