I am alive. This wasn’t wholly expected last week and I nearly didn’t make it through.
After my last post I did make it to 8:30am (just about) and called the GP surgery. I managed to gasp down the phone to Michelle, one of the receptionists I know well, that I needed to see a doctor and would it be possible to be seen almost immediately. She said I would but was I well enough to go to the surgery. Well no, I wasn’t, but as you will know from my last post I lost all ability to make sensible judgements so I said I would get there, and I did ... but I walked! It can only have been through the grace of God that I got there without collapsing. I arrived. I waited. Michelle came through to say that Dr Cn (the emergency doc for that day) hadn’t come in yet and asked me if I wanted her to phone him. I managed to gasp, ‘Anyone. I don’t care who.’ Within minutes Dr Cg called me through. I was barely able to make it down the corridor by this time, but somehow managed to get to Cn’s room where Dr Cg was seeing me. Dr Cg looked aghast at my state and immediately said I was going to hospital, which shouldn’t have been a surprise to me, but for some reason it was. He listened to my lungs, took my pulse, dashed out of the room and came back very quickly with a bottle of oxygen, which he then plugged me into. Dr Cn arrived, apologised, glanced at me, and looked scared. Dr Cg looked scared back at him and then said, ‘No breath sounds. Weak pulse.’ I was left in Dr Cn’s capable hands ... not that there was much he could do. He too said there was no doubt that I was going to hospital, and although I was completely unable to speak by this time I managed to communicate through writing that I wanted only to go to Ward 29 at the Freeman, and that I’d had some bad experiences at A&E in the past, although at this time I was unable to explain what they were. He rang the ward. They had no beds. I was going to have to go to A&E. He called the paramedics and in the 5 minutes or so that it took them to arrive I told Dr Cn (again through writing) that I was scared; that I was always scared when I had an attack and that I never got used to being so close to my mortality. He didn’t try to avoid it or say it’d all be okay. Instead I saw the reality of it sink into his consciousness and he just said, ‘Yes.’ I am hugely grateful to him for that, because all too often people can’t cope with my fear, probably because it makes them consider their own mortality, and they try to squash it. Allowing me to say I was scared helped me to feel not quite so alone.
The paramedics arrived while I was texting family and some friends to tell them what was happening. Despite not having a working car, and having just finished a night shift, W said she was on her way to meet me at A&E. And while I was being whisked out of the surgery by the paramedics Dr Cn rang A&E to tell them I was on my way but that I didn’t like it there and was anxious about how I might be treated so please treat me well. That was so lovely of him, and I think it really helped.
When in the ambulance the paramedic gave me a shot of adrenaline to try to help things, then tried to get a cannula in, but my veins are so knacked that he didn’t manage and he didn’t want to hang around too long, so we set off with lights and sirens and the paramedic (I think he was called Brian) called through to A&E to prepare them for my arrival, giving an ETA of 5 minutes, which is pretty damn quick for around 5 miles through the city! When we arrived at A&E W had also just arrived and she met me at the ambulance door, having heard the sound of the nebuliser and guessing it was me. W followed as I was rushed into resus where a team of medics and nurses were waiting for me, and there started the desperate fight to save my life, which was ebbing from me. I have relatively patchy memories of events in resus, although more is coming back to me with time, and it’s helped to talk it through with W too who stayed with me the whole time (bless her, she’s been utterly amazing this past week and a bit). I know that when I arrived they weren’t able to get a blood pressure from me until they’d pumped a load of fluids into my veins at great speed, using a pressure bag on the bag of Hartmann’s Solution. I remember having blood gases done, and I know it was more than once, but not how many times. I remember having the aminophylline and salbutamol infusions put up. I remember them putting an arterial line in, and I remember them talking about intubation and getting all the drugs and tubes together for that. Thankfully I managed to avoid intubation ventilation, but they did put me on BiPAP – a kind of non-invasive ventilation (NIV). This isn’t a usual course of action for ventilation of asthmatics, but the ITU consultant anaesthetist who came to see me in A&E wanted to try it first as there are significant risks of intubation, which includes the risk of the tube aggravating the lungs and thus causing difficulties with coming off the ventilator. I was also very keen to avoid intubation if possible, and was relieved to find the BiPAP did help. I still certainly had to work very hard, and the pressures were relatively high (so I’m told), but any relief was better than none, and I became a bit more alert fairly quickly. The anaesthetist did say that intubation was a judgement call that ultimately they would have to make and that although there were risks with it, there were also risks with avoiding it, so at the end of the day if they felt they needed to put me to sleep then they would. Then we had to wait to see if I would improve enough to be shipped across the city to RVI ITU/HDU, or if I’d have to stay at the General Hospital (NGH) ITU. I really didn’t want that, because the last time I was there was when they turned off my best friend’s life support machine 3 years ago. Thankfully I did improve just enough for transfer, although the ITU SpR (registrar – one doc below consultant) came with me in the ambulance, bringing with him all the intubation equipment and meds in case of any deterioration. And the last thing the ITU consultant said to me was, ‘All the best. I hope you get through this one.’ I knew what trouble I was in, but that was an indicator of how much trouble he knew me to be in as well. Not easy to hear, but I respect him more for his honesty.
I stayed on BiPAP for 24 hours and in ITU/HDU for 48 hours ... or maybe it was longer ... I don’t really remember, but I was very keen to get over to Freeman Hospital Ward 29 as soon as possible. In part this was because Ward 29 is like a second home and I know that I’m in excellent hands, but also because RVI haven’t always been very good at checking on things I’m allergic to, and I’ve had some close calls in other aspects of treatment at times, so I feel like I always have to be on my guard when I’m there. Of course I had to be well enough to leave critical care first, but I did eventually make it over to Ward 29, and I’m still there now. It turns out that in addition to the asthma I also have a ‘heavy growth’ MRSA chest infection, which has been causing me to cough up some thick blood. My haemoglobin levels are on the low side too, which may have been caused by the MRSA infection, but the docs aren’t completely sure yet so they’re keeping an eye on that aspect of things too.
It’s been a very rough ride this one, and I’m only just beginning to get my energy back. I’m on antibiotics (doxycycline) for the infection and after a few doses of that I started to feel a bit more like myself, even if still rather wiped out. Given the time I’ve had, and the all too close call with death, it’s not surprising I’m exhausted, and the doctors keep reminding me of that. It’s good to feel like I’m starting to make more progress now, even if I do still have a way to go, and it’s very good to be alive.