Pre-Surgery

I’m just barely awake this morning: pain, anxiety, and frustration kept me from getting any rest. I'm writing to distract myself from my thirst and hunger. I can’t just take the route of just eating breakfast and drinking coffee to make an effort to liven me up for the day. I’m supposed to be fasting, as I wait for a call to go back to the hospital. A complicated series of events that transpired since last Wednesday have left me in a less than an upbeat mood. I’ve been injured at work, the result being that my bicep tendon has been torn away completely, it least that’s the initial assessment that was made by an orthopedic surgeon. I waited eight hours there before I was sent back home, without even anything practical to use, like a sling, or pain-killers. I could have been in surgery the very day I arrived in the hospital on Wednesday, but things, of course, can never flow that easily. I have to be taken off other medications I use first before they can cut me open, or else I’d just bleed to death. I’ve been made to endure four days of pain, to allow for my blood chemistry to be readjusted, before they can admit me to reattach the connective tissue. In the meanwhile, I’ve been watching my arm swell up, and the skin around the injured area and the forearm sort of chameleonize to weird mottled shades of vermillion, blue, and purple. I was called on Sunday, told to get there for to prepare for surgery that morning. What ended up happening was an almost 10 hour wait in the emergency waiting room, only to be sent home again. It ended up that a couple of other accidents occurred while I was on my way to the hospital, and then as I waited there. The operating theatres became used for these emergencies, and my procedure got deprioritized, and eventually cancelled for the day. I ranted about it on a Facebook post, but I realize how senseless doing that all is. It’s mostly the pain talking. A friend commented that a silver lining has to be found here somewhere. I’m trying to find it.

I arrived home to find Ella very anxious, squeaky, and whiny. She either sensed how irritated and upset I was, or she was triggered by the tell-tale hospital stench that clung to my clothing after nearly 10 hours of waiting there. She has learned to associate that hospital smell with something bad. When my clothes were brought home, without me in them, from the last long stay at the hospital I had nearly two years ago, she went into melt-down panic mode. It was the longest that we’ve ever been separated from each other, and along with the hospital stench the clothes no doubt smelled with, they also stank with my own fear and angst tainted sweat, which made her upset. It has also been disappointing her for the past few days that I’m not allowing her to eagerly charge at me like a bullet to jump into my arms, and to sniff and kiss my face to greet me when I arrive home. She probably feels rejected. As much as I appreciate the welcome, I wouldn’t be able to stand the pain of the impact.

This morning, since 5:00 AM, still aggravated, all I could think of doing was tidying up the place as best as I could with only my right hand and arm, and a semi-useful left hand on an arm I can’t flex without pain. It wasn’t like I was doing anything too delicate or complicated: like threading needles or tinkering with engines. Tasks like changing razors, stocking my shelves, filling the fridge with frozen leftovers, throwing out garbage, folding laundry, and changing fitted bedsheets was enough of a challenge with just one hand and a quarter hand/arm capacity to use. I thought silly things like this stuff should be done before my arm gets put in some cast, and rendered even more immobile and useless.

So, where is the silver lining in all of this? I suppose if I was ignorant about how useful my left hand really was, I’m certainly not anymore. I’ve had a lot of time given to me watching people getting carted in the emergency ward who are in worse shape than I’m in. Something to remind me that my days could be a lot worse. I have that going on everyday for me at work really, but somehow one has to tune it out to keep oneself functional and sane. It sounds selfish, but it’s really a defense mechanism, especially now for the last while as my duties changed over to doing something more analytical. It struck me two entries ago, about how I said how important it was to keep strong and fit if one wants to do well with living in singlehood. I don’t exactly have that going on anymore; having a fraction of my physical capacity now. I’ve been forced to reach out to people I like and trust to ask for help with things: I’m terrible at doing that sort of thing.

I’m not posting this to any of the social media links I’m on. If people really care to know this personal stuff, they’ll trouble themselves to find this entry themselves. I was told that there is a regularly small risk of heart attack, stroke, or death during an operation. Given that I have some precursors that elevate my risks for those things somewhat, I’ll just say that to those who are dear to me, I’ll be thinking of all of you before they put me under. Thank you for being part of my life. I hope things don’t be going from bad to worse, but if they do, I’m going to be taking my memories of you with me.

They'll hopefully calling me soon, time to wrap up and get ready to go. I hope the next few weeks of healing from all this won’t be too hassle-laden and turbulent.

More Sick Leave Ponderings

It's Week Three post-hospital. Today I resumed a mission of re-organization. It started at first of the month, with paying bills, and taming down the stack of accumulated papers, correspondence, and other junk mail. I have only entered my office space maybe only three times since the middle of November, and now I'm trying to deal with the runaway state of entropy and chaos that has struck the place. I also went to the office of the Canadian Lung Association today to see if there were other options they had available to expedite a faster course of recovery for me. They had nothing new to share with me in terms of more strategies to use other than what I'm already doing. I was just given reminders: to be patient, to note that I am making progress (even if it's coming slowly), to avoid reviewing recovery information on the Internet (too much conflicting/bad information), and to just be thankful that I managed to survive this ordeal.

I've realized that this has so far been the longest time I've ever been off work, surpassing by a couple of weeks or so the longest stretch of vacation days I've ever had. The following random thoughts have been occupying my mind. I have no gumption to elaborate on them better, so I will just list them in a rough outline:

1. Discovering how badly in which impaired breathing affects my ability to mentally focus: I'm trying to commit to writing exercises (at least around 500 words a day, including this entry) but it just isn't flowing like it should. I usually can noodle out four star logic problems in a puzzle magazine without many errors or much backtracking, but now I'm having trouble keeping a bead on the clues of one and two star problems. I usually dominate in Jeopardy, now I'm zonking out midway through the show. I'm learning directly by comparison just how quality thinking is heavily dependent on getting oxygen. I never realized until now about just how much energy is really needed to just to be able to physically speak and sustain even a short conversation. I recently discovered that through my online chats that thinking, speaking and writing in a foreign language somehow deceptively uses about four times more energy than for me to speak English, and it wears me out quickly.
2. Discovering the hard way how ignorant I've been about how potentially harmful cold air is: The shock of sucking in air from a -42 wind chill outside with buggered up lungs is a bit of a jolt.
3. Wondering ahead to the retirement years: If I'm managing this poorly with the malaise and boredom of being this inactive and away from work or anything else useful right now, what the hell am I going to be like if I actually reach some age when I've really become some kind of feeble old man?
4. Thinking that I really need a meaningful new hobby/creative pastime: I haven't figured out yet what kind of low-impact, non-physical pastime I could do that serves as a satisfying substitute for running, hiking, biking, and skiing. It has to be one that's cheap to do and doesn't require me further straining my eyes by staring at screens or dealing with an intense amount of visual detail. From Wednesday, I can say that pissing around with wiring and trying to reconfigure network connections lacks some appeal, so electronics is out. Making more wine or beer is pointless because I'm well-stocked, lacking the storage room for it, and I can't regularly imbibe now due to the medications. Cooking without an appetite is uninspiring and seems like a waste of time also.
5. Discovering a changing attitude toward having company: Introversion usually suits me. It used to be such that I never had a problem being my own best company and to relish in any quiet moment of solitude I could get. Now the prolonged period of isolation and disengagement from the public due to both this condition and the past cruddy weather is starting to dull my wits and senses a bit. It seems that as I regain more ability to have longer conversations, the more willing I am to have some company. I never used to be as needy to be social this way.

PE Status: Week Two Post-Hospital

The recovery continues to be slow, but steady. I'm at least not getting stricken with anything else to put me a few steps backwards thus far. I'm still getting exhausted too easily, along with dizziness/light-headedness, laboured breathing, and a wildly pounding heart, but level of activity needed to reach those signs of pulmonary fatigue is gradually increasing each day. It's unfortunate and really aggravating that these are the only symptom barometers I have to indicate to myself as to whether or not I'm healing. It sucks that I have to push myself to those levels each and every day and measure how long it takes to reach and recover from such stress periods for me to figure out if I'm actually making any progress. It's so ridiculous. It's like being given a hammer to smash your fingers with as your only option to use to tell whether or not you have any feeling in your hand. It's counter-intuitive to push one's self closer to the edge of collapse, but I still manage to do it.
 
It was a more vigorous day than I should have allowed it to become; but snow fall warnings were being issued again, and I chose to be practical with the time and shopped a bit after going to the medical lab. Today, it took me almost an hour to do the sort of shopping task which ordinarily takes me 15 to 20 minutes to do for the same amount of goods that I ended up getting. The excursion today has left me really bushed, but it was worth it. The past stretch of eating soup several days in a row was getting pretty monotonous meal-wise. I couldn't resist the chance to find some delicacies that are more flavourful, and yet such that they can be prepared on the lighter side, which is more agreeable with my current state of appetite. I did it before this next predicted big dump of snow comes blowing in tomorrow. It was probably a mistake to be trying to tour through a place as large as the Superstore for groceries given the way I felt afterward, but it was close to the lab, there was heated underground parking, and they had what I wanted all under one roof.
 
I'm bothered by the fact that enough snow has fallen for cross-country skiing, and more is coming; but I'm not fit enough for that sort of rigour yet, and I may miss this season entirely. The next paragraph is a jump ahead into Friday.

Today is Black Friday in the states, but it's White Out Friday here. The snow is arriving, the result of the wet Pacific air jabbing its way across the mountains and far inland, mixing with the descending Arctic chill. I walked the dog outside at 5:45 AM, just because I couldn't sleep. The random yet necessary rest periods splattered throughout the course of a day, and no set routine of things throughout these past couple of weeks have been really messing up my sleep patterns. It wasn't exactly a bright or sane thing to do: for the dog and I to walk the streets alone in the dark in inclement weather with my defective lungs. However, it's better than taxing myself more with trying to tramp through a few more centimeters after an extra three hours of accumulation; and when it's expected later to blow up to 50 km/h gusting with increasing wind chill and whiteout conditions, all just for the sake of waiting for daylight. They say that this will all last until midnight, so today is turning into a total write-off for getting some relief from going shack-whacky or hoping to get stuff done outside of home. The doctor just phoned to tell me that my INR levels are a little high and we readjusted dosages. I should be taking it easy for today anyway.

The big American marketing phenomenon of Black Friday is oozing over our border into our own shops and stores. I had gave thought to checking out some Black Friday sales for tech stuff, specifically seeking out a hugely discounted big-ass external hard drive for network backups, but I'm going to let that pass today. I honestly don't think it will be worth the trouble. This wretched weather may actually be useful in dissuading me from impulse buying any other tech stuff out of this burgeoning madness to cure boredom, like an Xbox One console, or a super-mega home theatre system that I can't really afford. I'm hoping that the sale will extend beyond door-crasher specials for today, and will be available throughout the weekend as things simmer down. As much as I am getting sick of being stranded in here, I just have to turn my head 90 degrees to look outside through my living room window, and turn back again to read, binge-watch TV, and surf the net, and be thankful again that I don't have anything so pressing happening to make me be out there on a day like today, and to learn to be content with what I have.

PE Status: One Week Post-Hospital

It has been a week and a day since I came back home from the hospital. Recovery is happening, but very slowly. I've been spending the majority of that time being cooped up and shut in at home like some sort of fart in a jar; lingering around here and feeling like my wits are getting dulled by the staleness of the slow time and my lack of vigour. For the first couple days, I didn't have much of an appetite. Cooking and eating even felt too strenuous. Throughout the past week, the amount of energy/stamina that I seemed to have had for my most active periods during each given day varied between about one sixth and one quarter of that of my regular normal state of health when I compare and assess. The margin line of my daily activity where I start crossing into that red zone and begin to feel the effects of overexertion to my heart and lungs seems to shift each day, and happens so unpredictably: better one day, and then worse the next. The only remedy now is to move slower and take frequent pauses and breaks. Consequently, it takes about twice as long to do even lighter chores and errands that involve walking, repetitive motion, and carrying and moving stuff. My eyes are becoming really fatigued from all the extra reading and staring at screens. This is all getting boring. Ella, as fun as she is, doesn't contribute much to the art of conversation.

I'm trying not to weaken more and stagnate. I give myself some chore or reasonable goal to do each day with some form of progressive intensity. As tempting as it is to save energy and use extra money on processed/pre-packaged snacks and meals, or getting food delivered, I've been committing myself to cook my own meals mostly from scratch. I push myself to get off my butt and get more active with some walking and limb movement exercises. At Day Four after returning home, I began to walk the dog outside and around the half the block by myself; still some light-headedness, speedy heart, and laboured breathing, but nothing too severe. I welcome these chances to get the fresh air, but I still have to inform people when I'm heading out, and I can't yet go as far as my normal usual routes. I'm trying to expand my range though; I just hate how gradual the process has to be. Yesterday was really tiring after running around, because I felt pressured and relegated to do as much as I could to resupply, and get at least some essential tasks done that I needed my car for before the forecasted freezing rain and snow hit us later.
 
It's bothersome that I have to be all of a sudden so mindful about simple stupid things that I never had to take account of before. For instance, the weather is doling out a spell of freezing rain now, later to be blanketed by snow, which I normally didn't have much concern for. However, now I have to walk outside with more prudence. With me being on anticoagulants, any possible simple slips and falls on ice that I would have just simply shook off before are made more dangerous and potentially life-threatening due to the greatly increased risk of internal bleeding from such impacts. Now that I've cleared aside all the tasks that I needed to do with what little energy had, I'm now going to start using the treadmill downstairs in the rec room to have some means of measuring my progress and temper myself up. It's a handy option to have when the ice on the streets outside gets too treacherous. Not that I have the inclination or energy for it, but contact sports are a definite no-no. I never did bruise very easily before, but now with me being on Warfarin the least little hard bump/pinching pressure make me bruise like an overripe peach. The area surrounding my stomach around the injection spots where I was giving myself Tinzaparin looks like some weird black/purple/brown Rorschach ink blot. I'm glad, at least for now, that the last of the injections was yesterday.
 
I'll hopefully know more about how I am to proceed onward from here after I see the doctor next Monday.

Surprisingly, there is not much out there on the Internet regarding the aftercare and recovery for survivors of pulmonary embolisms; which is actually fine because I'm suffering from too much information overload already as it is.  The best website I think I found so far is THE CLOT SPOT (www.clotspot.com), although I wish I could glean something more definitive from it pertaining to my specific case.

Pacing, But Doing It Very Slowly

It has been an especially harrowing and significant week for me. I got to learn the hard way that I'm not Superman. Some of my readers and familiars may already know about what happened to me. This entry is for those who didn't, or were left behind in the dust as to the state of my condition throughout the chaos. I'm trying not to bog you down with too many details, but writing this out thoroughly just once spares me from having to explain it numerous times verbally on a person to person level and repeating the same conversations, which I have been finding very physically exhausting to do right now. It's the long-winded explanation that I literally don't have the wind for.

For the last couple of weeks or so, I was beginning to notice a gradual and progressive impairment to my breathing, and was getting interrupted sleep; sometimes drenched with intense night sweats. I started to notice things, like for instance, that while I was cycling to work, it felt like I was dragging an anchor behind me: using three times as much energy, yet going two times slower. I dismissed it as perhaps a cold coming on, yet I wasn't coughing or sneezing; just panting and wheezing. My energy seemed to decline dramatically and fizzle out earlier and earlier each day throughout the course of a week. When this past Monday came around, my breathing seemed even more stifled, my heart was pounding uncomfortably and uncontrollably, and the strange pressure I was feeling in my chest seemed to intensify exponentially after just a short stint of walking the dog, and a climb up the flight of stairs to my home.
 
It was a strange and unique form of pressure in my chest that registered in my mind, but not anything that I would have immediately identified or compared with in my own personal mental inventory of sensations of what I already knew of as "pain". Because it was more like simple discomfort and less like "pain" to me, I dissuaded myself from seeing a doctor earlier on, thinking that I would probably just be turned away, and then have "paranoid hypochondriac" stamped into my medical file.* After all, I reasoned, I just had a physical six weeks earlier and was given a reasonably clean bill of health. This time though, the discomfort prevailed a little too long and was really strong in magnitude at that time. There was even more breathing impairment along with the beginning of shakiness and feeling like my legs were going to buckle out from under me. It was a definite sign that things were taking a turn for the worse. I was prompted then to follow up on my friend's advice to see my family doctor to at least get a referral to see an allergist, or a respiration specialist to see if I acquired something like asthma. I just learned recently through a first aid class about what the signs for a heart attack were, and I didn't sense any of what I thought were the supposed internal symptoms of one. What I experienced accorded more with what I learned about as the symptoms associated with asthma. I drove nine kilometres to my doctor's clinic. It was a foolish thing to do in retrospect, because I could have passed out at any moment. I staggered from the parking lot, through their front door, to the reception. I was breathing as fully and deeply as I could, feeling my lungs fill to full capacity, and yet I felt like I was totally suffocating. I saw my doctor, who then rigged me up to an electrocardiogram to read my heart rhythms. Then, before I knew it, an ambulance was being dispatched for me to take me to a hospital emergency ward.

After several hours of waiting for a CT scan, I used much of that time watching my heartrate readout on the monitor being unable to sink below 110 beats per minute, despite the fact that I was lying down still and immobile. Any movement I made caused it to spike even higher yet. It lowered once they hooked up a blood-thinner IV and oxygen line on me. I finally received my CT scan results, and the good news was that they concluded that I did not actually have a heart attack (although I came close to it). The bad news however was that they discovered that I had pulmonary embolisms in, not just one, but both of my lungs. They can be as deadly as a heart attack if they aren't caught in time and treated. I suppose I managed to get some sense to get to the doctor just in the nick of time. I am lucky that my heart has had a bit of seasoning and conditioning through my running days, or else I really think that if it was just even a little bit weaker and unable to handle all this extra stress and punishment, I'm sure that I would have died that day.

It's fairly straight forward to understand what pulmonary embolisms are and what they can do. I'm not wasting time and energy to explain any further details about it. Use a search engine if you are curious and want to know about such things; you'll get a better explanation. What I don't understand yet however is the how and why of my particular case. I'm still struggling to process all of this onslaught of information now nearly a week after all this happened. The medical team working with me is just as mystified as I am as to how a person with my particular health and history could even ever have acquired such a condition in the first place. It would be something in which the people who I serve would be statistically far more likely to get rather than myself. I'm still slotted for a series of additional tests on an outpatient basis to figure out what's going on, and thus I have nothing more to say about my progress: except that for now I've been deemed well enough to be home, and recovery is going too slow far my liking. I'm pacing around indoors now, albeit very slowly, as my only exercise to promote better circulation in my limbs and body to prevent blood from pooling and creating more clots, even though the doctors currently seem to think that this wasn't a factor for me.

The most unnerving things for me about all of this are as follows:

• Even though I'm set on taking the right path in treatment for them and trying to not let them grow more, the clots still have a potential to shift, dislodge, and migrate as they began to shrink and loosen up. They then may potentially move to block vessels that feed blood in the lung tissue itself, causing pulmonary infarction and subsequent necrosis (death of tissues) in the lung, or else cause blockage and damage to other more vital bodily organs. It comes to my realization that it's like I've had a time bomb wired into my chest, and the only means I have to defuse it are anticoagulant medications, extra vigilance, and having a constantly charged cell phone nearby for a 911 call. I have no idea yet as to how long that it will take to clear this up, if it is clearing that is. It angers and disappoints me somewhat that I have been proactive in trying to stay healthy, and this still ends up being the result of it.
• The extreme limitations put on the amount of physical activity I can do within a day. My life has been turned upside down. Simply taking a small bag of garbage out thoroughly exhausted me yesterday. I caught myself on a couple more times being too light-headed after doing what seemed to be very little, and had to sit down immediately before I got so dizzy and could have passed out. It's frustrating to have all this time off, yet so little energy and ability to make what I would call good use of it. I'm still overwhelmed with uncertainty as to what this will mean for me in terms of future travel, energy, and time needed to deal with this problem alone. I'm also bothered by what this will mean for me in terms of possible future loss of work and income.
• A new routine of having to be dependent on medication. It's not just some simple pills either, but stuff that needs constant dosage correction and regular sessions of blood work to do it, and using other junk that I have to give myself through daily injections.
• What bothers me most now is the loss of some of my independence. Perhaps one reason that I'm not a good candidate for marriage, co-habiting with someone, or having a lasting romantic relationship is because I don't seem to respond or react well to being pampered, coddled, or asking and getting help for stuff that I should damn well know how to do myself. I really don't have the right words to describe the reasons, it's complicated. I'm just not used to asking for favours from anyone. Now, I'm put in a spot where I'm left to impose upon and trouble people to do chores with heavy lifting/exertion, or other errands for me. Worse yet is getting people involved in fixing up my stupid mistakes I have made and should be responsible for, like fetching a pair of my glasses for me that I had forgotten back at the hospital. I'm finding this role reversal of going from a helper to helpee a very difficult one to adjust to.

As much as this week really sucked, I'm at least thankful that I got out of this alive, I managed to avoid a full out progression toward a heart attack, and I didn't need to be treated with something as invasive as a surgery (at least not yet for now). For those of whom were involved with my particular incident throughout this week, I'm thankful to you who were there and helped as you did when you could. I'm sorry if I have been too grouchy and stricken with worry to express this gratitude appropriately. I'm sorry also to the concerned others who were worried about me, but never got any accurate information about what was going on. I declined some visitors at times, not because I didn't want to see them, but because with this condition and three days and nights in a noisy emergency ward unable to get sleep, I just didn't have any energy left to give them good company. It's a pain in the ass to park at RUH anyway. I was sparing some of you the trouble. I tried keeping quiet about all this at first, but all that seems to do is ignite a whole other bunch of panic and strange rumours. I hope you are satisfied hearing it directly from the source. I also wish to extend my thanks on behalf of Ella to those persons who have showed up and have been so kind as to volunteer to take her out for walks for me.

Today, my mission and ambition is to start walking the dog again for one time outside today. I have been given instructions by my medical team to limit my range within my surrounding block. It's sort of a place where I'm picking up from last Monday to work towards some normalcy. We'll see how life goes on from there.

*- A doctor, in my mind, is someone I see once or twice every year for a physical for taking preventative measures, or else for any other time when I feel real "pain" . . . that's it. As nice a guy as he is to see and chat with, I don't make it a habit to run to my clinic every time I feel "discomfort", or else I'd be there once or twice every bloody week.