Pushing it

Last time I wrote (far too long ago) I was in the final throes of my children's literature Open University course. I think I was doing the final assignment, but still had the ECA (End of Course Assessment - extended essay thing) to do ... or I might have been doing the ECA. Anyway, either way I was very busy and very tired and my lungs were going downhill. I managed to get both bits of work done, amazingly, although I have no idea how much sense my ECA makes as I was getting more and more poorly as time progressed and it was a real race against time. I didn't think I'd get the ECA done if I'm honest, but I did, and then I filled in an extenuating circumstances form, sent that off (with medical evidence to follow), and then went to hospital. On the Thursday, which I think was 20th May, I had to see my GP for a review of my newish med for the POTS, and he wasn't at all happy with my lungs. He wanted me in hospital that day, but I still had 1200 words of ECA to write at that time so I said that I couldn't go in. This was stupid, but at the time it was all I could think - I had to get the ECA done and sent in or I'd fail the course. Whether it was purely the POTS or a combination of POTS and worsening asthma, by the end of Thursday I couldn't stand up long enough to make a cup of tea without passing out, so things really were miserable and now I can see that they weren't safe either, but at the time I couldn't discern this. Well I got the essay done, and sent it off through the ether at something like 11:30 pm. I should've gone straight to hospital then, but I didn't. I knew that I couldn't go straight to Ward 29 at Freeman at that time of day and I didn't want to go to A&E if I could avoid it, so I hung on until Friday, which was really stupid, and as it turned out Ward 29 didn't have any beds so I had to go to A&E in the end after all. By this time I definitely wasn't thinking straight and was sitting at home wondering how I was going to get to hospital, and even considering going on the bus! Thankfully I had a moment of lucidity when I remembered about the existence of ambulances so called 999 and had the paramedics with me within 10 minutes. When I got to A&E the docs were very worried and I went straight into resus, where the consultant kept saying to the other doctors and nurses around me, 'Be airway alert! Be airway alert! We may lose it without a lot of warning. Be airway alert!' If I'd had the breath and the energy I might have pointed out that I was still conscious and this was doing nothing for my anxiety levels, but I had neither breath nor energy enough so just gasped my way through it as it was ascertained that I was now in respiratory failure with a pO2 of 6 (anything lower than 8 is respiratory failure) and a pCO2 also of 6, which is just about normal, but is not a good sign in conjunction with the low pO2. Basically I was desperately ill, and the docs were sure they were going to have to ventilate. They decided to hold off for half an hour, see if the aminophylline they were starting was going to have any effect, along with back-t0-back nebulisers, then repeat the blood gases and take it from there. In the meantime they decided to put in an arterial line so that they didn't have to keep stabbing me for gases, and I'd need one anyway if I was going to be vented. My arteries are so scarred from having had so many arterial lines that it took an hour to get one in, and ultimately they could only get it in my foot! The hour it took to get in was very hard work breathing wise (and fear wise), but it did give me just long enough for my gases to pick up enough to avoid immediate life support - an obvious relief in many ways, although also difficult as I was so tired I could've done with the rest really. Either way, I was still too poorly to be transferred from A&E to RVI, even to RVI ITU so I went to ITU at the General Hospital, where A&E is. I hadn't been in that ITU as a patient before, and hadn't been in there as a visitor since my close friend Carol died there at the end of 2005. It was difficult going there now as a patient. At least I wasn't in the same bed that Carol had had, although I was in the bed opposite so found myself looking over that way and remembering a lot.

It was touch and go for most of the night whether or not I would need to be vented or have BiPAP, but ultimately I got through without. I was hugely exhausted by the morning and still very poorly, but was able to be transferred to Ward 29 at Freeman by the middle of the afternoon. I'm still on Ward 29. I came off the aminophylline infusion on Friday, which is always a step in the right direction, and although I'm still on the oxygen (4l/m) I'm doing okay. However, for the first time I'm having horrendous problems with water retention. My whole body has been incredibly swollen, stretched, and bloated. For several days my legs were so full of fluid that I could barely bend my knees, and my hips are still incredibly swollen and tender. It's horrible. It's painful. It's been making me very miserable. Over the past few days the docs have prescribed furosemide for me, at first in tablet-form, but then by IV as the tablets weren't doing anything. I am gradually losing the fluid, but I've still a way to go and still very uncomfortable. I haven't had this problem before - a little oedema from inactivity, but nothing anywhere near like this - and I don't know why it's happened this time. I don't know if the docs know either...

Then, just to top things off, last night I asked for the usual evening mug of hot chocolate (the last hot drink of the day at around 8pm is a milky one if you want it :o) ), but instead of the normal Cadbury's drinking chocolate that I'm okay with the student nurse gave me Ovaltine. I took one small sip, realised it wasn't the right stuff and proceeded to have an allergic reaction to the milk powder in the Ovaltine. I'm fine with fresh milk, but milk powder has preservatives in it that I can't have. So had a double dose of two different antihistamines, 2 double-dose nebulisers, and 2 epi-pens, and although I felt rubbish I have survived to tell the tale. The junior doc came to see me while I was in the throes of the reaction, and she called in the registrar, who's a bit of a chocolate teapot doctor so wasn't much use for anything, and the junior then ended up calling ITU just to make them aware of me and my situation, although I was fairly certain by that time that I was going to be okay. I was. The staff kept a close eye on me all through the night, and I made it through, albeit it feeling rotton, and miserable and grotty. I rather suspect that the student nurse spent a lot of the small hours of last night learning about anaphylaxis.

This is not the best start to my summer holidays after a hard 9 months of study.