On Monday afternoon, the kids fell asleep in the shade of the beach umbrellas. Bill and I walked down to the surf to be alone. These days our conversations waffle between our usual "Gracie Allen and George Burns" routine and frank, heart-wrenching conversations about the future. Watching him plan and pack for the trip and play with the children on the beach while I watch from my chair, I realize that I am watching the trailer for a life in which I no longer play a part. "Does it feel like that for you?" I ask. "Of course, it does," he responds with far more honesty than I expect from him. His optimism is waning as is his strength. "Out of a 100 times of asking myself, would it just be easier to let her go? 99 times the answer in 'No.'," he explains, "It's still worth fighting for."
The water rhythmically rushed in, providing refreshing albeit brief moments of relief from the sultry heat. And as the water rushed back out to sea Bill and I sank in the sand. It is a metaphor for our lives, vacillating between standing on terra firma and sinking on unstable ground.
Monday night before going to bed, I uncharacteristically placed the kids breakfast dishes on the table and left the a note, "Good Morning!" They do such a great job these days of letting Bill and me sleep-in.
When I woke on Tuesday, Bill decided we should change the hubs at the end of my central line ports before joining our kids for breakfast. The nurse had not informed us to change them, but Bill noticed replacement hubs among the supplies and asked the pharmacist about them. She told him they should be changed once a week.
My central line is a special catheter placed in my subclavian vein which goes into my superior vena cava, one of the two major vessels that brings blood into the right side of her heart. My TPN flows in through this catheter. We were given almost no hands-on training on how to manage this line. And, over the previous two weeks, I found myself correcting the nurse on her sterile technique on multiple occasions. Last Thursday we finally requested a new nurse to start after our vacation. Despite the lack of training, Bill and I have been managing fine with the daily line flushes, TPN administration, and dressing changes. We didn't think twice about changing the hubs, both of us failing to realize that the hub contains a valve that keeps air from flowing into the tubing should the clamp fail to be closed. You see where this is going ...
Bill removed the hub and turned to get an alcohol wipe. Suddenly I heard a rhythmic swooshing sound. "That's not right," I said to myself. "Bill, I don't feel well," I muttered. In the next moment I realized aloud, "Oh my God, the tubing is not clamped." I tried to reach up to clamp it, but I fell off the bed and rolled onto my side. As I was slipping off the bed I thought to myself, "I have an air embolism. This is it; I am going to die." I remember only two other moments, Bill yelling at me, "Stay with me!" as he dialed the cell phone and then him drawing blood back to try and get the air, which of course, was long gone into my lungs.
Here is Bill's account from there:
"She turned completely stark white in 1 second and fell to her side onto the ground. She had a blank look in her eyes, I felt
a greatly diminished pulse, shallow respirations, and she was turning blue and not moving. I clamped the near end. I was yelling at her to stay with me and called 911. I turned on a nearby fan to try to act as blowby oxygen in her face. The ambulance luckily came in a few minutes and I told them I was an MD and grabbed the oxygen and started the non-rebreather on her immediately. She started to come around and eeked out that she could not feel her left side. The ambulance crew and myself got her down the stairs to the ambulance and I asked her to squeeze my hands and both sides seemed equal (yet weak). She was slowly starting to talk but did not know who I was."
I have no recollection of anything after Bill dialing the phone. I awoke, about 20 minutes later in the ambulance, flanked on either side by two sweet white-haired Southern gentleman. "I cannot feel my right arm," I told one of them, fearing that I had suffered a stroke. But as we drove on, the feeling returned. "I have a central line, but I don't know why." I was so confused and terrified.
Through the window of the ambulance I could see Bill driving in our Blue Saturn. And slowly my memory of the morning's events started to come back.
We spent most of the day in the ER. The staff at Carteret County Hospital and the EMTs were wonderful. A social worker entertained the kids for much of the morning until I was stable. Then Bill bounced between me and the kids in the family room as we waited for test results to be certain I did not have a heart attack and that the air had cleared my heart and lungs (this sounds weird but air is NOT supposed to be on the blood side of the capillaries in your lungs).
In the early afternoon, one of the EMTs popped his head into my room. "You're lookin' a little better," he said in that drawl that I have come to love. Then he looked at Bill, "She must be something else. You know what the first thing she said was when she came to? 'I must have been a son of a bitch in a past life.' She made me laugh." And, in a way, it comforted me to know that I was still me even in life's darkest hour.
When I was young I remember these wallet sized cards that read "I Am a Catholic. Please Call a Priest." I used to joke about them. I figured it I were in a situation where someone was rifling through my wallet, I either needed a doctor or a police officer. On Monday, however, I asked the nurse, "Do you have a chaplain?" It's my new favorite health care question. She assured me that they did and went off to fetch him.
He arrived shortly thereafter and prayed with Bill and me. We could hear the kids beating on each other so Bill left the room. I told the chaplain that I felt like God was picking on me (I did not say fucking with me b/c he was too much of a Southern gentleman to deal with my candid Yankee potty-mouth). And I cried and cried because I am just so tired of being sucker punched.
After I was released we piled into the car and drove back to the beach house. The kids fell asleep almost immediately, spent from the day's events. About 15 minutes into the drive I turned to Bill, "My goodness, this is a long way. You must have had your heart in your mouth." He explained that when he realized that the ambulance was not speeding and he could see little movement in the back, he assumed that I had stabilized. But the exhaustion on his face told a different story.
Yesterday I rested for most of the day. In the afternoon we took the kids to ride go carts, and I watched from a bench nearby. Later in the evening, Aidan and I walked to the beach and watched the pelicans flying low. Bill and Amelia caught up to us minutes later. Amelia ran in the surf while Aidan built a sand castle with a complicated wall system to keep out the water. Of in the distance, I spied dolphins jumping in the water. One more day ...
Last night I had a flashback to the event with my arms going numb again. I went to bed and eventually fell asleep only to wake today feeling terrified. One of my friends, a therapist, managed to get me out of bed and dressed via cellphone. I'm going to try and eat something and meet the family at the beach soon.
I feel like I have spent the last 6 months learning to put one leg in front of the other and, just when I get steady on my feet, some huge and malevolent force comes and knocks me over. I don't know how much more I can take but I really am trying, again, to do this one day, one hour at a time.