Tuesday, March 22, 2016

Flagylated

                                                                                                                                                                                                                                                                                                                                                                                                                                                                               The moment I put my tennis shoes on, I realized it: the simple pressure of tying on my shoes was enough to shift the blood back into the veins. And I was wearing, as well, relatively tight and high socks. All of this, plus the movement of walking around from place to place—going into the kitchen to make coffee, the bathroom to wash my hair, back to the bedroom to collect the pillows I had forgotten—all this made the sensation return to my feet”

‘Of course, I thought. I’d been lying in bed all weekend. Dammit, I was a nurse! How many pair of Supp Hose have I put on patients in my life?”

You may have seen them—the long, of waist high white stocking that are called Support Hose, or maybe just Supp Hose, and which are put on bedridden patients. Why? Because the heart pumps blood through the arteries, but what gets the blood back, through the veins? By the time the blood enters the venous system, the force of the heart is no longer stronger enough to return the blood to the heart.

In fact, it is the muscles of the legs that exert pressure on the veins: that pressure alone can be enough. Remember what you did the last time your foot fell asleep? You almost certainly, and instinctively, began moving your foot up and down, stepping in place. Or you simply got up and walked for a bit. At any rate, the numbness went away, and you thought nothing of it.

You didn’t, however, have a broken back. Nor were you essentially confined to a bed for a weekend, since the bedroom was at the back of the apartment, farthest away from the chaos unfolding on the streets outside.

And so I was already on edge, already besieged, and I took to my bed, shortly after venturing out early in the morning g to get food and wine. And then, when the blood began to pool in my feet, did I think like the nurse I had been? Of course not, rather than have the objectivity I would have in any hospital room, I was feeling the terror of the sickbed. The nurse would have sent Raf out to get Supp House: the patient was returning in terror to the emergency room, sure that a slow paralysis was spreading.

And so, I had acted like a complete fool. Should I now call off the trip to the ER? I decided not to, partly out of pride, and partly to be absolutely sure that nothing was happening. And indeed, despite the pillows and the blankets and all of the other accouterments I had brought for a lengthy stay in the hospital, I was seen buy a perfectly nice doctor who shot me up with muscle relaxants, and sent me out the door with prescriptions for more. His one question, really, was whether I was urinating, and that became my touchstone: if I was pissing, I was OK.

It had not been the first time that I had failed as a nurse. In fact, the most colossal failed had been what had started the long, tedious journey into the broken back itself.

Remember—I had been treated for a stomach infection in mid-November. I had gone to the emergency room of a once famed hospital, and had been treated brusquely and very slowly: two or three hours went by before I had even seen a doctor. And the doctor and I had clashed within minutes. From then on, I had undergone a series of treatments, none of which had been explained to me.

A phlebotomist appeared, drew blood, and then left the catheter in my vein, of IV fluids. Shortly thereafter, a nurse came and hung the first bag of IV fluid, with a smaller bag of Cipro piggybacked into it. OK—that made sense, and in fact, I went to get oral Cipro the day after I got out of the emergency room. Cipro attacks a number of bacteria, but what about the other possibility: intestinal parasites? And so I wasn’t surprised when the nurse appeared, and still unspeaking, hung a bag of Flagyl to be given IV as well.

I knew Flagyl, in fact, from decades ago, when I had worked in a venereal disease clinic. In fact, I had taken the drug myself, as we all did in those days of relative promiscuity—it was effective against trichomoniasis, which while common is often asymptomatic. And so we gave Flagyl out left and right, and patients undergoing the treatment were said to be being “flagylated.” And so, for every patient given Flagyl, I had counseled: be sure not to drink alcohol during the treatment, and for three or four days afterwards. Yes, it had been as much second nature as asking a patient if he had ever had an allergy to penicillin, and to making him wait for half an hour after taking the first dose, to make sure he wouldn’t go into shock.

So I had known all of this, decades ago—but what happened as I got released from the hospital, after completing the treatment? Remember, I had scuffled again with the doctor, and then managed to convince another doctor (who probably knew how impossible the first doctor could be) just to release me. He had read the CT report of my abdomen, and essentially told me it was normal. And then he sent me on my way.

Did I ask any questions? Did I do what every patient should do, such as asking about any possible drug reactions or side effects? And di I go home and Google the two drugs I had been given?

Of course not. I left the hospital and discovered that I was in a distinctly chilling ghost town. What had once been a thriving night spot was now deserted: a mugging seemed no likely but inevitable. In desperation, I hailed a cab half a block in front of me: miraculously, he stopped and waited.

So the long ordeal was over: I relaxed against the back seat of the taxi and breathed, seemingly for the first time in hours. I rolled down the window, and smelled the salt air from the ocean as it battered the rocky shore yards away. At last, I came into the old city, where there were people, where there was life, and where I was safe.

Raf, who had seen me briefly at the hospital earlier, and whom KI had incorrectly sent home to feed the cats, was waiting for my with a cheering…

….bottle of wine in his hand!