Thus Spake Russ

Posted By Russ Emerson on October 12, 2007 at 10:11 pm

I’ve been back from the hospital for about 32 hours now, and I think I’ve slept about 24 of those hours.
Part of that is the near total lack of sleep I had while actually an in-patient. Not only are those hospital beds terribly uncomfortable to begin with, but they have added inconveniences which maximize the discomfort for someone like me.

• They’re too short. At 6’8″, I am used to sleeping with my feet near or hanging off the end of the bed. I’m just used to it. Not so this week, though; the hospital rack had a footboard that constrained my feet, which is a serious obstacle to rest.
• The beds are also designed to force a person to slide down from the head end towards the foot. Any upward tilt of the head section leads to an inexorable involuntary migration towards the foot end. Perhaps this explains why they have a footboard. No hospital wants to be responsible for its patients slipping the long way off the bed onto the floor.
• Perhaps worst of all, though: the beds are designed with some sort of air compression system which is designed to reduce or eliminate the problem of bedsores by inflating sections of the bed and causing the patient to unconsciously shift his weight around to keep from falling out of bed. This would be fine, except that the air compression unit sounded approximately like a B-52 taxiing towards its runway. (Mom thought it was more like an F-15, but I’m not about to quibble.) It never stops, and you never get used to it.

That’s just the bed. Have I mentioned what they actually did to me there?
Monday:
I got to my room after about 4 hours of dithering. They said be at Admitting at 9am. OK, fair enough, we were… and then were kept waiting for about an hour, then another seemingly interminable wait for a wheelchair escort up to the room.
Once in the room, I met my day shift nurse, a real nice girl (indeed, the nicest thing about the entire stay there, named Melissa, very cute in a Shirley Temple sort of way — not The Littlest Rebel Shirley, more like Fort Apache Shirley) and then we commenced to wait for the Physical Therapist, so that I could be tested and a base level of neuromuscular performance could be set. ‘Round about 3pm, that person showed up. So essentially, I could have slept an extra five or six hours instead of dragging my night-shift-working ass out of bed at 0630 that morning.
The PT testing complete, it was back to my room — a private room, thankfully — to wait for the lumbar puncture. An IV antibiotic was plugged into my right forearm, and then the attending neurologist, Torquemada by name, arrived and set to work with a will. A bit of topical anesthesia at the insertion site, and then….
Pain. Pain. PAIN.
Perhaps not the worst pain I’ve ever experienced, but the margin was small, and gout isn’t voluntary. I mean, I didn’t have to show up at the hospital. No one made me. I think they’d have stopped if I’d asked. There wasn’t a prearranged safety word, though. Odd, that….
It would have been over quicker, but along with my being extremely tall, my bones, vertebrae included, are larger than a normal-sized person’s. Consequently, it took that particular agent of the Spanish Inquisition longer than usual to get the tap into place; he had farther to go. And he had to use a bigger-than-usual needle to get the catheter into place in the spinal column. He didn’t seem disappointed, if the chuckling was any indication. And I could feel every second of it, though oddly, I felt it in my hips rather than in my back. It went on and on and on and on for what seemed like hours, until… nothing. It was over.
Well, almost over. I had to be stitched to keep the catheter in place. The insertion had taken so long that the topical anesthetic had worn off. I felt the stitching… though compared to the tap insertion it was a sort of bliss. Sort of like the lesser agony marathoners describe as a “runner’s high” — still miserable, but the endorphins must have kicked in.
The catheter having been inserted and the flock of Jesuits having departed, taking their branding irons and thumbscrews with them, I was left on my own. For the remainder of the day and well into Tuesday, the entirety of my role in the enterprise consisted of laying in place while leaking cerebro-spinal fluid into a bag and having the IV antibiotic (which worked on some sort of incendiary principle, given the burning sensation) changed every six hours.
Due to the aforementioned bed difficulties, this was not as easy a proposition as might be supposed. Compounding the problem was one of my primary symptoms: when I lay flat on my back, my legs spasm uncontrollably. I didn’t sleep much.
Tuesday:
The therapist came back for part two of the testing — the idea being that if my neuromuscular responses improved after the fluid in my brain was reduced, it would be a good indication that installing a shunt might be the solution. There was measured improvement, but not enough to satisfy the neurologist. I had to stay another night.
By that evening, the IV antibiotics had corroded the vein in my right arm, so it was relocated to the back of my left hand. They were apparently saving my left arm for blood withdrawal… a savings of which they made good use.
Wednesday:
That morning my fluid levels were lower than ever. Having again had no sleep, I repeated the tests with the therapist. Despite the lack of sleep, there was more measurable improvement, but still not enough to satisfy my neurologist. So I had to stay yet another night. I was, to say the least, not thrilled at the prospect.
That night, I didn’t even try to sleep. The night nurse came in just before midnight to plug in my dose of napalm (after relocating the IV yet again, to the back of my right hand) after which I passed out for maybe two hours. From 2am on, I read one of the books I’d brought with me and waited for the Thursday day crew to show up.
Thursday:
First thing in the morning, the therapist showed up to test me again; again there was improvement.
In rapid succession the attending neurologist (the doctor previously known as Torquemada) removed the drain from my back and stitched me up; my neurosurgeon’s nurse came with a stack of papers to get me out of the hospital; a wheelchair showed up at my room, and I was whisked away. Fortunately, my ride (hi, Mom!) was already there with me, so I wasn’t subjected to being unceremoniously dumped on the sidewalk in front of the hospital. Almost as soon as I got home, I collapsed on my bed and actually slept.
And that was that.

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I’m still quite sore, and the improvement shown during the hospital testing has reversed itself now that my spinal fluid is not being actively drained.
I expect we’ll have a recommendation from the neurologist and neurosurgeon next week. Pins and needles time, people.

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