Seventh in a series. Click here for an index of all of the articles in this series.
Why I Have an iPhone
I’ve never been a big fan of Apple products. I always thought it was ridiculous that people would stand in line for hours to get the newest iPhone when they already had the previous model in their pocket. Why not just order the thing in the comfort of your home and wait for UPS or FedEx to deliver it. I’ve been very loyal to brands like HP printers, Gateway 2000 and Dell Computers but nothing like the fanaticism of Apple fans. Back in the day I had an Apple ] [ but I only had one because I thought it would give me more programming jobs. I never have owned a Mac of any kind. I’ve always been an MS-DOS and Windows and Intel-based PC kind of guy.
Many years ago I took a chance and bought an iPod touch version 1. It’s sort of like an iPhone without the phone. It was a touchscreen device for playing video, games, Internet access using Wi-Fi. I had a lot of fun with it and later upgraded to the iPod touch 4. However eventually the newer versions of iOS would not work with the iPod touch 4. I hated to buy a touch 5 at the time when the latest iPhone was a 6. I kept thinking they would come out with an iPod touch 6 but they never did. At one point I did a Google search for “Android alternative to iPod touch”. The recommendation was to buy a cheap android phone and don’t activate it. A few years ago I did just that. I purchased a Motorola Moto G android phone and did not activate it. I just used it like an iPod and was really happy with it.
Eventually I discovered a cell phone company called “Ting” which has a really cheap pay-as-you-go plan. You start with nine dollars per month. You get up to 100 minutes of talk for an additional three dollars per month. You get up to 100 MB data for additional three dollars per month. And you get an additional 100 text messages for three dollars per month. In most months I would need no data because I’m always at home on Wi-Fi. Also I don’t very often use text messaging. That means for $9+ $3 per month I could make a few phone calls and that would be it. Worst case scenario it was $9+$3+$3+$3=$15 per month if I talked, texted, and used some data. I couldn’t pass up that kind of deal.
I had no intention of going back to Apple or iPhone even if they did ever come out with another iPod touch. But then I discovered something amazing available in iOS. It was an but accessibility feature called “switch control”. Basically allows you to use a Bluetooth device with a couple of pushbuttons to have complete access to the phone without having to use the touchscreen. Although Android has a similar feature, it is so limited that it is basically useless. Here’s an article and a YouTube video that I created that shows how it works on my nephew’s iPad 2. It’s a little easier to see on a big screen like that than to demonstrate it on an iPhone.
When I was no longer able to use the touchscreen because my disability was getting worse, I absolutely had to switch to iPhone. I ended up getting an iPhone 6 and I was able to activate it using my existing inexpensive Ting plan. Of course I had to pay full price for the iPhone up front which was about $675 but all of you who are buying your phones on contract are paying that much for them anyway. You’re just spreading it out over a two-year contract.
I can’t really do everything with the iPhone that I used to be able to do with my old Android device actually using the touchscreen. I miss playing some of the games like Zuma, Where’s My Water, and at one time I was admittedly an Angry Birds addict. But for practical things like Facebook, IMDb, messaging etc. it’s been great to have full access to the iPhone. But I never thought that the phone would be such an essential item until I started using it in the hospital on December 5.
I normally keep my iPhone mounted on a metal bracket that attaches to a swingarm on my left arm rest. On the back of the bracket is a battery pack that I call a Printy-Boost that I designed for the Adafruit Learning System. And next to it is my “Ultimate Remote” which serves not only as a universal TV remote but as a Bluetooth device for operating the iPhone.
When dad brought the iPhone, we put it on one of those hospital bed trays that you can roll around and it extends out over the bed. We propped it up on its side but we needed something in back of it to hold it up. The nurses had brought in a pump to give me my G-tube feedings but for some reason somebody brought in two of them. We used the spare pump to prop up the phone. It was probably a $1000 piece of equipment we were using like a brick 🙂
Then we put the pushbuttons in my right hand and I called up the “Notes” app on the phone where I could type messages. Then the doctors or nurses or my family could look at the phone and read the messages. It’s interesting that all messages typed in the “Notes” app get archived in the iCloud. I’ve never thought I had much use for iCloud or Microsoft cloud or any other kind of cloud storage. But in the long run I was glad it did archive them. Even if you delete the messages, they remain in your trashcan for 30 days. So about 15 days into this endeavor, I decided that that was an excellent record of some of the things I had been through. I copied everything out of the trashcan into a special folder called “deleted messages”. Now as I write this blog I can go back and see every message that I wrote to the doctors, nurses etc. All the messages are dated however it doesn’t appear to have a timestamp or at least not one that I can find.
The first message that I typed on the iPhone was “Raise head”. Not exactly “Come here Mr. Watson I need you” or “What hath God wrought?” But it was a very practical first message. I couldn’t see the phone very well with the head of the bed lying flat. The next several messages were much more significant. They were notes that I wrote for the doctors and the nurses to try to explain some issues that I was having.
Avoiding the Trach
The next note that I typed on my iPhone gives a lot of insight into what I was worried about at that particular moment. I knew from experience with my mom that you can only be on a ventilator via an intubation tube about a week or so. Even though I had only been on this one a couple of days, I was already thinking way ahead. I wanted to make sure that I was not on the vent so long that they eventually had to do a tracheostomy. I was worried that I wasn’t getting the congestion cleared quickly enough. The ventilator tube had a built in suctioning device that they could stick down the inside of it and suck the gunk out of my lungs. They had done it once or twice in the beginning and it was extremely uncomfortable but it helped a lot. I was concerned they weren’t doing it enough. When I would spit into the Yankaur, all they were getting was spit and sinus drainage. I wasn’t coughing up anything and spitting out of my mouth. Here was the message…
Message to doctor
My breathing is good on vent but congestion is no better for the past 24 hours. Oral suction is getting saliva and sinus drainage only. I hate suctioning from vent but I’m willing,and requesting frequent vent suction because I think that it’s the only way I can get better. I want to know how long I can keep vent before I need trac. I want to avoid trac unless 100% necessary so I want to treat aggressively to avoid it. Tell nurse to tell doctor.
My next message was for the nurses to explain a little bit of a change procedure for using the message board. It read…
Message for nurse
I am only using the phone for long messages. Continue using paper for quick message about what I need. When I make click noise it means I want to use message board. You point at row. My eyebrows =yes. I twitch mouth= no. You point to each letter. I click to select.
Please explain this to next nurse at shift change.
This explains that rather than going letter by letter to the entire alphabet, we had determined it was easier to figure out which row the letter I wanted was in and then after picking the proper row going across the row and picking the letter. With the shift changing every 12 hours I needed to train a new nurse with all my signals and procedures. So I wanted to make sure that they didn’t just pass on my medical information but that they also pass on how to communicate with me.
Sometime after I wrote these messages the doctors must have come in and read the first one addressed to them. While they answered my question saying that I could be on vent for many, many days without having to get a trach, they didn’t get my point that I wanted to aggressive suctioning through the vent so that when I came off of it I would not have to go right back on or I would not have to go to the trach. The suctioning worked to clear my lungs but they weren’t doing it often enough. They kept coming in and giving me breathing treatments but they weren’t doing anything to clear the congestion. Apparently they were talking about taking me off the vent very soon. I wanted to be much better before they did even though I was anxious to be off of it. They seemed impressed that I wasn’t rely on the ventilator to breathe. There I was essentially breathing all my own even though I was connected to the machine. They were also impressed that my oxygen saturation level was consistently in the upper 90s. All that is great but if we don’t get the gunk out my lungs we are going to be in trouble again very soon. I wrote to them…
New message for doctor
They not understand my first message. I am certain that I can breathe okay if they removed vent right now but I am very certain I can’t cough up congestion if the vent is removed. That is why I requested that they suction through the vent. I understand that it would be easier to suction though a Trac but why cut a hole in throat if we haven’t tried suction thru the vent? The respiratory therapist have given me many treatments but not any vent suction in well over 24 hours. Please have nurse call doctor and read this message word for word.
This really illustrates one of the most frustrating parts about using the iPhone to communicate. It looked to me like they were skip reading what I wrote. They would just glance at it to get the gist of what I was trying to say. It took a lot of effort to type out a paragraph of text like this and I made every word count. This happened multiple times. I kind of felt like an ass telling them to “read it word for word” but it was obvious that they were not.
This type of aggressive most argumentative discussion with doctors is normal for me but had been impossible when all I could use was the message board. The iPhone really got me back in my game and got me actively involved in my own healthcare decisions. However in a few days those decisions would become so complicated that even the iPhone messaging system wasn’t enough. But for the time being I was extremely happy to be able to communicate more than a word or two.
Most of the messages were things like how to move my arm or leg to get more comfortable. A reminder to dad and Carol that if they saw the nurse move me around, to make sure that I got my call button back in my hand. One problem about using the iPhone was that I could either hold the iPhone buttons or the nurse call button but not both. So the plan was that anytime dad or Carol was with me, I would have the phone in front of me and if I needed the nurse they could call for me. But once Carol left at about 7 PM, she had to take the phone away and make sure that I had the nurse call button. I would not get back on the phone again until dad arrived in the morning.
One of the last messages on December 5 was to tell them to leave the TV on ESPN so I could watch the Colts game.
I did finally get the respiratory therapists to do more suctioning to get the gunk out of my lungs every time they came in every six hours to do a breathing treatment. It seemed to help. The plan was that I would probably be extubated and get of the vent tomorrow (the 6th).
There were absolutely no archived notes for December 6th. That’s because they did indeed pull the tube early that morning and I was able to talk normally all day.
To be continued…