Nautical Chronicles

NAUTICAL CHRONICLES:

OUR MOST RECENT ADVENTURE

PRELUDE (THE PRECURSOR)

I guess it’s time for me to recount our most recent journey. Louise just left for the day allowing me time to WRITE! She’s off to Victoria’s studio with Deb for some type of “brow darkening” appointment.

Leaving me some time alone.

As with most of my stories, this one started on the boat making it a true “Nautical Chronicle”.

It is a well-known fact that imbibing is a necessary part of boating, and to that end, I have been an active participant! Each year, at the end of “C” Dock, boater’s sponsor a Buffett Party to which we, on “A” dock are always invited. Of course we went.

Blurred vision (sounds like a song by Robin Thicke we play on the boat) is a common occurrence during and after such functions, but this year, my blurred vision was different.

On Thursday, July 18th, while working at my part-time-job, I was presented with a huge surprise; I was seeing two of everything; no pain, just two of everything. It happened in the morning and lasted thirty seconds; that was it. In the afternoon, it happened a second time at the office, for thirty seconds. When the vision returned, it returned to normal. The occurrences were enough, however, to report to Louise when I got home and for us to head to the emergency room.

I was admitted, overnight, for testing for a possible TIA (mini stroke). After CT scans, MRI’s, Echo’s, blood tests and various other tests, nothing was found to be out of the ordinary except my vision. I was dismissed the next day with no positive findings, after spending the night in a room with a young, big, burly, hairy guy who was up all night, moaning, asking for more oxy, moaning that his pain was insufferable, and who’s family attended to him until 11:00 PM wondering, out loud, why he was not being treated better. They also brought a young boy who ran around the room all afternoon and evening, yelling. I was thrilled to be discharged late in the afternoon the next day.

Since nothing was found to be wrong, I was instructed to see my ophthalmologist. Louise was able to get me an appointment with him the next day.

We met with the eye doctor. After numerous tests, and after his review of the hospital test results, and since the double vision was “intermittent” (no one ever saw it when it happened), he determined the causes to be related to the #6 nerve in the left eye and was due to high blood pressure readings taken at the hospital. The result of the visit was a recommendation to see a neurologist and that I was “suffering” (there was no pain and the vision issues were rare and lasted only short periods of time) from Diplopia.

We were able to arrange an appointment with a neurologist for the next day.

After a comprehensive review of tests taken and visits made to emergency and the ophthalmologist, my neurologist discounted TIA’s and stroke (all tests had been negative for these) and considered other possibilities. The two most likely, diplopia-related suspects were Lyme disease and Myasthenia Gravis. He scheduled tests for these nasty diseases. He also prescribed some nasty pills which would get a jump-start on “relief” (I still had no pain or other discomforts from the intermittent Diplopia). The pills interacted poorly with alcohol which sent me to bed very early that night with assistance from Louise helping me to get up the stairs. I quit taking the pills (we all have priorities) and luckily the blood tests came back negative for both diseases. That resulted in me having an overabundance of MG pills since he had prescribed a 90-day supply of them.

We scheduled an appointment with an eye surgeon to further explore the possibility of nerve or muscle issues with the #6 nerve to the left eye. The meeting was scheduled for Tuesday, July 30^th.

Which brings us back to the “C” Dock Buffett party on Saturday, July 27^th!

In the ten days between when the double vision started and when the Buffett Party occurred, I had been lucky enough to see many specialists and to take many tests toward resolving a painless but annoying, intermittent occurrence of double vision. But there were still no answers. In an effort to help reduce “blurred vision”, knowing full well alcohol did not help, I had stopped drinking a couple of days earlier, and I was alcohol free at the time of the party (and as a result did not feel like dancing this year).

While at the party, an extended bout of double vision occurred lasting thirty minutes (most previous occurrences had lasted only seconds!). I mentioned this to Louise, but we found no reason to do anything differently; the eye surgeon appointment was for Tuesday so we waited.

The party was Saturday night. We stayed overnight on the boat and Sunday was gorgeous. We took the small boat up the river and had a nice time with friends; we did what we do best…we boated, but still alcohol free. The big difference Sunday was that I had no episodes of double vision. When we got back to the docks, Louise packed up to head home (she had plans for Monday), and I had planned, as usual, to stay over on the boat.

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THE HAMMER CAME DOWN

Sunday night (more accurately Monday morning at 4:00 AM), out of a peaceful sleep and out of a clear, black sky, I woke up with a splitting headache, sat up in bed, not able to breathe, choking for air, not able to focus, holding my throat; not so much scared as surprised. I slid off the end of the bed and wobbled to the galley, hoping to get out of the door, into the cockpit and onto the dock. I knew Erik had stayed over and maybe I could get him up to drive me to emergency. The thought never crossed my mind to call 911; I wasn’t thinking, just reacting. So many things could have gone sideways at that moment; thank goodness my reactions were positive ones. I barely remember the walk down the dock to his boat; I do remember banging on his door, several times (he is a sound sleeper as are Victoria and their guest who had stayed over). Erik’s a cop; he’s good in emergencies!

He helped me up the dock and into his car, and got me to emergency within minutes (a different hospital than I was in before). I was admitted, subjected to another battery of tests which to my surprise, were not indicative of a stroke or TIA, and remained there for ten days. I remember telling the nurse to let Erik know he could leave, but the message never got transmitted…he ended up staying for hours.

This time, I was in pain. I was suffering from blurred vision but not double vision (the Diplopia went away that night and has not returned), and the lack of ability to swallow and breathe properly. The headache had disappeared before I left the boat that morning, but I was not walking well. I’m not certain why, after being admitted, they did not test for stroke. It was three days before another MRI was performed indicating “an acute occipital ischemic infarct” had occurred (a stroke).

Those eight nights in the hospital were a real adventure! At least I was in a room of my own. I was not in serious pain but couldn’t eat; my throat was killing me; I was constantly coughing and I was having trouble breathing. I was not on pain medication; all my parts were working so nothing looked like the result of a stroke. Blood pressure and vitals were constantly monitored and a potassium drip was, to my knowledge, the only IV I was getting. After a day or two, it was obvious I was going to need to get nutrition, and wasn’t able to eat! If my pain had been minimal to this date, it was about to change.

On the third day in the hospital, they placed a nose tube for feeding. I had had a nose tube placed once before by my ENT doctor to check my throat. That was what I was expecting; a small, maybe sixteenth of an inch diameter tube. Well, this nose feeding tube turned out to be the size of a large-to-extra-large doctor’s thumb and was sent all the way down to the stomach…next to rotator cuff surgery, it was the worst thing ever done to me; in fact, I’d rather have the shoulder surgery again than that nose feeding tube. Unfortunately, it was needed so I could be fed nutrients. The only other option offered me was a stomach tube placed through my side. After two days of the tube (Wednesday & Thursday) I had had enough. I raised holy hell, got a couple of nurses on my side as well as one hospitalist doctor to agree to its removal (without permission from the GI doctor who had placed it and was unavailable for consultation! This was happening on a Friday; I knew removal would not happen on Saturday or Sunday!).

They removed the tube Friday morning; the GI doctor came in late in the day and noticed it was gone and scheduled a stomach tube insertion for the following Monday. I remember telling him it wouldn’t be necessary; I would be eating by then…AND I WAS. The tube insertion was cancelled.

Interestingly, during the two days the nose tube was installed, I was given the MRI which indicated I had had a stroke. I was also given an echo cardiogram and a barium swallow test. Who would schedule a swallow test to a stroke victim who has trouble swallowing and has a nose tube blocking his swallowing? There were no test results. Who would schedule an MRI where you need to lay motionless on a tray, to someone who has a tube and can’t lay down and breathe at the same time? Somehow, I survived that test. Ahh, the adventure.

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WHO COULD MAKE THIS UP?

“Saving the best for last”:

During the first three days of my hospital stay, the nights were filled with excitement! To my knowledge, I was not on any strange medications. Just baby aspirin, maybe Plavix, a potassium drip; I had not been drinking and had not had much, if anything, to eat. I had been sleeping ok and don’t remember dreaming much. I was alert and functioning most of the time while awake. And yet, some strange things were going on around me. I know because I was awake. And to this day I remember them…

Though I never got out of my room while I was there, I remember there being some type of reception area outside my door with seating for visitors. I remember the nurse’s station was across from that area and partially within view of my room. There was another patient room outside and to the left of mine. And, to the right of my room there was a large storage area with windows which were dark most of the time. At night, I was visited regularly for review and documentation of my vitals, but the door was kept closed most of the time at my request.

It began Monday night, the partying in the reception area by the third shift nursing staff and the occasional doctor who might still be around. The sounds made it clear; they were moving stuff (chairs & tables) out of the storage area into the reception area. The sounds and voices were loud. I remained silent and motionless fearing they might be concerned that I could hear what was going on and mention it to, maybe, “someone in charge”. I remember putting up with it and, eventually, falling off to sleep. I did mention it the next day to one of the nurses, but the look she gave me indicated I should say no more and that this activity must be kept a secret; like she didn’t know what I was talking about!

I’ll be damned, but Tuesday night the same thing happened! It was actually louder and more boisterous than the night before with one huge exception…two busses rolled up outside the emergency exit door and unloaded more party-goers; they were somehow able to convince security to allow them in. I again stayed motionless but noticed how it got quiet when someone came in the room to do my regular tests. I swear, I was fully awake and functioning when these things were going on around me.

Wednesday, during the day, a male patient was brought in to the room outside and to the left of mine. He had a terrible cough which was continuous. His wife was with him. During the day, he came and went for testing. He had his own doctor who attended to him all day, and he had friends who visited all day, also attending to him. It appeared to me that he must be “a big shot”. After listening to some of the conversations he had with his friends (many of whom stayed in the reception waiting area), I learned they (thirteen of them) had rented a house in Newburyport and had been staying there for two-three months. I was not able to discover what they did or why they were there; I figured maybe construction? Later in the day, I figured they might be there for less legitimate reasons.

His wife, his best friend and his friend’s wife all stayed with him after visiting hours. By 10:00 PM, the three visitors were asked to leave the hospital, but argued with the hospital staff folks making the request. I wondered why they didn’t just call the cops. And that’s eventually what they did; the staff called the cops. The visitors were removed by the police. There was a lot of noise, walking and running around, but they were ousted. Peace reined for maybe an hour afterwards.

I remember waking to hear the women’s voices again. They had convinced security to allow them to return and were again talking to the patient with the cough (it seemed to me that hospital security was a little loose). Apparently when the women left the hospital, they couldn’t find their way back to the house which the men had rented and were lost since they didn’t know their way around town.

I must have dozed off because I don’t know what happened after that. I don’t remember what ever happened to the “goombah” with the cough and his buddies; they were gone when I got back from my tests on Thursday. I think I may have asked about him & his buddies but that was another secret kept by all of the hospital staff; like it never happened…privacy laws. I regret I was unable to get to the bottom of these activities (If, in fact, they really happened?)

*****

Friday was the best day of my hospital stay…the nose tube came out and I started eating real food again. I was working with OT, ST and PT to regain some abilities I had before the stroke, and I learned I had qualified for admission to Northeast Rehabilitation Hospital in Portsmouth for continuing OT, ST and PT work. In all to date, I had spent ten days with diplopia and nine days in hospitals, and was looking forward to another ten nights in rehab. Every journey is an adventure; I was looking forward to the next step.

*****

THE NEXT STEP

Post traumatic injury requires rehabilitation; to get your brain to re-learn how to walk, talk, eat, see, breathe, and function in daily life. If, like me, you are unfortunate enough to need such re-training, Northeast Rehabilitation Hospitals in Portsmouth and Salem are exceptional facilities to help re-learn how to live.

A stroke literally kills brain cells. They do not regenerate BUT the functions they performed can be taken over by other cells still living in the brain. Thank goodness we have so many cells that others can cover for the ones lost. Through therapy, these “other” cells can be trained to recover lost functions: in my case seeing, swallowing, balancing and thinking, all leading to clearly seeing again, eating, driving, working…living.

Twice daily, we had occupational therapy, physical therapy and speech therapy. Since swallowing, for me, was still an issue, all meals were taken with supervision. Food was initially pureed with liquids being thickened. Five of the ten days in this hospital were with this type of diet (I was considered a choke hazard). As well, I was escorted to the bathroom and taken to all therapies in a wheelchair (I was considered a fall hazard). On-staff doctors and nursing staff were constantly monitoring vital signs and progress, and were always available for consultation. Literally, it is impossible to not get better while in NRH.

Ten days of intense rehabilitation and I was eating solid food again, able to walk without assistance (much to my dismay, all of a sudden, one day while at PT, they stole my wheelchair, walker and cane and said “you’re done; no more help walking”); my vision had improved but they had set me up with a “neuro-ophthalmologist” in Portsmouth to work with and train my brain to again function with my vision. On Thursday, August 15^th, I was given my Independence at NRH. Several days after my release, Louise allowed me to drive her for the first time since the stroke, and agreed that I was ready and able to again drive by myself.

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AND THEN…

Sunday, August 24 we were back on the boat going up the river with friends.

By the first week of September, I was back building docks at Cove Marina, and spent that month working there and boating.

The second week of October, we flew to Florida for a week; the third and fourth weeks we drove to Ohio and then Lake Placid.

November and December holidays were exhausting but it was great seeing family, and trying to thank all our friends who played such a huge, positive role in our latest journey and adventure. I returned working at Great North part time helping manage condo associations and we are looking forward to what 2020 brings; more journeys and more adventures, we’re certain of that!

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I still complain, but shouldn’t. Not everything is “quite right” or “as it was before”, but I know I dodged the bullet. I know others I joined at rehab suffered much more debilitating consequences from their traumatic injuries than I have, and that their journeys will take longer than mine. The one thing all of us had in common was that the injuries came at us unexpectedly; unexpectedly out of the clear blue (or clear black or left field). The other commonality we shared and continue to share is how this injury affects those around us; we are concerned about how our life has changed and how recuperation efforts impact those closest to us, those sharing our daily space. Our hope is that we will still “get better”. The re-training of brain cells can continue for one to two years; 2020 should be a good year!

*****

CAPTAIN BOB,

1^ST MATE LOUISE

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