Tag: Gainesville

“Get to the choppa!”

You may have just read the blog post’s title in the voice of Arnold Schwarzenegger from the movie Predator: “Get to the choppa!” If so, that was my intention. Unfortunately, this post is my first in over a week. But, no, that fact does not mean I have floundered yet again with my blogging efforts. Once more, illness hospitalized me. Fortunately, this visit was of a shorter duration than even my November 2021 visit. Would you like to know what happened? Of course, you do, or else you would not be reading.

Who opened the main valve?

Well, where do I begin? I might as well relate it to atheistic cosmology. First, there was nothing, and then there was a big (wet) bang. Suddenly my universe materialized in the form of dysentery. Naturally, that is not the kind of start to any pleasant cosmology. The bottom line, which is not a pun when you have an ileostomy, was that I could not replace my output with sufficient input. Even the water I drank made a hasty exit through the esophageal sphincter. I dehydrated within a matter of hours to the point that my kidneys were noticeably affected. I knew I was in a losing battle and asked for transport to the local ER. I’ve mentioned before that my small town’s hospital is competent enough to realize their incapability to handle specific medical issues properly. Hence, they often provide transport to the larger hospitals in our region.

Wasn’t Future Shock a Herbie Hancock album?

I know that I should have just made the drive to the large hospital in the city “over the mountain” from my home. But I felt miserable. I was weak as water and could hardly even stand. My thoughts were that my wait time at the local ER would be less and that the local hospital could help me bypass the very long wait time I would have experienced at the larger hospital. In the interim, they could start me on IV fluids. Little did I know that my body was going into shock. My blood pressure and heart rate were unusually low. Since my lost year, my blood pressure has been lower, but my heart rate still reflected my tachycardia. But now, my heart rate dropped into the upper 30s to lower 40s a minute. So the medicine of choice was Levophed.

A quick rise is not always the best outcome.

I reacted badly to the medication even at a lower dose than is typically administered. However, upon reflection, this is likely because the nurse put me into the Trendelenburg position. When the medicine began working, the high blood pressure made it feel like my heart was rapidly beating throughout my entire body. I was throbbing in my chest, neck, and head. Indeed, my blood pressure had risen to a systolic pressure near 200 mmHg! The nurse raised me to the Semi-Fowler’s position and cut the dosage of Levophed. Once again, I experienced the throbbing of my heart, necessitating yet another cut in the dosage amount. Luckily, the nurse found a happy medium.

“Get to the choppa!”

The ER doctor had previously noted the surgical drain that remained from draining my abdomen’s internal abscesses. He asked who had put it in, and I replied with the name of the larger hospital in Gainesville, Georgia. In addition, I had mentioned that one culture revealed C-diff and that I had been septic a year prior. As I now was a hot potato, the doctor would hand me off to the hospital that had placed my surgical drain. I had counted on this. But what I had not counted on was the unavailability of an ambulance until 8 AM. It was four in the morning. Given that I was rapidly deteriorating, the hospital decided to put me on the last available helicopter flight from Air Life Georgia. So, in a way, I was told, “get to the choppa.”

Interesting statistical data?

Blairsville is nothing more than a village from a statistical standpoint. The latest census estimates list 718 residents. However, if you zoom out a bit on Google Maps, you will note that Blairsville is the county seat of Union County, Georgia. Union County’s estimated 2020 census is 25,521. And to be honest, I don’t think that the 2020 census accurately reflects the population growth rate. COVID-19 saw the influx of people escaping the virus, tax tyrannies, and rising crime rates. Many of these began moving in after the government conducted the census. In addition, the local infrastructure shows the strain from increased vehicular traffic.

Up, up and away in my beautiful…helicopter.

After being loaded into the “choppa,” we took off for Gainesville. The paramedic advised me that there might be some turbulence as we had to fly over the mountains to reach our destination but that I should not worry unless I saw that they had begun panicking. The motions one experiences in a helicopter are different from that of a jet with its sudden increase in G’s as the aircraft’s nose, pointed to the sky, pierces the heavens. Instead, a helicopter has a gentle rocking motion as the aircraft achieves its lift. And the chopper gets buffeted by winds, as you might experience when driving your car on a blustery day.  

A city on a hill cannot be hid.

As I looked down at Blairsville, I was impressed by the many twinkling lights that pierced the darkness of rural Appalachia. Of course, you would not have thought you were looking upon a burg with less than 1,000 residents. But this takes us back to the county’s population, whose distribution in a report from 2010 is about 66 people per square mile. So, although I was not looking at a big metropolis, it looked impressive set against the darkness.

Bright Lights Bigger City

I looked out the window from the stretcher as the lights faded away. There was nothing but darkness as we traveled over the Chattahoochee National Forest. As we increased in elevation to traverse the mountains, we experienced the most turbulence. Cleveland, Georgia, in White County, appeared off in the distance and was noticeably larger than Blairsville, judging by the lights. Finally, we came upon many twinkling lights. It was Hall County and Gainesville. Gainesville is a city of about 42,000 within a county of approximately 207,000 residents. The lights grew progressively brighter as the buildings began emerging from the darkness. Finally, we came to a gentle stop in the hospital’s parking lot. A transfer to an ambulance standing by took me to the hospital entrance.

What was it?

I spent about a week in the hospital, with the first few days being spent in the ICU until they got my blood pressure and heart rate stabilized. Once on the floor, I spent a few more days awaiting a CT scan with contrast and the results thereof. As to the diagnosis of the big hospital? It was shock. Ah, but what kind of shock? Toxic? Septic? Hypovolemic? The doctors did not specify, but hypovolemic shock seems more fitting to my circumstances since dehydration was the precipitant. Yet, what triggered the initial vomiting and diarrhea that led to this diagnosis? My home health nurse informed me today that a stomach bug is going around. That bug may have been the cause. Or could it have been related to the C-diff grown from the cultures taken during my surgical drain placement? We’ll call that our “How-many-licks-does-it-take-to-get-to-the-center-of-a-Tootsie-Pop?” dilemma. In other words, “The world may never know.” Thank goodness Union General Hospital told me to “get to the choppa.”                        

The Lost Year

I call 2021 the lost year. Though I realize that the world continued suffering physically and financially from SARS-CoV-2, the year was extra tough on me. I had thought to relaunch my blog for the umpteenth time. And I posted as much in January of 2021. Little did I realize that I would lose four months of my life lying in a hospital bed and several months in rehab. Was it the dreaded COVID-19 virus? No, it was not. Instead, it was gastrointestinal; my small intestine became blocked and perforated in May 2021.

Emergency surgery…

Living in a smallish town, our hospital is good, but only for what it has the capability. Unfortunately, that capability does not include surgeons capable of doing intestinal surgeries. Thus, the hospital transfers such patients to either Gainesville, Georgia, or Chattanooga, Tennessee. I chose Erlanger in Chattanooga. I was in considerable pain when I arrived. Upon arrival, A team of nurses and doctors greeted me. They quickly prepped me and took me into the OR. Naturally, the details have remained hazy since they anesthetized me.

My loved ones tell me that the surgeon opened me up, removed a foot of the small intestine, and cleansed my abdominal cavity. However, a detail I have not yet disclosed is that I am an ileostomate due to a colon cancer diagnosis in 2010, which necessitated the removal of my entire colon. Thus, it wasn’t fecal matter that the surgeon removed but a substance better described as “chyme.” (The curious may learn more about chyme here.) Unfortunately, as a blockage preceded the perforation, there was much chyme that infiltrated my abdominal cavity. Nevertheless, the surgeon did his best to wash me out.  

Removing a foot of the small intestine also necessitated creating a new stoma site for my ileostomy. (It is higher than my previous stoma, so it has been an adjustment. My appliance now hangs higher on my abdomen. The top of my pouch touches a few inches beneath my “man underboob.”)  My new stoma is smaller than my previous one. I christened “him,” his preferred pronoun, as “Billy, II.” Yes, ileostomates have a peculiar habit of naming their stomas. I am not alone in this.

Everything seemed well…

Around June 10, 2021, my sister and brother-in-love visited me. I vaguely recall their visit now. My sister tells me that I seemed fine but became sleepy toward the end of her visit. I went to sleep and did not truly awaken for at least a month. Then, I developed sepsis, and my organs began shutting down. The prevailing opinion of the doctors tending to me was to allow me to die. They said I would have no quality of life. Death is not something my family or I wanted. As I could not advocate for myself at the time, my father stepped up and threatened to sue unless they put me on dialysis.

I slowly returned from the brink with dialysis and began improving, surprising the doctors and nurses. Unfortunately, I retain no knowledge of this time other than the weird hallucinations I believed to be my reality. (Now, those would be a fascinating story to share on another occasion.)  Suddenly, it was late July, and the nurses had me restrained in bed, and I could not speak. In their defense, I had pulled out my ventilator early on while in my stupor. So, they feared I would pull other things loose. A trach now allowed my use of the ventilator.

I no longer had a voice…

It is exceptionally frustrating to be unable to communicate with others. I admit now that it was something I took for granted. But, eventually, as I came to myself, the doctors and nurses loosened my restraints, and I could write messages on a whiteboard. By August, they had granted my freedom, and I could get their attention by banging on things, much to their irritation. At one point, I even threw a ball someone had given me. Typically my insistence resulted from having a trach that needed suctioning. I felt like I was drowning in phlegm and would die without assistance.

On August 12, 2021, Erlanger, now swamped with COVID-19 cases, transferred me to Landmark Hospital in Athens, Georgia. Landmark is a long-term acute care facility, the type of care center to which doctors typically send patients receiving prolonged mechanical ventilation. Landmark Hospital was different from any hospital I had ever been in before. It didn’t feel like a hospital. I met my new doctor, and the first thing he asked upon seeing me was, “Why do they still have you on this ventilator?” He managed to wean me off the ventilator in about two weeks. Around September 1, 2021, I was speaking and eating.

The final hurdle…

One challenge remained before I could go home. I had to be able to walk again. Physical therapists began visiting me to get me up and seat me in a chair. Unfortunately, the first time I stood up, my atrophied muscles made it feel like I was standing on someone else’s legs. I had essentially lost my sense of modesty by his time. Strangers had bathed me for months, and I felt numb to my self-consciousness. Typically I would have found that disturbing, but I was thankful since it helped me get past my final hurdle before I could return home, showering.

Per my luck, an attractive young woman would be the one in whose presence I would bathe. (I know they are used to it and pay no mind, but I would have preferred the fellow with whom I talked about Georgia Bulldog football and anime .) I got up out of bed and moved slowly and painfully toward the shower with a walker. I showered. The pretty young lass gasped at clumps of hair falling out as I shampooed my hair. But I passed the test. And the hospital arranged for my home health care.

Homecoming…

It was September 10, 2021, when I returned home. I somehow climbed the steps and collapsed into the first comfortable chair I found. With the help of physical and occupational therapists who came to the house, I walked without a walker or cane by November. But the fallout from my perforated intestine was not over. I had imaging done in November that revealed internal abscesses near my liver and left kidney. I spent two weeks in the hospital in Gainesville, Georgia, missing the Thanksgiving holiday. Doctors had to drain the abscesses and treat me with IV antibiotics.

That more or less brings us to the present day. Unfortunately, the details I have offered are not a comprehensive explanation of all I endured during my lost year. I will be going in a week from the time of this writing to have more “fluid-filled sacs” drained. Yet, I feel much better than I did. Of course, I still have a long way to go, but I will make it with God’s help.