I have always had trouble breathing. In track I was great for a quick burst of speed in the 50 yard dash, but couldn't move enough air in and out to keep myself going for the longer runs like the 330. I had sleep apnea really bad, with the classic symptoms where I stopped breathing for a while and then suddenly snorted myself awake gasping for breath. For most of my life, surgery wasn't an option due to my JW lifestyle and employment choices (cleaning business = no insurance). Finally in 1998 I went to an ear, nose and throat doctor to see about having surgery. The doctor decided that I needed an operation on my sinuses and septum. I pointed out to him that my nostrils collapse when I breathe in, preventing me from getting enough air through my nose, but he said that sinus surgery would correct the breathing problem, and I figured he ought to know so I went with it.
Well, it did help, but it didn't fix everything. One bad side effect of apnea is a lack of REM sleep due to being always jostled awake in order to start breathing again. That means I don't get enough deep sleep to refresh my brain, and so I'm tired a lot. In younger years this wasn't as big an issue, but I'm older now and I need all the brain function I can get, especially in the demanding line of work I'm in. So when I got a new doctor here after my new insurance kicked in, I told her about the apnea, and she ordered a sleep study. The results were referred to an ENT here. I told him about the nose problem, and he decided to operate to take cartilage from the front of my nose and spread it out over the top to support the nostrils when I was breathing in. That surgery was scheduled for Friday a week ago at 10 AM. It went well, they observed me until about 3:30, and then I came home.
About 5 PM, I started bleeding from my nose. I dabbed at it with a kleenex at first, and with some more kleenexes, and then with a washrag, and then I filled up about three of them. We called the doctor, but it was Friday, and another one was on call for the weekend instead of him. So we waited for the on-call doc to call back while I sat and filled washrags with blood. If I tilted my head down it ran out my nose, but if I held my head upright it ran down the back of my throat and I either had to swallow it or spit it out. When the flow first started I swallowed it, because it was just a drop or so at a time, but pretty soon it turned into a steady stream.
When the doctor called, he asked if we had some Afrin nasal spray. We did, so he said to spray it up my nostrils because it would shrink the tissues and stop the bleeding. He clearly didn't understand. At this point, cramming the tip of that bottle up my nostril and squirting was kind of like trying to screw a water hose on a faucet when the water is running. But I gave it a try. Since it didn't work, he had us meet him at the emergency room of the place where they did the surgery.
There were people sitting around the emergency room trying to look like they were in serious pain and needed immediate help. Poor guys, they never stood a chance against me and my blood-flecked clothes and the stream of blood coming out of my nostrils and the bloody cloth I was holding. The ER people just came out past them all and took me straight on back. Put me on one of the exam tables and gave me a plastic tub to drip blood into.
I believe the people working that ER shift had just come back inside from a heavy toking session out back by the dumpster. One girl came in and looked at me and said, "Okay, can you tell me what's wrong?" There was this incredible ineptness going on. I remember thinking, "What is this, an ER version of Keystone Kops?"
The doctor showed up after about 15 minutes and, I guess, finally got a sense of what was really happening. I had the bottom of this plastic tub covered with blood that had dripped out since I got there. I was spitting it out of my mouth in big gobs. I had two big thick lines of blood out of my nostrils and it was all soaked up into my moustache and beard. Well, the suction pump wasn't rigged up at the exam table where they put me, and the doctor got pissed off and chewed out some guy who I guess was responsible for having the exam area functioning properly. When they got that working he tried to suction blood out of my nose, but the suction couldn't clear it away as fast as it was running out. So he had me tilt my head back so that he could see up my nostrils (this meant that all the blood ran down my throat, where I had the choice of swallowing, spitting in the doc's face, or holding it hoping for a chance to spit later). He decided to cauterize the places in my nostrils that were bleeding with some kind of thin metal stick called, I believe, silver nitrate and which apparently functions similar to a welding rod, but on skin instead. There were only of two of them in the exam area, so he told the nurse to call for more; she got on the phone to someone elsewhere in the hospital and asked for it. After about five minutes somebody came in carrying a bottle of some pills... they had not understood what she asked for, and didn't bother to clarify.
Finally he got a supply of silver nitrate and managed to get the left side of my nose cauterized. Then he crammed that nostril full with packing. He worked on the right side for the better part of an hour with me sitting there with my head tilted back, swallowing blood. Finally he stuffed the right side full of packing, too, so that I couldn't breathe at all except through my mouth. Then he had them admit me to a room for the night for observation. He ordered that the trays and equipment that were sitting there were to be delivered up to my room. He specifically said to me, not to let them take me up to the room without those trays of tools; that they were to follow me all over the hospital wherever I went.
Well, no sooner did he leave than the girl that had been helping him said that the trays were going back to surgery where they came from, that she was responsible for them and she wasn't going to get in trouble over it.
So they took me up to my room. By the time I got to the room, I had already felt a droplet of blood run down the back of my throat. I told the nurse who wheeled me up, "I'm bleeding again." I sat on the bed with a fresh plastic bucket, watching my blood gradually cover the bottom of it, and I thought about how much of it I had swallowed and how much I had bled out into washcloths, and thought about the previous bucket, and it began to occur to me for the first time that this had crossed a line somewhere from annoying to frightening.
The doctor had left; they called for him, but he wasn't answering the phone and the nurses didn't know what to do. I coughed blood a couple of times and it sprayed out all over the bedcovers in an arc around me. The packing in my nose forced some of the blood up through my sinuses, and I started bleeding from my eye sockets. That blood got on my eyeballs when I blinked, and made a red blur of my vision. I sat there in the hospital room as the center of this little circle of blood. Bleeding to death there in the hospital, and no way to make it stop.
The nurses got their suction hoses and were suctioning blood away from my nose and my mouth, but not as fast as it came out. And suddenly I switched into this kind of altered reality, where the time sense didn't seem right. Things started to happen in little jerky sequences set off by themselves, and I started seeing it all through the eyes of an interested but uninvolved bystander. Just watching the show, watching a man bleed to death. I realized I was being polite to the nurses by letting them suction off the blood when it was pointless and they were only annoying me; if they'd leave me alone, it would drip uneventfully into the bucket, but they were poking these nozzles at my nose, sticking them in my beard. I was being nice to them because they felt helpless to do anything, and suctioning away the blood was all they could think of to do, and I was allowing them to do it because it was helping them cope with their own helplessness.
While we were waiting for the doctor to come back, I was thinking that the next step was to knock me out so that he could operate on my nostrils without me being awake to screw things up.
Well, nurses know this stuff, of course, but I'm an average joe, and the average joe doesn't know anything about an emergency room. I did not know whether there would be a way for them to enable me to breathe, on my back, unconscious, without me drowning in the blood running down my throat. I sat there and thought that for me, the world had come down to this point in time, with me sitting in my little circle of blood, with useless nurses poking nozzles at me, waiting to be taken away to drown in my own blood. And I accepted that I was probably about to die.
When the doctor came, I asked him about it and he told me that they have the means to keep the passage open for air without letting other stuff get down there, too. He said he didn't feel that it was a life-threatening situation. Of course, I wondered whether he would tell me if it was, but I had no choice but to go with what he said. My life was in his hands. If it was left in mine, I would surely be dead in a few hours.
I also told him that I didn't want him to use blood unless it was life-and-death. I'd gotten Hepatitis C from the last transfusion I was given, and I'd prefer to avoid the chance of getting something else. He agreed. So back we went to surgery again. They knocked me out, and as I was going under I did not know whether I would ever be conscious again.
I woke up in the Intensive Care Unit, needing to pee badly. A nurse came around and I told her I needed to go to the toilet, and she offered me a plastic pitcher to pee in, there in my bed. I told her that wasn't going to happen, and she told me that, no, me getting out of that bed was what wasn't going to happen, and it was the pitcher or a catheter. So I got a catheter.
I had these things sticking out of my nose, that looked like hoses or pipes. Two of them, sticking out of the same nostril. I could see them floating down there below my nose whenever I moved my head. Turned out they're called "balloons." You fill them up with saline solution and they expand to seal a nasal passageway, the same way the balloon on a catheter expands to hold your urethra open.
A nurse came around and introduced herself to me, and said she was there to help me with my pain. Then she injected morphine into the tube they had put into a vein on the back of my hand. (merry-go-round music begins to play in background; scenery changes to watercolor pastels) Then an hour later she came around again and gave me some more morphine. Then, an hour later, she came around and gave me some more morphine. Then, an hour later, and an hour later, and an hour later... I spent two days pumped full of morphine. I remember those days as being a time conduit made of segments punctuated by the arrival of the morphine angel of mercy.
It turned out that what was wrong was my blood pressure. My primary care provider didn't have me on a strong enough dose, and it was hovering around 170/116. That's what set off the nosebleed and prevented it from stopping. So they adjusted my BP medication too, and we watched it come down to as low as 110/60.
I wasn't allowed to eat for 2 days. They had me on an IV drip, which essentially just went straight through me from vein to catheter. The third day, I got to have a liquid diet: broth, orange juice, jello. They gave me a pill which, they explained, was a stool softener, because morphine causes constipation. I asked them which stool it was supposed to soften, the one from the broth or the one from the jello, and we all had a good laugh, and they brought the stool softener again every time they brought the pills around.
As I passed the days in a drugged condition, anemic from blood loss and empty of food, I began to have flashes of insight about life. I saw the forces that drive the system as unstoppable universal mechanisms. We imagine that we hold our destiny, our future, in our hands with our actions and decisions ("Captain of my Fate"), but in reality we are running just to stay in the same place, just to keep functioning with the onrushing system, and if we misstep and fall, it roars over and past us and keeps on going while we watch helplessly, as I watched from my bed the bypassing moments. I felt, not just small and insignificant, but actually irrelevant. The universe rolled its great gears onward unmercifully, without a thought or backward glance at my fallen condition, and would do so again, with perfect indifference, at my death: continuing on without the blink of an eye. I had made plans for my weekend. I prepared and spoke and thought as though my will was enough to make it so, and then all those plans came to nothing, and my preparations for them were left as unused stubs into empty air, markers denoting cluelessness. Powerless; powerless over my fate.
I saw the social and commercial systems in which we function as lesser versions of the same relentless onrushing, cold steel machinery in whose gears the careless are ground without the skipping of a cog-tooth. I work in information technology, a field where what is state of the art now is obsolete a few months later. I am constantly reading, studying, trying to keep up with the onrush of knowledge and development. I'm 47 years old. I saw the future, not so many years from now when I've reached the point where I'll be retiring in a couple of years. I pictured the technology advancing even faster than it does now, and I felt the helplessness and futility of running ever faster in my studies, struggling ever harder to keep up. I saw myself giving up, becoming a "short-timer," someone just doing clock-time until retirement. I saw the young up-and-comers, the kids who are about 12 years old right now, talking about me behind my back, about what useless deadwood I was and how I should be cleared away for the company's good.
When I left the hospital, I had trouble walking; I was dizzy and kept listing to one side or the other. The doctor said it was because I was anemic. He told me to consume lots of steak, broccoli, spinach, liver, orange juice, and stuff like that to build my blood back up.
The first day I was home, I felt depressed, helpless, old, worn out, left behind. The second day I wasn't dizzy any more, and I went to work.
Getting back to work was kind of like cold water to the face. Instead of my visions of the great unfeeling universal machine, now I was back among friendly coworkers. They had given me an ivy basket and a get-well card, and I found a series of emails my supervisor had sent out to the entire web team, tracking my progress. My projects were still where I left them before the surgery. I remembered my plans for them, and at what point in their development I was with each; and I took them up again. And I ate steak and broccoli. And took vitamins with iron.
Within a couple of days I was back to being on top of the world again. In writing this, I fear I've failed to effectively capture the dispair, the hopelessness, the sense of irrelevance that washed through me, because those visions are gone now and I have only the memory of what it was like. I cautiously returned to a schedule of working out again. And I ordered Visual Studio.Net, Beta 1, bought a book about it, and commenced studying. :)
Moral of the story? Yeah, there are a couple.
Enjoy life with your wife, whom you love, all the days of this meaningless life that God has given you under the sun - all your meaningless days. For this is your lot in life and in your toilsome labor under the sun. Whatever your hand finds to do, do it with all your might, for in the grave, where you are going, there is neither working nor planning nor knowledge nor wisdom. - Ecclesiastes 9:10
Or, as Omar Kayyam put it:
Come, fill the Cup, and in the fire of Spring
Your Winter-garment of Repentance fling:
The Bird of Time has but a little way
To flutter--and the Bird is on the Wing.
Or, in the immortal words of Bill and Ted:
"Party on, dudes."
COMF