Thursday, August 27, 2009

The Beginning

In January, I had what I thought was my annual bout of bronchitis. I started coughing constantly, all day and all night. It was so bad, I had to sleep in another room so that Kim could sleep-- I was even coughing in my sleep.

Years ago, I read a statistic that said that married men live longer than unmarried men. I think that there's a simple explanation for that: wives make you go to the doctor. After the third day of me coughing and constantly gasping for breath, and me saying that it wasn't a problem, that it would go away in a day or two, Kim made a doctor's appointment for me, and told me that if I didn't go, we'd be charged 50 dollars.

Earlier that day, I had taken a drive out to Lagrange, Illinois, where my high school was. It was well below zero that day, and despite my wheezing and coughing, I made it there, trudging through the snow for a couple of blocks and walked into my high school, something I hadn't done in nearly three decades.

A couple of days before, I had gone to turn in my application to Truman College's nursing program. I had discovered that they no longer had my high school transcript, which I'd given them when I signed up to take Spanish classes at the school in 1988. They only kept them on file for seven years. I'd called the records person at my old high school, and when I drove out there, she had my transcripts waiting for me. I turned my application in, along with the transcripts, that afternoon.

The next day, I kept my doctor's appointment. My doctor clipped on blood oxygen monitor onto my finger and had me breath into a device that I learned, this summer, is called a spirometer, which measures your lung capacity. She had me walk around the hallway of the medical suite while observing my behavior and the oxygen level. I could tell that she'd formed a conclusion-- a conclusion I'd come to at the same time-- but was surprised about some readings. Specifically, my lung capacity was really high, given what she had concluded I had.

I realized something that had become painfully obvious-- that I had asthma. I asked her if she thought this was the case-- she confirmed that she thought it was too.

My physician gave me a "nebulizer" treatment, which caused me a little amusement-- my mother-in-law has a home nebulizer she uses twice a day for treatment of her COPD-- and told me she wanted to run two blood tests to rule out two other possibilities-- there was an outside chance that it could be a blood clot in my lung, which could be fatal if the blood clot broke loose and went into my brain or heart. Her thoroughness is something I've come to appreciate. She told me that if I had a "positive" on one of the tests, she was going to ask me to go to the Emergency Room that night.

On the way home, I filled the prescription she'd given me for an inhaler-- something my son has been using since he was diagnosed with asthma when he was little. I went home, had a light dinner and went to work.

I'd been at work for about a half hour when I got a call from my doctor. A test called a "D-Dimer" test had come up positive; it's a test for a protein that's present when you have a blood clot. It had a pretty high rate of false positives, she told me, but as a precaution, she'd already set me up for a trip to the Emergency Room at Northwestern Hospital. She'd triaged me to get in immediately.

I was a little stunned. If I left, there would only be one waiter on, so I asked if it was okay if I waited a couple of hours to go in, until the dinner rush was over. She told me that she would prefer if I went immediately, but it would be okay if I went in a couple of hours.

I told my boss the situation, and he showed me once again, as he had in the past, what a good guy he is. He told me to go. Immediately. For him, people and family always come first, something he's demonstrated in the past.

I called Kim and told her what was going on. I asked if she'd drive me to the hospital. She pointed out that I might have to stay overnight, and that I should pack an overnight bag. I agreed. I told her I'd meet her at home.

When she got home, she was in a dither. I had to kiddingly remind her that it was probably okay, and that it was me that might have a blood clot in his lung. Staying calm in emergencies has always been one of my strong suits.

We parked the car and walked down to the Emergency Room. My doctor was true to her word-- I gave the intake nurse my name, sat for maybe three minutes, and was whisked past people who had obviously been there for a while. I got more than one dirty look from other patients in the ER lobby.

I was brought in to the ER and put in a cubicle. They quickly hooked up an EKG and a blood pressure cuff. They were going to have to give me a CT scan, so they needed to make sure my kidneys were functioning normally-- they would have to filter out the dye they would inject in my veins for the CT scan to work. They drew blood and left the IV in me in case I needed anything else.

The kidney test came back okay, and after about a half hour I was brought to the room the CT machine was in. It took about two minutes for the CT scan and I was brought back to the cubicle.

At some point a male nurse named Duane checked in on me. He was a chatty, gregarious guy, about sixty years old. I told him that I had just applied to nursing school. It turned out that he, like me, had left another profession in his forties to enter nursing. He talked about how he had left Northwestern a couple of times for other jobs, but had come back twice. It was very clear that he loved his job. He told me that he intended to do it for at least another ten years.

A while later, a doctor came in and told me that my lungs were clear; no clot. It was just asthma. A couple of weeks later, when I checked in with my physician to see how I was doing on the asthma meds, she told me that they had also spotted a kidney stone and an "inguinal hernia," which apparently runs in my family-- my father and brothers have had them as well.

In April, I found out I had been accepted into the nursing program at Truman. They had had 190 slots and 1,000 applicants. I realize now how lucky I was.

Later, I thought about the lessons of that night-- how I was going to have to deal with people as stubborn as I had been. I'm certain now that I've had asthma since I was a kid, but had been in total denial, no matter how much I suffered from the symptoms. And I realize now how encouraging it been to meet Nurse Duane. I think I knew, at that moment, that I'd made the right decision.

Since January, I finished the last non-nursing school coursework I needed for nursing school, Anatomy I and II. I've since learned enough to actually understand what asthma is-- a constriction of the bronchiole tubes, the tubes that bring air to the alveoli sacs where oxygen is sent to the blood and carbon dioxide is taken out. I learned just what an inguinal hernia is. And I learned, I think, why my doctor was surprised to see my lung capacity as I suffered from an asthma attack on that bitter cold afternoon.

This summer we learned to use a spirometer, the device for measuring lung capacity, in my Anatomy II class. When we did mine, my lab partner Paul thought that we'd made a mistake and redid it-- my lung capacity was twice was most people's were, and about 30% higher than the next highest in class. We redid it, but it came out the same. I realize now that even in the midst of an asthma attack, my lung capacity appeared almost normal because it had so much excess.

Today, I had another short doctor's appointment, for the nurse to check my second TB test (negative) and to pick up my medical paperwork for school. I noticed that under the heading Medical Conditions, my physician had noted "Asthma (well controlled). I found it funny that as I head into one last career, in the medical field, one of the biggest lessons I got was outside of the classroom.

This week was a flurry. I'll try to post again this weekend about my initial observations and experiences starting this next adventure in my life.


Dale said...

Although it may sound ridiculous to say, I'm glad you have asthma (and not a blood clot).

bubbles said...

I hope it goes really well. My sister (Doad) is a nurse. She is the first person I turn to if I have a medical emergency. The first.

Mnmom said...

I'm glad you are finally being treated for asthma - please take it seriously. My mother died of an asthma attack at 66, in the middle of an otherwise healthy life. Asthma is nothing to fool with!!