This Ambulance Sucks… Not!

Second in a series. Click here for an index of all of the articles in this series.

This health crisis began with an ordinary viral head cold. I first noticed it the evening of Thursday, December 1. It was a scratchy feeling in the back of my throat and the soft palate on the right side of my throat. Throughout the night and into the next day I could feel it migrate from one side of my throat to the other and then up into my sinuses. Usually I’m very aggressive in treating any kind of cold because my lungs are easily susceptible to pneumonia. For most people if it’s obviously a virus, doctors recommend you do not use antibiotics because over prescription can be dangerous. But my doctor has always made it clear we need to be aggressive in preventing pneumonia.

In this particular instance I really didn’t think it was necessary. I didn’t feel any congestion in my lungs at all. I had no sign of a fever. It just didn’t seem necessary to treat it at this point. I have some antibiotics that I keep on hand. I keep them handy in case of one of my recurring urinary infections pops up on a weekend when I can’t get to the doctor. I knew that I had that option as well as an immediate care facility in Speedway that I had used on weekends on a couple of other occasions. So I just wasn’t very worried about the whole thing.

Friday afternoon the drainage from my sinuses was getting a little bit excessive and I was also having some unrelated intestinal issues so I decided to go to bed in the middle of the afternoon to take care of my breathing and to be ready to use the bedpan at a moments notice. I wasn’t having any difficulty breathing. I did not put on my CPAP or oxygen until my usual bedtime around 11 PM. But for some reason I just couldn’t sleep Friday night. That happens occasionally and I don’t know why. Sometimes my brain gets to moving so fast I just can’t turn it off at night. I was wide awake until the early hours of the morning so I told my dad to cancel the home health aide who was scheduled to come in at 10 AM. I finally got to sleep around 6 AM and slept until nearly 1 PM Saturday afternoon.

Dad got me up and dressed and I started working on preparing the message for the inside of my Christmas cards. I had already had the outside of the cards printed at VistaPrint.com and I typically print custom inside messages on my laser printer. I also did some tinkering with my 3D printer making some little gifts I planned to give for Christmas.

The drainage from my sinuses started to make me feel a little congested in the throat. Because I use voice control on my computer I decided I needed to stop talking and relax a little bit. I went in the living room and turned on the TV and reclined my wheelchair slightly to help ease my breathing. That usually does the trick whenever I start to feel congested. The reclining wheelchair is new since April. Reclining has always helped in the past but this time it wasn’t working.

Dad was getting ready to cook himself some supper but I interrupted him and said I needed to lay down. Laying flat on my back always helps my breathing. That way I’m not fighting gravity to try to cough up any congestion. I could tell immediately however that this wasn’t helping as much as usual. I put on my CPAP as soon as he got me undressed. I rarely ever do that under such circumstances but I really felt I needed it. It was like my windpipe or bronchial tubes were having some sort of spasms and trying to close up. I was having difficulty getting my lungs to inflate and I was sure that the CPAP would do the trick

The breathing difficulty would come and go in spurts. Sometimes it felt like I was breathing fine. Other times it felt like everything was closing up and spasming. This was definitely an unusual experience. I finally called dad again interrupting his dinner and saying we needed to call 911. I simply could not get my lungs inflated properly.

Firefighter paramedics arrived first and the ambulance shortly thereafter. They picked me up by grabbing the contour sheet off my bed with me wrapped up in it and transferred me to the gurney. They put a mask over my nose and started blowing a high rate of oxygen into me very hard. Much harder than my CPAP pressure. It was still barely enough to keep me breathing well. My oxygenation level was good but I was panting and only breathing with a small portion of my upper lungs.

We headed off to St. Vincent at non-emergency speed which was okay. I was getting by okay and I had the ambulance EMT there if things got worse. Dad would follow in our van and meet me there.

Because of my usual swallowing difficulty I needed to spit the congestion and ordinary saliva from my mouth. I asked the EMT if he had a suction tube and he reached over to the wall and grabbed a Yankauer. He couldn’t get the suction to work. He reached to the other side of the ambulance for another device and it didn’t work either. He said the ambulance was brand-new and they had probably never used the suction devices. Somebody had failed to test them. He had a portable suctioning device that he quickly hooked up and was able to clear my mouth.

There is a ground-level entrance to St. Vincent ER where anyone can drive up and unload but ambulances go down a steep ramp to an underground ambulance bay that is great because it allows you to unload despite the weather. Once inside have to go up elevator to get to the ER.

St. Vincent ER is the only ER I’ve ever been in. They put you in a small enclosed room that looks nothing like the ER facilities you see on TV or movies. On TV it’s always a big open bay with nothing but a curtain between patients or the exam rooms have lots of windows that allow patients to see through to the next bay which allows for all sorts of dramatic TV interactions. I always wondered if other real ERs had that open layout like they do on TV or if that was just to make the stories more interesting or easier to tell. An ER TV show or movie shot in a room like St. Vincent’s ER certainly would not be as interesting. Then again this was not a trauma room so that might be different.

I don’t remember a lot of details of what we did in the ER that night. They put me on a BiPAP machine which is sort of like the CPAP that I use to help me sleep. CPAP provides constant positive air pressure hence the name. A BiPAP is a bilevel CPAP that supposedly senses when you are trying to breathe in and out. He gives you high-pressure on inhale and then lowers the pressure on exhale. For some reason that never works very well for me. I like to let the high-pressure fill my lungs and then squeeze out the air against that pressure so that my lungs deflate slowly. When wearing a BiPAP, the pressure drops quickly and I exhale too quickly. On this particular occasion I was having so much difficulty inhaling it seemed like the BiPAP was not sensing that I was attempting to inhale. That meant it wouldn’t kick in that high-pressure like I needed to do.

Dad had brought my CPAP and the mask that I use at some point, I don’t recall if it was in the ER or he was in the ICU later, but I got them to use my nasal pillow mask rather than the full face mask they had been using. That helped a little bit but not much. As I mentioned before my respiratory distress seemed to come and go in waves. Sometimes I could breathe almost normally. Other times I was in serious distress.

At one point they took a chest x-ray and said that I had no sign of pneumonia. That surprised me considering how much difficulty I was having breathing. But really it did not feel like congestion as much as it did spasms in my windpipe and bronchial tubes. When I would try to inhale I would make a loud rasping sound. It wasn’t until a couple of days later that we discovered I was having some sort of vocal cord dysfunction. My vocal cords were slamming shut and that was restricting my breathing.

I seem to recall being transferred to the ICU sometime around 11 or midnight. Dad had brought not only my CPAP and mask but my special nurse call button that I’ve been using for many years. I’m estimating it was perhaps 30 years ago I was at St. Vincent and could not operate their call button. The biomedical engineer built one for me after I told him the type of microswitch that I could operate. He just told us when you leave the hospital, take it with you and anytime you come back bring it again. We been doing that nearly 30 years now. More on that later.

Because my primary doctor is part of the St. Vincent network and because I been in St. Vincent Hospital on several occasions they already have my medical history and all the necessary information so there wasn’t the usual long patient history to be taken. Dad left and most of the doctors wandered out it was just me and my primary nurse in the room. It was at that point that she told me we went through the questionnaire. A series of questions I had never been asked before.

To be continued not in the next post but in this following one

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