Sunday, January 16, 2011

Bad Ideas

Well, I've been a little quiet lately. I'm laying low because I've been a wee bit indisposed.

It all started so innocently. I got this cold. A little tiny cold. The wimpiest cold ever. No big. But then, I made a mistake. A Very Bad Mistake.

See, I posted on FaceBook that I had the wimpiest cold ever. In effect, I laughed at it. I gave it a virtual raspberry. I might as well have waved my metaphorical private parts at its aunties (silly English ka-nnnigit... with apologies to Monty Python and the Holy Grail.) Ultimately, it boils down to this: I taunted the virus.

Never taunt the virus.

Thing is, if you taunt the virus, it goes, "Oh, yeah?" and then it calls in reinforcements in the form of a secondary bacterial bronchopneumonia. And having pneumonia of any form, let me tell you, is a Bad Idea.

It's not my first round with pneumonia. I had it when I was an intern. I worked every day for a month with it. This also: Bad Idea. However, I was in a seven-intern program and we'd already lost two: One had broken her leg whilst cowboy dancing (no one could say she wasn't enthusiastic) and the other had wrecked her motorcycle. Five interns can (with great difficulty) do seven interns' work. Four interns can't. I knew if I went down the whole house of cards was going down with me. I wasn't going to do that to my intern mates. So, I lay on my side at night, feeling the secretions rolling down my airways, and then I coughed and coughed until I cleared them out. Then I rolled to my other side and did it again. I started on antibiotics and I got up in the mornings and I went to work. I also developed an interesting drug eruption as a result of an allergy to the antibiotic, but that's another story. But I got through it, my injured intern mates recovered and returned to work (one of them in a wheelchair at first), and I gradually got better. The intern program returned to full strength (for a while, anyway, until one of the interns left to give birth slightly prematurely - some people will do ANYthing to get out of their intern presentation! - and another had to leave the program for personal reasons.)

However, the entire experience left an indelible impression on me. Coughing your brains out for a month will do that to you. Go figure.

Which is how I knew, four days after the wimpy cold had started, that I was heading into Big Trouble. One day I was fine - mild sore throat, no cough, a little stuffy, a little blah. The next day I started coughing. Still no big, not much coughing. Par for the course. The next day, like a fool, I posted the wimpy cold status on FB.

Day after that, coughing a little heavier. By that night, it was kicking my ass. But I was off the next day; I figured I'd sleep it off. Still no big. Except that by the evening of the following day I Could. Not. Breathe.

If I concentrated hard I could draw a full breath, but I was drawing it against resistance, and it took effort to exhale. This - slow, deep respirations with effort - is an obstructive pattern, which indicates airway narrowing. A rapid, shallow pattern would indicate restriction, such as would occur with air or fluid inside the chest, anything compressing the lung tissue. But I couldn't tolerate any compression of my chest - not leaning back against the pillow, not laying down - and I had to concentrate on every breath. I didn't need a stethoscope to hear the crackles and rales in my chest. I could hear them just fine without (and feel them even better).

Okey-dokey. Time for a pulse-ox, and I may be heading to the people hospital to admit myself.

I struggled into clothes and tottered down to my truck. It was cold and the wind was absolutely howling - gusts into the 70 mph range. I warmed my truck up for 10 minutes - it took that length of time to recover from the trip down there, anyway - and I drove to work, concentrating on driving, concentrating on fighting the heavy winds as they snatched at my truck and bounced it around, concentrating on breathing. I made it to the clinic, went inside and leaned on a table for a while til I could breathe again. I put the pulse oximeter on my finger. I waited for it to pick up my heart rate - 120, too high - and my oxygenation - 90, too low. On room air I should be 98 to 100%, and standing at rest my heart rate ought to be in the high 80 to low 90 range.

This means that my lungs are impaired, but not as much as my bronchioles. My oxygenation is down about ten percent, but that's better than my respiratory effort, which is up by a factor of two or three above normal. I've never had this much effort breathing - ever in life - and that's for just standing there, doing nothing. Still, 90 isn't good - but it isn't dying, either.

Okay then. No hospitalization. On the other hand, big Yes to getting some meds (and yes, I do have a people doctor, why do you ask?)

So I started on antibiotics. I'm a proponent or reserving the use of antibiotics for those situations that merit them, which means I never take them for a cold. Especially not for a wimpy cold. But if said wimp-cold calls in a nice bacterial backup - okay, then. AB's it is.

Two hours later I felt markedly improved. Pulse ox had climbed to 92 (okay, not great, but I was getting it without the extreme effort.) I went home. I laid down. I slept. A miracle has occurred, and I can do both now. Or maybe it's not so much a miracle as the glory of antibiotics, appropriately applied, and thank God I live in a time and place where these things are available.

Meanwhile I got my truck stuck at the bottom of my driveway. The screaming winds have blown away the sand on my drive and polished the ice to something that even my Yak Trax are slipping on. It was a struggle to make it up the hill in the howling winds and the dark, but fortunately for Christmas (thanks, Dad) I got a headlamp that I believe might be visible in Russia. This means I could see even the slightest patch of traction, so I managed it in a under ten minutes, and only had to stop for breath every twenty feet or so. Easy-peasy. Fortunately I'd taken one Border collie along for moral support (I wanted two, but couldn't manage both), and he kept running back to check on me, facing into the knife-blade of the wind to watch me with quizzical gravity, moving up the drive when I did, as if concerned I'd forgotten the way. Every time I stopped, he'd run back down to me, watch, wait, lead me again.

Getting inside the house was lovely.

I slept and coughed the next day. I drank water and ate antibiotics and felt better. The following day I took a sick day and did it again. I called Rock Ridge and asked them if they had any miracle solutions for my driveway. They did, they assured me, and if I needed anything - food, medications, help of any description - I was to call them for rescue.

Gotta love Alaskans.

The next day I had challenges to face. Challenge number one was getting out of bed. That managed, I faced the Big One: making it down the drive to my truck, preferably without falling and breaking anything important. I put on my Yak Trax and crept out onto the icy drive, into the face of the howling winds. In the main, there are trees to grab onto - well, saplings, at least - and maybe a tiny rim of traction right at the very edge of the drive. Most of it I managed to do completely upright. Part of it I did literally on my hands and knees, where it was too slick and steep for the Yak Trax to grip the ice. The bank beside the driveway is devoid of both snow and ice, but the dirt is frozen so hard that there is no traction on it; my boots just slip off. I solved this by toeing in hard to the bank, bracing my knees against the steep slope of it, and using my frozen hands to find meager hand-holds of equally-frozen knobs of dirt knurling the surface. I crab-walked down that part sideways on my knees, but soon the bank's slope levels out and there is real footing again. Ah, success: My truck is there, the door is open, the dog and I are inside. My hands ache with cold and I can't feel my fingers, but steps one and two are complete.

Challenge number next: starting the truck, which has not had its block heater plugged in in three days. It is three degrees at my house - and, most unusually when it's that cold, the wind is still screaming by at vicious speed. The wind-chill is brutal. This might be a problem. But no, the truck fires right up.

Okay, now all I have to do is ease it out of the driveway without sliding into the lake, and then do my solo day at work. Piece of cake. Well, maybe not a piece of cake, but at least manageable. After getting down the hill, the rest of the challenges combined seem reasonably undaunting. My staff hunts around and finds me cough drops. They help me wrestle the tough dogs. They volunteer to slap me helpfully on the back if I need help coughing. We treat everything that comes in the door successfully.

Time to go home. Parked in the teeth of the wind for almost eight hours, the truck is dreadfully cold and won't start. It floods, straining to kick the engine over. Crap. I regroup, press the gas pedal to the floor, coax, pray. She tries, fails. Tires again, fails. Then a little gift: She turns over for me now, gargling and choking, but fighting through it to roar into life. Bless you, my little Canyon. I love this truck. I know Rock Ridge would come rescue me if need be - and so would any number of others - but I want to go home, crawl under the down comforter surrounded by dogs, watch Phantom of the Opera again (love that score), sleep. And that's what I do, because Rock Ridge has made my driveway navigable again, and the truck climbs right up.

Today I am better, and continuing on. It'll be a bit before I'm back to normal - once things settle into my chest, they stay a while - but I'm on the mend. But this is why I haven't posted the Bison story I promised Jenny - or anything else, for that matter. I'll get to it, eventually. I promise.

Meanwhile, on the plus side, I'm up to 94% oxygenation (heart rate mercifully 89 now). As a handy bonus, I think that all the coughing must be an excellent abdominal exercise, since my stomach muscles are sore, sore, sore. (Somehow, however, I doubt that the Bronchopneumonia Ab Workout will catch on and make me a million dollars.) I can think, I can breathe, and while I still have a lot of coughing in my future, I am now on the up-slope.

Also, I've learned an important lesson: Never taunt the virus.


Holly said...

Feel better!

Della said...

It takes a gifted writer to turn such misery into an interesting post! I hope you are all better very soon!!

AKDD said...

@ Holly: I do, thanks! Pulse ox 98 yesterday, and am downgrading my status to bronchitis.

@ Della: Thanks for saying "interesting post" and not "whiny post"!

MaskedMan said...

Goody! Now you can make the mango-salsa chicken.

Seriously, you really did a capital job of breaking the "Unspeakable Rule:" If 'It' is good, and you mention It, It goes away. If It is bad, and you mention It, It happens. If It is bad and has *already* happened, It gets worse.

Dragon43 said...

You are tougher than I. I can't do that anymore.

Hang tough and breathe free.

AKPonyGirl said...

Call me anytime, for anything. I do have some hot buttered rum batter than I forgot to send on the sander. If you are at work on Tuesday I'll try to get it to you.

I need orange said...

Antibiotics, properly applied, are a miracle, I think....

Glad you are feeling better!