Wednesday Night was a normal night. Laurie and I had a nice dinner, polished off some muffins she’d baked, and splurged with an Angry Orchard cider (very nice, good flavor, not just sweet).
Next thing I know, this happened.
I’m in the emergency room, wired up to a bunch of machines — including the machine that goes ping (and bloop and spung and a few other noises).
It’s been an interesting few days. Today was spent running around between my doctor and my tests (okay, shambling between). The stress treadmill showed my heart was healthy and nothing was clogged, and so today my doctor released me back into humanity with no restrictions.
If you followed my twitter feed, you might have noticed that I live-tweeted the event. (If you don’t follow it, you should, you’ll never know what appears in there, and the material that shows up on this site is only a small piece of my twitter life).
I think there are interesting stories and insights coming out of this, and a message I want to send out to other geeks who, like me, haven’t taken as good care of their body as they probably should. I’m treating this like a two minute warning to accelerate some of the lifestyle changes that I started on when I left Apple, and I hope I can get people’s attention enough that they realize they can’t go down the path I did. I’ve been open about some of the previous challenges I’ve chased and the response has always been supportive and positive, so we’re going to try it again.
If you’ve never been lucky enough to find yourself in the emergency room wondering if you’re going to die, here’s a quick summary of the evening and the last couple of days..
About 9:15 I’m sitting with Laurie on the couch watching something — baseball, I think. Or hockey. around here, it’s either baseball or hockey most of the time. I suddenly realize my pulse is way up; fast enough for me to notice it. I think about it, decide to keep an eye on things, and check it out later after laurie crashes, because I didn’t want to worry her. Then I got that pressure on the chest where I started feeling I wasn’t able to breathe.
So much for not worrying Laurie. I call her name, she hears the tone in my voice, and I ask her to call 911. About now things start getting a bit blurry to me because so much started happening. The room was suddenly filled with five medic types (three paramedics, two ambulance guys). Four of them start working on me. One gets co-opted into petting duty by Manon the cat (seriously), because, well, new people to pet her. I get wired up to the first of many machines. My pulse is 115 (my resting rate is around 60). Blood pressure up, but not dangerously. The symptoms came in waves, cycled on and off. By the time I got wired up it was off; as I was talking to them I got a second, lesser round. They ask if I want to be transported. I think about it a bit, say yes.
It was one of the mellowest ambulance transports they’ve probably had, given I walked out of the house to the waiting gurney. At one point they misjudged the slope on the driveway and I was wondering if I’d break an arm or rib when the gurney tipped over, but they caught it fast and nothing happened (but it would have been really amusing, in a not very amusing way). It took them longer to wire me up to the machines and tie me down for the trip than it did to get me to the hospital, and I was wheeled in, checked in and shifted over to the bed. My pulse is still around 115, I’m still getting those pressure bursts, but they’re slowing going less frequent and less intense. None were as intense as the first one.
I meet my first doctor, and a couple of nurses and aides. I’m wired up to even more machines, and holes are drilled in my arm and blood extracted. I spent some time coaching the nurse where to find the right vein (you get used to this) and she did a really nice job of hitting it the first time, which doesn’t always happen.
This first blood draw was a CBC and a test for an enzyme that shows up in your blood if you’ve had (or are having) a heart attack. The doctor decides to start a saline drip in an IV. We’re maybe 45 minutes from the phone call.
At this point, because I’m stable and not evidently about to die on them, the pace slows down. The purpose of the emergency room is not to heal someone (although if the solution is obvious, it will) but to keep them alive, stabilize their condition and start the process of understanding what’s wrong. Once you’re stable if it’s safe you get to go home and work with your doctor to finish figuring it out and solving it. If they aren’t sure, you get transferred into the hospital where another team takes over.
For a person of my age and weight (T-shirt size: small tent) suffering from pressure in the chest and abnormal pulse, the first thing to rule out is heart attack. I got my first of many EKGs in my house by the medics, and was on one for the trip to the hospital, and then monitored in the ER until I left, and they looked normal (YAY!). So now we’re more in wait mode, monitoring for symptoms or problems. We’re waiting for tests to come back, and as the doctor noted, they typically give the enzyme test twice about four hours apart to make sure, so there’s waiting for that to happen. I’m going to be there for a while.
And at that, I send Laurie home to go to bed, so she isn’t sitting in a chair doing nothing for hours. I’m not (evidently) going to die OR leave, and she doesn’t need to be there. I told her I’d call when I got released.
My pulse is still up there, hasn’t gone down. When I moved from the gurney to the bed, I got short of breath more quickly than I should have. Still a mystery.
I meet my second doctor, and we talk some more. The good news is it’s pretty clearly not a heart attack. The weird news is it’s not obvious what it is. One thought was a blood clot in the lung, another dehydration. I didn’t think I was dehydrated (I tend towards that strongly and tend to be really careful about fluid intake). the blood clot wasn’t that likely, because of the lack of pain.
That’s an interesting thing about this event: I haven’t mentioned pain once, because there wasn’t any. Pressure? yes. weird pulse? yes. But nothing ever hurt, except when I bruised a finger on the Oxygen sensor.
The second saline bag hits the IV. Half a liter a bag. And then I go back to trying to relax.
One aspect to all of this is stress. After all, something happened I don’t understand, it might kill me, my house gets invaded with friendly burly people who carry me to the hospital, and now I’m sitting in a bed in a hospital not sure what’s going to happen. that’s a great scenario for stress, and the last thing I need are stress hormones running around kicking body parts in the knee. All along in the back of my head I’ve been trying to keep myself from stressing out (with some but not perfect success — long years of practice here) but now I start going into my measured breathing routines, borrowed from my yoga days. It works, but I keep tripping the machine that goes ping, which keeps setting off the low respiration alarm. So it becomes a game, how slowly I can breath without setting it off. At some point an orderly comes in to fix a sensor that pulled loose that was setting off a different alarm at times and he noted that alarm goes off all the time with people.
And I calm down. I don’t sleep; not quite ready to be that unaware, but I work on some measured resting (also borrowed from my yoga days, and then beaten into a new shape with a stick) where I can really shut down into a relaxed state but not off into sleep land. It’s a useful tool for me because I don’t always get to sleep easily, and it’s not as result as full sleep, but it’s definitely helpful — and yet I’m still aware of my surroundings.
Along the way, I’m occasionally firing up the phone and tweeting about all of this. Yes, I live-tweeted my emergency room trip. I’ll talk more about that and why I did it (and some of the social media implications) in the next article, but it was as much distraction and stress management as it was anything.
The third IV goes in. The kidneys have made it clear they’re still functional; the bladder is not yet close to complaining. If I’ve had over a liter pumped in and I’m not having to pee, then yeah, I think I’m dehydrated. That’s troubling on a couple of levels, because I did have a good amount of fluid during the day and I didn’t think I was a quart low. I’m going to have to recalibrate myself on this…
On the other hand, as they pump fluid into me, my pulse is coming down, and I’m feeling better.
I’ve now met my third doctor. At about 2AM they get me out of bed and walk me through the ER, to see how I do. I do fine. breathing good, nothing out of breath. no negative symptoms or reactions.
About 4AM they come back and take more blood. I told them to take a pint, that I’d make more.
At about 5AM, my pulse is under 80. Still high, but not too high. BP is normal. Kidneys are working, bladder has checked in but not complaining. My doctor comes in, we talk, and he suggests I can go home. I call Laurie and she comes over and picks me up. I’m in the obligatory wheelchair waiting for her, which they locked the wheels so I couldn’t wander the waiting room. When laurie arrives, I decide to walk to the car — breaking protocol. The person at the desk asks if I feel up to it, and I said if I couldn’t walk to the car, I probably shouldn’t be leaving… So I exit the emergency room on my feet and with a chuckle, which is something, I guess.
I’ve now been up about 24 hours, and I’m feeling every one. Not quite ready for bed, still wired. First thing I had to do when I got home was pee, by the way. I didn’t want to screw up my sleep cycle, so I decided to just sleep a little to refresh, so when I started dropping off at the computer, I went and crashed for about 4 hours. Definitely helped, although I took a couple of one hour naps along the day as well, then went to bed at my normal time. Ultimately thursday was a lost day, but when I woke up Friday, I felt pretty normal.
Friday was a busy day, too. Early doctor appointment to start the followup, which we ended up pushing to the afternoon after the stress treadmill. Off to another facility for the treadmill test, which I passed — no weird signs in the EKG, no signs of any blockages, the heart gets a clean bill of health (and a whole layer of low level stress flows away….). I got the chat about my weight and poor state of my conditioning and the need to ramp up the exercise. In a positive and team building way. And yeah, he’s right.
Then back to my doctor to talk. I have a great doctor. We’ve been together for years. he’s worked with me on getting my act together on my diet and lifestyle, he got me through my apnea and diabetes, he and I talk about the weight and options and why it’s been such a struggle to get the damned stuff off. Very good at helping to point in the right direction without being a nag. He also knows I’m enough of a geek to not need explain terms like atrial fibrillation. He clears me for work. He clears me for exercise. He clears me for my upcoming trip to Lee Vining.
There’s still a lot we don’t know, that we’re exploring. Mostly we know that it’s not the big hairy evil boogiemen we all worry about. Something’s changed, though, and it’s not clear what it might be, but it’s not overtly life threatening. We’re working out a plan to understand it and what to do about it. We have some ideas, and we’ll poke at it and see what we can learn.
Mostly, what I learned was that something definitely happened — but not what that was, other than it probably wasn’t life threatening with or without the excitement. It’s not every day you get chauffeured from your home and driven around town in the back of an ambulance. I vaguely remember at least some of the neighbors out watching, so I’m going to have to track them down and chat with them so they don’t worry. Somewhere I vaguely remember the phrase “only a flesh wound” being uttered as I’m being shoved in the ambulance.
What’s obvious, though, is that this is the “two minute warning”. I’ve been fixing my lifestyle since I left Apple, and it needed a lot of fixing. The one thing I continue to struggle with is weight, and at my age, my weight is a significant risk factor. This event wasn’t the big nasty one it could have been, but it’s a clear hint that I have to accelerate my attempt to get the weight off (for what it’s worth, I have lost 20 points from my high, but I still have a long way to go…)
You look around any tech conference or company, and you’ll see people doing what I did: ignore taking care of the body, eat bad food and gain weight, and sit at a computer all day geeking. The damage done by decades of neglect aren’t undone overnight, and sometimes, you can’t fix it fast enough to undo it completely. I’ve made a lot of progress — but what I really wish is that I’d been smart enough when I was younger that I wasn’t in this situation today.
So if this series does anything useful, I hope it’s that it gets the attention of that person out there that is me at 20 years old, and keeps them from wandering down the path I took. Because sooner or later you’ll hit the toll bridge, and under that bridge is a nasty troll.
And as we wander through this series of articles, we’ll talk about that path, and what happens when you meet the troll.
Coming in the next installment: Live-tweeting an emergency room visit. How social media permeates life today and what the implications of that are. Also, later on, I’ll get into some of the lifestyle choices that a tech career makes easy to choose and why you really need to take care of yourself. and I’m sure I’ll figure out some other things to natter on about as this goes along…
Assuming of course I’m still here to write about it. (Status update: not dead yet)