♦Time, before and after.

♦ How I will make the most of it ♦ And how it will make the most of me.♦


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with each post successive afterward.

First Post is "Time" January 11th, 2012

SOB = short of breath


Wednesday, March 7, 2012

The Day of "Tests"


My time for testing was fast approaching, my fears right alongside. I had heard some scary things about the testing and especially the bicycle stress test, and if you have read this blog you will know how I dislike things like this. We had arranged for our daughter’s best friend (and caregiver) to stay with her for the overnight and full day that we would be spending out of state. And away we went in the mid day. As we traveled northward we discussed the fact that it was kind of like when we were escaping for a getaway, just to two of us (something we rarely get to do). Unfortunately, when we do get a chance to get away there has been a reason similar to this getaway, or we just don’t get a window of opportunity large enough, and have to return home too quickly.
So we traveled northward for about 500 miles winding our way through Portland, Oregon’s traffic which was actually not as bad as it could be, but then it was Sunday after all. Even though the commute was nonexistent, there was still traffic, because in Portland, Oregon, there’s always traffic. I think they set it up that way to keep as many tax dollars in the state as possible, since many Portlandians have the tendency to move north of the Columbia River into the state of Washington to avoid the high real estate taxes that we have in this state, since there’s no sales tax.
As we left the state of Oregon behind us, magically the road lanes widened and straightened out, and the ruts and potholes disappeared almost completely and our gas mileage increased exponentially now that we didn’t have to drive as hard just to get around. And something else that was quite fun, was that the mph speed increased to 70, a fact I had not known about. So they’re doing something right in Washington that the State of Oregon hasn’t realized yet. Of course, Oregon does offer coffee at the State owned Highway Rest Areas. Too bad they are unaware that Washington has Seattle’s Best coffee everywhere, always tasting like it has been fresh ground. Imagine stopping to fill up the gas tank and buying a cup of coffee that could easily be Starbucks or rival them in quality. From a gas station on I-5 no less!

As we approached Seattle I marveled at the gorgeous city, and the tall beautiful buildings. The Sun just happened to burn through fog to shine on the metro district, and the gulls came out and sailed on thermals in and out between the sunlit high rises! A beautiful sight to see, I must say. Even though there were folks living underneath almost every single elevated freeway lane and overpass, the town actually shone bright.
We reached our convenience suite, easily found parking right in front and went upstairs (yes, I climbed 2 sets of stairs with 7 steps each, shock of all shocks), and soon opened the door to our conventional room. Even though it was not over fantastic, our room was very livable and functional with a large screen TV with cable programming, which was nice. Our view was of the parking garage next door, but it was Sunday so it as devoid of vehicles and peepers.
The only caveat we ran into was a toothache that developed in my mouth. It had started on the Friday prior to leaving; starting just as a gum that might have been scratched by an errant tortilla chip as it passed through, but once it didn’t heal and go away, it blossomed into a regular pain in the butt, and by the time we reached Seattle, I had a situation that I describe as a little raft floating on a pool of lava in my mouth.

I couldn’t bite down on anything much less my own jaw. And if you have ever experienced something like that, it is very agonizing and all thoughts of wandering around Seattle’s neighborhoods in search of a quaint little Thai or Indian cafĂ© for our first and only night out on the town, prior to my day of hell testing, went right out the window. Instead, Danny went out alone and returned with subway sandwiches with mild and unobtrusive flavors, since I couldn’t enjoy anything anyway. So we laid on the bed and watched TV and fell asleep early.

Upon waking, we only had enough time to get our things together and arrive at the hospital around 8 in the morning. I wasn’t allowed to take my meds or drink my morning coffee, and if anything was to be eaten, it had to be light. So we just didn’t eat. Danny, did get his coffee after settling me into my wheel chair equipped with an air tank at the valet parking. It was when he was wheeling me into the hospital that he told me the story about the time he was wheeling his Dad in a wheel chair at the Dodger Stadium in LA and how he left him and went to get something, but didn’t put the brake on and his dad started rolling away! I laughed when he told me, but when he went to get his coffee I still double checked to see if he had set the brake……..
First stop, radiology! Danny parked my chair facing the wall and I said something like Hey, while I was hearing the guy chuckling next to us, and Danny said “you’re lucky we’re not at Dodger Stadium!” And that started us on a day of discussion about wheel chair protocol, since we had just alighted from the elevator where Danny had wheeled me directly in, which just so happened to leave me facing backward. It was then that I had a memory of seeing nurses pushing wheel chairs turn the chair around and pull it backwards into the elevator to keep the patient facing outward. This wheel chair protocol we aptly name “Wheel Chair Etiquette” from then on.
When they took me back to my VQ scan or Pulmonary Perfusion test they injected me with radioactive isotopes and put me in a scanner and CT scanner combination machine. They told me I was their first person to use the new camera set up. It was quite a magnaminous set up and I saw from the corner of my vision images similar to the lungs in the last post. This machine below is very similar to the one I was in, only I was on my back, and the boxy arms rotate around the patient taking images from different angles.

At one point they fired up the CT scanner and dipped me in and out a couple of times then the final series, a 360 degree set of images to compile into a 3D image while I lay there unmoving and those arms rotated and stopped every several degrees, shooting images through me. This all took about 70 min, or so, and right before I left they handed me a yellow card asking me to carry it with me for several days for legal and medical explanations, lest I set off any radiation alarms in my travels. Imagine ending up on a No Fly list because I caused the Geiger Counter tickers to tick!
From Radiology, it was off to the Pulmonary Diagnostic Dept for my “Full On” Pulmonary Function exams. First they drew my blood for an arterial blood gas test, and of course I have teeny tiny veins and a vein was pricked instead of the needed arterial line, so I had to be needled again. After that it was back to the dreaded glass box and many, many spirometry tests. I say many, many because they need three tests that are within a certain parameter of each other, and each time mine were so different that it was hard to get three alike. They allow up to 8 tests. And I finally achieved my three on the 8th attempt. Of course that was only one test. If you have ever had a spirometry test, you would know how much they can be disliked especially if you have any breathing issues.
For a Spirometry test, you wear a nose clip and place your mouth around a tube-like funnel and when instructed, take several breaths naturally in a resting phase and then a deep breath and you blow like you have never blown before. And you do not stop blowing until you have every possible bit of air blown out, and then you keep on blowing even after that! In other words the tech sits there ready to catch you if you pass out (and he told me that people occasionally do pass out)… One would think I would have after 8 tests. But I didn’t. Then there were the other tests. For some, I breathed in a resting phases until instructed to very lightly puff in and out ever so lightly while holding my cheeks to ensure that I did not cheek puff and while puffing, and then they shut the air off completely! I would puff like that for a couple of seconds then the tech would instruct me to draw a deep breath and then softly blow out…every bit until I was ready to pass out again, in 3 matching tests, of course after about 5 we got 3. Then there were the tests that had me rest breathing, for several breaths then taking huge breaths in and then out, that’s right again out, out, out, almost pass out. Some tests blew air back into my lungs swelling them up. They also had a test where I was instructed to blow out and inhale, sucking and blowing as hard as I could, over and over and over and over again, with the tech coaching by doing it alongside me. I hope they have brown paper bags for some people after that test. If asked, I would name that test: The Hypervent test, because basically that's what almost happens.

Oh and by the way, every one of these tests are the color producing tests, and by that I mean they make your face change colors through every phase of the color wheel especially through the reds and purples and almost, but not quite blue. I would like to say that green is actually avoided, but yellow and green is what I feel when I think of those tests. Those bloody pulmonary function tests, now that I have completed all my tests, they were actually the worst for me, but I didn’t know that yet, since I was fearing the bicycle test the most.
I was approaching the day with my advance visionary technique, which means looking past what I was doing in order to see the light at the end of the tunnel in this case the end of the day’s testing. I had two more tests to do before that happened. We had a quick lunch break since all of those pulmonary function tests had pretty much dissolved our allotted lunch time.
~*~
The bike test was after lunch, and was initially my dreaded fear. Seeing that bike sitting there caused the blood to drain from my face. I was told that it would take about 30 min on the bike, and that after 8 minutes with no drag (and always keeping the bike at a speed of 65) they would then start to add the drag and I would be going as long as I could until another set amount of time passed. If I had to stop I would be informing them of whether I stopped because my legs gave out or my breath gave out, in other words, which ever happened first.

I never did tell the tech that I have never ridden any longer than 20 min on the recumbent bike at my gym on the lowest possible setting; the setting so low that when my timer is up, the 5 min of rest pedaling does not change at all. And here I was going to have to continue for 30 min on an ever increasing drag? Oh gee. And I would be in an upright position, not a recumbent position? I had visions of vomit, or falling over the handles while passing out. All of this with a full oxygen mask strapped around my head and 35% oxygen being pumped through me, including the pulse oximeter that was glued to my forehead in a head band set-up. I really dreaded this. And when it started there was no way out of it for me.
Actually this is where I have to admit that it really wasn’t as bad as I thought it would be. Partly it is because I was being pumped full of that 35% oxygen. When I work out at the gym, I am always at 3L/min of air (which is equivalent to about 28% or somewhere around there and lower than the 35%), and when I get short of breath (yes even at 3L) I get hot all over, and go through all the phases of SOB, many times feeling as though I am going to pass out, but I never do; so I endure it all, always watching my timer because my reward comes at the end of it all, when I get to rest. This test did take it all out on me but I was able to keep going far longer than I ever thought I would, and when my tech told me that he now had what he needed and that my time had passed and that I could stop when I was ready I did. I was hot and sweaty, short of breath, but not like I usually am in the gym and that is probably from that 35% Oxygen which I figure was continually reviving me as I was passing out! The tech said I did great!
And then I had one last test; another blood test. Piece of cake! We went into the blood draw area, they sucked a vile of blood and we were off to the surgical center for our consultation! We were done with testing!
At the Surgical center I filled out more paperwork and answered questions about my family history my medical history and things like that. We were taken into the exam room and asked more questions including questions about my toothache which I have pretty much ignored here, so far. But I tell you now, that toothache followed me all day long and interfered with everything in my functioning body, but I wasn’t about to let it get in the way of these tests since my life depended on them; and if I were sent home because of a toothache, I would die right there in Seattle. Of course, now in the exam room everyone seemed to want to know more especially when it was discovered that I had a 99.5 degree fever (which I did not notice at all), and my resting bp was too way high for me, even on my Bp meds that I take every day.

The nurse came in took my vitals and then in came the surgeon, the case manager, and even a pre-op specialist, all of which were quite concerned about my toothache which had emblazed itself into a swollen mass in my jaw. I promised to get it checked as soon as we returned home, even though it appeared to have reached its own threshold and might now be subsiding on its own.
Meet my surgeon! Dr Michael Mulligan



My Surgeon's Story! 
My surgeon is AWESOME!!!
THIS, is Dr McDreamy:

Published Jul 12, 2013, 9:00am  This blog updated:  July 31, 2016


What it’s like to
SAVE A LIFE WITH AN ORGAN TRANSPLANT

Michael Mulligan
Program Director for Lung Transplantation at University of Washington Medical Center
I was driving to work at UW Medical Center on 9/11 when I heard that a plane hit the first of the Twin Towers. An hour later, my team got an organ offer out of Alaska. At the time, we had one patient with cardiomyopathy who needed a heart and one with emphysema who needed new lungs. The FAA had grounded all civilian aircraft, so we figured we wouldn’t be able to retrieve the organs. But the medical director of the hospital came marching into our operating room and told me, “If you don’t fly up there to get the organs, the terrorists win.” We decided to go.
I asked my father, a former naval pilot, how best to navigate the restrictions. Then we flew up to Fairbanks, harvested the lungs and heart, and started back toward Seattle. We were almost home, flying over the Space Needle, when we suddenly veered back out toward the water and headed north. I tried to alert the pilot that we needed to land immediately, and then I looked out the window and saw two fighter jets off our wing. It turned out that our flight plan was not correctly registered with the FAA; we were identified as a civilian aircraft with no registered flight plan, flying at max velocity toward Seattle on 9/11. The jets had us targeted, and our pilots were on the wrong frequency.
They finally forced us down in Bellingham. The organs were in the cooler, and we were on the clock. The patients had already been prepared for surgery, and it was going to go very badly if we didn’t get to them fast. Both would have been at an acute risk of death.
We woke up a colonel on Whidbey, and he personally cleared an air corridor right down to Husky Stadium. They set up a helicopter and said, “We can take one person and the organs, that’s it.” So I jumped in with the helicopter pilot and we flew down and landed just outside the stadium. We were only allowed 60 seconds on the ground, so I quickly grabbed the coolers from the back of the helicopter, and sat down on the field as it took off with a torrent of wind. I took a few deep breaths, and then rushed to the hospital and transplanted the organs. The surgery was perfect, and both recipients did phenomenally. It was a matter of not relenting. Eyes on the prize.

****


I was told that I was in the best grouping of candidates, that my exercised state of life had placed me in the category that can get the very best results from the surgery! The surgeon explained different types of surgery and let me know that he expects to be able to go in from the sides with video assist and remove everything that he needs to, without cracking open my chest, splitting the sternum right down the midline. So healing should be significantly faster for me this way! And then we were given a choice of dates for surgery and we chose March 27th three weeks from now. Our choice was a cancellation date that had just occurred for this Friday, March 9th, which would be very handy but we were not ready for it this soon, or the March 27th date, and the third date was out around April 9th. So we did “good.” And we were done for the day and ready for the 5 hr drive homeward.
Good thing too, because the air was icy and Seattle was expecting a surprise snowstorm to blow in that night, so we beat feet to get out of town.
We made it southbound for about an hour and a half until stopping to gas up, get coffee, and to get me a cup full of ice for my toothache.


And I burned through every single ice cube wrapped in a towel all the way home, including when we stopped for our beloved Weinerschnitzel Chili dogs in Vancouver, Washington.
We even stopped in Albany and finally found my Brewery for Chili beer but it had already closed for the night, so we returned beerless after all of that.*
My tooth blazed all through that, and this morning after due consideration I called my dentist and they got me in early when someone else cancelled. One xray and the bad news came to me. The tooth is fractured and the root canal I had below it was highly infected. So in two days it comes out. The whole tooth gets removed and in several months, after surgery is over and done with, we will look at what my options for that missing tooth. Luckily it is my molar so it is not openly viewable to others. At that point I was immediately put on antibiotics.

Needless to say, I called Seattle and let them know and they quickly returned my call gathering all the pertinent information to collate into my file. Cool.
*I discovered that we do have the chili beer locally so tomorrow I will be picking up bottles to put into the frig so that after my course of antibiotics has been completed and when I am on the mend I can sit back and rejoice.
I have to give thanks to my Golden Heart friend (we’ve been calling him Robert) for getting me fired up on the exercise bike. His prodding got me to practice and with good reason too. I was able to keep on trucking on the bike right through the test and when I stopped it was not because my legs were tired, it was because my breath was short! And I think that’s what they wanted to know!
Now it is time to prepare for the big day.