Arrival

The moment the EMS guys wheeled me into the Transplant Center, I could see that I had been transferred to a state-of-the-art teaching hospital. Everybody wore an identifying uniform – you could tell a nurse from a tech from an admissions person by the clothes they wore. It was like going from Motel 6 to the Ritz-Carlton. I gulped at the thought of my insurance shelling out for this place, with everyone with whom I had contact asking me about my well-being. I was put into a private room in ICU that was spanking clean with a parade of folks hooking me up to telemetry, bathing me, and most importantly, getting me out of the all-over pain inflicted upon me from the demon ambulance. As soon as they inserted the line-in catheter into my arm, they flooded it with painkiller. It would be that way during my entire stay. Keeping me out of pain was high priority. I’d had to scream for pain medicine at the L-TACH. They were always late bringing it, sometimes by an hour or more. Now, someone was always coming in to check on my pain level. They’d ask if I was hungry, thirsty, or merely uncomfortable. They’d stand there and adjust my bed until I was content with my position. They’d called my wife. She’d be there tomorrow, staying in the Transplant House, a sort of hotel for folks with loved ones awaiting transplant. These people were all taking care of each other, and my wife found a support team among them. The doctors were always explaining things to her. For the first time, there were more doctors in my room than nurses and techs combined. They checked my vitals every fifteen minutes. The wait was on to get me to the top of the transplant list. I only needed to get sick enough. My MELD score was rising as I lay there.

The first bad news: I was much more sick than they had expected – so sick that my kidneys were failing. I was put on dialysis every other day. I had but one test remaining to see if I met criteria for surgery: the cardiac stress test. I told them I couldn’t walk anymore. How would I be able to run on a treadmill. Surprise: they didn’t use a treadmill for patients like me. The cardiac team had chosen to wait until the weekend was over to run the test. My hepatologist intervened. She wagged her finger at the cardiologist and said, “This man is going to die if we don’t get him transplanted right away.” Fortunately, I didn’t hear about this until a year later. As it turned out, the stress test was pharmaceutically induced. I was so happy my wife had come in for the test. They began shooting me with a drug that raised my heart rate. It felt like an overdose of methamphetamine must feel. I was shaking all over so much, my teeth chattered. I couldn’t take it. I begged the doctor to stop. He kept saying, “It’s almost over.” I kept saying, “You’re lying to me.” It was true. He was lying.

They put me into a cycle called, stacking. I was on and off the transplant list hour by hour. When my blood pressure dropped they took me off the list and gave me medicine. When my hemoglobin dropped they took me off the list and gave me blood. I cycled on and off the list for days. I became so toxic from ammonia poisoning that they put me on a drug called Lactulose – a nuclear laxative to get the ammonia out of my system. It stimulated my bowel functions to the point that diapers and bedpans weren’t enough. I needed two tubes to get waste products out of me. One of them was the deadly Foley catheter. After having this thing inserted into my urethra, I now have it written in my advance directive that no urinary catheter can be inserted unless I am sedated with versed and Fentanyl, or completely unconscious from illness, accident, or knocked out with propofal. This thing hurts like – well, a male person would have to experience it to know that kind of stabbing pain. It’s the most horrible thing ever. Then there was the tube that carried semi-solid waste out of me. Even though they fed me this laxative, I still began to hallucinate, or it could have been lucid dreaming. I couldn’t tell the difference. I was unable to talk above a raspy whisper, so they gave me an alphabet page that allowed me to spell out one letter at a time. I’d forget where I was and would have to start over again. Finally, I was able to tell my wife I needed three things that didn’t exist: A heat generator, an Active-X driven voice repair module that had been used on people with paralyzed vocal chords caused by screaming at the Super Bowl, and an Ng bypass tube, which was simply a tube that looped from one nostril to the other to help breathing. None of these things existed, but I was sure they did. I kept pointing to the list Wifey had made for me. She was confused because the doctors were telling her completely different stuff than what I was requesting. Even with my mentals gone, it didn’t matter. I had made it to the Transplant Center, and I was being listed for transplant.

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Visit Part I, Part II, and Part III of Barry’s Ambulance series.

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