Thursday 13 August, 2015. It is an evening that will be forever etched in my mind. Not so much the date as the event.
I walked down the drive from my client's home, and as I walked I thought what a beautiful evening it was. Still, calm, not many clouds, quite a few stars out, almost balmy! One of the rare Wellington evenings at this time of year. I thought it would be a lovely evening for a walk. It was around 8:30pm. I got into the car and called Boar, to let him know I was on the way home, and to check if there were any other things needed from the supermarket.
I drove back to Johnsonville and decided to go to the larger Countdown on the main road. I parked and wandered in. I had an idea about the client's costume so sent her a text, partly to fix it in my mind and so I would have a record of it. It was a few minutes after 9:00pm. I got the few items we needed, went through the self checkout and headed back to the car. I went at my usual pace, which isn't fast. I suspect my iron (haemagblobin) is low again and I need to get it checked. It has been up and down since 2009 when it was found to be really low. Iron pills usually help.
When I got back to the car I felt a bit breathless and thought, "That's odd! Maybe I walked more quickly than I thought." However it resolved quickly, by the time I got to the lights, 30seconds, it was fine again.
I got home a couple of minutes later, got my bags out of the car and started up the path. By the time I was halfway up I was again feeling breathless. Got to the top, paused for a moment, then went across to and up the steps. By now I was feeling even more breathless. Made it inside the door, glanced in at
Boar who said, "Hello, dear," and didn't seem to think anything was out of the ordinary. I decided I needed to sit down so went to the sofa and plumped down there. NO! Still couldn't catch my breath and so thought I'd go and sit on a more upright seat, one of the dining table chairs . . . chucked off my jacket, and sat down.
I felt as though someone had suddenly slammed me in the chest, or I'd been dropped on my back and winded . . . really badly. I was gasping, at the time I didn't think I was making much noise but I'm assured I was! I couldn't call out, my mind was going a mile a minute, "If this is an asthma attack they're not much fun!" I've never had asthma. "Maybe I've got that virus Mr Magoo (2yrs old) had that put him in hospital over the weekend," "What will happen if I collapse off the chair, will anyone hear and find me?" "I can't breathe I cant breathe I CAN'T BREATHE!!"
Then I started to talk myself down as I could feel I was beginning to panic, the nurse in me kicked in . . . it's still there. "O.k, calm down, you ARE breathing, slow your breathing down, that's it, slow deep breaths, you're doing o.k, you'll be fine, see your breathing is easier now . . . " During this time Pa had appeared out and glanced at me as he went to the loo. A few minutes later Locket came down from upstairs and asked if I was o.k. At this point it would have been sensible to say, "Get Dad!" meaning Boar. Did I? Nope! Boar hadn't heard all my noise, he was in the bedroom, TV on, and is a bit hard of hearing these days after years of working with noisy tools.
"Yes," I said. "You sure, you don't sound o.k." Locket said, looking a bit worried. "I was a bit breathless but I'm doing o.k now. I'll be alright."
I decided to go to bed, so I pottered around, got a hottie, went to the loo. I did find whenever I walked even a short distance I was breathless. I took my pulse at one stage and it was 135. I thought that was a bit fast! Did I do anything about it, like call
Healthline? Nope! I went to bed!
Boar realised I wasn't feeling so great when Brains brought me his inhaler and suggested I have a couple of puffs, in case it was asthma.
I slept reasonably well, woke up once to go to the loo. Walked to the bathroom . . . 15 steps from bed to the loo, ordinary walking steps. Breathless by the time I got to the loo, and more breathless by the time I got back to bed. Fell asleep again. Woke again at 5:30am . . . a repeat of before. I ended up staying awake, sitting up in bed. I couldn't be bothered trying to get comfortable again. By this time I'd decided that I would go to the doctor. I was tossing up between my GP or after hours at Kenepuru. I thought that even if it was a virus and I needed Ventolin I shouldn't take it without a prescription. I mean, usually a walk to the loo and back doesn't leave me breathless!
I let Boar know I was going to see a doctor and got him to wake Brains as I decided on Kenepuru and I could drop Brains off at Whitireia before I went. I didn't feel like climbing the stairs though to wake Brains myself. Throughout this time I kept feeling basically fine . . . until I walked anywhere, even the shortest distance in the house would leave me breathless. No pain at anytime.
Into the car we climbed, driving was fine, dropped Brains at Whitireia and then drove myself to Kenepuru. Parked in the closest carpark and walked slowly in. By the time I got to the reception desk I was breathing pretty hard, coughing a little. The receptionist asked if I'd been there before . . . yes. Then my name. I was able to answer, but only by pausing and taking a breath for nearly every word! While I was confirming details the nurse, at the counter close by, got up to take a file to the back of the office. She stopped and eyeballed me, put the file away and sat down again, by which time the receptionist had said for me to have a seat and the nurse would be with me in a minute. The nurse said something to the receptionist who then told me to go right over to the nurse. Nurse took my pulse, temperature, oxygen levels and asked briefly what had brought me there. I replied, slowly, lots of pauses. Nurse asked me to sit down, then almost immediately a nurse came through from triage.
It was around 9:25am. This time I was put on the BP machine and I looked at the numbers as usual. 177/78 . . . "Gosh! That's a bit high!" I said. They agreed and asked if it had . . . "No, I've never known it to be that high before!" I said. The senior nurse popped out, the student continued the obs and next thing I knew they were taking me back to a cubicle. The senior nurse had spoken with a doctor and an ECG was wanted. As far as I knew it was fine. Then the doctor asked if I could walk to her room. I did . . . and she saw how breathless I was. Again obs were taken, then questions asked which I replied to slowly, and with many pauses. At one point I remember the doctor saying, "So, at no time did you not think it was strange that you were so breathless so suddenly?" "Ah . . . no . . " and I told her what to me was my logical reasoning from the night before!
After taking my history the doctor rang through to speak with the ED doctor, questions, answers, and the comment that when I'd walked from the cubicle to her room I had been very breathless. There was also my history of high D Dimer and CT Scans for possible clots in 2009 and 2014. The upshot was that the ED doctor said I should be sent on there.
I queried whether I should drive myself there, absolutely not, I was told! I tried A-M Prof's home number but no reply. I was on the point of going online to find the church's office number when the doctor said not to worry, she was going to arrange an ambulance. Say what?! Dimly in the back of my mind I realised they were thinking "clot" again, but still I had no pain anywhere. Both the other times I did! So no pain, no clot, was my next piece of logical reasoning.
While I waited back in the cubicle the nurse took some bloods to go to ED with me, and put in an IV leur plug. I tried to get hold of Boar, or his work . . . no luck. I was taken in a wheelchair to the ambulance, took the two steps up into the ambulance . . . and sat down puffing! I was observed on the way in, as usual and then triaged by a nurse when I got to ED. Then I nearly cracked up laughing . . . because ED was really busy, no spare rooms and so they put me out in the main waiting area! Oh, well, I thought, at least there are people around if I fall out of the chair!
It wasn't that long before I was taken through to a cubicle. Another ECG, more bloods done, an X-ray and the questions. More thorough ones this time. They were looking for causes.
Have you had a long plane ride in the last few weeks? No.
Have you had a long car ride in the last few weeks? No.
Have you had a swollen calf or leg. No?
Do you have pain when you breathe. No?
Are you on an oral contraceptive. No?
Are you on hormone replacement therapy (HRT)? No.
So I didn't fit the criteria for what they were looking for! The blood tests discovered that my haemaglobin was low, very low. 75g/l when it should be between 115 - 160g/l. I also had an ultrasound of the heart to see if one of the chambers was enlarged. So the medical consultant decided I needed a blood transfusion. They were going to send me round to MAPU (Medical Assessment and Planning Unit) and do it there. They were still deciding about doing a CT Scan. My D Dimer was raised, which can indicate a clot, but can also indicate other things.
So I was taken around to MAPU. There I was admitted, then the consultant came to see me with a medical student. I had the consultant a bit puzzled! The medical student took a more detailed history. Then went to write it up. In a while the consultant and student came back.
It was about 8:00pm by this time. Boar had been driven out to Kenepuru by Smurfette to pick up the car from where I'd had to leave it. When he had dropped it home they, along with Brains and Locket, came in to see me. They brought me the things I'd asked for as I realised I'd be in for the night.
There was a plan. Instead of a blood transfusion they were going to give me an iron infusion. It is safer and gives as much iron in an hour as your body takes two to three months to absorb. Also the consultant had decided that they would do a CT Scan, just to be on the safe side. I do remember him saying, "I don't really expect to find anything though. I'm still a bit perplexed about your past history."
I was given a jab in the stomach of a drug called Clexane in case there was a clot. It would start to thin my blood. A new IV line was put in as the CT Scan contrast dye needed a larger one than I had in. Soon after that the orderly arrived with a trolley to take me to have the CT Scan. So my beautiful family had to go home.
Scan done it was back to the ward and the iron infusion went ahead. You are observed for the first 15 minutes, i.e. the nurse stays with you. This is in case you react to the infusion. I was all good and so I was checked on a couple of times over the next hour as it went through. Towards the end my neck was feeling warm, and I felt a weird pressure in my neck and my chest. I was thinking if it kept up I'd ring the bell, when the infusion finished and the feelings stopped. Since the machine was beeping the student nurse and a senior nurse arrived to disconnect it, took a look at me . . . and asked if I'd had that rash on my neck and under my chin before? No. Explained why my neck was feeling warm! They decided it had better be checked by a doctor.
By the time the doctor arrived I'd flung back the sheets and was rubbing my knees . . . the rash had come up there, on my arms, a bit on my chest, and it was darn itchy! The doctor prescribed an antihistamine. By this time it was around 10:00pm. I don't sleep well when I'm away from home so was sure I was in for a pretty sleepless night. Anyone who has been in hospital knows they are not the quietest of places!
I slept! Woke to go to the loo a few times, but went back to sleep straight away. Perhaps the antihistamine helped.
In the morning, Saturday, the consultant arrived, asked how my night had been and how I was feeling. Then he asked if they'd given me the results of the scan last night. No. (Cos nurses and technicians are not allowed to say till the doctor has . . . I didn't even bother to ask!)
"Oh!" he said, "There is a clot, a very large clot in the right pulmonary artery! Radiology rang me last night to tell me."
Now, I used to be a nurse, so I know that radiologists don't ring consultants after 9:00pm on a Friday night unless they really need to. I'm guessing the consultant was glad he'd decided to order the CT Scan! #:-S
I know that
Pulmonary Embolism can be fatal. I did not know that when they are in the vessel leading to the lung they do not always cause pain. 1 in 3 people die of a pulmonary embolism, sometimes within 30 minutes of it happening. I remember thinking that it could have killed me . . . silent, no signs, a clot sitting there somewhere had moved. And I had gone to bed!
The consultant went on to say that he would prescribe an anticoagulant tablet, Rivaroxaban (Xarelto), for me to take, that I would be under the VTE (Venous thromboembolism) clinic after I was discharged, and that he wanted me to stay in another day at least so they could keep an eye on me. Also I wasn't to just stay on the bed. To try and walk around a bit, go further than I thought I could.
By the time I'd stood and talked to one of the nurses, then had a shower, slowly, I decided I'd rest for a bit. I fell asleep! Slept for around an hour or so. Most unlike me, and shows what my body had been through, to me anyway.
In the afternoon I had a few visitors, and Locket took my photo and put it on Facebook . . . no details though. After a few concerned queries from cousins, friends and family she edited it so folk would know what had happened. Turns out a number of the people who commented have had clots of various types.
The rest of the day went past . . . I was pretty tired and even though I had a book and knitting I wasn't able to concentrate on anything for too long. Mostly my thoughts just roamed. The one front and centre was that I was very glad to be alive! It's quite a surreal feeling to reflect that it could have gone the other way. Not that I'd know of course!
Later that night I was moved to another ward, the usual musical beds in the hospital.
When my obs were taken around 11:30pm, I think, my temp was up. Some blankets were taken off and it was checked again about 30mins later. Still a bit feverish. So I had to do a urine sample, and I think they took bloods. I had a urine infection of all things, again no symptoms of it. So I was given antibiotics for that. It took me ages to get back to sleep . . . around 4:00am or even 5:00am.
So then it was Sunday. I went for a wander, very sedately, but I made it most of the way round the ward, and my pulse wasn't too fast when I got back. Late morning or early afternoon the consultant arrived. He wasn't too worried about the fever, said that as the clot begins to break down it can cause a slight fever. It would take 3-4 weeks for the clot to break down. I queried whether it could happen again . . . not likely as I was on the anticoagulant.
"But if something like it happens again . . .?" "If it does, don't go home, don't go to your GP . . . go straight to Emergency!" O.k, message received and understood.
I called Boar to let him know I could go home. We had to pick up the medication from a pharmacy in Newtown as only certain ones stock it. I did find out I should be able to get it from my local pharmacy so long as I give them enough time.
I did get dressed to go home, but got into my PJs and dressing gown pretty quickly once I was home. Walking was still a major effort and if I walked too far - even in the house - I'd start to cough.
So good to be home, with family and enjoy a roast dinner. I wasn't able to eat much, but what I did was lovely :D
