Failing to be Boring

Since being pronounced the "most boring patient" just under two weeks ago, I have had three separate bouts of nausea+vomiting+diarrhea. Last night, after a really good day, during which I even mixed a little jogging into my morning walk, was the most draining (literally and figuratively) of the three. Around 2:00 a.m., I started having a new additional symptom — shakes and chills — so we called my doctor.

We discussed going to the local ER vs. driving up to Chicago. My past experiences with ERs is that you often wait a very long time to be seen, unless you're bleeding heavily. I thought the odds were good that I could get to Chicago in less time than it would take to be seen locally, and then I would still need to be transported to Chicago. The doctor called the ER in Chicago so that they were expecting me. Jan called our friend Bonnie to ride up with us, and the two of them split the driving.

We checked into the ER in Chicago around 5:00 a.m. Initially we were given the impression that they would start some treatments in the ER (like IV drips to re-hydrate me and provide additional antibiotics) and that I would shortly be admitted back to the sixth floor. As the morning dragged on, we learned that there was not currently an available bed up on the floor I would be heading to. The ER nurse recounted a cautionary tale of a patient warehoused in the ER for five days while waiting for a room.

Around 7:00, the blood cancer fellow comes by doing his rounds. He tells me there will be a bunch tests to look for infection, but I might also get scoped, from both ends. And don't eat anything for now, because the GI doc may decide now is a good time to take a peek (I'm already empty). The fellow has blood test results from blood taken shortly after my arrival. Good counts! My platelets are at 130, which is higher than they have been since I was diagnosed with aplastic anemia six-plus years ago. My white counts are also very good, with hemoglobin lagging but still good enough.

There's less privacy in the ER than there is on the blood cancer floor, where each patient gets his or her own room. The ER is more similar to a cube farm. Each "room" is a (fairly large) curtained space, which means you hear what's happening on nearby beds. There's the woman from Puerto Rico who can't breathe or communicate in English. (Fortunately, at least one of the doctors speaks passable Spanish.) There's the man with some excruciating pain, leading to over an hour of "ohhh... ohhh... ohhh... OHHH... ohhh... oh, God... ohhh... ohhh... ohhh... ohhh... Jesus!... ohhh... ohhh...." It could be the soundtrack for a particularly unimaginative porn flick. After an hour, he receives some pain relief, and a few hours later, I see him walking out a much happier man.

The attending comes down to visit. As he puts it: the number one suspect for my symptoms is an infection, the number two suspect is an infection, and the number three suspect is an infection. So they will initially focus their attention on getting some cultures (blood, stool) to look for infection. There are several types of infection, not based in the intestines, that can cause the on-again off-again pattern I have been experiencing. Or, it could be something intestinal. He does not think it is graft-vs-host disease, because of the pattern.

I get cleared to eat, since the attending does not think any scoping is in order at this time. I start thinking about what I would order of the menu that I have memorized from my previous stay, but it turns out to be a waste of time. In the ER, they decide what you want to eat and when. For a patient in the hospital because of nausea and vomiting, this seems like an approach sure to fail to supply adequate nutrition. Of the lunch that is delivered, the only food I feel like eating is the tomato soup and the crackers. I supplement later with more crackers and some ginger ale.

Back to privacy: I have an 8-foot curtain at the front of my space. Unfortunately, the front opening is 10 feet wide, leaving me 20% exposed when peeing into a handheld urinal. Oh, well.

I take a nap. The mattress is nice and firm, but there are no pillows in the ER. They earlier brought me some extra blankets, folded up to form a "pillow" slightly softer than a log.

At 5:30, my dinner  arrives! They have decided I would like roast turkey, dressing, french fries,  cooked carrots, salad, applesauce, milk, and decaf coffee. I hope they're right... but they're mostly wrong. I have a little turkey, a little dressing, a few fries, a little applesauce. Then I hear I've got a room to move into, so I stop eating, figuring I can order what I want when I get up there.

At 7:00 p.m., I get transported to my old stomping grounds. It's one of the medium-sized rooms -- not palatial like my last one, not claustrophobic like one I spent a few weeks in. It will be fine for what I hope is a stay lasting only several days.

My nurse and NSA remember me from my earlier nine-week stay. Around 7:30, I place an order for some bland food: baked fish, plain noodles, canned pears, ginger ale. A mere 2 hours later, my order arrives. I pass on the fish, since I don't know that it hasn't been floating around the hospital for two hours. At least the noodles with parmesan hit the spot.

And then, after an intake interview with nurse and my nighttime meds, it's time for bed.