Saturday, 13 August 2016

The Ides of March

The Ides of March

A single departure from previous and future postings.  It's mainly to catch friends and family up on what some may not know already and it's longer than it should be, though I've taken out a lot of details.

Our friend Susan went with us to Narbonne last March 15th to look at a camper while I had an MRI, after about a year of worsening double vision.  When Tim came back to get me, we were told I was to be sent immediately by taxi to emergency in Montpellier, so he took Susan home and waited for news, as we were given almost no information.  (Susan inspired the title of this posting in an email later that same day.)

In emerg, after another MRI, they said I had a large intra-cranial aneurysm and would have surgery the next day, then was taken up to the intensive care ward of the neuroradiological section, where I was given a towel, a face cloth, a bottle of Betadine (an iodine solution) to disinfect myself from tip to toe, a mortifyingly backless hospital gown and - horrors - a single-bladed razor with which I was to perform much more than a bikini shave - or else the surgeon wouldn't operate.  The alternative was for the orderly to do the shaving - not a chance.

Then to a bed in ICU, where the side rails were raised and I was hooked up with several stickers to a monitor with flashing blue lights.  What do I do when I have to go to the loo?????  I was to ask for a bedpan.  Yuk.

That night was an insomniac's ultimate nightmare.  I was in an open ward with 7 other patients, all of whom had had neurological surgery.  Across from me, a man bellowed names, obsenities and gibberish until about 5 am.  Every time he shouted, the man beside me rang the bell for the nurse.  Alarms sounded, red lights flashed and staff came running and shouting.  Just as things had calmed down, the staff changed shifts and began serving breakfast, but not for me, since I was to have surgery that day.  Then no lunch.  And still no surgery.  Like all the meals I had during my stay in hospital, the evening meal was plastic-wrapped, microwaved and tasteless.  Some of our friends have rhapsodized about their wine-acccompanied French hospital meals....

Same routine the next two days, as there was no opening in the operating block.  No meals till evening and a Betadine shower each day until the skin on my arms began to peel.  But - I didn't have to shave again, the shouter and the flasher were moved out of ICU and one of the aides gave me a second gown to put on backwards, on top of the first, restoring my dignity.  Best of all, they left the bed-rails down and let me go to the loo. Apparently, as I was the first person who'd ever walked into ICU, they didn't know what to do with me and had followed the usual routine, ignoring my claim that I felt perfectly healthy, except for seeing two of everything.  I should say at this point that all of the nurses, aides and orderlies were kind, thoughtful, helpful and often very funny.

They let me roam the halls and eat lunch in the cafeteria with Tim - until the fourth day, when a stern new head nurse I called la commandante sent me back to my bed each time I got up, not wanting me to die on her watch.  When her shift was finished, a cheery crew came on duty, cracking jokes and entirely changing the ambiance.

The surgeon appeared one day with a coterie of interns and students, none of whom looked older than 20 to me (including the surgeon), to explain the procedure.  When he learned where we lived, he enthused about Minervois wine, pulled out his smartphone and bookmarked the names I mentioned of nearby domaines.  He also said that the MRI showed there was the beginning of a slight tear in the wall of the aneurysm.

Late on the fourth day, I was wheeled into the operating room, put to sleep, and a catheter carrying a stent was inserted into my femoral artery, pushed up through the blood vessel system, into the aorta and out again, then up into the carotid artery somewhere behind my right eye, where the stent was expelled into the artery to block blood from flowing into the aneurysm, while the surgeon kept his eye on a fluoroscopy screen in order to propel the catheter in the right direction.  One name for the procedure is endovascular stenting, which avoids the necessity of cutting into the skull to clip, coil or stent the aneurysm.

Another night in ICU, where I woke up to find myself trussed like a turkey, with a snorer going full blast across from me.

Next day, into a double room - hurrah!  Except - my room-mate was the previous night's snorer, who talked, snored and coughed in her sleep.  I called her name, shouted, flicked the lights on and off - no response.  I rang for the nurse, who poked a tranquilizer into my mouth.  Still trussed like a turkey and hooked up to several monitors, I could just reach a roll of paper towels on the side table, tore  off and crumpled them with one hand and, one by one, threw them at her.  Nothing woke her - I gave up and did a crossword puzzle on my iPod.

My second room-mate, Margaret, was wonderful.  Intelligent, discreet, funny and in great pain from acute apendicitis.  There'd been no room for her in the usual ward.  She was taken off for emergency surgery next morning and we've kept in touch since.

My third and final room-mate was in for her second femoral aneurysm, having continued to smoke after the first one.  Smoking is a major factor in the development of aneurysms and I was told that my having smoked half a package a day for about 4 years in my 20s might have played a part in mine.

After 8 days, Tim took me home.  Ratty and Badger had made the trip between Oupia and the hospital several times (close to two hours each way) and were becoming progressively more morose and thoroughly fed up with the boredom of the autoroute and the parking lot.  I was greeted me with lots of licks. 

At home with my MRI file, I learned that I had a "giant" aneurysm, meaning it was 25 mm or more in diameter.; mine was 27 mm and have been told that it would almost certainly have ruptured if the years of cycling hadn't kept my arteries strong and elastic.  I'd had no headaches, no dizziness, no symptoms at all except, luckily, the double vision, caused by the aneurysm being so large that it was pushing the right optic nerve further and further out of line.  So - keep exercising, everyone!

For the next couple of weeks, Tim took care of me, the dogs, the cooking (oh the food - real food!) and everything else.  He was amazing. The dogs cuddled up to me on the sofa and were unusually gentle - no Jack Russell head butts.

Here's my favourite get-well card, from the Centre d'Éducation Canine d'Azille - i.e. the dog school in Azille or, as a couple of us with difficult dogs call it, the Field of Humiliation.  Ratty and Badger have been going to dog school for more than two years and are still in the beginners' class.  Or, more accurately, Tim and I are still in the beginners' class...

Just as I was feeling better and stronger, I woke up one morning with a headache that kept getting worse and began throwing up everything I ate or drank.  Back to emergency in Montpellier, where another MRI showed a clot had formed in the stent.  Three days of injections and drips and home again, though the headache lasted for weeks and weeks.  When it finally stopped in early June, I felt great; lots of energy, back on my bike, rides to Minerve, trips to the Tuesday market in Olonzac, walks with the dogs and back to dog school.  The double vision began to disappear as well, helped by temporary prisms on the right lens of my glasses.

I'm still on a couple of anti-coagulants and bruise and bleed easily.  My GP joked that if I wanted to sue for divorce, now was the time - I look like I've been in a brawl.  I am SO looking forward to stopping the stronger of the two blood thinners in September and not having to worry about falling off my bike...

Here are three of the MRI images from before the surgery:

Side view

Front view - 
dark spot behind right eye

Medical care here is incredibly good and, whatever my complaints about meals and iodine baths, I'm very grateful to all the doctors, nurses, aides and technical people who saved my life.  All the good things you may have heard about the French medical system are true.

St Martial, August 7, 2016 - my biggest cycling accomplishment since March (loads of climbing, fabulous scenery and great downhills, for those of you who haven't done it) and one I'll be showing to the surgeon:

Susan above Minerve, August 12, 2016 (also lots of climbing, but easier than the previous ride):

No more grim postings from now on, I promise, but more about our adventures with Ratty and Badger and our camper and, sometime in September, notes on my "political career".

And, because this is supposed to be about the dogs, here they are, with Tim: