I asked the nurse "Why am I a fall risk?" Now I was a total klutz and have tripped and fallen plenty of times over the years, but the bracelet was somehow insulting. She said "Hon, you've had Atavan and Dilaudid. You may not feel lightheaded, but if you should try to get up and walk, you would probably hit the deck. It'll just help us take better care of you." She smiled at me reassuringly. I liked her immediately. She would take wonderful care of me over the course of that night. A little while later, she advised me to order some dinner. It was after 4 o'clock and I had not had any food all day. I picked up my phone to order and the operator had to check to see what kind of diet the doctor had ordered for me. She told me I was on the cardiac diet. I ordered an open faced roast beef sandwich, mashed potatoes, green beans and some pudding. Also a Sierra Mist, which I drank the whole time I was there. I laid there and rested while I waited for my tray to arrive. The pain dissipated somewhat as I ate. I made sure to eat slowly though because I didn't want to puke it all up. Being sick is the thing I hate and dread more than anything in the world. Shift change had happened but my friendly nurse was still there for some reason. When I asked why she was working over, she said the third shift nurse had called off and she had volunteered to stay. Later, I would be glad this angel of mercy was with me. She was in my room every half hour asking "How's your pain,Cheryl?" I had to admit it was getting a lot worse and I was beginning to feel short of breath. She went to report this to the doctor, who I still hadn't seen yet. The doctor was ordering pain medication without even seeing me. She returned swiftly with a hypo which she told me was Morphine and asked if I'd ever had it. Yes, I had it after my hysterectomy. In fact, I had a pump where I could hit a button and get a hit every half hour. I'd loved it because it had taken away my pain without making me sick the way Demerol did. She began to push it slowly into my IV so that I wouldn't have that dreaded "head rush" which I hate so much from pain meds. She told me the lab had been alerted and someone was coming down to take two vials. One was to check my cardiac enzymes again and another one for a test called a dedimer. This test checks for blood clots. The dedimer test wasn't conclusive, however, because you can have an elevated level just from having an IV, which I did. Twice she had given me this awful tasting concoction that was supposed to help raise my potassium, which was low. The guy from the lab arrived and, without much preamble, found a vein and drew the required two vials of blood. I was aware now that I'd had a lot of blood draws already and the needles now stung as they went in. I admitted to my nurse after the lab guy left, that I was afraid. I didn't want to have a blood clot in my heart or lung. She told me to just relax. A STAT order had been placed on my test and the results would be back in minutes. When they arrived, the news was bad. My cardiac enzymes were elevated and my potassium was still low. By this time, there were five people in my room, including, finally, the doctor. He was tall and trim, just like the ER doctor. He was attractive and efficient. He spoke to me like a person. "Cheryl, your cardiac enzymes are elevated. Not a lot, but enough that I'm concerned based on how long standing your pain is." He listened to my heart and took my blood pressure, which was very high. He asked me if I knew what an angiogram was. Sure, I knew. It's where you inject me with radioactive contrast, thread a catheter through my femoral artery and look at my cardiac arteries. Cigi had had one a few years ago and so had my roommate before his bypass surgery. I took care of his wound (because he's diabetic). I knew how risky and painful they were. He wanted to do one. He said he wanted to see what my arteries were doing and if there was any damage to the heart muscle. I said "OK" and the doctor gave me a consent form and a pen. Saying a silent prayer, I signed it. He told me I would be going to the Cath Lab shortly. I'd never been inside a Cath Lab before but I was so scared and in so much pain I didn't care what they did to me as long as, when it was all over, I was out of pain. Two men, one of them ruggedly handsome, came into the room with a metal table on which was resting a plastic yellow sheet. I asked what the plastic was for and the handsome one said that sometimes, when the dye is injected, people pee themselves. The plastic sheet makes it easier to clean up. Wow. This was good to know but I was mortified by the thought of peeing in front of a good looking doctor and his ruggedly handsome assistant. They got me on the table, which was freezing cold, and began to wheel me to the lab. All the while, the doctor is giving me the odds of certain things happening. One of them, an arterial bleed, was given as 1200 to 1. When I arrived in the lab, I understood why the table had been so cold. The room was freezing. It was so cold that my teeth were chattering and my legs and arms were shaking. The doctor explained that the room was cold due to all the sensitive equipment and because I would become really hot when the radioactive dye was injected. I would be grateful, he assured me. He asked his assistant (the handsome one) to give me some Verced. A female nurse was there, too, helping the doctor put plastic sheeting over the flouroscope (the X-ray machine that would allow him to see my artieries). The handsome guy pushed the Verced into my IV. "I'm giving you some Verced, Cheryl," he told me. "It's to put you into twilight sedation. You won't care about too much after I give you this." Before it hit, the doctor asked me where the scars on my pudendum had come from. Because I'm in the spanking scene, I keep my hoo haw shaved. Otherwise, he would never have seen the scar. I explained that I'd been born with a hernia and had had it operated on when I was two years old. He numbed the area on my groin that he was going to go in through. I felt nothing and didn't care. Verced was the best stuff in the world. The nurse patted my shoulder and let me know that she was going to inject the dye now. I would feel it and it would feel cold at first, then really hot. It felt like ice water going in. By the time it hit my heart three seconds later, I felt like I was on fire. The doctor said "You have a blocked artery, Cheryl. It's being a bratty artery, for sure." I was praying because I thought I'd just heard the doctor say I had a blocked artery. I asked "Just one?" and he said "Yep, all the others look beautiful. You have very large arteries." He explained to me that he was going to insert a stent into the artery to open it up. It was the right coronary artery, which carries blood to a large part of the heart. And it was blocked. Terrific.I saw the doctor remove the stint from its packaging. It looked huge. I thought 'That's going in my heart?' He said he had done balloon angioplasty on the artery, in which a balloon catheter was put into the artery and then inflated in order to push the plaque build up against the walls of the artery, moving it out of the way for the stent. A stent is a plastic tube with cobalt chromium wires criss crossing it. The stent was top of the line, he told me, given only to the healthiest patients. As soon as the stent went in, every bit of my chest pain disappeared. I was so relieved, tears began to fall from the corners of my eyes. The ruggedly handsome guy said "You OK, hon?" I told him I felt a thousand times better and was so relieved to be out of pain. The doctor said "Well then, you're gonna hate me. I'm inserting a collogen seal into the artery. That way, you only have to lie flat and motionless for a couple hours instead of six hours. But it's gonna make you feel like your leg is on fire." When he inserted the seal into the artery, the pain was the worst I'd ever felt. I cried out for real and shed new tears. The ruggedly handsome guy, who I acertained by now was the anaethesiologist, advised me to breathe in deeply through my nose and then out through my mouth. "Slow deep breaths, Cheryl", he coaxed. Little did I know that my pain was about to get a lot worse. I was still crying from pain and the doctor asked Mr. Ruggedly Handsome to give me some more Verced. I was in pain again, but at least it wasn't my chest. The bratty artery was now unblocked.
However, despite how relieved I was that I wasn't going to need bypass surgery, I continued to be in severe pain as I was wheeled back to my room. My sweet, caring nurse was there waiting for me. She smiled and applied a wet wash cloth to my forehead, knowing that I was still hot from the dye. Another nurse applied a heavy sandbag directly to the wound. The pain incresed again. OK, I lied before. This was the worst pain I'd ever felt. Suddenly, I began to feel very strange. I said to my nurse "I'm gonna be really sick!" She went to get one of those vomit bags they give you and, because I couldn't raise my head (I still had to lie flat and still) she bunched up a blanket around the side of my head. "Go ahead if you need to, honey." I lost my lunch all over the place. Then I lost my bladder. The bed was soaked under me. I felt like I was going to pass out and I said so. I felt so weak. Lucky for me, my ministering angel didn't leave the room during this time. Something in how I looked made her grab the blood pressure cuff and check it. "She's crashing!" she said. I heard footsteps running away. I didn't feel THAT bad. The doctor charged into the room. It was like a scene out of "ER". "What's her pressure, Janet?" he asked. "90 over 65" she said. The doctor whisked my sheets off without ceremony and shoved up my gown, exposing my in all my sick, suffering glory. Then he did it. He pressed on my stomach. More pain washed over me like a wave. I was sure I was dying. This doctor had killed me. He wanted a CT of my belly. I was so out of it that I couldn't even sign the consent form. I had to raise my arms over my head for the scan and, for some reason, it made me feel a lot better. I was able to follow the directions I was given. The tech injected me with the contrast and I felt like I'd wet my pants again. But I knew this was the effect because Cigi had had a number of CT's. The effect didn't last very long. Neither did the test. It confirmed the doctor's worst fears: I had bled into my abdomen and the resultant hematoma (pool of blood) had ripped a hole in my peritoneum, the lining of the abdominal cavity. I heard the doctor curse under his breath and ask a nurse to get me "type and crossed for two units." I knew what this meant, too. I was going to get a blood transfusion to replace what I'd lost. I was informed of the bleed and the tear and told that I would be moving to the Intensive Care Unit. Terror gripped me and I began to cry again. The nurse patted my arm. "It's OK, sweetie. You'll be OK. They have the best people over there." I wasn't stupid. I knew that it only took a few minutes to bleed to death from an artery. They moved me swiftly to the ICU and the blood was waiting for me when we got there. We were met by Jennifer, a young ICU nurse and a man from the blood bank. He read the number from the red bracelet I'd had put on before I even got out of the CT tube. I began to think of my blood type--B postive. I told myself to do that. Be positive. It was close to midnight by now and things were quiet, except for the nurse hooking up my blood transfusion. In the ICU, I was given Fentynal for my pain every two hours. No one was asking me to rate my pain anymore. They knew it had to be bad and it was. Every movement was torture. I thought I had a high pain threshold. Everytime the young nurse lifted my gown, I whimpered because I knew she was going "appreciate" how hard my abdomen was and I knew it was going to hurt a lot. A foley was inserted into my bladder and immediately my abdomen felt less full. Getting rid of the urine took a lot of pressure off my belly. The nurse who catheterized me told me it might hurt but that she would be as gentle as possible considering what I'd already been through. At another time, I might feel self-conscious having a woman spreading my lips open and fingering my pee hole. But I was so sick I didn't care. They could have injected me with Draino and I wouldn't have cared at that point. She came in at the wrong angle the first time and it stung. She rubbed my leg. "Sorry about that, Cheryl. I'll get it this time." It slid in easily this time and immediately urine began to fill the attached bag. I let out a sigh of relief. "Better, hon?" she asked. I nodded and was rewarded with a nice shot of Fentynal. A blood pressure cuff was attached to my arm and it took my blood pressure every fifteen minutes. It was coming back up but still low. "This takes awhile," Jennifer told me. "Just rest and hit your button if you need me, OK?" Again, I just nodded. She was concerned enough to ask me "Cheryl, can you speak?" "I can but I'm so tired," I told her. Again, she patted my arm. I couldn't tell if this was respect afforded an elder or if she just empathized with her patients. "Is there anyone I can call for you, Cheryl?" she asked. "Your family?" I looked at the watch. "Not at this hour," I said. "My big sister will be here at 5 o'clock and she'll wanna see me. She'll spread the word." There weren't any phones in the ICU but the nurses would make calls for patients. The way it works in ICU is that every patient has a nurse assigned to them. That nurse is your nurse only. Unlike out on the floor, where there might be four or five nurses for 15 patients. I saw the room number on the wall--271 and noted with irony that that was the very same room I'd been in when I had visited my roommate just a month before. I never thought in a million years that when I was visiting him I would be in the exact same bed. This was one for "Ripley's". Sure enough, at 5 am my sister came into the room. Apparently, someone knew that she was my sister and had told her when she came in. She hadn't wanted Kathy to see my name on the board when she came in to clean the rooms. She wanted to make sure I was OK. My new nurse told her I was stabilizing but not out of the woods yet. My big sister, who's so stoic that her childhood nickname was General Patton, was crying. "I just lost my other sister" she said quietly. "I know" the nurse said understandingly. They brought me Fentynal and ice chips at regular intervals. I couldn't have any solid food (as if I wanted any) just in case another test was ordered. My memory is a bit hazy but I remember having pillows placed under me and being turned so they could see the lividity my internal bleed had caused. Because I was lying flat, the excess blood settled in my back and bottom. Just being breathed on, let alone moved, was excrutiating. When I would cry out from being handled, the nurses would rub my shoulder and say "There, there, sweetie. It's almost over. We just have to see how bad the bruising is. I know it hurts to be moved but it has to be done." When they were done with their examination, one of the nurses came back with some warmed up baby lotion and massaged my back and bottom (yeah, I got aftercare in the hospital). The pampering was nice. For five years, it had been all about Cigi and what I could do to make her clean and comfortable. Then I had been caregiver for my roommate, an assignment that never should have fallen on me in the first place. Now it was about me for a change. I know this sounds selfish, but I relished the attention and made no secret of the fact that I ate it up. I never got pampered like I did in the ICU.Unfortunately, the vampires were still coming to draw my blood every four hours, no matter the hour. Most were gentle but some weren't. When the pain overwhelmed me, I cried. I had been through the wringer so I thought I deserved to indulge myself. I'm not a crier by nature, but I defy anyone to go through what I'd been through and not shed a few tears. Between the pain and the fear that I might die, I did a lot of silent crying and praying. Later that morning, I was resting quietly, waiting for my pain meds, when the doctor who had wanted to discharge me walked by. When he saw me, he did the double take of all double takes. He pushed the glass door aside and came in. "What happened to you?" he asked. "I had a blocked artery," I said. "I had a heart attack and then an arterial bleed and then a peritoneal tear. I'm feeling pretty miserable." He didn't come right out and say it, but the expression on his face said "I screwed up big time." "Are you gonna be OK?" he asked. I shrugged. "I hope so." He was clearly uncomfortable so he said he hoped I felt better soon and left.
When the blood transfusion was complete, they gave me some medicine in my IV that would help it circulate better. I was getting saline wide open as well. Because I was right by the nurses' desk and the nurses had Report before every shift change, I heard the litany of what had gone wrong with my stent placement a number of times. The nurses talked loud, it seemed. The charge nurse was a caring lady; every bit an old-fashioned nurse. Alot like my mom, I thought. I remembered being in the same hospital 17 years earlier for a hysterectomy and many times the nurses would come in to check my catheter, simply spreading my legs and looking without so much as saying anything. Nowdays, I think the nurses do a better job of guarding patients' dignity. If the nurse had to come in to check something, they would always say what they were going to do before they did it. Hospitals aren't good places to sleep in. Even at night, they're very noisy. The doors stay open much of the time and the curtains stay open so that the nurses can spot a patient who might not be able to reach their call button. But if something private was about to be done, they would take great care to close the door and draw the curtains.
I was starting to feel much better by mid-day on Sunday. Blood tests and examination of my belly showed that the bleed had stopped. The blood would be reabsorbed by my body. But the peritoneal tear will take a long time to heal. I was continuing to have severe pain due to the tear but I could now move my leg and only experience moderate pain. Before I was told I could order my dinner, the nurse came in and gave me a bed bath. I had thought those had gone the way of white starched hats. "Not in the ICU" the nurse said unsnapping the snaps on the shoulders of my gown and gently pulling off my robe. She covered me with towels, both to guard my modesty and to keep me from getting cold. The warm water felt so good I just laid there and let her bathe me. It hurt so bad to move my arms I couldn't even wash my own crotch (and I didn't even try). She was a professional, doing her job. She took special care with my belly, back and bottom. They were (and still are) badly bruised. The blood was just puddled up under the surface and as I was moved, I could feel some of it moving with me. It's not like to went over to the other side or anything, but I definitely felt it moving. When I'd been bathed and put into a clean gown, the nurse brough the menu to me. I was starving. "You're on the cardiac diet so stick to that, OK?" she said. I ordered a chicken stir fry with brown rice and some orange sherbert. My throat was so dry, despite the steady diet of ice chips I'd received during my transfusion. I was on a sodium restricted diet because I was now on meds for my blood pressure, but I could still have soda so I ordered a Sierra Mist. When my tray came, I couldn't raise the bed high enough to sit up to eat. Sitting up put too much pressure on my belly. So I left the bed down and grabbed the food with my fingers. Pathetic, I know but I was so hungry I would have eaten it off the floor if need be. The nurse brought in my pills that had to be taken with food and offered to feed me. I passed, wanting to keep what was left of my dignity.
Time passes slowly in the ICU. Even though there was a clock on the wall, I had no real sense of time because I was drugged much of the time. The Fentynal served a two-fold purpose. It managed my pain and kept me relaxed. Because my potssium had been so low, they were worried about me developing muscle cramps, which would have been very painful. People from my church came to visit me and I barely remember it. My world consisted of being prodded and moved and Fentynal. And blood draws. This was my life. But sooner or later, it was time for me to go back onto the floor. Again, I got a bath first. But I had to do it myself this time. And I had to get up and walk to the end of the hall. I was shaky but I did it. The real pampering was over, I knew. Now it was time for me to start recovering. That meant doing as much as I could for myself. I bathed myself with wash clothes that had been microwaved. I also got something called a shampoo cap. This thing looks like a shower cap but inside is some water and shampoo. You put it on your head and rub it around as best you can. I was aware that I had severe bed head. Before I took my bath, a nurse came in and removed my foley. Removing it proved more painful than inserting it had been. But I was glad it was going away. Instead of being moved on a gurney, I was moved in a recliner. One nurse pushed me to my new room and another followed behind with my bags of belongings. I bid all of my nurses a fond farewell and went to my new room. I was told I was still going to get Fentynal for another 8 hours or so but then I would be given Percocet for pain. Obviously, I was healing fast. The move had exhausted me and I slept for three hours after being made comfortable. When I awoke, I had to go to the bathroom really badly so I hit my call button. I had been used to not having to wait more than a few seconds for my nurse. I had to wait almost ten minutes before the nurse came. I needed help to the bathroom I told her. I was a fall risk, after all. When I got in the bathroom, I noticed there was a little plastic pan to catch my urine. In the hospital, urine is like gold. Every drop is caught and measured. But I was worried because I hadn't had a bowel movement since before I'd gone to the hospital on Saturday. The nurse told me not to worry. My bowel sounds were good and I hadn't had that much solid food. Plus, most narcotic pain killers cause constipation. I learned that cardiac patients weren't given laxatives or enemas because it would cause problems with the heart. The best I would get, if I didn't go soon, was a stool softener. I was a very dignified person and the thought of being helped in the bathroom rubbed me the wrong way. Having to have my ass wiped because I couldn't reach back far enough galled me. There was some comic relief though, when one of the cardiac nurses came in and told me that, because I'd had blood and because I was having good bowel sounds, I was going to start releasing a lot of gas. She was going to show me how to do that without hurting myself. I looked at her incredulously. "Farting lessons?" I asked. She shrugged. "Pretty much, yeah." She had me turn on my right side, facing her and told me to tell her when I felt one coming. I was mortified. I thought nothing of farting while playing, but the thought of farting in front of a nurse who was going to coach me, well, it was bizarre beyond words. But I got through it and was later glad she'd taken the trouble to teach me the safe way to fart.
Since I'm really tired now, I will continue the rest of the story tomorrow.
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