T-61: When You Ain’t Got Health, You Ain’t Got Nothin’

There is an old saying, "for want of a nail, the kingdom was lost."  It speaks to the way small errors can cascade until real danger or loss can occur. 

The debacle that began yesterday continued through a real comedy of errors that ended with a life threatening situation for me.

At the dentist, I was asked if I wanted Vicodin as a painkiller.  I turned it down, saying I didn't do well on codeine, that ibuprofen would be fine.  Fine, no codeine, they agreed.

 
I went to another office where they extracted my molar, and gave me a prescription.  I crammed the prescription in my purse without looking at it, anxious to get home before the big storm hit.  That was a lost cause.  I drove home through sheets of rain in heavy traffic.

 Once home, I pleaded with Wes to go the pharmacy and get my prescription filled.  At the drugstore, the pharmacist made him sign a release, and warned him that the prescription was a narcotic.

At home, the Novocain was wearing off, and the pain kicking in.  I took two pills and went to bed.  Because the dentist had warned me to not let the pain get started, I wake up every hour or so and take an ibuprofen...or so I think.

About 4:30, I wake up to itching all over my body.  I take another pill, but have the presence of mind to look at the label. Acetaminophen.  That's odd, I think.

Around 6:00 wake up again to sound of Wes leaving.  I laid there, waiting for my alarm to ring at 6:05.  I felt weird and itchy all over.  My alarm rang and I sat up.  The room whirled, went gray.  The next thing I know is it is 6:30 and the alarm is still going off.  This time I make it out of the bed, and can barely walk.  My equilibrium is shot; I am immediately nauseous, and there are distortions in my vision.  I collapse back in the bed.

 The next sound I hear is the phone ringing in the next room.  I get out of bed and again feel distortions in my balance and vision.  It is Wes, checking up on me before school begins at 7:15.  Hearing my voice, he asks, “Are you all right?”  I tell him I don’t feel well.  Later, he tells me my answers didn’t make sense and my voice sounded clotted and heavy.

 I have to hold on to the wall and stair rail to make it to the restroom.  It is a race to urinate before I vomit.   Instead of feeling better after emptying my empty stomach, I feel worse and the visual distortions are beginning to resemble hallucinations as the room’s dimensions begin to wander.

 I make my way back to my bed and collapse again.  I have the vague thought that something is really wrong.  The next moment of consciousness is an hour later.  I cannot sit up without getting dizzy, so I look at my phone to see if something about acetaminophen[SN1]  that could be making me so sick.

I read about acetaminophen overdose: nausea, upper stomach pain, itching…check, check, check.  I find out it is the most common source of poisoning today.  The maximum to be taken is 325 mg every 4 hours.  Thinking it was ibuprofen, I have taken way too much.

I try to get up to feed my whining cats.  This time I make it to the basement, but I am quite ill.  I vomit in the sink and begin to really worry about what is happening to me. 

I get the number for poison control and call.  A kind woman named Danielle takes me through a series of questions.  When I tell her about my visual distortions and passing out, she says, “Read me what is on that pill bottle” 

 I tell her acetaminophen and she asks, “Does it say anything else?”  I peer at the label, and pull the “Do not drink alcoholic beverages when taking this medicine” label away from name label.  “It also says Cod #3”

 "Codeine!  How much have you taken?  What size are the pills?”  There is a real note of urgency in her voice.  She helps me find that each pill is 325mg.  “How many have you taken?”  I don’t know.  “How many are left in the bottle.”  I count the pills which seem to be wandering in my hand. 

There are 13 left.  I have taken 7 in the past 10 hours.  The normal dose is 2.  She quickly figures that I have taken a dose of 2.275 grams.  A toxic dose is 4 grams.  She asks about my side effects, and especially about the all-body itching. 

She makes sure there are no respiratory effects and that my heart rate is neither too fast nor too slow.  It appears I am having an allergic reaction, as well as taken too many pills.   She tells me to call my dentist, get some salty food in my stomach, and keep my head below my feet as much as possible.  

I do all that, losing the contents of my stomach several more times.  I conk in and out at least two more times, with each awake period becoming a little more cogent, a little more mobile.   I listen, with dread fascination, to the horrifying and surreal news coming out of Boston.  Who would have dreamed of any of that just a week ago?

By 3 in the afternoon, I am well enough to do some work, and get a proposal to a donor completed and sent.  When Wes comes home, and hears the story of my bad day, we are able to untangle the chain of errors. 

 Error #1: I tell my regular dentist no codeine, but she does not convey that information to the doctor who does the extraction.

Error # 2:  The extraction doctor gives me a prescription for pain without discussing it with me.

Error #3:  I take the prescription without reading it or discussing with the doctor.

Error #4:  I send Wes to get the prescription that I still haven’t read.

Error #5:  The pharmacist tells Wes that this is a narcotic, but Wes doesn’t tell me.

Error #6:  The pharmacist partially covers the name of the drug with a warning label.

Error #7:   I just take the pills without reading their documentation.

Error #8:   I compound the damage by 1 pill every 90 minutes or so.

Error #9:   When I woke to full body itch, I should have realized it was an allergic reaction, and not taken another pill.

 

Who knows what would have happened if I had taken another pill?  It was bad enough and scary enough as it was.  Thank goodness, someone-- and woman named Danielle-- was watching over me today.  

 

Lessons for the day:

1.        Never, ever take acetaminophen and codeine again.

2.       Always, always read and understand your prescriptions.

3.       Life is fragile and can slip away in a moment.

4.       American Association of Poison Control Centers (www.aapcc.org or1-800-222-1222) offer a wonderful service.

5.       When you ain’t got health, you ain’t got nothin’.

.
j

---

 [SN1]

T-76: Getting Ready--Body Version

When we tell people we are going on a cross country bicycle trip, they have two responses.  The majority shake their heads ruefully and allow that we must be soft in the heads to do such a ridiculous thing.  A certain number bounce with enthusiasm and wish they could join us as we head out.  Though their responses are quite different, they share a common question, “How are you training?”  In the case of Wes, the answer is, “I take an occasional walk with the dog.”

In my case, the story is quite different.  Not only have I returned to the gym and started working with a personal trainer---more on that in a moment—I also thought I should get a physical for the first time in years and years. Thus begins a journey that has not yet ended.

I go to my long time physician and friend.  I am prepared for the worst, I think.  Multiple tests—blood, urine, height, weight.   “Weight shockingly high….let’s check one more thing.  One of my staff will be in shortly to give you an electrocardiogram.  It will be good for a baseline as you have never had one.”

Ok.  The assistant, who seems remarkably surly, comes in and rather roughly attaches contacts to various points on my chest and ribs.  She connects a whole handful of wires to me.  Turns on the machine.  Pulls off the leads.  Leaves without a word.  I gingerly pry the contacts from my body.  And wait.  And wait some more.  In desperation, I grab an out of date Readers Digest, and discover that a friend and an acquaintance are the cover story. 

My doctor comes back and tells me to sit down.  It is clear she is shaken.  She shows me the EKG and points out that it shows a major problem on one of the sectors.  I need to see a heart doctor…pronto. 

Well, what the hell.  I knew my life was stressful; I knew I was heavier than I have ever been, but I had been exercising hard at the gym with no problem.  But what do I know? 

My fifth line was going up instead of down

It will take two weeks to get an appointment.  Don’t worry, we’ll figure out what’s going on.  Ok.  I won’t worry, my mouth says, but my brain has already started spinning desperate scenarios at warp speed. 

The spinning notches up a few days later, when my doctor calls me with the news that though my blood pressure is great, and my heart rate is low, my cholesterol level is dangerously high.  So now I am convinced that I am going to have a heart attack at any moment.  I tell myself that my grandfather died of a heart attack in March (it’s March now! I worry) when he was younger than me.

I try to beat back the dread, but I fail at it miserably.

I have several visits to the cardiologist, who, of course, is miles and miles away from my office.  I have to miss a bunch of work, which only adds to my stress and anxiety.   More blood tests, a carotid artery sonogram, a stress test, another EKG.  The doctor calls me in.  I can feel my anxiety tighten a fist around me.

“We can find nothing wrong with your heart.  The previous test must have been done wrong.   You need to keep exercising and get your cholesterol down.  Oh, by the way, there is a nodule on your thyroid that needs to be checked. We’ll see you when you get back from your bike ride.” I guess I am relieved, but now I have to take a bunch of tests on my thyroid. I read about goiters and worry about cancer.  This is ridiculous.

I will keep working out and trying hard to increase my fitness level.  I am making good progress, contacting muscles, like those cut during my abdominal surgery,  that have been out of communication for years. I find I like the free weights.  I sweat to achieve minimal results like walking 2 miles or biking 5 miles in 30 minutes.  I need a Masters in body knowledge and maintenance, but I am struggling for basic skills.   It is what it is.

I know I will get in better shape on the bike, but I sure do wish I wasn’t starting at such a deficit.  But like my trainer says.  It’s not where you start, it how long you keep going, that matters.  Well, I can see a long and winding road ahead of me.