I've been away. I went for one night to Arnside in Cumbria with W. The plan was to go away on the Friday, spend the night in the youth hostel, and on the Saturday go to South Lakes Animal Park to meet the giraffe that W sponsored for me for my birthday. Although the weather wasn't great we had a lovely drive over Hartside Pass, stopping at the top to picnic in the cafe car park, taking in what we could see of the view over to the Lake District. There's something about W and I that seems to curse the weather, and on almost all of our days out it buckets down with rain, and Friday 8th July was no different, but as ever, we weren't going to let it spoil our fun. Onwards to Arnside.
We arrived at the youth hostel at around 3pm, but couldn't book in until 5pm when reception would be open again, so we went for a wander down the path from the hostel to the 'prommenade'. The grandly named promenade that's actually little more than a small pavement, runs along the edge of the Morcambe Bay estuary with its fast-changing tides and sinking sands. Needless to say, we didn't venture onto the sands, but followed the promenade to the shops on the waterfront, where W bought an ice-cream (actually it was 2, because she had to have one for me as well ;oP ), and I bought a bottle of Peroni for later on as we planned to come back down to the waterfront later to watch the sunset while we had a drink in celebration of W passing her graduate diploma.
Taking a bit of time to relax and get into holiday mode, albeit for only one night, we sat on a damp bench on the 'pier', getting increasingly wet ourselves as the rain clouds rolled in, and we heard thunder rattle off the mountains to the north. After I'd finished nebulising, we decided that maybe it'd be best to go back to the youth hostel and wait inside for reception to re-open, so off we toddled. But it wasn't quite as easy as that, because the path up from the promenade to the youth hostel is really quite steep, and my rubbish old lungs aren't that good at 'steep', so I had to take it slowly, and breathlessly, and getting wetter as the rain got heavier. In the end we both made it up the hill, stumbled out of the rain and waited in the youth hostel kitchen for an hour when reception opened again.
It seemed rather ironic that two severe asthmatics should be allocated a youth hostel room right at the top of the building, but so it was. However, we did appear to have the seven-bedded room to ourselves, and there were great views on two sides of the estuary, so after making up our beds we rested a while, enjoying the views and taking time to relax some more before dinner.
When we went down to make dinner I decided that I'd take things with me to do in the lounge afterwards so that I wouldn't have to climb all the stairs again. So after dinner, W and I sat in the lounge chatting, drinking Peroni (although W had champagne), and doing cross-stitch, while it rained rods outside. It looked as though our plans to watch the sunset by the waterfront weren't going to happen, but then sod it, we decided that we'd go down to the estuary anyway and watch the rain go down instead of the sun.
Back we went down that steep path from the rear of the youth hostel, and along the prom the other way this time, not that we could go very far before the path disappeared into the sand. We saw a couple of herons flying over the sands a little further out, and one flying from the tree tops, and then we realised that the thunder was getting louder, the storms were getting closer, and perhaps it'd be best to go back and dry out.
The path back to the hostel was more of a challenge this time, I think in part because I was tired, and in part because of the muggy, thundery air. It was a real struggle, and I had to stop several times whilst W soldiered on ahead. I could feel my lungs tighten and knew that some serious nebulising was going to have to happen when we got back inside, and indeed, by the time we got into the youth hostel I was wheezing well and knew that I'd be stupid to try to climb the stairs to the dormitory before nebbing, so we went into the lounge instead. Thankfully it was quiet.
I'm more than used to using my nebuliser in public, and it doesn't bother me, but I can't say that I like an audience, especially if I'm feeling ill, which I was beginning to confess to myself that I did. More than anything, though, the overwhelming feeling was one of being pissed off. I had come away for one night of fun and relaxation, and celebration of W's graduate diploma, and to meet a giraffe. How dare my lungs play up now. I was going to neb them into submission. At least, I was going to try to.
An hour and a bit later, with five nebules of salbutamol, 500mcg of ipratropium, and an extra 25mg prednisolone on top of the 60mg I'd already taken in the morning (my current maintenance dose), I was only very slightly better ... or perhaps that should be, only a little less bad. I was struggling and I'd run out of options. W asked if we should go to hospital. Speaking only a word or two at a time, I replied something along the lines of, 'The problem is that I'm in no state to drive, you're not insured to drive my car, and we don't know where A&E is.' Then W pointed out that the NHS have their own transport services, and I realised with an explosion of expletives in my head that I was obviously losing all ability to think clearly - a very bad sign - and that I was most likely not going to meet my giraffe, but instead end up in the back of an ambulance.
W went off to reception to get help. The man sitting on the sofa in the window opposite told me he was a district nurse. He said he was impressed with how I coped with my illness, without a flicker of panic, but my primary reaction being one of pissed off-ness. W came back, closely followed by the First Responder Unit (FRU) paramedic, who W had already genned up with my medical history and the course of the evening's events. The paramedic was lovely, but there was something unconventional about her. I couldn't work out what it was. I sat, breathing in her oxygen-driven nebuliser with a pulse oximeter on my finger, while she asked W to phone ambulance control to make sure an ambulance was on its way, when it struck me - although the FRU paramedic had on her shiny, hi-vis, paramedic jacket, underneath that she was wearing pyjamas! This was rural ambulancing, and she'd obviously been tucked up in bed when the emergency call had come through. Bless her.
It was only a matter of five minutes or so before the paramedics arrived with an ambulance, into which I was quickly bundled. They tried to get a cannula in, but my veins are so buggered from all the cannulations over the years (hence my portacath, but you have to be trained to use it) that they didn't have any success. Instead of IV hydrocortisone, I was given an IM dose instead and then whizzed at great speed on sirens and blue lights along the country roads, and down the M6 to Lancaster, where upon I found myself in the A&E department of the Royal Lancaster Infirmary (RLI).
The doctor I saw in A&E seemed rather scared, not terribly confident, but also reluctant to ask any seniors to get involved. He did okay, overall, although didn't actually get me any better in the three hours I was under his care. To be fair, though, he did take on board my treatment protocol from my consultant that I carry with me, and he started the aminophylline infusion before sending me off to the Medical Admissions Unit (MAU).
I have to say that I was impressed with how they dealt with me in MAU, and also with how they treated W. I was seen quickly by the junior doctor, who soon realised that he was going to need advice from his senior so got the registrar (SpR). The SpR was a lovely man - ever so gentle - who made sure that W was okay, and asked if she had any questions. He also recognised that I know my disease better than they do, and that W also knows how things go for me with attacks too, so he regularly checked in with us to see how we thought things were going. He was also quick to get ITU on the case, and they were quick to assess that I needed BiPAP and transfer to ITU. I definitely wasn't going to meet my giraffe.
W had work the following day so had to get back to Gateshead. This meant that she'd first have to find her way from Lancaster back to Arnside, where they youth hostel team would hopefully let her get some sleep before booking out and trying to find her way from Arnside to Newcastle, where she'd left her car outside my flat. Loathed as she was to leave me, she had to, and it was only a little while after she left that I was transferred to ITU.
The care I received in ITU was great. They were lovely. They were on the ball. The consultant (Dr W) who was on over the weekend happened not only to be an ITU consultant, but also a respiratory consultant, and he was fantastic. He immediately liaised with my care team here in Newcastle, and I had absolute confidence that I was very capable hands. I stayed on BiPAP for about thirty six hours, and in ITU for four days before I was well enough to be moved to the respiratory ward, but Dr W said that he was more than happy to keep me under his care whilst I was in the hospital, given how ill I had been and how complicated, difficult and brittle my asthma is. I think this was something of a relief to the doctors on the resp ward.
I'll blog more about the resp ward in my next post, but I'll leave this here for now.