Friday, December 27, 2019

The Annual Vet Visit

December 27, 2019.

I took all the boys to the vet today. It's two days after Christmas. Two days after Christmas is when I brought Colby and Thimble home five years ago. I think they may not have appreciated commemorating this day with a visit to the vet.

Apricot has, given all his vet trauma this year, taken to peeing in the crate on the way there. I knew I couldn't have this situation continue. It makes everyone unhappy.

Did you know you can get diapers for cats? You have to also have something to keep them on. I used the onesie I had gotten him as an alternative to a cone that he didn't appreciate.

And it worked! We got there with dry cats and a wet diaper. Not that I'm happy Apricot loses control of his bladder muscles from fear; I wish he wouldn't be so scared. But I'm happy I found a way to make it so none of the three have to suffer the consequences of it.

They told me when they got blood for yearly bloodwork that they got urine samples from Colby and Thimble but not Apricot. I said, entirely unhelpfully, "If you can get it off the diaper that's where Apricot's all is" motioning to the trash can. (No, they can't get it off the diaper and I knew that. I was being a smart aleck).

Well, Thimble is doing well. She heard a faint heart murmur from him for the first time. I asked if stress could cause it. She said yes, actually, it can. I said because he's been really stressed out with Apricot's illness (see the blog post about Apricot's Expensive Scare). So we'll see if he still has it next year.

Colby's heart murmur is still there. And the poor guy is constipated. So he'll be getting miralax in his pumpkin. He doesn't mind it (I had already been giving him a little bit as I knew it was okay to give cats and I suspected what the problem was). So hopefully that will get things moving and he will stop throwing up half of what he eats.

Apricot's all healed up and is just waiting for his fur to grow back in the spots that got shaved when he had the biopsy. She was very pleased at how well he looked compared to the last time she saw him.

We had to stay a long time. Judging from what I overheard (the walls are too thin for my autistic ears not to overhear stuff), there was an emergency visit from someone whose dog may have broken his foot/leg. Apparently it's not broken, just sprained. Anyway, although nobody said it, I think that's why it took my vet so long to make it to us even though we had the first appointments of the day.

I had to keep them out of the crate so the vet could examine them when she did come in, and they were not happy to be locked out of their home away from home. Colby roamed around as usual, spending some quality time on my lap and then moving on to other things and returning as he pleased. Thimble squashed himself into the corner under a red chair and Apricot joined him. Colby thought they were silly.

After far too long (and a big bill--three cats with bloodwork, two with vaccines, and one with xrays cost a lot), we finally got to go home.

The crate lives in my bedroom on the side I don't use with the door off in case anybody wants to visit inside. I've never seen anyone do so but there it is. I put it back when we got home. And eventually got around to going in my bedroom again to make the bed with the sheets I'd washed and put in the dryer before the vet visit.

Apricot, startled, emerged from the crate. I was equally startled, but apologized for scaring him. I said I didn't know anybody went in there --- and I was astonished that he would go in so soon after the vet visit.

I wonder ... he knows he peed on the way there. He also knows it should have gotten everywhere and didn't. I wonder if he was in there trying to recreate the event in his head so he could figure out what happened to his pee! I mean, it's not like a diaper is something a cat has any basis for understanding.

And everyone was very glad to be home and very loving, which was nice. They can be standoffish after a vet visit sometimes. But today I had cats all over me whenever I sat down!

Apricot Gives Me an Expensive Scare

One day in September I was petting the cats and noticed Apricot had scratched the area right in front of his ears raw. I couldn't see anything wrong with his ears. I hate taking him to the vet because he's so scared of them. He is a "freeze" scared kitty, not a "fight" scared kitty, so he at least has that going for him--no one has to restrain him unduly.

I thought maybe I would trim his nails, as that task was in my to-do list at the moment. (It shows up regularly in the app I use for reminding me to do things.) So I trimmed nails.

And I found Thimble's back foot was bloody and there was this weird growth beneath one of the nails and he was definitely touchy about the area.

Fine. I'll take them to the vet. I got an appointment the next day, and ended up with all three of them because I honestly couldn't figure out how to leave Colby behind without (a) letting him out of the house accidentally while I carried the crate with the other two to the car and the door stays open while I do that, or (b) locking him in one room the entire time I was gone, which would be traumatic.

Apricot peed on them again. I mean, he lost control of his bladder on the way there from fear, and the pee ended up on all three cats. Mental note to do something about this.

Thimble didn't have a growth. That was just his nail bed. It looked like a growth because his nail was almost ripped off completely. In fact it came off in the vet's fingers when she went to see how secure it still was. (She's still embarrassed she did that while I was holding him. Luckily for me I had my eyes closed when I saw she was going to test it. Neither of us expected it to come off in her hand.)

So basically he just tried to declaw himself. Again. It was the other back paw he'd done it to before. And as before, all we could do was let it heal and make sure it didn't get infected. (He's fine, by the way.)

Apricot had a yeast overgrowth in his ears again. So I was taught how to clean them and given a ketoconazole solution to use to clean them. It worked like a charm and no more yeast infection after a week of daily ear cleanings.

But at the vets I casually mentioned a scab on his side near his backbone that he had, because I figured while we're here anyway, she might as well look at it. We both thought it was just from playing with the others. Thimble's a sweet cat and doesn't do things like that on purpose but he could easily do it on accident as he's so strong and doesn't realize it. She took the scab off to make sure it wasn't a puncture wound (it wasn't).

It didn't heal. It just kept getting bigger. Another one popped up. And another. Each started small and slowly grew. None of them would heal.

Two vet visits and a predisone shot later. The wounds are still getting bigger, still not healing, and more are still appearing. The predisone made him throw up repeatedly so no more of that steroid for him. My vet confessed she was completely stumped and had never seen anything like this and sent me to a specialist, a dermatologist for pets.

I am very fortunate to live five minutes from a world-class specialty vet practice. They have everything from dentistry to cardiology to surgery to oncology ... and dermatology.

My poor rescued feral kitty. He was on an antihistamine to try to reduce the itching (he had washed a spot raw on his tummy from the itching by this point). But antihistamines don't work all that well in cats. They don't know why.

Dr. B- examined him and gave me three options. It was either a deep fungal infection, an allergic reaction, or, and she thought this was a remote possibility, cancer. The spots had a specific type of white blood cell mixed in with all the scab crud that are allergy related.

She did a biopsy a week later. She only does a local anesthetic and gives them a sleepy gas to knock them out only as much as needed. She said they didn't even have to knock him out completely. He just lay there and watched them take punches out of him. (That's a biopsy punch; kind of like a hole punch without the other side, I think.)

After that he had a (different) steroid pill. By this time I had put him in a cone after first trying a surgical onesie. He is an old fashioned cat, apparently, who doesn't believe cats should wear clothes, and he wouldn't go to the bathroom while wearing it, so he leaked from his full bladder before I realized what was going on. So a cone it was.

I found a clear plastic cone online for him so the others couldn't sneak up on him. Thimble is Apricot's best friend; they're great buddies. But Thimble is also a bit of a practical joker and I could just see this turning out badly if I restricted Apricot's field of vision.

I had to get a second cone because Apricot had a bad tendency to get a drink and soak the fabric edge of the cone and then go use the litterbox and get litter coated all over the edge. So I'd put the second cone on, take the dirty cone off, clean the dirty one, and let it dry until I had to swap them again. Usually about every two days.

The steroid really helped. The lesions started healing. And then the biopsy results came back faster than anticipated. Apricot was allergic to something.

Seriously? That is one nasty allergic reaction.

They'd taken a blood sample to do an allergy test if such was needed when he was under for the biopsy, so now they sent that off.

Apricot is allergic to dust mites and molds. Just like me.

Instead of an antihistamine, there is a drug that goes even farther up the chain of events that leads to the active allergic reaction and stops it at the source. My ears pricked up. What is this drug and why don't I have access to it?!?

Oh. Because it's cyclosporine. It shuts off the immune system. They're not going to give that to a human just for allergies. Phooey.

But for a cat that doesn't have to interact with anyone besides the other cats who live with him and also don't interact with anyone, it's okay to use.

So he got that pill while we weaned him off the steroid, and as a long term solution ... can you guess?

He's getting allergy shots. Just like me. For practically the same things. Only I have to give him his allergy shots.

Luckily he's absolutely fine with me sticking a needle into his shoulder fat. I've been told they don't have a lot of nerves there and it seems to be true. I tell him it's time for his shot and show him the (already prepared) needle and syringe and he just shrugs and lets me stick him.

And having had allergy shots myself for years now, I'm familiar with how they work and all that goes with it. At work I use syringes (without needles) all the time so I'm really familiar with those too. His are smaller, I'll grant you, and have a needle at the end, but the action of filling / emptying the syringe is very similar.

I was convinced he had cancer. What else could non-healing lesions be? I'd never even heard of an allergic reaction like that. Thank goodness humans don't appear to have that reaction. It was horrible just to watch much less imagine having it.

So Apricot is off the steroid. He doesn't appreciate the cyclosporine every morning but he lets me do it. He hid under the couch twice but I had previously discovered I could actually tip the couch over, and that's more traumatic than the pill, so he's stopped doing that. I tried giving him a treat reward afterwards but he doesn't want it. <sigh>

He's building up the allergy shots to the maintenance level (humans have to do this too) so his shots are every three days but once on maintenance, which is in about two weeks, he'll only have to have them once a week.

The shots take a shorter time to work than humans, too, which is a good thing given our comparative lifespan. The end goal is to make it so he doesn't have to take the cyclosporine or have the shots.

All this medical work was very expensive though.

And it's definitely worth it to have a happy, relatively healthy kitty.

PS. Thimble's been having trouble with this whole thing since Apricot's his buddy and has been more needy and acting out more, just like a toddler. Poor baby. I'm trying to reassure him but his grasp of English, while impressive for a non-human, isn't up to explaining allergies.

That Time I Almost Died

I'm writing in May but this all happened back in March.

Now I understand (from internet research, so take that as you will) that most bronchitis is viral. Not the kind I get. Mine is always bacterial. It's like the bronchitis bacteria lives permanently in my bronchial passages (which may get referred to as "lungs" later on but I do know the difference) and it comes out to play whenever I get too stressed and my immune system can't handle it anymore.

For many months (possibly even a year or more) before March I had been getting very little sleep, about 4 hours a night. My job had gone crazy and was piling on the stress, and then one of my remaining friends decided to leave for a different job. He convinced me I could actually manage his job (as no one thought the company would simply not fill it; it was kind of important) and so after he let the lab manager know on March 11 that he was leaving, I made a pitch to the lab manager on the morning of March 12 on how I would be a good candidate.

This was majorly stressful for me and in fact I now realize I wouldn't actually be able to do that job ... but it's all good since the company isn't backfilling it anyway.

All that stress, all piled on ... literally I made the pitch at 8ish in the morning and by 10 I could feel the bacterial infection building in my lungs. (See? It's just shorter than typing bronchial passages every time. Deal with it.)

I hoped I was wrong. I've been accused of being a hypochondriac before. And there was a strange sensation not normally a part of it; my chest felt cold like the guy in The Incredibles was aiming a freeze-ray at my chest.

But by the next day, Wednesday, I could hear the rattle cough starting. So I made a same-day doctor's appointment for after work. Not with my regular doctor--it's impossible to get a same-day appointment with her. But with the nurse practitioner I'd seen before at the same place. By the time I got there I was extremely miserable and just wanted to rest.

She mis-diagnosed me with sinusitis and gave me a script for antibiotics. Well, silly me, I figured whatever, antibiotics are antibiotics and it'll work for the bronchitis. (No, it won't. You need a different type.) It was a ten-day course. I stayed home from work the next day, getting steadily worse, and then tried a half day on Friday simply because I should have been feeling better by then.

That made it even worse. But the half day gave me the ability to go for groceries the next morning at least... good idea as far as eating went, but bad as far as getting better. Because then around noon I came down with the flu.

It was textbook. Major chills/fever, aches and pains (and my word were they severe!) etc etc. I was so miserable and in so much pain* it didn't occur to me to go somewhere and get antivirals.
*Yeah, I know you can take ibuprofen or aleve for the pain of the flu. You can. I can't. All those medications just give me headaches now and don't do a thing for pain. It's what happens when you over use them (as I did during the ten years of living with undiagnosed endometriosis). They're called analgesic headaches. Learn from my mistake. Be sparing with them.

The cats were walking warily as I was behaving in a completely different manner than usual. The gunk in my lungs was making it difficult to breathe and I was having to cough frequently just to get enough air.

Since I had the flu and bronchitis I decided to stop walking my usual three miles outside in the morning and rest and stay hydrated, drinking water like usual, which means a lot. I also decreased my food intake as I wasn't exercising as much. These decisions sound like they make sense, right? Not ... really.

I didn't go to work Monday. I had the flu, and I knew this spring batch was particularly virulent. I avoid the news like crazy and even I had heard that. I called my doctor's office but they said the antivirals wouldn't help at that point. They didn't actually tell me to stay home though ... that ended up being an oops later, financially.

By this point I was so tired I couldn't do anything requiring concentration so I just sat on the sofa and watched the cats. I managed to feed myself and do the necessary things for me and the cats but that was it.

This is how I know that every morning Thimble basically does calisthenics. He runs through the house, leaps up onto the 5.5 foot cat tree from the floor, leaps down again, runs through the house, rinse and repeat. No wonder he's so strong. The other two just settle into nap mode. And some of the time that was with me, which was nice.

The gunk collection in my lungs was worse when I was lying down (I discovered later it wasn't just lying down that did it; it was sleeping). I would wake up, unable to breathe, coughing violently to clear a passage for the air. If you've ever coughed so much you expelled all the air from your lungs and you couldn't stop coughing long enough to inhale, you know how it feels.

Luckily for me, I'd had the flu shot, and while it didn't keep me from getting this strain, it did shorten the time I had it. By Tuesday the flu symptoms were dissipating and I knew something was wrong since if the antibiotics had worked, my bronchitis should be gone.

And the flu had done something to the bronchitis somehow. Now the gunk only collected when I slept. So I was waking up every four to six hours coughing violently. And the cough was so thick it wasn't doing the characteristic rattle anymore.

I called the doctor Wednesday to get another appointment with the NP, only to be informed that she'd been let go that very morning. And from the tone of voice (shock), it had not been her idea to leave. My actual doctor had appointments available on Thursday as she was doing some extra days to fill in.

Thursday morning I woke up, coughing my lungs up as usual. About two weeks before all this I'd gotten a new mattress and this one could bend and prop me up in order to sleep , and I really don't know what I would have done without it! If the gunk collection was that bad sleeping propped up ...

Something happened though. All the sudden my muscles in my back went from being aching and in pain from coughing to being violently in pain. This was, I discovered later, when I broke a rib on both sides from coughing so hard. At the time I didn't know what happened; I thought it was an accumulation of muscle stress.

When I went to my doctor that morning, she misdiagnosed it as post-flu syndrome, which is where a symptom (or two) from the flu hangs on even though the flu is gone. She gave me prescriptions for prednisone to reduce the inflammation in my throat so I'd stop coughing, a muscle relaxer for my muscles to reduce the pain since I can't take analgesics, and a hydrocodone cough syrup for immediate cough relief. (I didn't know hydrocodone reduced the cough impulse!)

I took all three in the parking lot of the pharmacy as I knew I could get home before the sleepy part of the hydrocodone / muscle relaxer combo kicked in and I needed relief from the pain. That was around noon.

The muscle relaxer wears off in six hours. The hydrocodone wears off in 12. And I'd never had a steroid before ...

By 6 I was having trouble breathing, and not the bronchitis trouble. By 7, as I had waited to see if it improved with the muscle relaxer wearing off, it was worse. I called the nurse helpline and consulted with them because I was getting freaked out. Because I wasn't breathing unless I was actively thinking about it.

Should I call EMS?

Yes, the nurse said.

I'd never called EMS before. I promptly dissolved into an anxiety attack. This didn't help the breathing problem.

I called my dad to come over (my poor parents had no idea how bad things had gotten because I hadn't told them). Then I called 911. I was not coherent enough to specify what I needed, apparently (I thought I was; I said I was having trouble breathing, which would mean ambulance) but what showed up first was the fire rescue people. You know, the non-fire-truck fire car? They have oxygen and stuff like that. And I gotta say, the oxygen helped more than anyone realized.

My dad got there, and then the ambulance proper got there. The fire people left and the ambulance people were a little bemused. They didn't know what to do. I was having an anxiety attack, obviously, but I was also having trouble breathing, and I didn't want to go to the hospital but I didn't know what I wanted (other than to be able to breathe).

My cats had vanished at the first sound of strangers. The ambulance people, three of them, stood around while I sat on my sofa with my dad (I'm 43, he's over 80, seriously, I think I should have been able to do this on my own). And one of them basically talked me down. Got me talking about my cats, and that helped. I think I vaguely remember Thimble showing up at one point, taking a look at the four other people in my living room and disappearing again. I don't know for sure.

Sheesh. Just writing about this is traumatic. And believe you me, the trauma got worse as time went on.

So finally both my anxiety attack and my breathing problems subsided enough that I thought I'd be okay with just Daddy. I asked them, where did the breathing thing come from? I was very clear that it had started before the anxiety attack--that's what caused the anxiety. Turns out I had a rash directly under my left eye that I hadn't realized I had, and the main guy pointed out that between the rash (me: what rash?) and the breathing problems he would guess it's an allergic reaction.

And I had no idea which of the three medications caused it.

This meant that I couldn't take any of them. I let my dad go home after a few more hours when I felt my breathing was strong enough on its own without me thinking about it constantly that I would wake up again in the morning.

On Friday I couldn't get a doctor's appointment with anybody at my doctor's office (which is something I highly resent ... what part of "allergic reaction to the medication I was prescribed" doesn't mean you need to do something?) So I went to a doc-in-a-box, those walk-in places that have popped up all around the country.

They did an xray to make sure I didn't have pneumonia (I didn't. I never do.) and prescribed basically the same thing as Nyquil only with Sudafed added. Seriously? But I didn't have another choice.

Saturday I woke up and the coughing to clear my lungs was so very painful I decided, rather irrationally, to stay awake a few nights so I could get better and maybe sleep without pain upon waking. (It would have been more rational to say, okay, I'm now down to two hours before I wake up coughing. So let's set an alarm for one hour and at least get some sleep.)

The irrationality started before the sleep deprivation. And there's a good reason for that.

I got groceries. And vacuumed the house. As usual for a Saturday. That wasn't rational either. I should have asked for help with the groceries and let the house go un-vacuumed for a week. And I stayed awake all night. I also took one of the muscle relaxers that afternoon and just kept an eye on myself. I figured it was probably the least likely to have caused the allergic reaction. I was right about that. It was fine.

The cats thought my staying up all night was strange but rather marvelous. Especially as mostly I just sat and petted anyone who showed up.

Sunday things were seriously deteriorating. The coughing was worse. The sleep deprivation was even worse. I couldn't think straight. I was actually aware of this at this point. I felt I should probably have someone like a doctor see me but I didn't want to go to a doc-in-a-box. She hadn't even known that hydrocodone was a cough suppressant. Granted, I hadn't either, but I'm not a doctor.

That meant the ER. Was I really bad enough to go to the ER? I didn't know. I remembered (why couldn't I have remembered this earlier?) that we had tele-doctor access now. So I did that, signed up and followed directions and talked to a doctor via skype. She said I should go and get checked out.

Well, I was thinking enough to realize I wasn't really safe to drive by myself to the ER. So since it was Sunday and my brother wasn't at work, I called and asked him. He came over, heard I hadn't slept since Friday night, and said indignantly "what makes you think you're safe to drive?" after I asked him to follow me to the ER. He had a point.

So he drove me there. I was in such pain of my own I didn't sense how uncomfortable he was. This is usual for me as I usually pick up on that sort of thing.

Finally, finally, a doctor actually got it right. (No, he didn't, but more on that later.) Turns out it was still bronchitis. Even though the gunk was only collecting when I slept (I'd tried to sleep sitting up earlier that day and that's when I found out it was sleep that did it, not lying down). Even though the cough wasn't rattling like I was used to bronchitis sounding. This was just another possible manifestation of bronchitis, although an unusual one, and I was fortunate I had an ER doc who actually knew about it.

He prescribed antibiotics. The correct ones. The problem was ... they made me nauseous. Severely. As in, don't bother eating because it won't stay down.

My brother had taken me home and then left for his own home, so there I was. Sleep deprived, irrational for more than one reason (which I didn't know yet), and in severe pain from the broken ribs (which again, I didn't know about yet).

I knew I had to keep my blood sugar up. Research on the 'net and asking my sister on the phone led to trying honey dissolved in hot water. I could keep down a spoonful at a time. I switched to agave nectar (it's more caloric than honey for the same volume). I had a spoonful of applesauce every six hours or so. That was it.

Monday the pain was killing me. I needed something desperately. Everyone was at work. I didn't want to bother my parents again. So I called EMS. This time I rode in the ambulance (it almost didn't have shocks or springs at all. Talk about pain) and went to the other hospital system's ER.

Mistake. They treated me like a drug addict. They ignored me, left me in pain, and finally prescribed lidocaine patches which did nothing more than numb the skin of my back. They didn't pick up on the fact that a woman who can't walk in a straight line, who is confused and can barely pick out words to use, a woman who can't walk at all without support, might be something other than drunk. (At least, I assume that's what they thought). They didn't pick up on the fact that someone who is crying in pain might actually be in pain. They did an xray for pneumonia. Not gonna see broken ribs on that.

They told me I was almost ready to go home so I called my parents who came and then four hours later they let me go. Any number of times I was ready to walk out of there but I thought maybe I might get help?

The lidocaine patches have two covers, one on both sides. Kind of like a bandaid. I didn't realize that and had one on my back with the plastic against my skin. It didn't work very well. When I did get it on right, it worked a little better but it actually added to the nausea, although not that noticeably. What's one out of a hundred? Like my nausea was 99 and it added 1 to it, so now it was 100.

And I was so desperate I took some of the hydrocodone cough syrup. Remember, I had a 50/50 chance of that being what caused the allergic reaction. It wasn't ... which means I'm allergic to prednisone. To the very drug they give people who are having a violent allergic reaction. And I probably shouldn't try any other steroid either, since they have such similar chemical structures. Great. Another whole class of drugs that I can't have.

Between the antibiotics and the cough syrup, the cough was actually subsiding. I was actually getting to the point where I could sleep and still breathe.

But something else was going wrong. Something that had been going wrong since the beginning but was accelerating dramatically now that I had stopped eating anything besides the honey. I didn't know.

I slept well Monday night, exhausted from the all-day stay at the ER and from simply being so ill for so long. When I woke Tuesday, I was actually hungry. I carefully ate a protein bar, the simple ingredient one that I knew didn't have anything to disagree with my stomach even a little bit. And then I went back to sleep.

When I woke to use the bathroom, I was going to wash my hands afterwards. I couldn't walk in a straight line, and my brain felt foggy and floaty and all confused. I had taken to writing down the times I took my various medications, so I wouldn't overdose the hydrocodone and so I'd remember the antibiotic (which was a early afternoon thing since that's when I started them and it's every 24 hours).

(Sorry for the vivid description to come.) I had to steady myself against the counter before I turned the water on. I was looking down at the sink. And then I threw up the protein bar. It was like a magic trick, though. No convulsions. No nasty taste or burning sensation in my throat. Just liquid with well-chewed pieces, pouring into the sink. Like I hadn't digested it at all.

Maybe, I thought, maybe my blood sugar was low. Maybe that's why I still feel all foggy and confused. Obviously I hadn't gotten any benefit from the protein bar. But I'd slept, and slept well, so it wasn't sleep deprivation anymore. (I now realize it could have been because one night does not make up for a week of constantly interrupted sleep plus a night of no sleep, but it wasn't sleep deprivation and it hadn't been.)

I called my doctor's office when they opened. Could they test my blood sugar without an appointment? No. I called a doc-in-a-box. They could test my blood sugar but they couldn't do anything about it. Because if it was my blood sugar, I was going to need a glucose IV drip as obviously I couldn't keep anything down.

Dang. That meant the ER. AGAIN. Three flippin' days in a row?!? Do I have to?

Thing is, I never throw up. Even when I want to, having eaten something I shouldn't have. Even trying the finger down the throat thing. I never throw up. And I had never, even as a child when I could throw up, thrown up like that. Like a magic trick.

Between that and the brain fog, which wasn't right either ... yeah. I had to. Staying home ... I might not wake up. I seriously felt that odd in my brain.

I called my parents, as all of my friends work during the week. My mom, utterly stressed by the four hour wait in a horrible big echoey waiting room the afternoon before, almost burst into tears and begged me to just do home remedies. I hung up.

One friend had started a work-from-home job, and while that didn't mean I could interrupt her job for frivolous reasons, it did mean she had a little more freedom that someone who worked for a corporation and had a boss to ask if they could leave and so on and so forth. I called her.

She actually had a glucose meter. So she brought that over and we tested my glucose. It was fine. (Thanks to the agave nectar in water I'd been able to eat, apparently.) She left it up to me on the ER visit.

And I honestly don't know how I made the right decision. I don't know what made me decide to go for the third day in a row, bothering my friend even more (and I hate putting people out), and leaving my cats behind without so much as a goodbye. But I did.

We got there and were waiting. She'd gone and gotten a wheelchair which was most helpful. My house is small and there's always a wall or a piece of furniture to help keep you upright, but ERs are not so well designed. I went to the original ER, where they'd properly diagnosed my bronchitis (or at least gotten me the right antibiotics for what I actually did have).

Literally from the time I woke up and threw up to the time we were there at the ER, the nausea had increased to severe pain which actually was worse than the coughing pain from broken ribs! I felt the need to lie down ... I didn't want to throw up again, considering I had nothing but water in my stomach. The thought of a convulsion related to throwing up happening in conjunction with the pain from coughing was enough to terrify me.

So I used the wheelchair and a waiting room chair that was two people wide to lie down, being grateful I was a small person. I don't remember triage, where they take your blood pressure and ask why you've come to the ER that day and do the oxygen thing on your finger and temperature and stuff. I don't know if they did that or not. I don't think so.

The next thing I remember is being escorted in the wheelchair to a rolling bed in the hallway (yes, they're that packed and that small). This was much better than the makeshift bed I'd come up with in the waiting room.

My friend stayed with me.

She stayed with me all day.

They started an IV drip. Just saline, since my glucose was fine. They took blood for a blood test. A doctor came by and pushed on my stomach in various places and got told to stop, please, multiple times, along with a bunch of "ow, ow, ow"s. I think I managed not to moan about it while they weren't wanting to see where it hurt. Unless the other lady I heard complaining about her stomach hurting was me. Could have been.

They wanted to do a CT scan and you have to drink contrast stuff. They put it in ginger ale or something like that, clear and sweet and carbonated. I can't drink carbonated beverages at the best of times (it goes up my nose, not down my throat). I couldn't quite convince them. My friend wrangled a doctor (the nurse couldn't put it in anything else) and said she can't drink this can you put it in water.

Yes, he said, but it'll taste terrible. Me, slurring my words: don't care. Can drink it.

And I did. And it tasted terrible. But at least I could swallow it. And amazingly, it stayed down long enough for the CT scan (and afterwards). They'd given me an anti-nausea med in the IV when I first got put on it, but as the pain had not subsided yet, I thought it wasn't working. I guess either it was working better than I thought or it was the fact that the contrast was in water, which I was still drinking and still able to keep down.

When they brought me back, we met my bed being rolled down the hall with my friend beside it. They were putting me in one of the ER rooms. How lovely to not be in the hallway with people walking back and forth all the time.

But this meant I was all confused with directions again, and couldn't find the bathroom. I was walking better (yes, there was a reason for that ... and I've mentioned it. Do you know what it is yet?) and so while my friend was off hunting down lunch for herself, I was hunting the bathroom.

A doctor asked me if I was making a run for it. Had I been back to myself, I would have said something like, "yup, at top speed too" considering I was walking very slowly and carefully. But instead I said, "where'd you guys move the bathroom to?" He laughed (as I meant him to) and said "they're where they've been since the building was built." And then gave me directions which consisted of turn around and walk straight till you go through that door. (Literally it was that easy).

Different bathroom than the one I had been using, though. I still don't know where that one got to.

Finally a doctor came in and said, "we're going to keep you overnight."

And my reaction was pure relief. Something was actually wrong. Something they could fix. I wasn't going crazy. I wasn't a hypochondriac. And I would be able to sleep without fear. Because if something did go wrong, they would come in and do things to revive me. For the first time in three weeks, I could sleep without fear. I hadn't even realized how much that had been hanging over me.

The doctor continued, "your sodium was really low when you came in and we have to raise it slowly. Your potassium is low too and we're going to put a potassium drip in too."

I knew about what low sodium did to you. My dad had had the same thing, for a different cause, years earlier. The sodium was everything. The confusion, the floaty feeling, the foggy brain. I literally couldn't think because I didn't have the ions to make electricity to pass impulses from one neuron to the other.

The potassium is similar. But the sodium chloride drip (saline) is fine. No pain. Potassium chloride burns like hell. They had to split it into the sodium line way way up the join so it was diluted enough before it got to me, and I only had to have a mini-IV-bag of it! It was horrible, like a tetanus shot times a hundred. Luckily it wasn't for long, just an hour or two. If I could have handled more pain I could have gotten it done with sooner ... oh well.

My friend had to go home that afternoon. I still can't believe she stayed with me all day. She called my brother to see if he'd come after his work. I asked her if she could take care of the cats when she went home, since she goes right by my house. So she did that. She said Thimble was curious. ("said" via text.)

When my brother finally was able to respond, he said that he could only come for a couple hours. I asked him (via text again) if he could stop by my house and pick up stuff for me. My friend had my physical key, so I sent him an electronic one, thanking my own forethought of putting in electronic locks the previous year. Because of course this was the only visit to the ER where I hadn't come prepared to stay the night.

I got a nice big corner room. This hospital only has private rooms, but they're usually smaller than than the one I got. The end of the building is a wedge so the rooms at the end are two half-wedges. Lovely bank of windows looking out over other hospital buildings which gives a view like of a downtown skyline.

Good thing I was walking, talking, and thinking better though. The room was too big for my previous style of walking! And being by myself meant I had to advocate for myself. But I was amazingly able to do that, discussing my anxiety medication with my doctor (it has a withdrawal possible side effect of "death" so I figured they might want to continue it--they did--but it's a controlled substance and would have to come from them), discussing other things medical (like what my sodium numbers actually were, for example).

My brother came and that's when I realized just how uncomfortable hospitals make him. I was actually recovered enough to pick up on it. But I wasn't recovered enough to block the sensation so I was kind of glad when he went home. It was calmer without his silent tension. I'm really glad he came though. He said both 'Coons had followed him around as he gathered up my over-night-stay stuff. I said really? Colby too? Wow.

And I ordered a hamburger for supper and actually was hungry and not nauseous and kept it down. Because guess what, the low sodium makes you nauseous too, not just the antibiotic. Plus I'd forgotten to take the antibiotic that day (I wonder why ... haha) and they'd given me more anti-nausea medication before in the ER.

It was the best hamburger I've ever had.

Later I was still hungry and asked the nurse desperately if there was a place to get food (I was thinking a vending machine or something) but she said "we have food for patients" and told me my choices. So then I had a ham and cheese sandwich on a croissant with a side of fruit (melons and pineapple which I normally don't like melons but I was starving and ate it too) and a dessert of a graham cracker. And it was all delicious and my tummy liked it too.

After midnight I wasn't allowed to eat anything though since they wanted to do a fasting MRI the next morning. They'd seen "something" on the CT scan. (Lovely phrase there, people.)

I went to sleep around 9 or 10 and got the most wonderful sleep in the world despite the fact that they came in and took my blood pressure and then stuck a needle in my non-IV arm and took blood every four hours. I barely remember it.

At this point in May I had to stop writing because it was that traumatic living through it again while writing about it. It's December 27th now.

When I woke up I felt better than I had in weeks. (Not that that was odd or anything!) I was able to make a phone call to my insurance to make sure the MRI would be covered. And I don't do well on phone calls to places like that at the best of times. (They say MRIs have to be pre-approved but apparently any test, including an MRI, that gets done while you're admitted to the hospital is automatically pre-approved.)

And I think I might have been a bit of a pest, asking when the MRI was going to be. The problem was I was now absolutely starving. I wanted food so badly. They actually got me to the MRI fairly quickly for a hospital system--about 10:30 am, but since I naturally wake up at 4 am (I'd gone back to sleep till 7, but still) I was awake for a very long time with a hungry non-nauseous tummy.

I was a little worried about the MRI since I have mild claustrophobia, but this MRI can handle a 500 pound person (they told me) and I could barely reach the top of the tunnel with my arm outstretched. It was huge. It was open on both ends so I didn't have any trouble with it. They also warned me it was loud and I had both in-ear hearing protection (they provided) and over-the-ear headphones (through which instructions came).

They were disappointed in my ability to take deep breaths. I wish I had known at that point that my ribs were broken because I would have retorted, You try taking deep breaths with broken ribs!

The MRI was done with and without contrast (the without part first, obviously), and this time the contrast was put in through the IV. They warned me it would make me flush warm as it went through my system and make me feel like I had to pee really badly but it was a fake feeling and would go away in a few seconds. This was all true.

I commented that I was disappointed. They asked why. I said that my feet were still cold. It was supposed to be funny (I mean, it was true, but it was meant to be funny). I don't think they got the joke, though.

And then they discharged me around noon, but I was able to get breakfast first, and take my antibiotic. Within half an hour of taking it, I felt the nausea returning like some awful beast. I had already been discharged but was waiting for my parents to get there. So, feeling guilty, since I wasn't technically a patient anymore, I called the nurse line and asked if it was possible to get an anti-nausea pill (I had a prescription for them but obviously hadn't gotten to fill it at a pharmacy yet) in the next 20 minutes.

They managed it; wonderful people.

The 20 minutes was my fault. I'd been under the impression my whole life that there was no more of this hospital "downtown" as I'd been one of the last babies born in their downtown facility. (I didn't know that they'd then torn the building down and rebuilt it). So, given something someone had said that I'd overheard, I thought this facility was referred to as the downtown one. And that's what I told my parents. I knew where I was; it was ten minutes from my house on a bad traffic day and thus ten minutes from their house. But I don't navigate by street names, I navigate by patterns, so I didn't know what street it was on to tell them that way.

Oops. Luckily I'd been chatting to a "driver" (the person who pushes your wheelchair around--they didn't let me walk to the MRI and back, for example) and mentioned that I'd called it the downtown hospital and she set me straight, and I had to call my parents and tell them oops, sorry, and they were almost to the downtown one at that point and so had to turn around and come back.

Anyway, we got home, and I was even able to drive to the pharmacy and get my nausea med prescription filled and buy some Gatorade.

Apparently, your body has a balancing system that keeps your sodium in your blood at the right level. But when you screw that up, the system takes ages to reboot. The minute I switched from the Gatorade I bought (because I used it up) to water later that night, I started feeling that confusion returning. So the next morning I went to a Walmart and bought a lot more Gatorade.

And after that I found Propel, which is a powder version of electrolytes you can add to your own water and not have quite the intensity of flavor, and I'm still using that in my water to this day. I have noticed a difference in my mental acuity, especially at work, and I think drinking as much water as I do was actually keeping my sodium just a tad low constantly.

So you still don't know what the original illness was. It wasn't bronchitis. It wasn't the flu. It wasn't any of those things. It was a far sneakier and unusual illness. I found out in June.

June is when we go to our family reunion. My dad and his siblings are old enough that they were children before all the vaccines we have now. I was describing specifically how I broke my ribs to my Uncle C- (I was staying at his house) and he said, in his delightful accent, "Oh, well, now, that's whooping cough."

Wait, what? But I never made a whooping sound.

A bit of internet research showed most adults with whooping cough don't make the whooping sound.

Curious now, on the way back I described how I broke my ribs to my father without ever mentioning what his brother had told me or referring to it in any way. Daddy promptly commented, "That's whooping cough."

More internet research convinced me that is what I had. It fit all the symptoms, even the odd ones. The pattern (the first week mild, the second week flu-like symptoms and violent coughing, and the third week it gets even worse but luckily that's when I was prescribed an antibiotic that is commonly used for whooping cough too) matched.

I told my doctor my conclusions, and she said that we could do a titer value on my blood and see if I was right.

Yeah. I was right. I'd had whooping cough. That was the most sick I have ever been in my life. If I hadn't gone to the ER that third time, I most likely would have had a seizure from the low sodium and gone into a coma, and from there death if I wasn't found soon enough. And who would have found me? My sister said she probably would have started worrying after two days ... that wouldn't have been soon enough.

It was a scary, terrifying experience and one I will never go through again as I will be getting my vaccine boosters every five years for sure.

It was the gift that kept giving, too. The stress gave me the first cavity I've had in over 18 years; the three rounds of antibiotics (I had to do the antibiotic that worked twice because of skipping it the day I was admitted into the hospital) ripped up my stomach so bad I ended up having to have a colonoscopy and endoscopy in July to make sure they hadn't caused an ulcer; the MRI had to have a followup to make sure the lesions hadn't grown (everyone was so careful not to say "cancer" but that's what growing lesions are); and my ribs still hurt when I over stress them. (The second MRI showed no changes had occurred so that was a relief.) (And there's no ulcer. Just a stomach that's gone from being picky to being super picky.)

I'm glad this year is almost over.