06/29/2016 - My One Month Mark - The Crack Debate & Sperm Count Request

I was looking forward to the psychological 1-month liver-versary of my transplant.  No special reason really other than in my mind I've got this logically divided into three months with the first month being the most rough (most drugs, highest likelihood of rejection, ost frequent hospital visits etc).

As part of moving through the recovery, they are trying to slowly decrease my anti-rejection drugs as long as my prograff levels are where they need to be.  They're also lowering my dosages of steroids by 5mg every two weeks.  Those are the puppies that amp me up, make it hard to sleep, and give me mood swings.  Once completely off the steroids, there are several other drugs that I can also discontinue.  But I digress.

On the eve of my one month anniversary, I got a splitting headache.  I logged it in my MediSafe app which I use to track my daily meds (you can laugh at my but it keeps me sane and also allows me to track my temperature, blood pressure, and pulse on a daily basis).  I figured I would crash early because Tessa said she could put down the twins.  I have never really had headaches like this.  I needed it cold, very cold, and dark.  I went around unplugging any LED lights or power indicators on electronics, they bothered me and were too bright.  I thought I could pound some water and sleep it off, I would be better in the morning, I thought.  Morning came and my head was still throbbing when it was time to take my 8am pills (that's when I take the majority of my pills).

One by one I put the pills back with water...still feeling horrible.  You don't need an award in journalism to tell where this is going.  Five minutes after, I threw up.  It was mostly water as I couldn't see any pills or pill casings.  I called the on-call transplant coordinator, who instructed me that it's likely the pills are still ok, and to call back if I throw up again.  The big concern is that I would miss a dose of the anti rejection meds and if still ill at 8pm, might throw those pills up too at which point I would need IV administration of said drugs.

At 9am, or shortly there-after, everything came up.  There was nothing left in my stomach and there was no question that all my meds were gone.  We called the on-call transplant coordinator back and she suggested coming in to the Georgetown ER.  So we packed a bag, water, anti-bacterial hand wipes, something to read, and headed in.

Transplant had called ahead and told them I was coming, but I still needed to get vitals checked and then see the charge nurse.  I explained everything, and then she gave me a face mask, and sent us to the "family waiting" area.  Thank god, this was a room with only 4 seats and it was only for us.  With a suppressed immune system and people coughing in the ER, we were worried that I could pick something up.  Being isolated and with a mask, it reduced the chance of infection / getting sick.  Tessa takes the following picture of me looking super excited and sends it out to the family via Text Message.

Ramon, Tessa's younger brother with a funny sense of humor, immediately takes a selfie from his home in California to cheer me up and sends it back out of the family.  In the below picture, the left is me in a red shirt with names of four of the best Arsenal players on it (which was a gift from Tessa).  On the right, is Ramon mocking me with his red shirt (also a gift from Tessa) with four of the best players from Manchester United.  He put on a dusk mask he found somewhere and also had a red backpack.  It really lifted my spirits and made me laugh.  Perhaps I should gift a native american dream catcher to the ER at Georgetown to make it nearly identical?

When they finally did call be back, there were no rooms, so I got stuffed in the hallway.  Lack of space is a constant and re-occurring theme at Georgetown.  Below is where they had me.  This is when this story gets good...and it's not about me, but more about our surroundings.

Because I was in the hall, I had one patient on either side of me and nobody had privacy.  Now I'm about to make fun of my situation and the surrounding conversation.  That's not to make light of the conditions that each of these people had, that's for the doctors to take care of.  Yes, I might go to hell, and yes, some of you might be offended, but this is my life and I was laughing at the whole situation.

ER Patient A

Patient A in front of me talking to a seated doctor who had a clipboard taking copious notes.  Patient A had a person from her support group there with her, which was good for her (bad for me).  Keep in mind there was absolutely no tone change during this conversation between the Doctor and patient.  It might be like if you and I were having an exciting conversation about filling your car up with gas.....very routine.

Doctor:  "So, you're feeling upset"
Patient A: "Sometimes"
Doctor:  "Have you ever cut yourself"
Patient A: "Yes"
Doctor: "When was the last time you cut yourself"
Patient A responds with a date
Doctor: "When was the first time you cut yourself"
Patient A responds with a date

Doctor: "How many times would you say you've cut yourself"

Patient A responds with a number

This number was apparently a good segue into the next obvious line of questioning.

Doctor: Have you tired Heroin?
Patient A responds
Doctor: Have you tired Cocaine?
Patient A responds

Doctor: Have you tired Crack?
Patient A responds, then Patient A's support group friend then asks the doctor to define the difference between crack / cocaine.  A lengthy conversation ensues between the three of then and somehow laughter starts. (I don't know all the differences but google turns up something).

All the while I can't help but to think, this doctor is getting honest responses (which is good) but can't this person see that there is no way they're going to let her out of here when she poses such a danger to herself?!  The other thing I kept thinking, is that movie 'As Good As It Gets'...where Jack Nicholson comments to his depressed neighbor who had just been robbed and says...."What if this is as good as it gets....".  No, I didn't say it....but thought about it in my twisted humorous mind.

After the doctor departs to likely make overnight arrangements, Patient A's support groupie (I'll just call her Groupie A) decides it's a great time to cheer up Patient A.  Groupie A then opens up her iPhone and starts reading off knock-knock jokes as one liners.  Now, I'm the biggest Dad joke teller of all time, but these were horrible....like....shameful. After each joke, Groupie A would play this sound from her phone.  It might have been the worst amatuer commedy hour ever.

ER Patient B

Patient B was behind me, much less entertaining, but much more annoying.  Patient B, a woman in her 20s, was ushered over right behind us.  She was moaning and dry heaving.  At first, I thought to myself, "Wow, something must really be wrong with her".  Every 2-5 minutes....you heard this throat gurgling noise...as she tried to wretch but couldn't.  Her dry-heave literally made you want to vomit yourself.  Seeing as how I had nothing in my stomach, it didn't bother me, but I could see Tessa get so uncomfortable she had to head out to breathe the diesel clouded air right outside the ER where the ambulances park to run patients in.  Plus, this vomit queen wanna-be wasn't covering her mouth as Tessa was informing me.  Feel sorry for her right?

Doctors and nurses would be walking the hall, and as they approached she would make her vomit noises, again producing nothing.  Everyone kept walking past her like she wasn't there.  I thought, man that's rough.

Not long there after, I found out why.  Apparently this is a person who "frequents" the ER with the same condition / symptoms.  I got that from the doctor who came over and said "Oh, I saw you a couple days ago with the same thing.  What do you think is causing it this time?".  That was about the extent of the interaction she got...I was discharged from the ER before I could get to the root of that story...but who knows, if I get back in sometime, maybe I'll see her and be able to finish this putrid tale.

ER Patient C: The Coup De Grâce

This was the most entertaining story.  It happened chronologically last but I save it for those of you who have faithfully read all this way.  A little gem here.... A DC ambulance rolls up to the ER and the wheel a construction road crew worker (I could tell because of his boots and high visibility vest) into the back rooms of the ER.  Again, there was no pace for him so he was in the hallway with the joyful bunch of us (Patient A, Patient B, and Myself).

A hospital worker comes over to try to put a wrist band on him and admit him to the hospital.  He looked at her and said, "You ain't puttin that shit on me. Hell no".  She wisely decided that arguing with  him was out of her scope or work and just attached it to the stretcher he was on and reported it to the charge nurse.

Moments later, the charge nurse came over with his driver's license and another wrist band.  She handed him his driver's license:

Charge Nurse: "Here you go"
Patient C: "You sneaky little bitch, how did you steal my wallet".

Charge Nurse: "I didn't Sir, the arresting officer took if from you."

That's when my ears perked up and I thought, this could be an interesting one.  And I was a good judge of that.

Charge Nurse: "Sir, did you do any drugs today?"

Patient C: [Inaudible mumbling]  clearly not 100% there.
Charge Nurse: "Sir, did you do any drugs today?"
Patient C: "YES!"
Charge Nurse: "Can I put this armband on you for your safety?"
Patient C: "No way...not putting that shit on".
Charge Nurse: "Sir, we scan this when we give you medications, its for your safety"
Patient C: "Ok, fine....alright".
Charge Nurse: "The doctor will be over to talk to you when he can"
The nurse begins to step away and walks halfway across the ER.

Patient C: "NURSE!!!  NURSE!!!"
The nurse comes quickly back over
Charge Nurse: "Yes Sir, are you ok?"
Patient C: "I need to get an HIV test"
Charge Nurse: "Well, that sounds like a good idea and you should discuss it with the doctor when he's here"

Now I'm thinking....well, he's drugged up but if he was injecting, that probably is a good idea.  The nurse begins to walk away before...

Patient C: "NURSE!!!  NURSE!!!"
The nurse comes quickly back over
Charge Nurse: "Yes Sir?"
Patient C: "I need to get a sperm count check too"
Charge Nurse: "Sir, we don't do that here, you should talk to your primary care doctor"

At this point, Tessa and I are about to laugh our ass off but don't because this guy is drugged up, large enough to crush me into fine powdered cocaine or crack rocks (depending on who won the argument from patient A, Groupie A, and the Doctor).  So we did what anyone my generation would do, we started texting on our phones to each other despite being two feet apart.  I must say, the charge nurse handled it with aplomb.

Now I realize I've written a book with this post, shortly after all this I was able to keep down some crackers and ginger ale and left as quickly as we could.  Let this lengthy post also represent the lengthy 8 hour visit we had on my one month anniversary.