...in the ICU. At least that's what my Bride told me as I lay on a gurney at Cottage Hospital. Let me back up a bit.
I'm taking a short break from my family historian duties to share some more recent events. To be specific, my first whack on the head in a long time, my first few CAT scans, my first ambulance ride, and my fourth night in a hospital ever. Also my first experience with an intensive care unit. I've been told at times that I'm not always receptive to change. After the last few days, I don't think that situation is likely to improve.
Not to give away the ending, but I've been home for several days, required only observation in the hospital, and am seemingly on my way back to normalcy. At least what passes for normalcy for a gentleman of advancing years.
It started a couple of weeks ago on March 30th. I had a follow-up appointment with the family doctor to review a few test results. My Bride had previously asked me to hang a birdfeeder on a hook located on our roof overhang just outside the family room window. I decided to do it before leaving for my appointment.
The hook in question is about 10' above the ground. Of further note is that this area immediately behind the house is in transition, from having been covered by a deck to becoming our new patio. At present, it's a rather uneven sea of mud, small pieces of broken stone and about a billion wood chips left over from the grinding of the stump from our old deck maple. Sort of a hard hat area. In retrospect, I should have worn one.
With the best of intentions I sauntered out the backdoor to the garage and grabbed my two-step ladder. It's called a two-stepper even though it actually has a top level which can be - but shouldn't be - a third step. I can now offer a testimonial to that principle.
I placed the ladder sturdily, I thought, in the dirt next to the house and began my climb. I quickly realized two things. I forgot to take the birdfeeder with me, and that even on the second step I probably couldn't reach the hook.
A reasonably competent handyman at this point would have climbed back down the ladder, gotten a bigger one, grabbed the bird feeder and resumed the climb. But being a liberal arts major with concentrations in philosophy and late-night bridge, none of that occurred to me. Hey. The (dreaded) third step was right there, and I was (pretty) sure I could reach the birdfeeder with just a little stretch. And it felt like the hook was staring down at me with a wry grin, taunting me. I swear I heard it mutter "you wimp" under its breath.
Well I guess what happened next is no mystery. I went for it. I reached over and down to grab the handle of the birdfeeder as I raised my leg to achieve the third step. In my defense I did reach out to the side of the house with my other hand for purchase as I executed this maneuver. But neither the reach for the house, the grab for the feeder nor ascension to the third step were consummated. Instead, I found myself suddenly airborne and not in a good way. My flight plan was short, downward, and bumpy. Head bumpy. I ricocheted off something hard on my way back to Earth. I believe it was the brick house at 651 Vernier Rd.
The next thing I remember is trying to sit up from an odd prone position. It seemed like my eyes were recording events two to three seconds either before or after they happened. Was I remembering or peering into the future? My mind was sort of buffering.
This next part I learned later from Nancy, as I still have no memory of it. She managed to get me to my feet, back into the house and into a chair. She then asked me a couple of questions. Simple ones like "Do you know why you were going to the doctor?" and "Do you remember that you went to the dentist yesterday?" After giving the wrong answers (even more wrong than the answers I usually give), she escorted me to the car and drove me to my already scheduled doctor appointment. It was while riding in the car that my memory began to return. Not about the last five minutes but about my life before the fall.
So I was all better, right? No. My doctor took one look at me, heard Nancy's report and planted me in a wheel chair on its way across the street to the Cottage Hospital emergency room. It was a pleasant ride as I recall. Friendly conversation with the nurse like, "How many fingers do you see?"
Once in the emergency room, I was pretty quickly ushered into a treatment room and examined. I was asked more questions as I lay on my back staring into bright lights. I wasn't feeling too bad, but my grip on what was happening was less than firm. And my head hurt.
The ER doctor ordered a CAT scan. So I was returned to my wheelchair and given a short ride to the scan room. Ten minutes sliding back and forth in and out of this giant metal donut and it was done. I was trucked back to my ER bed to await the results.
It was about a half hour or so when the doctor returned with less than happy news. My brain was showing signs of internal bleeding. That meant a second scan, a more detailed one, to map the current state of the blood vessels around my brain. At this point I was pretty sure I wasn't going anywhere for awhile. But I was lying down and reasonably comfortable. So I had that going for me. Yes, my head still hurt. At this point it was about a four on the ten-point smiley/frowny-face pain scale.
After the second scan, it was determined that my blood vessels had been bruised, but they were intact. That meant that the brain would probably heal itself by clearing the blood away naturally in a matter of a couple weeks. Maybe a little longer. But - it also meant that I was in a critical 24-hour period during which things could go bad.
If the healing didn't commence as predicted, pressure could build in the brain that would require "intervention". The kind of intervention that you hear about in gothic horror novels. Like drilling a hole in your head. All I could think of was poor Chekov in Start Trek IV - The Voyage Home. If you recall Pavel, like me, suffered a head injury.
He was in a coma and about to have a hole drilled in his head to release the pressure on his brain. Kirk was trying to get back to the 23rd century with his sperm whales, but he couldn't leave yet because, as Dr. McCoy put it, "We can't leave him (Chekov) in the hands of 20th century medicine." I felt the very same way. Can't you just beam me out of here? I felt a little better when I realized that I was actually in the hands of 21st century medicine.
I was quickly ripped out of my fantasy world when the doctor told me what was going to happen next. It turns out the protocol for this critical 24-hour period was frequent monitoring in a controlled environment. Very frequent and very controlled. So, if things go south one could be whisked promptly into surgery for the hole-in-the-head thing. This monitoring process might be thought of as, I don't know, intense? Then the doctor dropped the other shoe. I would be transferred downtown to the Intensive Care Unit at Henry Ford Hospital where this critical monitoring would occur.
As I processed this information, several thoughts occurred to me. One, how was I going to get there? Would Nancy drive me? Two, what about the items on my Prioritized Daily Task List (to-do list for you non-Franklin folks). What things could I still tend to from my ICU bed? And three, would I get to the ICU in time for the dinner hour? I'd already missed lunch due to all this monkey business, and I was getting peckish.
The answers came swiftly and painfully. My ride downtown would not be provided by my loving, supportive spouse. Rather, I'd be relocated by "two men and a truck", sometimes generously referred to as an ambulance. I did rally on the day planner issue remembering that most useful of techniques, the arrow forward. I mentally arrowed everything indefinitely, known in the trade as a "Custer's last stand" moment. That provided me with the faint but welcome illusion that I was actually still in charge of something.
But the biggest blow was the food thing. Since technically I was one wrong answer from brain surgery, there would be no food. None. Not until the threat of surgery was passed. Ugh. They did allow me a sip of water to choke down a couple of Tylenol tablets, but that was it. None of the staples of my normal nutritional regime like coffee, whisky, ginger snaps or Skinny Pop. It was brutal.
After an hour or two deep in dietary depression, the "two men" showed up. That was about 4:30, so I was a little over six hours into the adventure. The pace was about to pick up.
The two ambulance guys were friendly, dutifully concerned and seemed just a little befuddled by the paperwork. At least that was my impression as they went in and out of my little holding room a few times muttering with the hospital staff. I was hoping that it wasn't about directions to Henry Ford. But finally they wheeled in a rather skinny gurney that I surmised would fit neatly into their vehicle. They had me swivel off my ER bed and onto the gurney, whereupon I was strapped in like I was getting into one of those theme park thrill rides I try to avoid. Little did I know.
After bidding farewell to my Bride and my new friends in the ER, the boys whooshed me out the door and over to the ambulance. It was large, boxy, and had a pretty loud paint job. They squared me up to the rear door and with a big heave ho, slid the gurney into the vehicle. The wheel supports of the gurney folded up in the process, and I felt the package - me and the gurney - snap into place. Locked and loaded. They elevated my head rest a bit so I could see out the back window. Thoughtful.
So I was secured in protective equipment in an ambulance built like a tank. What could go wrong? Just then the two attendants parted ways, one to the driver's cab the other into the rear compartment with me. The attendant with me took a seat built into the wall of the compartment and strapped himself in. As he did he explained to me how strong the wind was today and that "these high-profile vehicles are just like giant sails. Might be a bumpy ride." Great. A bumpy ride (off my ladder) is how I got here in the first place.
The ambulance pulled out of the hospital parking lot and made it to I-94. So far not so bad. A couple of potholes on the way to the freeway told me this truck was built for strength, not comfort. As we merged onto I-94 toward town, I finally realized why I was strapped in so tight. I was actually on one of those theme park thrill rides I try to avoid. Perched up high on the gurney with my head rest elevated I could see everything out the back window just after it happened.
The impact of every pothole was recorded by my aging organs. The sway of the truck from one side of our lane to the other as our driver battled the wind was recorded by my wounded sense of equilibrium. I would have hung on for dear life, but my arms were immobilized. So I just stared out the back window and tried to convince myself that the engineers who designed this contraption knew what they were doing.
After about 20 minutes, the G-forces on my psyche began to subside. We had dropped out of warp drive and were coasting into the HFH parking lot. Whew. The boys parked the truck and whisked me out, the folded gurney wheel supports springing back into action. As we broke through the ER doors, the gurney took a hard right and came to a halt. After a few more minutes of paperwork, my fellow travelers transferred me to a larger, more comfortable hospital gurney and took their leave. Package delivered. They were on to their next victim.
An ER nurse found me a short time later and wheeled me through another set of doors into the HFH ER. A different world from Cottage Hospital in Grosse Pointe. She steered my gurney around a number of other gurneys, work stations, and briskly moving staff members into a small space between a nurses' station and a small curtained area occupied by another poor soul needing help. There I would lie for about five hours.
My Bride joined me a little while later. She had tended to a few other items at home while I was on my way downtown. We had kept in touch by texting, so she knew where to find me. I was lying back, head slightly elevated, masked of course, and holding an icepack on my sore head. My pain down to about a three now thanks to a couple of Tylenol I'd been allowed to take. Here's a photo to confirm my lowly state.
We visited for an hour or so. The ER staff had told me upon arrival that I would be moving to an ICU bed as soon as one was available, and that I would be here in the ER until then. The answer every time I asked when was - soon. What else would they tell someone in my position. So after awhile I stopped asking.
About 8:00 Nancy decided to go home and tend to the dog and other matters. We knew from the doctors that I would be there at least until tomorrow afternoon, so there wasn't anymore she could do for me. So there I was, now about ten hours into the adventure turned ordeal. With not much to do except freshen my ice pack and pay attention to my surroundings. And I found my surroundings interesting.
What I remember most was so many people, with occupied gurneys in every open space leaving just enough room for passing through. And with modern casual hospital attire and everyone wearing masks, it wasn't easy to discern who was a doctor or a nurse or sometimes even who was a patient. I guess most of the patients were lying down, but occasionally some would get up and walk around. At first it looked like chaos. But as the hours went by, I realized it wasn't chaotic at all. It was just complicated and busy. I began to see patterns, and to get a sense of well-honed efficiency.
I can't say it was quiet, but it wasn't really noisy or distracting. It was more like a constant hum of voices, footsteps and power tools. Expensive sophisticated power tools. And there were frequent PA system messages, seemingly intended for particular audiences. Every once in awhile either a staff member or group of doctors would come by and ask me how I was doing. Some I assume were nurses responsible for my care. Others I think were interns or residents in teaching rounds or possibly checking up on ER operations. All and all, I felt like I was in the good hands of professionals who knew what they were doing. It felt good.
About 10:00 the preliminaries came to an end. I was notified that my bed in the ICU was available and that I would be moving "soon". This time they meant it. About 10 minutes later a staff worker came in to bag up all my worldly possessions for safekeeping while I was in the ICU. She said she had to take my phone, too. As my phone (and its charger) are my lifeline to the outside world, especially to my Bride, I balked.
Ostensibly, the rule was intended to minimize theft as patients in the ICU can be moved to other areas including operating rooms without much notice. And upon occasion they don't come back to the ICU. Gulp. A little dose of reality. But after a few minutes of polite resistance, the staff member smiled and revealed that if I wouldn't give my phone up, she had no authority to take it from me. So I smiled back, thanked her for the tip, and kept the phone.
Finally, after hearing about the ICU for about 10 hours, I was on my way. And my head pain was sliding down a bit more to a two. I was beginning to feel like the tide was turning. I texted Nancy that I was on my way to the ICU, and that I would check-in in the morning. Then I was ushered through a double-doorway marked "Pod 6". Yikes.
I arrived at a very large room where I was met by a team of at least six. They went right to work. They removed all of my clothing - all of it - including my mask. They began washing me - all of me - with some type of cleaning solution. One of the team, a doctor I believe, told me "you can't bring those ER germs into the ICU." I felt like I was being promoted from steerage to first class.
Then I was given one of those not-quite-as-big-as-you'd-like hospital gowns and wired-up. Actually wired and tubed-up. They took blood, and inserted a port in my arm to introduce meds. I had about five chest wires, I think, and a semi-permanent blood pressure cuff. These attachments were, of course, connected to a number of devices. I felt very-well monitored. After all the set-up, I was then left to rest. Until the next check-in. One other item of note. I didn't have to wear a mask in the ICU. I received a COVID test upon my entry into the Cottage Hospital ER, and passed. From there, ICU protocols are apparently trusted to keep COVID out of the pod. That was nice.
Through the night the staff checked on me every couple of hours with the same routine. Light in the eyes, how-many-fingers questions, and a series of "can you feel this" probes. I assume I passed each time as nothing untoward happened after these little chats. I have to admit that except for the intrusions I was able to rest pretty well. Probably a combination of comfy bed and mental fatigue. I was tired of thinking about the day's events.
About 9:00 in the morning, I was allowed to eat. Apparently the risk of surgery had subsided enough to prevent me from starving to death. I was offered a decent menu to choose from. My pain was down to about a one at that point, but my brain was not much interested in unnecessary engagement. That I could eat seemed much more important than what I could eat. I took the special. I was also told that after lunch I would receive another CAT scan. If it looked good, I would be released. That got my attention.
I updated my Bride on developments and learned that she would be able to come into the ICU to pick me up if I were released. So she went about her day and kept in touch. After lunch - opted for the special again - they took me as promised for the scan. As this was my third CAT scan in a little over 24 hours, I was a pro. It's not that difficult actually, but I like to think one improves with experience.
About an hour later they gave me the good news that my scan was favorable, and that I would be discharged in a couple of hours. But had to have a follow-up with my own doctor in two weeks. I accepted their terms and notified Nancy. She arrived right on schedule about 3:00 with my clothes. I dressed, signed some papers, and walked out of the ICU and hospital under my own power. Good to go. Here's a shot of me shortly after returning to the scene of the crime, complete with warning label.
Since then I have laid low, mostly. It didn't really require much of a change from my normal routine. Rising from lying or sitting positions slowly. Avoiding as much bending over as possible. No alcohol. And keeping reading and computer time to a minimum. I did pretty well on the first three. Slipped a bit on the last item as I normally spend a few hours most days reading and on-line. But I managed, and a few days ago my lingering headaches finally subsided.
Today I had my follow-up scan. The head issues (at least the medical ones) are now resolved, and I'm back to just the usual aches, pains and other aging challenges. It's been an experience I'd like not to repeat, but I did learn a few things:
- Ladders require two people for proper use. Be the one steadying the ladder as much as possible.
- If you must ride in an ambulance, bring Dramamine. Either that or a blindfold.
- Don't believe everything you see on TV about emergency rooms. Just the good things.
Looking forward to my next Manhattan to put this episode into proper perspective. And, by the way, anyone need a slightly used, slightly bent two-stepper? No charge.
Grosse Pointe Charles.
