Friday, January 8, 2010
I go to pieces, part 2
You may recall me telling you about my trach collar and trach falling apart during a fitful night's sleep in December.
Somehow, I was able to pull myself together and got through the holiday season without another incident.
Two nights ago, the same thing happened. But this time, when I placed the trach up against the hole in my neck, it wouldn't slide in; the circumference of the trach was just a bit more than the circumference than the hole.
I considered panicking. Instead, I sat at the computer and e-mailed my doctor, telling him that I hoped he would be able to help me if I just showed up in Kaiser's Head and Neck Department. Then I threw on my jacket and shoes, tossed the trach in a Zip-Loc bag, grabbed my keys and drove to the Head and Neck Department at Sunset and Edgemont.
The receptionist almost didn't recognize me without the familiar plastic apparatus around my neck, which she has been seeing on me for almost a year. But I held up the Zip-Loc bag with the disassembled pieces and handed the receptionist a note explaining what happened, which I wrote in the elevator ride to the sixth floor.
It was before 8 o'clock and the clinic had not opened yet but the receptionist checked me in and said that the on-call doctor would arrive shortly before 9.
I was the only one sitting in the dark waiting room for 15 minutes or so, then a young kid walked in and took a seat opposite mine. I expected him to catch him staring at the hole in my neck but instead he seemed more interested in my flannel Mickey Mouse pajamas.
After a short wait, a nurse led me to one of the exam rooms. I was hoping that Dr. B1 would have been on duty but another head and neck specialist, Dr. T, walked into the exam room.
Dr. T read my note and then pumped up the chair so that we were eye-to-eye. He held a flashlight above the hole in my neck and peered inside.
"Bummer!" he said.
"What do you mean?" I wrote in my pad. Along with "Code Blue" and "I'll send for the chaplain," "Bummer!" is one of the last things you want your doctor to say when he inspects your breathing capacity.
The hole in my neck, Dr. T explained, was already beginning to close up, which was the reason I could not slide the trach back in. I didn't think that could even happen, I wrote. Dr. T said that trach holes could close in within a matter of hours and when that happens, the surgery needs to be repeated.
He left the room for a few minutes and returned with a tray of instruments and tubes of gel and lubricant.
"This is going to get a little messy," he warned, wrapping a large towel around my chest and shoulder.
My knees were knocking as Dr. T lubricated the rim of my trach hole, and then applied the same gel to a fresh trach. I clenched my eyes tight as the round end of the trach pressed against my neck, and Dr. T applied more and more pressure.
Finally, I heard a soft pop, and then felt the trach slide in. When I opened my eyes, Dr. T was lifting the blood-splatted towel from my chest.
I held the trach with a finger as I rode the elevator down and walked to my car. Two trach-separation incidents in as many weeks doesn't give me confidence that this won't happen again. When it does, the trick will be to get to Kaiser before the trach hole seals up.
And also I should have a pair of Donald Duck pajamas ready to wear for the next emergency. You don't want your doctor to see you in the same jammies twice.