The Transition

Fourteenth and the last in a series. Click here for an index of all of the articles in this series.

No More Cloud

In our previous installment I had an emotional meltdown over by inability to talk with the trach. I was facing a wide variety of issues that need to be resolved. Not being able to talk and to participate in the decisions was a real mess for me. When I finally got the talking valve late in the afternoon of December 12, I still had lots of issues to deal with but at least I could now actively participate in those decisions. It’s hard to say that there was any advantage to not being able to talk but the fact that we had to type everything on my iPhone into the Notes app did give me an archived record of everything that I had typed. All of the messages were saved in my iCloud account. Even though I deleted them, they remained in the “recently deleted” folder for 30 days. When I had realized what a resource those messages were for piecing together this blog, I restored all those recently deleted items into a folder called “formerly deleted” and I’ve used those messages to help piece together the story. Put that together with my Facebook posts and I had a pretty accurate blow-by-blow picture of what I had been through. Now that I was talking, there was no more permanent record in the cloud. It’s taken me so long to get to this point of writing the blog that it’s more than three months later so my memory is a little bit fuzzy on details.

Outstanding Issues

Even though I didn’t have the benefit of an iCloud archive, I did seem to have a lot of clouds hanging over me with all the issues that needed to be resolved. Once the valve was in and I could speak I could begin dealing with issues one by one. I suppose the biggest issue was if I was going to need a ventilator to replace my CPAP so that I could sleep. I had proven many times in recent years that I simply could not sleep without a CPAP. For example if there was a thunderstorm and our power was out overnight, I had a backup oxygen tank to replace my oxygen concentrator but I had no way to operate the CPAP without power. Despite my best efforts to sleep under those circumstances I could not do it at all.

On the morning of the 13th I got off of the ventilator and put in the talking valve. Sometime during that day I tried to take a nap without any mechanical assistance. Much to my surprise I was able to doze off for about a half-hour or 45 minutes without the ventilator or a CPAP. That was very surprising. However the experience did tell me that I wasn’t sleeping well enough to really sleep through the night. I explained that to the doctors and they all agreed that yes I did need a ventilator at night to replace the CPAP. They begin to understand that I have been using the CPAP not only to open my upper airway but to assist with keeping my lungs inflated. So then we had to go about the process of getting the ventilator for my home.

There was a woman who was my case manager. It was her job to get whatever I needed to get me home. As I mentioned previously however, the process of getting an in-home ventilator was theoretically going to take a full two weeks. At first I thought the delay was because it took that long to get some sort of Medicare or Medicaid approval. Actually that part was relatively easy. It was just logistics of finding the right durable medical equipment provider and jumping through a bunch of hoops necessary to get the equipment. Among the things they wanted to do was to inspect my house electrical system to see if it was sufficient to handle the equipment. It turns out this was a totally ridiculous requirement. The ventilator doesn’t require any special electrical capability. It probably uses no more current than an ordinary CPAP machine. The problem is that once you say the word “ventilator” it raises the image of someone who is dependent on the thing to stay alive. The image is of a person who will die within minutes if the ventilator fails. It turns out that this ventilator has a battery backup that is good for several hours so even if I was in a life critical situation, electrical failure wouldn’t be fatal. In my case I’m NOT in a life critical situation. In fact I’m less dependent upon the ventilator than I was on the CPAP. However none of that mattered. We still had to jump through all the hoops.

The case manager was initially talking about using a company called Apria Homecare which is one of the biggest equipment providers in the area. Years ago I had got my oxygen equipment from them but they were a little bit difficult to deal with and we ended up changing to a different company. I was willing to go with them despite my previous bad experience so I didn’t say anything against them. Then the case manager came back and said she was going to try a different company that was an independent small company run by a respiratory therapist. I forget the name of the company. I like that idea because I had recently changed to a different home health aide agency that was a relatively small organization. I had felt like I was getting more hands-on attention from a small group that I had with the larger company in the past. So the idea of a small operation for the ventilator provider was attractive to me. Unfortunately somewhere along the way she came back to tell me that we cannot use either of them because different durable medical equipment companies have contracts with Medicaid to cover certain geographic areas. It turns out that I had to use Home Health Depot because they had the Medicaid contract. But we didn’t find that out for a couple of days. That delayed the entire process even further.

The next issue to deal with was that I wasn’t sick enough to be in the ICU and I could not be transferred to a regular room because they don’t allow ventilators on regular medical floors of the hospital. So the alternative was to transfer me to a long-term critical care hospital also known as St. Vincent Seton Specialty Hospital named after St. Elizabeth Ann Seton. She was the founder of the Daughters of Charity of St. Vincent de Paul. They have founded a number of institutions including the St. Vincent Healthcare System. Seton Specialty Hospital was just a couple blocks away on Township Line Road. So we began making arrangements to have been transferred there. It would probably happen on Wednesday the 14th. I asked the doctors directly “If I had all the medical equipment that I needed at home, when do you think I would be medically ready to go home?” The doctor said perhaps two or three days. So that meant I was going to spend 9 or 10 days in this other hospital unnecessarily just because we could not get the logistics of getting me a ventilator at home.

And people wonder why healthcare is so expensive.

The final issue I needed to wrestle with was that I now had a urinary Foley catheter stuck in my stomach instead of a proper G-tube. I made it clear to anyone who would listen that I wanted this issue resolved. I came into the hospital with a proper G-tube that had the proper kind of valve on the end of it. I intended to leave there with the same kind of G-tube. I wanted someone experienced in replacing the tubes. If we had to go down to the radiology department to use x-ray assistance then that was okay with me. In fact I would prefer it. That’s how they’d put the tube in to begin with. We had tried 2 different sets of incompetent surgical residents who couldn’t seem to get a tube in properly. They finally agreed that on the morning of Wednesday the 14th they would take me to the radiology department and replace the Foley with a real G-tube.

Other Loose Ends

In addition to dealing with the case manager, I spent a fair amount of time with the young resident Dr. Heaven. She had really appreciated my emotional state when I was demanding the valve and was instrumental in getting everybody to agree to it. One of the questions I had for her was where was the medical student Brady who had sort of been my other go to guy when trying to resolve problems. She explained that he had taken a few days off to study for his residency exams and then would be taking exams. I was disappointed that I wasn’t going to get to see him again before I left for the other hospital. Fortunately I did reconnect with him later. After I got home, I got an email from him saying that he had found my blog. We swapped a couple of emails and became Facebook friends. He has been following this blog with great interest. By the way he passed his residency exams and was accepted into a residency program in a military hospital in California. He was really looking forward to it. He had been in the military previously.

Sometime on the 13th or the 14th before I left St. Vincent, I had my second conversation with the nursing supervisor about the way I had been treated and my wishes being disrespected while I was unable to speak. I had already recounted that story in previous installments but this is when that second conversation actually occurred.

 

The Most Interesting Doctor in the World

On the morning of the 14th they took me down to the radiology department to finally replace the Foley with a proper G-tube. They rolled me down to a waiting area that I was familiar with. This was my third trip to that particular department. The first was one time in 2006 when I was in for my intestinal problems. They had inserted a central line in my carotid artery. The other time was last May when I had the G-tube the first time. After a brief wait the doctor arrived. The instant I saw him I thought to myself “I bet the ladies around here are going absolutely nuts over this guy.” He looks like the kind of doctor that you would see on a medical TV show and could’ve easily replaced Patrick Dempsey on Grey’s Anatomy and be given the title “Dr. McDreamy”. He was Hispanic at about 5’10”. He had black hair and a short neatly trimmed black beard and mustache. It was so precisely shaped it almost looked like it had been cut out of black felt or velvet and been glued onto his face. He had on scrubs for pants but he was wearing a tight fitting “UA” brand athletic shirt made of some slick material with lots of tiny holes poked in it. His upper arms were massive it looked like he worked out in the gym eight hours a day or something. In some ways I thought of him like a 35-year-old version of the Dos Equis “World’s Most Interesting Man”.

I will fast-forward till after the procedure when I asked a couple of the nurses if he was really popular and if the nurses had a crush on him. They told me that they probably would have except that he already had a very hot looking wife and a couple of gorgeous young children. That didn’t surprise me at all. I jokingly described him to one of the nurses as “He’s hot enough to turn a straight man gay”. One of the nurses came back with “Or to turn a lesbian woman straight.” We all got a big laugh out of all that. Disclaimer: I don’t really think you can turn someone gay or straight. It’s not a choice. People are wired gay or straight. We were just making a joke about what a hunk this guy was.

Anyway he questioned me why I wanted the tube changed. I explained “Look there are two different kinds of tubes. There are Foley catheters for your bladder and there are G-tubes for your abdomen. They wouldn’t have invented two different kinds of tubes if they didn’t really have a difference to them. I’ve been using a G-tube with a valve on the end of it ever since May and it works out really well for me. The Foley just has a cap with no valve. The stupid surgical residents couldn’t get a regular G-tube put back in. I don’t know what they were doing wrong but it hurt like hell. You need to numb me up so it doesn’t hurt, use the x-ray as a guide, and put in the right kind of tube.” He said okay as if he appreciated the guy who knew what he wanted and wasn’t going to take no for an answer. They wheeled me into the procedure room which was also a very familiar place from my two previous experiences. A couple of shots of lidocaine took care of any pain and the tube was replaced in no time.

I thought that that was the end of it until someone got to looking at the tube and there was speculation that they had put the wrong kind in. A traditional G-tube goes a short distance into your stomach and is used for people like me who have swallowing difficulties. However if part of your problem is digestive, there is a different kind of tube called a J-tube that extends down into your intestine. There is also a combination G-tube and J-tube that is a two-in-one device. Because the valve on the end of this new tube had 2 ports on it, some of the people who looked at it thought that it was perhaps one of these combo tubes. We didn’t do anything about it at St. Vincent but the issue got raised later in the day when I was transferred to Seton. They thought perhaps the people at Seton were going to have to replace it again. As it turned out it was not a combo tube. It was just a regular G-tube with 2 ports. It did not need replacing again and the tube has worked flawlessly ever since then.

The rest of the afternoon was sort of a “hurry up and wait” situation. I was going to travel by ambulance from St. Vincent ICU to St. Vincent Seton Specially Hospital but we didn’t know exactly what time it would be. I was one of 2 patients who were going to make the same trip. Of course it always takes a lot of paperwork to discharge someone. Transferring them to a different hospital is no exception. And to have 2 patients from the same department making the same trip also kept the nurses very busy. Eventually it was my turn. They loaded me onto a gurney and wrapped me up in a bunch of blankets. The ambulance trip took only five minutes or so. Getting in and out took longer than that. My notes tell me that I posted on Facebook at 5:19 PM that I was settled in to room 207 of St. Vincent Seton Specially Hospital.

Final Thoughts

That essentially wraps up the story of “The Man with No Voice”. It was most definitely the most emotional and stressful hospital experience I’ve ever had. The repercussions of it will carry well into the rest of my life. However I think the story of my adventure at Seton is sufficiently different that it is a story unto itself. It’s not nearly as dramatic and there will not be as much detail to talk about. I will get to work on writing it very soon. The brief story is that I spent from the afternoon of December 14th until December 28 at Seton. It did take exactly 2 weeks to get the ventilator ready for me to go home. If not for the logistical nightmare, I could have been back home within a few days.

I still am amazed at how differently I was treated when I couldn’t talk. I’m still a bit haunted by the fact that there are many, many people who face these challenges every single day of their life. I struggled with it for a little more than a week and it nearly drove me nuts. I spoke of the surprising level of commitment and support from my friends in the maker community especially those at Adafruit Industries. One of the consequences of this experience was that I was recommitting myself to developing assistive technology not just for myself but for other people. For example for months I had promised to write a tutorial about how to do switch control using an Adafruit Bluetooth device and an iOS device such as iPhone or iPad. One of the very first things I did once I had settled back in at home was to finish that tutorial. I’ve also connected with another group called ATmakers.org which is run by a man named Bill Binko. His organization is working with high school STEM programs to encourage kids to use their science, technology, engineering, and math skills to assist disabled people with their assistive technology needs. I now have a very deep commitment to make sure that everything I know about assistive technology gets passed on to other people who can make use of it. The folks at Adafruit have also taken up assistive technology as one of their pet projects. They are working with me and Bill to develop new devices that will be of use to the AT community. Now that I have my voice back, I’m using as much of it as I can to give voices to others who have no voice.

You can click here to read my other series titled “Holiday Hospital” about my experiences recovering over Christmas at the other hospital.

The Meltdown

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

Wrapping Up a Good Day

In our previous installment I talked about a Facebook posting I had made on the afternoon of December 11 which was very upbeat. It was just a few hours later however that everything fell apart. A series of unfortunate circumstances came at me rapid fire and led me on a downward emotional spiral that was the worst of the entire hospital experience.

The 11th was a really good day. I had been off of the ventilator most of the day. Dad had brought in my laptop because I thought perhaps I could operate it using my ultimate remote Bluetooth device. It would’ve had a bigger screen than typing on my iPhone. As it turns out I discovered the on-screen keyboard built into Windows 10 wasn’t nearly as useful for switch control as was the iPhone. So I had dad pack up the laptop and told him via iPhone message that once I got that talking valve in and could use my voice control I would switch back to the laptop. I was just about to tell dad to switch the TV to AMC channel before he left so that I could watch The Walking Dead. Then things started going wrong.

My John Hurt Experience

In the classic 1979 sci-fi film “Alien“, the advertising tagline was “In space, no one can hear you scream.” The most memorable scene of course was when the character played by John Hurt suddenly starts having a convulsion and spitting up blood at the dinner table. His fellow astronauts swipe all of the food off of the table and lay him out. His stomach starts bulging and a small alien creature bursts through his abdomen spraying blood everywhere before scurrying off to the hidden recesses of the spaceship.

My experience fortunately wasn’t anywhere nearly as bad but I was put in a position where I had horrible pain in my belly and I couldn’t scream.

It started when I noticed something wet on my belly. I thought perhaps I had missed peeing in the urinal that I kept propped up between my legs. I asked dad to check the urinal. It was in the proper place but he soon noticed the cause of my unexpected wetness.

My G-tube had come out of my abdomen.

A G-Tube is a rubber tube that goes through a hole in my abdomen and sticks into my stomach for feeding. I had had one since the previous May because it became too difficult for me to swallow food normally. The G-tube is held in place by a small inflatable balloon on the inside that keeps it from pulling out. However if the balloon bursts, there is nothing holding it in place and it just pops out.

A couple of months earlier, we had accidentally gotten the tube tangled up in my covers and when I rolled over in bed, we yanked it out. We stuck it back in temporarily but had to go to the ER to get it replaced. Since then we had been very careful not to get the tube tangled up in anything.

Unfortunately one of the many consequences of not being able to speak was that I could not warn people if the tube was getting tangled up. Over the past several days there had been many times when it had been yanked upon pretty severely. At that point I wasn’t surprised that it came out. I was more surprised that it had stayed in that long. Usually the tube hangs out of me about 6 or 8 inches and we pump the formula into it using a large syringe. But in the hospital they had kept me connected to a pump machine with a long tube. On several occasions, one quite memorable, a respiratory therapist had gotten tangled up in it and it had gotten yanked. I hadn’t said anything to anyone because it seemed to be holding up.

So when Dad discovered that it had come out again I was frustrated but not worried. I don’t recall if we temporarily put the tube back in or what we did to keep me from leaking further. The bottom line was they sent for some surgical residents to come in and replace the G-tube. It had gone smoothly in the ER a few months ago when Dad and I had pulled it out. I didn’t expect any complications.

Unfortunately these residents didn’t seem to know what they were doing. I think they were using a larger diameter tube than I had used previously. They kept trying to jam it in but it wouldn’t fit. The pain was phenomenally bad! And the worst part was, I couldn’t even grunt or yell or do anything to let them know how much it hurt. It had been bad enough the past several days that I could not talk. Now I couldn’t even yell or moan when I was in excruciating pain. I felt like I was living in outer space and no one could hear me scream.

One group of residents gave up and another one came in later. They had decided that as a temporary measure they would insert a Foley catheter. Foley catheters are normally used for your bladder. However like a G-tube they are small rubber tubes with the balloon anchor on the end of them. Foley’s come in lots of different sizes and so they searched around to find a small gauge pediatric version hoping that it would go in the hole easier.

Unlike the G-tube however which has a valve on the end it makes it easy to fill, a Foley catheter just has a cap which you can close when not in use. I presumed this was just going to be a temporary fix until they could do it properly. Fortunately the Foley catheter went in much easier and painlessly. Well… not 100% painlessly because I was still pretty sore from the previous botched attempt. But things were okay for the time being.

To Sleep… Perchance to Dream

Dad had to leave before they got the Foley inserted but I told him he could go. I have an archived iPhone message where I told him to turn the TV on AMC channel so I could watch The Walking Dead and I told him to tell the nurse I was ready to get back on the ventilator. I was hopeful that I would not have any more personal drama for the evening and could just watch some good juicy zombie stuff on TV. Unfortunately there was more drama in my life to come that evening.

Since I had had the trach installed on December 7, I spent most of my time connected to a ventilator. The plan was to gradually wean me off of the ventilator and eventually install a device called a Passy-Muir valve that would allow me to talk normally. I had always presumed however that I would still need the ventilator at night in order to sleep. For 25-30 years I had been totally dependent on a CPAP machine in order to sleep at night. There was no way I could get comfortable and breathe well enough to get to sleep without some sort of respiratory support. When I had first agreed to the trach, I presumed possibly there was a way I could use it with my regular CPAP. I should’ve asked but I didn’t.

On the evening of the 11th when I was ready to get back on the ventilator so that I could go to sleep, the respiratory technician didn’t want to do it. He said that the goal was to get me off of the ventilator as much as possible.

I could not have been more blindsided. Nobody had ever indicated to me that I would be expected to be COMPLETELY off of the ventilator especially since I had been so dependent upon the CPAP. They tried to explain to me that the CPAP was designed to keep your upper airway open. It keeps your throat and upper airway from closing. When it closes it causes you to stop breathing. That is what they call sleep apnea. Because I had the trach, I would not be breathing through my mouth or nose anyway so theoretically I didn’t need the CPAP.

However even though I needed the CPAP to keep my upper airway open, I was also using it to assist me keeping my lungs inflated. In many ways I had been using the CPAP as if it was a ventilator. I needed it to get volume in my lungs. Of course trying to explain that in an iPhone message typed using switch control was nearly impossible. Here’s all I was able to say…

At home I’ve been on cpap for 30years
I I need it or I will never be able to sleep without it .
I don’t use cpap for snoring . I need it to keep my lungs inflated
We will figure this out tomorrow

In between each of those sentences lots of other people were saying lots of things and I couldn’t participate much in the discussion. The bottom line was they agreed to put me on the ventilator at least for one more night.

As if I didn’t have enough problems, sometime during the night that night, my nurse call switch quit working. Fortunately I did not need it much during the night. The nurses were in and out and I slept as best I could although my mind was racing and I was getting very furious and very upset. The inability to talk was just too much for me to handle. The pain from the botched G-tube insertion, the argument with the respiratory people over the ventilator, it just all was weighing down on me too much.

Planning to Leave

I don’t recall how well I slept at night and I don’t think it was very well. My mind was racing about all of the things going on. I had decided that I need to put my foot down and get on that talking valve right now. There were too many things going on that I needed to talk about. Amidst all this on the morning of the 12th we had a visit from a woman who was my case manager. It was her job to prepare me to get out of the hospital and to give me whatever support I needed once I got home.

I was getting well enough that I really didn’t belong in the ICU. However they have a rule that on a regular medical floor you’re not allowed to have a ventilator. So they could not move me from ICU to one of that regular floors. The alternative was to move me to a different hospital called St. Elizabeth Ann Seton. Actually the technical name is “St. Vincent Seton Specialty Hospital”. It’s located just a couple blocks down the street from the regular St. Vincent Hospital where I was. While I would’ve preferred to stay in regular St. Vincent, if the rule was there could be no ventilators on the regular floors I really didn’t have a choice.

We also discussed (or rather they all discussed in a way that I could not participate) the fact that I was going to need a ventilator when I got home. According to the case manager, the process of getting a home ventilator takes 2 weeks minimum! At first I presumed that delay was to get Medicare/Medicaid to approve the device. I thought that was insane. When I needed a CPAP they just called up a medical supply place and said “Get this guy a CPAP” and it was there in no time. I later discovered that the delay wasn’t necessarily the insurance issues. It was a whole complicated process where they have to come to your house and make sure that your electrical system is okay, train your family members to operate the equipment, the whole thing was a mess.

At one point I got a visit from Dr. Chad Davis. He had been the surgeon who had done my bowel resection back in 2006 as chronicled here

“Interesting Times”… In the Chinese sense of the words.


I really liked Dr. Davis as you can read in those previous articles. He was there to report on my G-tube situation. The previous night after they got the Foley catheter inserted in the G-tube hole, they had taken an x-ray to make sure that it was in the proper position. He had read the x-ray and came in to tell the nurse that it was okay to start using the Foley to feed me. The nurse looked at him like he was crazy. We had already heard the results of the x-ray and I had had 2 feedings already. The nurse said to him “This Foley is just temporary right?” Much to my surprise and disappointment he said “No… It will be okay. We can just leave it in.” My reaction runs “Like hell you will!”

The Ultimatum

This G-tube versus Foley situation only furthered my frustration that I could not discuss these issues. Decisions were being made with little or no input from me and that’s not the way I operate. I was depressed, angry, frustrated… there are not enough adjectives to describe what I was feeling. So I went about composing several messages. Here are the contents of those messages courtesy of my iCloud archives.

Here was a message I wrote to dad when he arrived the morning of the 12th…

?
News from over night
I took more laxative last night and it will kick in sometime today so be aware.
Surgeon says folly cath in stomach is not temporary but I want it replaced with proper kind

Here are series of messages that I wrote expressing my anger and frustration.

?
Note for doctors. Nurses, everyone,
I need to be able to talk. Too much going on and I can’t deal with it by phone! I’ve got to be able to talk as soon as possible! Everything else can be resolved once we get me TALKING!!
If you’re wondering “is he pissed off?” The answer is YES.
Sorry. I’m not blaming you or anyone. I just need to discuss too many issues that can’t be resolved by twitter-like messages.
Can we rig something temporary such as finger in hole just so I can discuss issues?

issues I need to discuss with doctors
I’ve already said I want to talk but if I can’t then I will have to type. I’m preparing multiple messages in case we can’t get me talking but these messages don’t fully address my concerns. That is why I want to talk.

Issue#1 cpap
I’ve been on cpap over 25yrs and experience says I’m totally unable to sleep without it. I’m aware its primary role is open upper airway but I feel I’m also using it to keep my lungs inflated. Its hard for me to believe that I could sleep without mechanical assistance. I feel that the cpap has been working as more of a vent and I’m dependent on it. I’m willing to try sleeping without vent or cpap but I’m highly skeptical. I hope to try it nap this afternoon but ironically I slept really well last night.

issue #2 vent
I did all afternoon yesterday but required multiple trach suctioning throughout the day. I’m doing well today but still need trach suction from time to time. Do you have concerns that my need to suction is still ongoing?

Issue #3 G-tube
Last night I believed that use folly was temporary but the surgeon Dr.Davis said it can stay. I’ve had him before and I like him but I don’t agree with hims this time. I really want a proper g-tube of appropriate length and diameter and with a valve like I had when I came in here. I’m willing to go down to radiology if needed. Last night surgery residents hurt like hell jabbing around blindly.

Issue #4plans
I’ve taking things one day at a time but I feel blinded by some of these issues (such no more cpap). I need it discussed completely so I’m prepared. After I began writing this the case manager came in and raised a dozen issues that had not yet been discussed. This is why I need to talk.

I think the main person who read all of these messages was the young female resident Dr. Heaven. She took the time to read the messages and she understood that I was really serious about all these issues. The nurses were also well aware that my whole attitude had changed. One of them actually expressed concern that I wasn’t my usual cheerful self. I have written a separate message that repeated that line about “If you think that I’m pissed off then you are right.”

The nurse said I needed to be able to look out the window to cheer me up or perhaps to watch some TV. I found some time to write her a message as follows.

For nurse
I have to giggle when you say I need a window. You should see my office at home. One window mostly closed. I like my man cave 😀
Regarding TV I’m too busy frantically writing notes because even once you get them here I’m not confident they will let me talk. 😠

That last line reminds me that Dr. Heaven had asked for the other doctors possibly the attending doctors to come in and talk about getting me the talking valve. At some point the attending doctors did come in and they agreed that we could try the valve. My recollection was that it was perhaps 1:30 or 2 PM before they arrived. Then they needed to write orders to the respiratory therapist to actually bring me the valve.

Meanwhile I had other issues to attend to. Some of the nurses were having a difficult time using my message board. They would point to each letter one by one rather than using rows and columns. So spelling messages to them was getting really difficult. Even if I was going to have the talking valve soon, I was still going to need the communications board at night when I was on the ventilator. I wrote dad the following message.

When you get a chance you need to show nurse how use the letter board. She has been pointing to every letter. Show her how we pick the row before picking letters.
She needs to train night nurse how to use board

There were a series of other passages that showed how inpatient I was becoming.

Can you see what going on?
Docs said they would call RT an hour ago

very anxious to try valve
lots decisions being made and I need to weigh in. Hard to do without talking 😀

I’m not sure if that last message was to my dad, a nurse, or Dr. Heaven. It was the last message that I wrote on my iPhone on December 12. In a Facebook message I also expressed my frustrations. In a message posted at 1:26 PM I said “doing well today but being unable to talk means can’t properly participate in planning. The issues are too complicated for brief messages I’ve been typing on my phone to my doctors”

The Prayer Request

I think it was about now that I decided to send some text messages to Judy to ask for prayers. So we have come full circle. This was the point in time that I talked about in the very first installment of this story. The first of two messages said

I’m feeling wonderful physically but not talking is looping me [out] of important discussion. loud noise from south side is my mom spinning in her grave 🙂

Judy said she literally laughed out loud when she read that. I then followed that up with the following message.

I’m been raising hell all day with some minimal progress.
Pray that they listen to the man with no voice.

In case you forgotten, you might want to go back and reread the first installment of this series which you can find here… It describes my emotional state on Monday, December 12 at 3:36 PM when I wrote those words. Basically when I reread what I had just written it shocked the hell out of me. It’s so perfectly described the sense of despair and isolation that I was feeling at that moment.

The next text message to Judy said

This whole situation is a mess but on okay. Hugs

She replied

That’s all I care about… your feeling better. The messes will be resolved. I will pray for patience and peace to you. Love.

The Reply

There’s a saying that says “God always answers our prayers. Sometimes that answer is ‘No'”. Fortunately for me this time the answer was “Yes”. I don’t know exactly what time it was, but very shortly after that text exchange I sent her the following text message.

Just got “talking valve”! Damn your prayers work fast!

At 4:30 PM less than one hour after my desperate prayer request I posted this on Facebook.

Shortly after that Carol walked in and about freaked out when I said “Hello”. She was so surprised and relieved that I was talking. Soon thereafter dad left because he liked to get home before it got too dark. I had Carol grab my iPhone and we went on Facebook live to post the following video.

Before Carol left at about 7:30 PM we always had a series of things that I would ask her to do before she left. She would move the iPhone out of the way and plug it in to the charger. She would make sure I had my call button in my hand and my hand was propped up properly. We would have to get the TV on the right channel. Get my little “Chris Young users manual” properly in place where nurses could discover it. In the past it had taken us maybe 15 or 20 minutes to do all of this because I was typing instructions on the iPhone to tell her what to do. Now that I could talk, we were able to get everything organized for her to leave for the day in just a couple of minutes. The difference was amazing.

I would like to be able to say that finally being able to talk resolved all my problems but it didn’t really. I still had the wrong kind of G-tube in my belly. I was still facing the fact that I didn’t belong in the ICU but could not be moved to a regular room because I don’t allow ventilators. I still had the issue of when I need the ventilator in place of the CPAP at all or were they correct that now that I had the trach I didn’t need anything else to sleep. And if I did need a ventilator at home, it was going to take 2 weeks for me to get it. But at least now that I could talk, I can start resolving these problems one by one.

Our next installment of the story will probably be the last in the series. It will recount my final day at St. Vincent Hospital and my transfer to Seton Specialty Hospital. I will then start an entire new series of articles about my recovery at Seton Hospital. That story will not be nearly as dramatic or stressful as this one has been. It’s time to wrap up this story about the man who couldn’t speak. Because obviously… Now I can!