Tuesday, September 01, 2009

Thrombosis Summer 3

Venter’s Note:
If you haven’t read Thrombosis Summer Part One or Thrombosis Summer, Part Deux, I’d recommend scrolling down a bit or clicking here to get caught up.

My third visitor in the ER treatment room arrived pushing a sonogram machine, a piece of equipment I recognized from my wives’ pregnancies. At first, I was confused, but once the technician lathered enough KY on my affected leg to supply a porno flick, I understood her intention.

After twenty minutes of “mmm-hmmm’s” and scrunchy faces, I understood exactly nothing more. The young woman repeatedly attacking my injured leg with the hard, plastic probe obviously knew what she was looking for, and -once she found it- what it was, but she wasn’t sharing. When I could unclench my jaw enough to speak, I asked if she had found anything interesting.

“Mmm-hmm.”

Scrunchy face.

Eventually, the woman rolled her medieval torture device away and the attending physician rolled in. “Well, Mr. Lukac,” he said. “We believe you have a deep vein thrombosis and that it may be infected.”

I had no idea what a thrombosis was, but I sure as hell understood infected. That part made sense; it explained the angry racing stripe decorating my shin. I breathed a bit easier, mentally calculating the co-payments necessary to fill the regimen of antibiotics I figured was coming.

But Doctor Thrombosis wasn’t finished. “So, once they have a room ready, we’ll be moving you upstairs. In the meantime, we’re going to start an IV to get that infection under control.”

Upstairs? A room upstairs? Wait a minute . . .

“I’m being admitted?” I asked, waiting for the punch line. “What the hell is a thrombosis anyway?”

“It’s a blood clot,” he said. He continued with a lot of technical, medical mumbo-jumbo, but I was still focused on “upstairs” and “a room,” and interrupted with a carefully thought out list of objections.

Why was I being admitted? Give me a pill. Give me a shot (an option I would never request under normal circumstances, but a needle or two was infinitely more desirable than whatever waited “upstairs”). Get the laser beam or the sonic blaster. Call Doctor McCoy on the communicator and have him wave the Tricorder whosie-whatsit around for a few minutes. Get Dr. McDreamy or Dr. Carter or Marcus Welby, M-freaking-D down here, but for God’s sake, do not make me go “upstairs.”

Now I know what my face must look like when I’m explaining to a customer that we can’t look books up by color.

While my wife and daughter headed home to gather supplies for my unexpected stay, a nurse installed an IV tap in my left arm. I’m not a fan of needles, but she was fast and skilled, so my discomfort was minimal. On her way out of the room, she passed another nurse on her way in.

“I need to give you a shot,” Nurse Number Two said. “The Doctor’s ordered a blood thinner.”

I held up my newly bionic arm, but the nurse shook her head. “Fine,” I said, offering the other arm. The nurse shook her head again.

“I have to give you this injection in your stomach.”

Goodbye thrombosis, hello panic attack. I said, “Then you’d better go get a lot more nurses.”

Nurse Number Two thought that was hilarious, but I was serious. God knows I put a lot of things in my stomach that have no business being there, but at least I use the traditional route to get it there. What Nurse Number Two proposed was an affront to all things natural, and I wasn’t submitting without a fight, or at least, an argument.

Then, I thought about my youngest son.

Zack’s been diabetic for seven years. For six years, eleven months and fourteen days, he’s given himself several insulin injections a day -something I know my teenaged self couldn’t have managed-, and I felt ashamed. I badger my son constantly about managing his condition, and here I lay, freaking out about a procedure designed to help me. I knew what a subcutaneous needle looked like; it’s a tiny thing, less than an inch long. I’m a man. I could handle this.

I swallowed my cowardice and lifted my gown. Bring it on, I thought. I can take it.

The nurse roared, “There can be only one!” and pulled a syringe the size of Excalibur from a scabbard strapped to her waist. Before I could react, Nurse Kurgan impaled my abdomen with a medieval weapon designed to eviscerate and inserted a slab of magma into my flabby gut.

Suddenly, a blood clot didn’t seem so bad.

Soon my family returned and I was eventually moved to a semi-private room on the hospital’s top floor. I considered recounting the horror I’d endured in their absence, but the Kurgan kept hovering outside the door, and I didn’t want to incur her wrath, especially without a MacCloud around for protection.

I’ll dispense with the standard, clichés regarding modern health care because –regardless of their potential humor- I found most of them to be untrue. My caregivers were kind professionals, willing to bend a rule or two to make me comfortable. Patients’ diets are categorized by condition, and since there was no “Thrombosis” classification, I was placed on a Heart Healthy program. That made some sense, because my blood was the problem, and blood comes from the heart. Okey dokey; bring on the boiled chicken.

I quickly found out that one of the no-nos of the Heart Healthy program was caffeine. Again, okey dokey, now get me a cup of coffee.

“Coffee contains caffeine,” I was told by the dietician with the electronic Deal-A-Meal dispenser.

“No shit,” says I. “Make it two cups.”

Here’s where the kindness of nurses comes in. Every evening, my night nurse would stick her head in the door and ask if I wanted a taste of that sweet, forbidden Colombian brown, and every evening I’d smile and nod like a good addict and my connection would hook me up. Maybe their compassion came from pragmatism rather than sympathy (after all, they wouldn’t want a Folgers deprived maniac limping around their halls, stealing Maxwell House from patient’s dinner trays), but I didn’t care as long as I got my fix.

For the mornings? Let’s just say “Thank God for text messaging,” and leave it at that. Even my wife, a drill sergeant when it came to everything else thrombosis related, knew better than to deny me coffee.

On Day 2, my personal physician came a’ calling, he who had one week earlier delivered my clean bill of health with much surprise and great rejoicing. “See what happens when you visit the doctor like you’re supposed to?” he said. I warned him not to expect to see me in his office again anytime soon, and we got down to business.

He confirmed the ER’s diagnosis of a blood clot, but seemed skeptical of its location.

“What’s the difference?” I asked. He explained that a deep vein thrombosis, if that’s what I had, was more serious than a clot in a superficial vein.

I asked how I would know if the clot –regardless of its variety- dislodged. Doc smiled and said, “Dropping dead would be the first sign.”

Okay.

He skimmed through the pages on my chart, his frown deepening with every flip. When he finished reading, he announced his intention to change my treatment regimen. No more shots in the stomach, he said. If I could have walked, I’d have crossed the room and kissed him full on the mouth. I settled for a small round of applause.

He also told me he was bringing in a vascular specialist to examine my leg again, and a hematologist to test for any rare and exotic conditions that might have caused the clot to form. I reminded him of my seemingly worthless Multiphasic tests, but he said the hematologist’s screening would be more thorough.

He failed to mention the amount of blood necessary to complete these tests.

Later that afternoon, a pair of phlebotomists appeared at my bedside, carrying a plastic tackle box filled with specimen tubes. The man was younger than my sons; the woman was probably my age. While the woman pulled a twelve-pack of empties from her tackle box, the kid examined my arms, both of which now sported active IVs (another omission from my doctor: the price I paid for a needle-free belly).

“How about here?” he asked his partner, indicating a spot on the back of my hand.

“That ought to work,” she said.

“Time out,” said the fat guy with the clot in his leg. I’d been a pretty good sport so far (not really), but here was my line in the sand. There were already plenty of holes in my arms; let them re-use one of those, rather than drilling fresh ones. And, it quickly became obvious the kid was a student, inexperienced in drawing blood from big babies masquerading as mature adults.

This young man had the delicate touch of an Ax Man, digging around my circulatory system like a plumber trying to clear a recalcitrant drain trap. My eyes were closed, so I had no idea how many liters he’d drained when he suddenly said, “Oops.”

Oops is not a word you want to hear when a teenager is attempting to reenact the Crucifixion in a semi-private hospital room.

“It stopped,” he said.

My eyes opened, I turned my head and screamed, “Of course it stopped! Y’all are gonna have to come back later after I have a chance to refill.”

Mercifully, the woman shooed her protégé out of the room with instructions to tap the veins of some unsuspecting, unconscious senior citizen, and topped off my keg herself.

Now, while I understand the need for real-world experience in an educational situation, I don’t like trainees touching my Big Macs. I’m OK with the occasional newbie-prepared French fries, but if you’re touching me with something sharp, you’d better have a diploma hanging on an office wall and some serious malpractice insurance.

Eventually, the senior Cullen finished her exsanguination and pranced away to deliver my offering to the rest of her Clan. Except for a quick visit from the vascular specialist who promised a new round of sonograms the following day, I was left alone in my captivity for the rest of the afternoon.

And through it all, my leg continued to throb in agony and the red racing stripe threatened to expand into an all-encompassing paint job.

But Then Again, You’ll Have This . . .

To be continued