E.R. Revisited

I had to visit the emergency room at Scripps Hospital in Encinitas again today. My trach was obstructed again. Early this morning while being trach suctioned, I couldn't breathe and my nurse, Ernie had to grab the ambu bag and got me breathing again. I decided to go to the E.R. later this morning after trying to get some sleep. At the E.R. I found out that Dr. Eisman, the pulmonologist who always treats me, was not there; they thought he had left the country for vacation. I have a lot of confidence in Dr. Eisman, and to have another pulmonologist treat me made me a little apprehensive. No one knows my situation as well as he does. He has been treating me for 13 years. I would be treated by Dr. Clark, his associate.

Again I had the usual chest x-ray. But, this time they had to do the dreaded blood work. I am very difficult to draw blood from. I usually end up like a human pin cushion from all the poking. Luckily, I was only poked twice. The RT(respiratory therapist), Janet, who has worked with me many times over the last 13 years, came in the exam room to set up the bronchoscope. Unlike the two stooges who had trouble setting up the bronchoscope during my E.R. visit Saturday night, Janet is very much on top of things. I have a lot of confidence in her. Dr. Clark soon came in. To my relief, he had contacted Dr. Eisman, who gave him advice on how to handle my situation. He put the bronchoscope down my trach and saw the flap of scar tissue in the trachea that keeps blocking my trach tube. He advanced the trach farther past the obstruction. After he was done I was allowed to go home. But, I will need to undergo a procedure soon to have the scar tissue removed.

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.

I am Back

On May 8 of last year, I was hospitalized with double-pneumonia and fluid around my lungs. I had drainage tubes inserted in both sides of my torso to drain the fluid around my lungs. But, that was not all. A fistula, or hole, was discovered in my trachea. This allowed fluid to leak into my lungs from my esophagus, which caused the pneumonia and the infection that caused the fluid around my lungs. My pulmonologist, Dr. Eiseman, was unsure if the fistula could be repaired. I thought I was going to die. Luckily, Scripp's Memorial Hospital in Encinitas (in California north of San Diego) has a very skilled ear, nose, and throat surgeon on staff. Dr. Ling knew how to go about fixing the fistula.

The surgery involved removing some muscle tissue from my neck and using it to seal the fistula. It was a success. I was put in to a drug-induced coma for three weeks so as not to undo the surgery. On July 3 I returned home. Since then my recovery has been slow and frustrating. I have had a few setbacks with my trach. Scar tissue blocked my trach quite a few times; twice I stopped breathing and blacked out. Luckily, my mom knows how to use the ambu bag! The paramedics were called both times and I was rushed to the hospital. I have been hospitalized twice and been to the ER numerous times since returning home. I've become a regular at Scripps Memorial Hospital in Encinitas. They should name a wing after me. I lost the ability to swallow; I am fed formula through the peg in my stomach. Also, I am not able to talk most of the time. But, I am hopeful to regain my voice. I am determined not to lose my ability to speak. Although I have gone through many trials and tribulations over the last 10 months, I feel that my life is slowly improving. I am glad to have cheated death once again.