E.R.

Saturday morning started off badly. I was having frequent trach suctioning and the suction catheter would not go down all the way. Also, there was a persistent wheezing coming from the trach. It felt like there was an obstruction. My mom squirted saline water numerous times down my trach to loosen things up. But, it had no effect. I felt something was wrong. After a restless morning, my lungs were somewhat clear. I thought the worst was over. When my nurse, Ernie showed up for work at 2:00pm things seemed much better. I had less suctioning, but the catheter kept meeting resistance, but Ernie was able to force it through. I thought it might be a dried mucus plug at the end of the trach tube. But, at around 6:00 as I was talking to my sister on the phone, I felt an urgent need for suctioning and had to end the phone call. Ernie went down the trach with the suction catheter, but the way was blocked. As he went down again, I couldn't breathe. Frantically, I mouthed to him that I couldn't breathe. He quickly grabbed my ambu bag, and in a few seconds he had it attached to my trach and pumped air to my lungs and I could breathe again. My heart was pounding so hard it felt like it would come out of my chest. It is always a scary experience, especially when you have the fear that the ambu bag may not get you breathing again. Thank God for the ambu bag! After that episode, I knew it was no dried mucus plug; I suspected scar tissue. I have been down this road before. In January I stopped breathing a few times, until the pulmonologist at Scripps Memorial Hospital in Encinitas, Dr. Eisman, finally removed the scar tissue. For the next seven months, my trach was unobstructed. I felt that the problem was gone for good. I was surprised when it came back again. I had to go to the dreaded E.R. Ernie drove me in my van to Scripps Hospital in Encinitas. On the way, I listened to U2, to take my mind off things.

When we arrived at the hospital, the E.R. waiting room was almost empty; a good sign that they were not very busy. After a somewhat short wait, they called my name and I was allowed in the E.R. First I had to meet with the triage nurse. She was told what the problem was, and then took blood pressure, and temperature. I was promptly ushered into a procedure room to wait, and wait for the doctor. While waiting, the nurse hooked me to the heart monitor, automatic blood pressure monitor, and pulse oximeter to measure my oxygen levels. My heart rate was 120. The nurse told me to relax and not to talk. When she was gone I continued to talk. It wasn't the talking making my heart rate go up, it was because I was stressed out from what happened to me earlier! They also took a chest x-ray. After a while the E.R. doctor came in the room to evaluate me. At the time I was breathing well, and by the doctors tone it sounded like he would send me home. During the evaluation I needed suctioning. Again the catheter met resistance and I couldn't breathe. My nurse, Ernie grabbed the ambu bag and got me breathing again. This convinced them there was a problem. The E.R. doctor contacted the pulmonologist, Dr. Eisman. I was relieved that he was on duty. He knows what to do. That put my mind at ease.

Soon two R.T.s(respiratory therapists) entered the room with the broncoscopy machine. The two stooges couldn't figure out how to connect the equipment. My nurse, Ernie helped them connect it. He was an RT in the Navy so he knew how to do it. It's unbelievable they didn't know how to do it. The doctor came in and put the bronchscope down my trach. He found a flap of scar tissue at the end of the trach tube that was causing the obstruction. He advanced the trach tube past the scar tissue and the airway was completly clear. I was soon allowed to return home.