Monday, September 29, 2008

A Close Call

I had a close call on Thursday, September 18. It was an upsetting experience and I was unsure whether to write about it or not. That is why it has taken me so long to post it. I decided to write it as a reminder to my fellow ventilator users how tenuous our lives can be.

That night when my dad transferred me from my wheelchair to my bed for the night--a routine occurrence-I ran into a problem. When my dad connected me to my bedside ventilator I couldn't breathe. A tube on my ventilator circuit was disconnected, and for some reason my dad panicked and couldn't reconnect it, or forgot where it went. The frustrating part was that I knew what the problem was and the solution, but I couldn't talk. It would have taken a second to reconnect the tube, and I would have been breathing. So, he turned me around with my head at the foot of my bed so I would be closer to the ventilator on my wheelchair, but it was too far away and the tube wouldn't reach. He didn't think of free wheeling my chair closer, or taking the ventilator off the chair and bringing it closer. When he was moving my head to the foot of the bed, he forgot to disconnect my bedside ventilator's tubing from my trach. The tubing pulled tight and the trach was yanked out. I found out later that my trach was pulled out all the way out and was resting on my shirt! I thought it was just partially pulled out. It was worse than I thought. With the trach out, there was no way to connect the vent tubing to my trach. My dad called my mom and she came in, grabbed the ambu bag, but she had no way to connect it to the trach. Instead she covered the stoma and put the air piece in my mouth and started to pump air into my lungs. At the same time she managed to call 911. I heard the sirens within a minute coming down my street. Then I must have blacked out, because next I saw the paramedics leaning over me, then I blacked out again and came to in the E.R. I have no memory of being put on the gurney or the trip in the ambulance. When the paramedics arrived I was turning blue. They added a face mask to the ambu bag and continued to bag me. I didn't get sufficient air the way my mom was doing it. My mom was pumping the air through my mouth, but air was leaking through my nose. She should have connected the face mask to the ambu bag. It is great that I have two fire stations within a mile or so of me, so they were there within minutes. Any longer, and I probably wouldn't have made it.

At the E.R. they continued to bag me, while they tried to find out what trach I needed. In the meantime, my dad put my wheelchair with my vent in the van and delivered it to the hospital. They managed to get me to talk long enough that I could tell them, my extra trach was in my bag on my wheelchair. When my nurse and friend, Ernie, arrived, he connected me to my ventilator. The E.R. nurses' arms must have been very tired. Then he showed the E.R. doctor how to put in the trach. I guess the doctor had never done it before. Once I was with a new trach and connected to my ventilator, and was breathing fine they allowed me to go home. I drove my wheelchair out of the hospital and rode home in my van. It felt great to be back in my own home and alive.

This is yet another reminder of how fragile life is, especially for ventilator users. It is also a reminder to my caregivers not to panic when something goes wrong, for this prevents clear thinking. The solution was as simple as plugging the tube back in. But, panic caused my dad not to see the solution. Panic can happen to anyone. Once it starts it is hard to stop it. The frustrating part was that I could see the problem and solution, but was unable to talk to tell my dad. Everything seemed to be moving in slow motion. I felt like this was the end. I couldn't do a thing about it and was becoming resigned to this outcome. I was also angry that my life would end in such a stupid manner. It brought to mind my good friend Joe Malone, who died in a similar way. It was a sense of relief when I woke up in the E.R. I had used up another of my nine lives. At first I was upset with my dad, and when I could speak, I said,"what an idiot!". But, once I got that out of my system, I couldn't stay angry. What would have been the point of being angry? It was an accident. I had made it, so that was what was most important. It was a learning experience for everyone involved. I doubt it will happen again.


Kay Olson said...

Wow. I'm glad you made it. And I'm glad you told the story because I think this is a common experience for many of us. Just recently I've started trying to talk to my nurses and family members about panic in hopes that explicitly mentioning some key things to do when panic hits will be helpful.

I know that emergency personnel, military, etc., train by inducing panic and then teaching what to do when the mind is clouded with adrenalin. I'm not sure how to be that effective in training my help without going through a situation like you have. But I'm working on it too.

Kimi said...

I'm glad you are all right John! I know how frustrating it is when the circuit becomes disconnected and I know exactly where it is but can't talk and tell them where it is. Thankfully I can still breathe on my own, although its getting harder everyday, but breathing thru the disconnected tubing is hard. If they can't find it they can plug my trach so I can talk.

Lately I've been more anxious about my breathing, and your story frightens me. I have little faith in most of my caregivers that they'd be able to act without my help in an emergency. It's hard to confront people who "think" they know everything.

I hope you are feeling better, and stay safe!

Greg said...

What a close call you had! Sometimes it's the simplest things that separate us from life and death.

It never amazes me how many times I have to educate doctors or nurses regarding my disability (quadriplegia), I love it when they say squeeze my hand.

I really enjoy reading your blog and if you don't mind I will add you to my blog roll.

Lisa said...

Hi John,

Nice to meet you my name is Lisa and I reside in Canada, our boy fraternal twin has a trach and I find your blog very interesting to hear your view points with regards to your medical issues. As I write with how I feel regarding my son's issues and what our life is like.
Thank-you for the insight John,

Warmest Regards,

Lance Anderson said...

Hey John

Wow man that was a really scary story. Thanks for sharing it, I know it was not an easy one to tell, especially since your dad isn't shown in the best light... But you know better than I do, how much he loves you and only wants what is best for you... Please give your parents my best.



Emma and Mommy said...

Just now reading this, I know I am late. Wanted to say I am glad you are ok.

I know a lot of people panic in situations like that. I am sorry your dad paniced but its very easy to do.

My sister is like that, but I am the exact opposite for some reason, I jump right into "fix it" mode when something is going wrong with Emma. Once the problem is over, I am a nervous crying wreck but I make it through the situation first.

Your story sounds like a nightmare, I can't imagine how that must have felt to you, and I am thankful you are ok.