Catch Up – or what you missed last month (Part 3)

Feb 1-7 Welcome to Louisiana.

Texas has been great – people are friendly, Stetsons are everywhere and I’ve caught up with friends. It’s a big state, so at times it can be a little barren, but the highs of San Antonio and Austin have left a favourable impression.

Charlotte and I make our way east from Houston, in no hurry as we wander through Baytown to Beaumont and finally Lake Charles in Lousiana.

We take our time – I want to spend a few days travelling the Louisiana Bayou Byways and eventually getting to New Orleans for a coupe of days of Mardi Gras before the big finale on Fat Tuesday Feb 9.

Lake Charles is a little place of about 75,000 people – I’m just stopping here to spend some time planning the next few days route to New Orleans. I do have my first taste of Alligator at Botskys, based on reviews by locals, and it is really good, albeit a little chewy. Regardless I can add another animal to the “devoured” list.

The next couple of days see me wander the backroads of Louisiana to Lafayette and Baton Rouge. I stop and sample local foods – from Boudin to Crawfish to Frogs legs. It’s a fine introduction to the South – the “y’alls” flow more and more readily from everyone. and I’m having a great old time. I’m behaving myself, taking my time, keeping myself lowkey as I suspect Mardi Gras will be fairly full on.

I stop in at a small town to pay my mobile bill, and whilst waiting suddenly suffer a bout of dizziness, almost as I was going to feint. I fight it off, thinking not much off it, but over the course of Thursday and Friday I suffer a few more. I’d initially put it down to a bug or something but the last two have started to come on whilst driving. I can feel them start and have time to slow down/pullover, but it’s a little scary so I have travelled very slowly the final steps to Baton Rouge, where I have a long rest and sleep at Walmarts (around 15 hours)

Once the dizziness passes I’m fine for hours, and I’m not getting any other symptoms, but if this continues I might have to check in at the Docs.

Feb 7-9 A rude surprise.

So I wake up in Baton Rouge, get to an Anytime fitness, have a shower and am feeling really good. Maybe it was just a little bug after all.

But about an hour into the 100 min drive to New Orleans, i feel another one coming on and pull to the side of the road. It lasts a little longer than the previous ones, the dizziness feels more like I’m blacking out and for the first time I get a hot flush with it.

I’m in the middle of nowhere, no cell reception, so  I take a rest and then slowly continue in the right hand lane.

20 mins later it hits again, this time  I barely have time to pull right and start to brake, before I think I actually blackout, albeit for a micro second – I come to whilst  still braking to a stop.

Shit, this is no good.

I’m flushed and nauseous but after a few minutes of deep breathing and closing my eyes that feeling passes.

I’ve got a little reception, and I search for the nearest Medical Centre or Hospital. There is one  on the road ahead about 5 miles – that’s the target. It will be open (it’s early on a Sunday morning) and I’ll get there before any ambulance gets to me.

Charlotte helps me there, happily chugging along 5-10 mph below the speed limit. I arrive at the spot and there is nothing there. No hospital, no commercial building at all, just some houses. I triple check but google seems to have led me astray. Maybe it’s an old entry – the town seems a little too small to have it’s own hospital anyway.

I’ve been better for the last little bit – fully alert, though cautious and concentrating on both the road and how I feel. I check for the next hospital – which is the brand new LSU hospital right smack in the middle of New Orleans. It’s only 8 miles away – I can do that.

Now if you have ever been to Louisiana and the New Orleans area, there is a hell of a lot of marsh land, it’s on the Mississipi, and there are huge bridges everywhere. Interstates and major roads are the main links – it’s hard to find side streets and backroads between  towns.

I’v managed to get to the western outskirts of New Orleans but have to get on a freeway and drive over the Mississippi if I’m to get to the ER. That entails a huge bridge at least 50-100 m high! Gritting my teeth I start to look at merging left, when I spot a massive billboard for West Jefferson Hospital, 2015’s Cardiac Hospital of the year. It’s got to be close doesn’t it – after all it’s got West in the name. If it is I can avoid the risk of passing out on  the bridge – no-one wants that disaster

Google and Garmin both find it, so I detour down the river bank and putt along. I have to stop once more, this one a little more mild than the scary ones, but the episodes are coming on more frequently. I know I’m probably in a bit of trouble, if I’m honest I probably knew it for a while, but if I can get to the hospital I’m sure they’ll sort me out.

I have to traverse one smaller bridge, and Garmin takes me onto a freeway only to go down the exit despite the ‘avoid highwways’ setting, before I finally turn into Emergency.

Ever the thinker I don’t just pull into the ambulance bay, instead I push past the Entrance to the Emergency car park and give Charlotte a home. As I’m stepping out from behind the wheel I have one last moment. Deep breaths, laser like focus and I make my way calmly to Emergency.

Thankfully it’s fairly empty, so i walk up to the triage nurse and somewhat matter of factly say – “Hi, I think I might be having a cardiac event”. They usher me into a prelim room, take a few vitals and details and then it’s straight into a treatment room.

I’m calm, conscious, to be honest I’m taking this all in my stride as I describe what has happened over the last 72 hours.  I get hooked up to an ECG, am lying on the bed when all of a sudden another episode comes on, the alarm starts sounding and next thing I know I’ve got about  half a dozen staff around me. It passes and they look at me in disbelief.

Apparently I’ve just had a 30 second episode of Ventricular Tachycardia or V-tach at over 200 beats per minute. I’m given a bolus of fluids, and they push a dose of a drug, Amiodarone, via IV, which is the AMAs nominated treatment to bring heartbeats back into rythmn.

Someone suggests that it might be a good idea to move me to trauma, where they can deal with things if my heart stops beating – I’m told V-tach is a fatal arrythmia and is often part of a full on heart attack.The nurses and doc are amazed that I’m conscious throughout, normally V-tach leads to unconsciousness, and often they will have to use the paddles to bring the heart back into rythmn.

I’m wheeled into trauma, where they attach the charging plates to my chest, just in case. Just as I think I’m good I have another episode – this time for around 2 minutes – it’s the worst one yet.

Every-one’s checking the monitors whilst I again just clench, breathe and fight it off. Eventually I go back into a different rythmn – Atrial Fibrillation or AF where the top chamber of my heart beats a little out of time. It’s not great, but it’s not fatal and I can sense everyone relax a touch, including me.

They push a second does of Amiodarone, a so called loading dose. Amiodarone is the gold standard and works on nearly everyone. If the loading dose doesn’t do the trick and stop any future episodes they will have to give me another drug which actually stops my heart for about 6 seconds, then starts it again. I won’t pass out but I will like I’m going down in a really really fast elevator.

I’m staying sureally calm, happy to listen and understand – I even manage a few jokes with the doc and nurses.

They have the other drug on standby and I give them a few worrisome moments as my heart is popping off prelim signs (PCVs or preliminary ventricular contractions) but the Amio seems to be preventing the full blown misfire.

I’m in trauma for a few hours, with 2 nurses keeping watch. My heart settles into a permanent AF rythmn, rather than a normal sinus one and my PCVs are reducing

During that time one of the nurses generously goes to secure Charlotte, pulling down the blinds and grabbing my laptop bag and essentials. She comes back and complements me on Charlotte’s setup.

Being a nurse and not shy, she queries whether a bottle in the back contains wee – I have to admit it does –  not having managed to empty out the previous night’s work when I couldn’t be bothered changing out of PJs to walk into Walmart.  The fact that it is a empty jelly bean jar is hilarious to her (more on that later).

I’m told that I hve to be admitted to the hospital and they are just waiting on a room in ICU for me.  We chat, she finds a copy of People magazine in her handbag for me to read, and the next thing you know it’s 4 hours later and I’m off to ICU.

I’m presented with a decorated hospital urinal as I leave, as a reminder of how much fun they had with me (and I with them) – apparently West Jefferson is on the seedier side of the tracks and their usual patients are drug overdoses, drunks and the like who can barely speak and are aggressive and obnoxious. My cheery ability to crack jokes, Aussie slang (dodgy ticker, wonky heartbeat) has been a change for them.

I’m wheeled into ICU where I’m told that I’m probably the healthiest person there – my blood work has come back without issue, i have no enzymes showing heart damage, blood pressure is good, kidney function is fine and the Amio seems to be taking effect as the warning beeps on the monitors come less and less often.

Outside a little electrical problem I’m in pretty good shape according to everyone.

However it is ICU –  blood pressure taken every 15 minutes, blood drawn every hour,  a formal paper ECG every hr to send to the cardiologist to examine, 3 IVs in my arms, a finger heartbeat monitor taped to my Right hand and being fretted over by everyone means that it’s hard to get comfortable or any sleep.

My laptop is a bonus as if free wifi – I manage to catch-up with quite a bit of telly between the interruptions. I don’t have any pain other than the IVs becoming a little sore – the drugs i’m getting tend to inflame veins and they are scheduled to be moved eventually anyway. As I have “beautiful veins” I think they use me a training tool for one of the less experienced nurses, who does a fine job btw.

Next morning I’m told I’m improved but still not back in normal sinus rythmn and the PVCs are still popping up everynow and then so will but staying at least another night. Apparently Amio can take a while to complete the job. The prognosis is a little better however – if all goes well they can probably move me out of ICU and into a room downstairs. I don’t expect much will change but at least the hospital room will be cheaper than ICU (I have insurance don’t stress).

They manage to find me a room late in the afternoon and again I’m wheeled out to a fond farewell.  Seems I’m a fun patient, and to be honest the accent and backstory don’t hurt.

Downstairs the finger monitor comes off as I move to a mobile pack with leads and a battery around my head, and they agree to finally take of the de-fib charge plates. God that feels good. I lose two IVs, with one canula kept in just in case. the IV drugs have been replaced with pills every 4 hours, and the constant interruptions for ECGs, temperature etc are reduced so I manage to catch a few zzs. I’m even given a air of non-static socks as I’m allowed to get out of bed for the first time in a day.

Fat Tuesday arrives and I’m feeling good. My heart rate is steady, and the docs want to let me go a little after lunch to let me get to Mardi Gras (I’m sure the specialists didn’t really take that into consideration, but the attending does at least mention the upside).

Eventually I’m completely de-hooked, allowed to go out to Charlotte by myself to get a change of clothes, take a shower and get changed. I request to be wheeled via trauma, but my nurses aren’t in to say goodbye to – instead I leave them a big thank  you at the desk.

I’m carrying my discharge papers, follow up instructions with the specialist for a week’s time and 3 months worth of prescriptions for Amiocand a blood thinner which I go to fill. Since I’ve been kept fully in the loop, I’ve manged to research the cost of the scripts  the Amio I can get from Walgreens for around 10 bucks per 90 pills if I joining the pharmacy club (the next best is around $25 per 90). I need 540 as I’m now on 2 pills, taken every 8 hours, for 90 days. After a long time without a routine one is imposed on me – Amio at 7 am, 3 pm and 11 pm and the blood thinner once a day at 5. I set my alarms – conscious that this regimen will change things for the next 90 days at least

The blood thinner thinner is expensive – anywhere up to $300 for 30. However I’ve found a loophole – the manufacturer offers a zero co-pay if you have medical insurance (they must bill the insurer direct) so I download the details. There is also a voucher for a 30 day trial for free which I take just in case my travel insurance doesn’t work at the pharmacy. Another huge benefit of having a US mailing address.

Walgreens is across the road and open so I go and submit the scripts. I’m asked if I really want them all filled as it will cost me around a thousand dollars! It takes a bit of fiddling in their system but I eventually get the Amio as advertised for $60 . My travel insurance isn’t registered in their system so I take the 30 day trial offer instead. I’ll discuss the blood thinner at the follow up.

By now its around 2 pm, so with everything packed away, and a relatively clean bill of health from the docs in hand Charlotte and I head to my prepaid parking spot to see if we can catch the very tail end of Mardi Gras.  I’m told one drink per day won’t do any harm, though I think I’ll wait on that front for a bit. Murphy’s law and all.

It’s been an adventure to be sure.

I can’t  speak highly enough of the care I got from everyone at West Jefferson but I’m keen to get back on the road healthy and  safe. The electrical thing is a bugger and will change immediate plans but all in all a pretty good outcome.

Continued in part 4 (last one)