A Visit to the Local ER

          It was 10 o’clock, June 14, 2021. Anne and I were watching TV. I got up to fetch a snack from the kitchen. As I was collecting my treat, I noticed that my hand wouldn’t reach out in the time sequence with the commands that my mind was issuing for it. My hand seemed to just hover near the plate. That’s odd.

I got goodies gathered and I began my walk back to the TV room. My gait might have had the appearance of someone returning late from an outing at the pub. I was aware of my bipedal instability. When I reached the two-steps, which lead to the TV room, I carefully raised a foot to the first step. As I transitioned lifting energy to the foot, I lost my balance. I fell backward onto the living room carpet.

Things clattered, but I was uninjured. Try as I may, I could not make my body roll over. I was trying to get to my knees so that I could rise to the sofa. Anne rushed to my side. I explained to her what had happened. She encouraged me not to try to move.

Whoa! Play what I had just said back again. I doubt that I could mimic the vocal chaos that had been spewed out as normal Rob dialog. My ears had heard it all. It had been the sounds of what a parent would hear when the infant first slobbers its tongue around while making noises. Naturally, one parent will say to the other, “Oh, listen to what our baby is trying to say. Isn’t that adorable?”

Anne kept trying to keep me down. I kept trying to get to my knees. She had called Chris to the house. During the next several minutes, I succeeded. I sat on the couch, where I could watch the loving concern being spent over what had just happened. 

Within a few minutes, I was able to stand and to walk. My speech had returned to normal. We buckled into the Honda, and Chris drove us to the Rogue Regency Hospital, Asante, ER. The tale of my episode was told two or three times to different ER staff members. I eventually was admitted. I was wheel-chaired to ER Room 5.

My first instruction was to strip down, and to slip into an open back gown. Then, I was helped onto the gurney, aka bed, and I was made comfortable. One cannot be in a hospital ER unless he is attached to electronic machinery. A technician wheeled a cart into the room. From the cart, he collected a handful of black tags. Each tag had a peel-off sticker. The technician stuck tags all over my chest. The tags were connected to different colored wires.

These wires fed a large plug that was drawn out through a hole in the front of the gown. Hanging off the wall near the head of the gurney was a video monitor. An array of button, and knob cluttered small pieces of hardware shared space with the monitor. A cable came from this cluster. The cable mated with my chest-fed plug. A lone wire came from the cluster. This one held the finger clip, oxygen level monitor. Things started beeping. Much of my main bodily functions were now being displayed and tracked.

I was told that I was on the waiting list for the use of the CT scan (Cat Scan). The wait would be a couple of hours. Chris and Anne returned home. The room light was turned off, the front drapes were drawn across the large glass sliding door, and the door was shut. Gentle beeping from the monitor was a constant background noise. As was the cacophony created by the large ER staff that worked outside my room.

Anne had recommended that I bring along my iPad. I could use the pad while I waited for things to get done. The pad was on the sideboard. I occupied some time with the app called Word Calm.

I suppose that most visitors to the ER are either in a state of significant pain, or they are unconscious. In neither case are they in an ER room trying to get some sleep. I soon discovered that I, too, was not there to get some sleep-time. What seemed like every 15 to 20 minutes, the door would slide open, the light would be switched on, and I would be asked to extend my arm. The nurse would then wrap my bicep with a pressure cuff. Pumped to a point of low pain, my arm would pulse with each beat of my heart. Slowly, the pressure would reduce. I would be returned to my wondering about how much longer I was going to be waiting for my turn with the scan.

Some time in the wee morning, my turn came. I was wheeled on the gurney down the ER hall. I was able to view into many of the rooms that were like my Room 5, all were occupied. Down more hallways, and through several sets of electronically opened double doors, I rolled into the Cat Scan room.

After being transferred to the scanner bed, I had an IV stuck into my left arm. I was told that this capped intrusion would be used to inject Iodine into my blood stream. I wasn’t informed of the reason for the need of the Iodine, but I was advised that when the Iodine was injected, that I would feel a significant body warming surge.

Securely affixed to the scanner bed, I was fed a short way into the tube. The machine whirred, and my body felt several moments when the temperature seemed to quickly rise. Then I was finished, and I was unceremoniously wheeled back to my room. I asked how the scan turned out. I was told that the doctor would be studying the results within the next couple of hours.

A short while later a young technician wheeled a cart into the room. The cart was dedicated for use for Doppler Echocardiography.  Doppler echocardiography is a procedure that uses Doppler ultrasonography to examine the heart. An echocardiogram uses high frequency sound waves to create an image of the heart while the use of Doppler technology allows determination of the speed and direction of blood flow by utilizing the Doppler effect. This is the same ultrasound technology used to examine the status of a fetus, within a pregnant woman.

I visited with the sonographer while he worked. He had done his study at Oregon Institute of Technology (OIT), in Klamath Falls. The Asante Hospital in Medford hosts a staff of over 20 cardiologists. This young man was offered a position, immediately upon graduation.

When the sonographer was finished, I asked him how everything looked. He said that interpretation of the results was done by a cardiologist. I suggested that someone with his level of training certainly would be able to summarize the logged output. He smiled, and he winked as he pushed his domain to the sliding door.  

The corridor outside my room had become quieter as the morning wore on. I was told that the results of the CT scan had shown no abnormalities of the brain. The CT scan, however, produces inferior results, when compared to the output of a Magnetic Resonance Imaging (MRI).  The advantages of MRI over CT scan can be significant. A CT scan uses X rays to shape up a picture. MRI uses a magnetic field to do the same, and it has no known side effects associated to radiation exposure. MRI provides advanced detail in soft tissues. The greatest advantage of MRI is the capability to alter the contrast of the images.

I awaited my turn at the MRI. This instrument would provide clear images of the results of any past brain injury, or trauma. Once again, I was wheeled down corridors and past doors. I was backed into a freight elevator and taken to the basement level of the hospital. Down a couple of long corridors, and around a few corners, I was then parked in the MRI waiting area.

A nurse arrived. She wheeled my gurney into the MRI room. My initial impression of the room was that it was a stadium. The volume was large. There were many nurse/technicians in active roles. I was moved from the gurney to the MRI trolly bed. My head was placed in a device that held it rigid. I had been asked if I suffered from claustrophobia.

Any fear of close enclosures would not have mattered. The MRI trolly carried me into the cylindrical cave. I was given a headset to wear while inside. One of the nurses asked what genre of music I would prefer. I suggested Country & Western. Over the headset speaker, an operator told me to remain still. I was then cautioned that I would be hearing some loud noises.

An unbelievably bad song began to play. As I analyzed what I disliked about the tune, all hell seemed to break loose inside my tunnel. The lousy song was instantly unavailable to my ears. The MRI was banging and clanging and whirring. It was like being inside an empty coffee tin while it was being beat on. I wondered if the technicians knew that some of their magnets may have fallen loose, and that they were now tumbling inside the tube.

The noise stopped. I was drawn from within the tube. After the headset had been removed, I was asked how I had enjoyed the experience. That nurse really shouldn’t have gone there.

While visiting the MRI, my room had been given over to a more needy visitor. Under normal ER conditions, a patient isn’t held overnight in an ER room. He is assigned a room elsewhere. COVID 19 prevailed. The house was booked. My gurney was jockeyed backwards into what felt like a hallway closet.

Anne joined me in the closet. We were visited by a nurse who said that she was beginning my release procedures. A physician, whose name I could not pronounce, would arrive soon. He would give us a full briefing of the test results.

This wait wasn’t long. A doctor arrived. He introduced himself, and then he dedicated his time standing in front of the computer cart. While he typed on the keyboard, and while he moused over displays presented to him, he told us what the tests had revealed.

I had suffered a Transient Ischemic Attack, or TIA. This is a brief stroke-like attack wherein symptoms resolve within 24 hours. It can cause paralysis in face, arm or leg, usually on one side of the body, together with slurred speech. It occurs because of a buildup of cholesterol in the artery supplying blood and nutrients to the brain. Treatment involves medication, and surgery, if necessary.

The doctor verified which pharmacy I used. He then sent them a prescription for a 90-day supply of Plavix, generic drug name clopidogrel. Clopidogrel is used to prevent heart attacks and strokes, in persons with heart disease, recent stroke, or blood circulation disease. It is also used with aspirin to keep blood vessels open and prevent blood clots after certain procedures.

The doctor had made an immediate follow-up appointment with my personal physician, Neil Olsen. He also passed along his referral to a Cardiovascular Surgeon. I was then discharged. So, it is called slurred speech.

“Wow, Rob. Couldn’t you have just told us that you had experienced a mini-stroke?” Yes, I could have. But then you would have missed all the tedium and tests that I got to experience. I enjoy sharing drivel.

The true reason that I am giving you all the background information, is because I have been scheduled to undergo a carotid endarterectomy on July 9^th. This is a procedure to treat carotid artery disease. This buildup of plaque (atherosclerosis) has restricted blood flow to my brain. Removing plaque that is causing the narrowing in the artery can improve blood flow in my carotid artery. This will in turn reduce my risk of a future stroke.

Surgery for any reason brings risks. Carotid endarterectomy is no exception. The opportunity for a serious negative side effect is quite minimal. However, it does exist. My wish is that post-recovery I will be able to give you all a big hug, and that I will be able to pass along my Love in non-slurred speech. The next time you see me stagger, it will be because of a long overdue visit to the pub. Cheers, Rob.