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The blog of Frederick Clarkson

Archive for November, 2009

I’ll Die Another Day

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Through the grey tinted glass at the end of the hospital hallway, I could see the last of the peak fall color. Bright yellow, red and orange leaves in the distance. Probably maple. There is nothing like Fall in New England.

I was recovering from treatment for “massive pulmonary embolisms,” (blood clots in the blood vessels affecting my lungs) at Bay State Medical Center in Springfield, Massachusetts. (Bay State is a major regional teaching hospital.)  I had had a procedure (via a catheter up through a vein in my leg) to remove some of them, dissolve others, and to install a filter in my vena cava to collect any others that might turn up before they could kill, or leave me permanently impaired.  A retired doc said, snapping his fingers, I could’ve “gone, like that.”

I was fortunate.

That was more than a month ago.

After a week in the hospital, I was discharged, only to be readmitted the next day with fresh symptoms, notably a rapid heartbeat. It took another week in the hospital, but I am pleased (and relieved) to report that I am rebounding, recovering well at home, and getting back to work.

Again, I am fortunate — and not only to be on the road back to health.

I was able during my first hospital stay, to gain access to a bootleg computer long enough to send an email to my love who was worried and far away, and to check out Meteor Blades’ diary at Daily Kos about my hospitalization. I had heard about it while in the intensive care unit, thanks to my good friend Jonathan Hutson. It was a warm surprise in the middle of a strange and harrowing adventure.

I was and am profoundly grateful for the prayers, good thoughts and wishes, and kind offers to help in some way — not to mention the simple act of recommending this diary such that it stayed on the rec list for a day. I certainly did not expect any of this.  I was and am, honored. Thanks too, to kossacks, street prophets, and others for the cards, calls, emails, flowers, visits — and a cake! And a special thanks to Rain from Street Prophets who specializes in making get well quilts, and made a beautiful one as a “big, comfy get-well card” from the community. The quilt features messages from friends (on the white squares). It was very nice to know from Rain’s comments on Meteor Blades’ diary  that that she was making one. It was even better to hear from Rain that it is done and on its way.

Any of us can feel scared and alone, even when we are not really alone. It meant more than I can say that so many helped to make sure that did not happen. I have seen this community come through for many people in remarkable ways over the years, and I am grateful for your having been there for me through this. Thank you. Thank you all so very much.

I hope I don’t bore anyone with the medical details, but I just wanted to update my condition, and offfer a few vignettes from my recent adventures.

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I felt pretty good when I was first discharged from the hospital. But it didn’t last long. Shortly after arriving for my follow-up appointment, I was packed in an ambulance, sent strait to the overflowing emergency room at Bay State, a major urban hospital where although no one said so, it was obvious I was a high priority in the triage. (They were afraid that another clot had cut loose from my leg and was, damn the filter, looking for a way to wreak havoc.)

Even with that, what still amazes me most about this episode, was when my two EMTs rushed me through the ER doors on a gurney — we immediately found ourselves in a line of other gurneys, each with two EMTs, waiting to talk to someone.  I asked my EMTs if this was unusual. They said it wasn’t.

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I had never had a major medical problem in my 56 years, and so everything about my hospital experience was new, and often strange.  What’s more, I knew little about clots, and so I tried to learn as much as I could, even as I was being treated and recovering.

It was more than a little humbling not to know what people were talking about, even as — especially as — they were talking about me.

First there was the medical short hand thrown around. I had, for example, DVTs (deep vein thrombosis) PEs (pulmonary embolisms) and afib (atrial fibrillation).  I would be asked if I had ever taken various medications. I hadn’t even heard of most of them, (but no, I had not taken them either.) At one point, a nurse asked me if I understood about clotting. I didn’t, and so she launched into a remarkably clear and concise 15 minute lecture on the circulatory system. (I wish I had a video.)

My case confounded the medical team and the specialists because I had, as far as they could tell, none of the risk factors for clots. And so I became a subject of Grand Rounds. Every morning, three white coated doctors and two or three medical students would stop by and discuss my case, among themselves, and with me. (Did I have any questions?) I liked my doctors and am grateful for my care and treatment, but it was very odd being a subject as well as a participant, in the intimate study of me.

But of course, being more than a little curious about my situation, and visited by a parade of doctors and nurses over two weeks, I managed to get up to speed enough to meaningfully participate (and even successfully challenge some aspects of my treatment.)

I was in a teaching hospital, and I was learning.

                                            —————

Since my release, I have learned more.

One  comprehensive discussion of pulmonary embolisms, based on a survey of the medical and clinical literature found some amazing things.

The average annual incidence of venous thromboembolism [blood clots in the veins] in the United States is 1 per 1000, with about 250,000 incident cases occurring annually. The challenge in understanding the real disease is that autopsy studies show that an additional equal number of patients are diagnosed with pulmonary embolism at autopsy, as were initially diagnosed by clinicians. This is led to estimates of between 650,000 to 900,000 fatal and nonfatal VTE events occurring in the US annually. The incidence of venous thromboembolism has not changed significantly over the last 25 years.”

Only 4-5% of these cases are “massive pulmonary embolisms” like mine, but depending on the study — the death rate runs between 30% and 60%, and the majority of these deaths occur in the first 1-2 hours of care.

I was and am, very fortunate.
                             
I have been home for more than two weeks now, much recovered. And getting back to work. Unfortunately, I am at least month behind, and as a freelancer, that is not good. Anyone who has any writing, editing, or speaking they need done, please write me. I’m available.

Written by fred

November 30th, 2009 at 11:55 pm

Posted in Uncategorized