Rewind to Tuesday, July 6. (For context, look at my post of June 5.)
That morning, it was time to get my second spike in the crotch. Kathleen drove me downtown to O'Hair Medical Center, and we wended our way through a maze of corridors until we reached the Spike-in-the-Crotch Department. Contrary to my childhood memories, the procedure was not as bad as it sounds. I would not want to do it for fun (not that there's anything wrong with that), but, with the right sedatives and pain killers, it's tolerable, and, unlike the week before, I don't remember it at all.
Once again, the neurosurgeon (whom I have yet to give a silly nickname) threaded a catheter up through my femoral artery, past my heart, and into the arteries in my nose. This time, it wasn't just to look around, but to take care of business. Zillions of tiny arteries had blossomed in my nose--far more than I needed for normal nosing. The neurosurgeon released tiny beads that blocked off the extra arteries. I don't remember any of it, but the neurosurgeon told me he had a lovely time.
Once I left the recovery room, I was rolled up in a wheelchair to the neurological intensive care unit. There is a small potential for a stroke after such a procedure, and they thought it would be fun to watch.
If you ever have reason to go there, I highly recommend the O'Hair Medical Center Neurological Intensive Care Unit. Four stars--the fanciest I have ever worked in or stayed as a patient. Unlike the last one I where I was a patient, I wasn't miserable and hallucinating, but there is a lot more to recommend it. It is clean and modern-looking. The rooms are singles, and pretty big. They are closed off completely. (The staff could look in through the window that covered one wall, so it did lack a certain privacy.)
It just to happened that my nurse and student nurse had no other patients that night, so they fussed over me even though I felt perfectly fine. They wheeled me down for an MRI--a fun trip, and we laughed and traded medical war stories. They even went downstairs to the lobby to get me something from the Au Bon Pain (which translates to Oh Bone Pain) because the kitchen was closed. Then, I went home in the morning and slept much of Wednesday.
On Thursday, June 8, I went back to work at the office. I began to get a little ache in my face and a little bit of a bloody nose (which defeats the point of the whole procedure). It wasn't terrible, but it wasn't what I expected. So, near the end of the day, I called the surgeon's office and asked his nurse whether this was normal after the procedure or whether I should go to the Emergency Department. She said I should. I was skeptical, but, after work, Kathleen and I went all the way back to O'Hair.
That visit to the ED was kind of fun, if inconvenient. One of the docs there liked to tell doctor-lightbulb jokes like, "how many psychiatrists does it take to change a lightbulb? One, but the lightbulb has to want to change." The neurosurgery, and ear, nose, and throat staff were unimpressed. Apparently, this was not so unusual after the procedure I had had. They sent me right back home, and, the next day, I went back to work with a little ache in my face. I still don't know why I was supposed to go to the ED in the first place that night.
Then, Friday night, I started to get a really bad headache--the worst I had ever had, and I had a temperature of 103. (Friends not from the US, don't worry. I wasn't boiling alive. In Celsius, my temperature was about 39.) We got a little freaked out and called the O'Hair neurosurgery coverage. They kind if yawned but said I should go to the Emergency Department. They said I didn't have to go all the way downtown this time, so I went to a nearby hospital where I had worked but never been a patient. That's always nice.
They seemed slightly more excited, but once they talked to the neurosurgery coverage at O'Hair, they yawned too. They sent me home, and I tanked up on full dose acetaminophen and ibuprofen (known more commonly by their brand names, Tylenol and Motrin).*
I slept all day the next day and had an even worse headache and a fever. This time, I had neck stiffness, and it was painful to touch my chin to my chest. This was kind of scary, since, when a patient comes to me with these symptoms, I send them to the emergency room, and they get admitted to the ICU. These are the symptoms of meningitis. So, Kathleen called the covering neurosurgeon. He yawned, but he actually explained things better this time.
Some of the blocked arteries had been doing more than just causing bleeds. They had been feeding tissue that was getting inflamed after losing some of its blood supply. That's apparently something that can happen after the procedure I had, and it can feel like meningitis. So, I just took the big painkiller combo (with an acid-suppressor--omeprazole--to protect my stomach) for a few more days until everything stopped hurting. It seemed to be a happy ending. But the story was to continue.
Next: Ooey, Ooey, Gooey--the Revenge of the Nosebleeds.
* This is actually a very good combo for severe pain, and I recommend it too my patients. Acetaminophen is unrelated to all of the other over-the-counter pain medications, so it does not conflict with any of them. You can take it in combo with ibuprofen. Just remember that acetaminophen can be deadly for people who drink three or more servings of alcohol every night, and ibuprofen might burn a hole in your stomach or blow out your kidneys if you take it for more than a little while. In clinical trials, they do as well as narcotics.
I met this dog about a month later. He's not really relevant, but he's awfully cute.
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