Friday, February 23, 2018

Halifax Hospital

Late afternoon on Saturday, February 10th I arrived at Halifax Health on the cargo bed of a red beach ambulance with a black eye dressed in my sandy bicycle togs and plastic blue Crocs. My bicycle was nowhere to be seen. Halifax Health is a longstanding (1928) hospital in Daytona Beach located within sight of the world famous International Speedway.  Coincidentally the hospital has recently opened its prestigious France Tower named after the France family which founded NASCAR and owns the Interntional Speedway Corp. My arrival at the hospital was the result of a Traumatic Pneumothorax, basically the collapse of my lung caused by an injury that tore my lung and allowed air to enter the pleural space (the area between the lung and chest). Though this injury can be caused by motor vehicle accidents, gunshot or knife wounds, it is just as normal to arise from bicycle accidents. I also broke my ribs.

Everything I can now recall about the incident is that the lung damage, head concussions and broken ribs arose from a fall on my bicycle when I was somewhere along the beach near Ponce Inlet. As far as I can recollect there was no one else involved. Indeed the beach was virtually empty at the time. My last few photographs taken on my iPhone prior to my accident are proof of the desertion of the beach. Reportedly I was completely passed out for about 30 minutes (and I have suffered some lingering minor cognitive effect as a result - primarily literary challenges like spelling).

Someone had obviously seen me fall and called the beach ambulance (whose operators had more than a little trouble convincing me anything was wrong).  I then remember being stretched on the bed of the truck surrounded by two paramedics winding my way with a siren through the sunset streets of Daytona Beach to the hospital where I would end spending the next 13 days until February 23rd when at last I was considered well enough to return to the condo. Throughout that two-week period in hospital I spent almost all of it reclining in a chair and the rest of it propped on my back in bed. It mattered also that my immobility was the result of being chained to intravenous (IV) therapy to decontaminate my lung; and to provide connection for regular blood pressure readings.  Initially it was hoped that the decontamination of the lung would pass naturally; and accordingly the tube into my lung was withdrawn after several days.  But after tracking the healthfulness of the lung it was decided that a specific surgery to clean the contaminates was required.  This surgery took place Monday or Tuesday, February 19th or 20th. Though I have trouble recalling the exact date of the surgery I know for a fact that I hadn't eaten or drunk anything for 24 hours prior.  When I awoke the following morning after the surgery I ate everything on my plate.  But my repair was not then complete.  A new tube was inserted into my lung to drain whatever remained of the contaminates.  Actually there were two tubes.  These tubes remained until the morning of February 23rd when - like metal straws - they were thankfully removed with the same urgency that one removes a bandaid.

Initially being back home made me question the utility of what I had endured for the past two weeks in hospital. My time in hospital (whether during the day or the middle of the night) was marked by repetitive blood tests and measurements of vital signs (blood pressure, body temperature, pulse rate, respiration rate, height and body weight).  But I discovered not long after my return home that the collapsed condition of my lung was far from over.  Within hours of my first night's sleep I found my capacity to breathe seriously at risk.  No matter how strenuously I sought to fill my lungs with air I seemed unable to do so.  It was only when I lay in a reclining chair for some time that I was able to restore the normal sensation of breathing.  I have since used the Voldyne pump to practice the recovery of my lung's strength.  Even though it is a prescribed medication I have stopped taking Percocet, an opioid pain reliever which I know from previous surgery is a dangerous constipation. Meanwhile I appear to be responding to the laxatives given me at hospital.

This brings me to an account of the people at the hospital.  There is no doubt of the hierarchy of staff, beginning with the doctors of various arcane specialties, followed by Registered Nurses (RN), Certified Nursing Assistants (CNA) and cleaning staff. As might be expected the doctors primarily addressed the interpretation of need while the nurses primarily fulfilled the maintenance of need. Without exception the staff appeared to be dedicated to the well-being of their patients.  Some of the cleaning staff were superbly generous, almost motherly in their attention.  The nurses, even when bordering on dictatorial, were inevitably committed to doing what was right. The CNAs accompanied me on occasional walks about the corridors. The nurses who had the expertise of acute care were remarkably skilled.

While I can't say that I regretted my discharge from the hospital, I certainly recalled my stay there favourably. As I begin to discover the complications of my illness here at home I appreciate more what I endured among the professionals.  For the time being the appearance of the beach and crashing ocean waves is distant.

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This story doesn't stop here.  On the morning of February 24th (the day after my discharge from hospital) I began a series of convulsions, perhaps as many as 6 to 12.  Though I did not know it at the time I have since learned from the cardiac unit of the hospital that I was experiencing 3rd degree heart block (which naturally explains the reason for my initial fall off the bicycle).  By noon that day I was back in an ambulance en route to the ICU of the hospital whence I had departed less than 24 hours previously.  The decision was made that I required a Pacemaker.  Though this sounds simple enough the real problem became that the Canadian health insurer insisted that I fly back to Canada for the procedure.  My Florida physicians refused to allow me to fly because of fear that my lung would collapse or that I would suffer another heart block - and in neither case would there be sufficient resources to keep me from death.  This battle between the insurer and the physicians continued for days.  It was only at last on March 1, 2018 that I had the procedure of installation of the Pacemaker performed at the Halifax Health.  By this time we had begun procedures to pay for the service ourselves if necessary. We have since been informed by the insurer that the cost of the initial medical care (not including the physicians and lung surgery nor the subsequent Pacemaker and surgery) was $289,000.

Today March 2nd I returned to the condo. There is of course still much to adjust to but I insist on looking at the bright side of the misfortune.   Initially we had thought that our sojourn on Daytona Beach Shores was at an end but now we shall remain here as hoped until early April next.  While it won't be ideal we are nonetheless rejoicing at our luck in being able to do what we had planned (which includes a jaunt to Longboat Key prior to our final departure to Canada). Being this close to death obviously has its influence.  We prefer to dwell upon the happiness of the result.

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