Showing posts with label pneumonia. Show all posts
Showing posts with label pneumonia. Show all posts

Saturday, September 14, 2013

Sleep, Sweet Sister

Well hey there… I’m not your usual host, I’m her older sister stepping in to bring you up to date.

If your usual Vet were here, she'd surely say… “I’m SO sorry I’ve neglected my story telling duties, but it was for a REALLY good reason.  I’ve been busy with changes in my job, and visiting my family, and I just needed a little sabbatical.”

If she were here.  Which, sadly, she is not. 

So you have me. 

My younger sister was a wickedly smart, hugely talented, quirky, endlessly entertaining, complex, independent, and occasionally troubled Veterinarian who practiced her passion in the only place she could imagine living, Alaska.  And she finally did take that sabbatical.  One from which we will not see her return.  In May, 2013, the Vet on the Edge - my sister - passed away.

If you have followed along with her tales of life in the wild, you know that a while back she had pneumonia.  Although she had technically recovered, I think it took a much greater toll than any of us but her knew.  Some of those closest to her were concerned for her health, but she chose to struggle with it alone, and in May that struggle came to an end.

She will be sadly and sorely missed.  There are many years of tales that should be following here that she will not get to tell you.  But if you will pull up your chairs one more time, I will tell you a tale of my own, one about your host and narrator, about a talented and funny Veterinarian who lived in the wild land of Alaska. About the little sister she once was.

I suppose I should tell you who I am.  I’m the older sister, the one who, much to our mother’s dismay, took shears to my sister’s hair when she was three… something she remembers clearly and I remember not at all. Except, of course, from the many times it’s been told at family functions as part of our family’s oral legacy. 

I am the missing sister.  Our mom thinks of me as Haley’s Comet flying into the family’s night sky just once every 72 years.  Our dad once referred to me as the geigenshine – the trail of particles left behind as the earth travels through space – something even astronomers rarely see.  My nieces and nephews think of me as a unicorn – an exotic creature with mystical powers that they all know lives in the forest, but that they only barely catch glimpses of. 

What they say is true.  In one sense my sister and I have not been close since I left home at 15.  Our relationship has been one of intermittent phone calls and rarer emails, often occasioned by my need of some veterinary advice. We did not keep up with the details of each other’s lives.  And yet, once she’d helped me work through some veterinary conundrum, the conversation would bounce and spring and dash in all directions like spring lambs cavorting in the grass.  My husband would shake his head and chuckle that any two people could talk so fast and leap so quick and never miss a beat.

In another way, and despite the long gaps in contact, we were as close as it’s possible to be – we were sisters, just 2 years apart, and I’ve known her all her life.  I *know* her, who she is… was… how she was made, what strange mechanisms rumbled about in the darkness of the emotional undercurrent she hid with her ironic sense of humor and her quirky take on life.  We sprang forth from the same genes, the same tribulations.  We shared talents and intellect, quickness of mind and of words.  We shared the ability to skip lightly from idea to idea, from observation to conclusion, like big horn sheep springing from outcrop to tiny outcrop along the edge of a vertical rock face.

Once, I was regaling some of my bellydance friends online with the tale of how I discovered that sheep eat goats whole (at least goats think they do), and how I know that dairy goats have much better brakes than draft horses.  At the end of my story, a third-connection acquaintance – someone  I’d never met in person or even emailed with directly – said I’d made her laugh until she cried.  She said the only other person who ever made her laugh like that was a blog she read, and that I reminded her of that writer.  She posted a link to this blog. 

It seems that we were so much alike that even random folks we’d never met could identify us as sisters by our words alone.

And yet for all we were alike, we were as much different.  I came into this world as blunt and raw as lava struck from Haleakala by the goddess Pele.  My sister arrived with a winning, graceful charm, sailing smoothly in like Botticelli’s Venus on the half-shell.

I think I must have been 7 or 8 when I finally understood the power of her charm.  We had been trundled off to bed and our parents had tucked themselves in for a bit of bedtime reading.  Neither she nor I were ready to sleep, no shock to those of you who know she mostly functioned without it.  I had gone to our folk’s bedroom to try to wangle out a stay of bed-time execution.  I had hit upon a question, a science question, a clever and interesting one, no doubt – science questions were always good for getting their attention. Perhaps one question could be parlayed into another and yet another and maybe into half an hour or more of that delicious space beyond the bedtime rule.  Somehow, my parents detected my ploy (who knew parents could figure out that sort of thing?) and I was sent packing back to bed. 

As I turned the corner from their door into the hall, there was my little sister, slipping under my arm and through their doorway. I watched as she laid her head down on mom’s knee, turning just so, like a puppy going belly up for a tummy rub.  She turned on that charming smile - if you ever met her in person, you’d know the one - and flashed her dark eyes with the thick velvet lashes. Then she said something that made mom laugh and it was done.  Just like that she had captured the up-past-bedtime prize, the Stanley Cup of parental attention, won the Superbowl of sibling rivalry.  I knew I had been aced, skunked, shut out.  Well and thoroughly trounced.  Game, set, match to the girl with the wit and the charm and the velvet lashes. 

It’s funny though, I never held her to account for it.  I knew it was her gift. And even though we were rivals, she charmed me with it too.

If you’ve been keeping score, you know we have a plethora of parents and an even larger number of siblings – full and half and step – not to mention friblings and others who have volunteered as family.  Four of us share the same two parents, and of the four I think she and I were the most different. I’m fair skinned and freckled, with gray eyes and straight blond hair that turned mouse brown as I grew.  She had olive skin, curly chocolate hair and hazel eyes with lashes lush as pampas grass.  I was a stick until my mid-twenties but she always curved like a girl.  While I’m not tall, I break the average. And she, as you know, was always short.

When I was 10 and she was 8 we both had 4-H lambs. They started out as they usually do - bottle babies with big liquid eyes and soft nubby white wool and tails that waggled wildly when they nursed.  And they ended as 4-H lambs are expected to - in white waxed paper in the freezer.  My reaction to a dinner of lamb chops we knew by name was to eat hearty and become a sheep rancher when I grew up.  Hers was to cry for weeks, then grow up to be a Vet.

We differed on what did and didn’t matter in men, too. I said the right man had to be smart and have table manners, she said she didn’t care if grease ran down his chin and he wiped his fingers on his shirt, as long as he made her laugh.  We differed on marriage - she never married, and I kept marrying until I got it right. 

I brewed wine and she brewed beer.  Even in the same hobby we took counterpoint.

We even differed on the blessing-ness of the late-graying gene we both inherited from mom - she thought it was a gift and I wish my hair would just finish going silver already (something Mom assures me it will never do. Ever. Salt and pepper is the final endpoint. Live with it.)

Despite all that difference, I think she needed to *tell* me that we were different.  She used to call me up with one problem or another she was having and ask for my advice.  She’d listen carefully to the best I had to offer, all very practical and well thought out, then she’d set about telling me all the reasons it would never-ever not-even-remotely in-a-million-years not-on-this-planet-or-any-other work for her.  At the time it used to frustrate me no end, but now I wonder if she needed to build the contrast because, underneath, we were in some ways so much alike.

Both of us believed that the things we did without much effort - the talents we were born with - didn’t create anything that anyone could really value.  That if someone said something nice about our artwork or our intelligence or our contribution to others it was only because they were polite.  Neither of us believed they could really mean it. Neither of us could take in people’s appreciation or respect, their gratitude or thanks, their acknowledgement or praise.  I think it created in her a sadness, an isolation that she defended against with her charm, her wit, her ability to entertain.  Her gift gave her a way to cope, a way to keep that sadness at bay.  Without that gift, I had to live with my demons, share space with them all the time, and eventually I had to confront them and make peace.  I think perhaps my sister never did.

Once, while I was working in Florida, I took the glass-bottom boat tour of Wakulla Springs.  We cruised over the outlet where the underground river flows out into the greater pool.  Wakulla flows more gallons per hour and at greater speed than any other freshwater spring in the country.  Looking down through the glass, you can see the outlet like an underwater cave.  And that huge volume of water rushing out by the thousands of gallons looks like … nothing.  It’s so clear that you cannot see it at all - just the bottom sand sparkling there beneath the boat as if the torrent of water at the outlet was as placid as the surface we were floating on.  I asked the guide how far up the spring the divers had explored and he said not far, that the current was too much for human beings to swim against for long.

I think my sister was like that.  On the surface, she was sparkling and light, with a humorous observation for even the darkest events.  But underneath there was in her a current of sadness that she swam against, camouflaged by her humor, transparent and unnoticed.  I think that’s why she often didn’t sleep, because she needed to keep swimming. I think its why she always entertained us, because that humor brought her light.

I think her humor was her truest gift, her compassion was the power in her life.  And I think the pneumonia took her stamina and finally the strength she needed to swim against the tide.  

So I will just leave you with this…

Sleep, my sweet sister. Rest. Our dreams go with you. Calm waters await, you do not need to fight.  Just know that sometime in our long future I will flow down the mountain like Pele’s lava and I will meet you again when you return like Venus on the tide.

-----------------

To you who knew my sister through her writing… she left a little gift.  There are unpublished stories.  From time to time I will post one for you here. 

And she left a manuscript.  It will take a while, but we (her siblings) are working to bring it to print.  It was her dream, something she worked long and hard to realize and we will take it through that final step.


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.