January 11, 2009

Kerstin's Brain - Part II

This is the second part of the saga of Kerstin's Brain. Go here to read part one.

Once I was past the waiting room I was taken into the ER. I could tell I was having trouble, but I couldn’t tell how bad it was. I wasn’t sure what kind of shape I was in to evaluate myself. My hands and arms were still numb when they brought me into a large room and set me down on the bed. Things get a bit fuzzy after that, so Ilana will give the details.

This is Ilana’s recollection: Kerstin walked into the ER with me and the attending nurse and she set him down on the bed. While he removed his clothes, a male nurse came in with a dry razor, shaved off a patch of his chest hair and attached several electrodes to his chest. Another nurse came in, introduced herself as Ashley and put in an IV. Kerstin was struggling to talk at this point. He could get most of the right words out, but he was very slow and deliberate, and would clench his jaw with every syllable. He seemed very disoriented, and seemed to have a hard time understanding what we were saying to him.

The ER doctor came in a few minutes later after Kerstin's vitals were taken and asked Kerstin to describe his symptoms. Kerstin was disoriented, numb from the shoulders down and sick to his stomach. He made a few attempts to describe what was happening, but ended up saying things like “I’m having dif-…. I’m hav-ing…fuck!... I’m having diff…iculty… to speech….” He’d clench his jaw when he’d get hung up on the word, as if physically straining to find it in his brain. I noticed that while he had a big problem finding words to complete his sentences, cursing was surprisingly effortless.

The doctor ordered a CAT scan and I had to stay behind. He and Ashley wheeled Kerstin down the hall and I was left alone and trembling in the ER room. I called Joseph, who was watching Alden and told him what had happened. Then I called Karen, who asked if she should come to the hospital or be with Joseph and Alden. I opted to have her stay with Alden, since he’s most comfortable with her, and since I didn’t really know how long we'd be staying at the hospital. An administrator came in at some point during this lonely and scary time to ask me to fill out paperwork for insurance and billing purposes. I understand that this sort of thing needs to be done, but I was really irritated with this woman for being so goddamned insensitive. I was alone in the room after that and I passed the time by pacing and reading cabinet labels.

It took 23 minutes for Kerstin to return. They re-situated him in the corner and Ashley asked him if he remembered her name. He did (which was more that I could say!) and we were both very impressed. Kerstin then asked me to verify text on posters and cabinets in the room. I think he was trying to regain his vision and trying to keep his brain active. Ashley told me that on the way to the CAT scan, Kerstin counted from one to ten over and over again, with varying degrees of success. We waited in the ER room for a while – I can’t remember how long exactly, with both of Kerstin’s arms and hands alternately going numb and regaining feeling. He complained that he felt nauseated and exhausted, but was afraid to sleep. Ashley wanted to give Kerstin an anti-nausea medication intravenously, but Kerstin refused. After she left, he told me he thought he had food poisoning (?!) and that if he could only throw up, this would all go away. I figured he was delusional, but was happy that at least he was talking.

The doctor returned and announced that the CAT scan was negative. I breathed a huge sigh of relief at this news. The doctor then said that he might still be having a stroke or a tumor that couldn't be detected by the CAT scan, heralding in a fresh wave of panic. The doctor seemed surprisingly detached, puzzled and non communicative. He also seemed to be at a loss for what to do next. He finally announced that Kerstin probably needed an MRI, but that he’d have to be transferred to Portland (an hour away) to get it. He left to “start the paperwork”, which was ultimately completed a mere 3 hours later.

I don't know why it took so long or if Kerstin was running out of time for treatment, so these 3 hours were absolute agony. During this time, I called my Dad (who, conveniently enough, is an ER physician!) and asked him to talk to this doctor, in the hopes that he could speed things up. I think my Dad convinced him to go through with the MRI that night. Dad also decided to come up to help us with the diagnosis, and we agreed that we’d meet him down at the Portland hospital. Karen and Joseph were pretty frantic to see Kerstin by this point too, so they left Alden with Ben at home and met us in the ER. We were all there for maybe an hour or two, trying to make sense of everything. Joseph spent most of the time talking to Kerstin, while I brooded in the corner of the room trying to figure out what the hell was taking so long. Karen was the squeaky wheel and hovered just outside our room so as to pounce on the nurse, doctor, or anyone else who happened to walk by for an update. It seemed to take forever to get Kerstin out of that ER.

(Note from Kerstin - I remember some of what Ilana describes. I don't recall time length at all and wouldn't know how long I was in the Augusta hospital if asked. I remember not wanting to go to sleep or allow myself to slip up and not correct myself when I was speaking. I felt I had to fight to keep my mental state and I worried what would happen if dozed, which is why I counted and read the wall text. I was also worried about the nausea medicine more as a strangers-offering-unknown-pharmaceuticals than anything else, and had reservations about taking drugs while my head was being screwy. I was more fascinated than scared at my condition and thought the best thing to do was to talk about what was happening to me at the time in case some bad brain-mojo happened and I would be unable to talk in the future. )

Kerstin started to feel more sick to his stomach and really looked bad. He was still struggling to finish his sentences. Ashley gave another impassioned pitch about why he should take the anti-nausea medication – mainly to prevent his brain from jarring even more when he retched. I think he finally started to realize that this wasn’t food poisoning at some point and agreed to the medication. Ashley’s shift ended before she could administer the drug and her replacement, Ingrid, actually did the deed. Ingrid was much less sympathetic than Ashley. She seemed defensive when we questioned her about what was going on and irritated when we asked for updates. She made flippant comments about how this was probably just a small seizure because that’s what happened to a friend of hers and told us not to worry. These kinds of comments really riled Karen and me, mostly because we had very little information and the doctors still hadn’t ruled out something really awful (like a stroke too early to detect via CAT scan or AVM) and just who was this nurse to breeze in and casually diagnose Kerstin anyway?

Kerstin threw up right after he was given the anti-nausea medication. At first, it was just a little spit up (and I know a thing or two about spit up vs. vomit, thanks to Alden.) He really lost his lunch just before he was loaded on the ambulance and transferred to Portland. This was about 9 PM – 5 hours after his symptoms started. Joseph opted to go with Kerstin in the ambulance. He reported that the trip was largely uneventful, with Kerstin still fighting sleep, but managing to doze lightly for a while. He woke close to the hospital and they had an interesting exchange. Joseph described it as “confused and incomprehensible, but pleasant.”

Karen and I returned home to fetch Alden and relieve Ben. I nursed Alden and changed his diaper, then bundled him up and loaded him in Karen’s car. Alden was pleasantly amused by all the activity and happy to be allowed to stay up so late past his bedtime. We arrived at Maine Medical Center in Portland around 10:30, just a few minutes after the ambulance delivered Kerstin to his room. My Dad met us in the parking lot and we all entered together. Ben delayed his trip to make us some dinner and then brought it down to us in the hospital.

To be continued on Kerstin's Brain - Part III....

1 comment:

Anonymous said...

The image of the carotid artery is really cool. The second image makes you look like you have a very bizarre expression--all bulgy eyeball and missing nose... Pretty neat. You should use them for some art project.