Tuesday, August 30, 2011

Unattractive Leisure Pursuits: The Bronchoscopy

I had a distinctly unpleasant day yesterday.

A couple of weeks ago, I got a good dose of bronchitis. The same cough went through every kid in this neighbourhood, but I'm the only one that got raging bronchitis. Personally, I think it's because of my pathetic cough-ability. Somewhere in the last few years, I lost the ability to cough deeply, and bring out all that wet, nasty shite that goes with minor respiratory tract disorders. As a result, my goddam lungs are probably better at incubating vile bacteria then they should be.

The doc who saw me for the bronchitis said he'd set me up with a referral to a respiratory physician. Well and good. And about a week ago, I got a note from the Launceston General Hospital telling me I was on their waiting list. They also said they'd notify me when my name came up.

Well, fine. The waiting list is apparently several months long. I could try going privately - but it's not really urgent. No big deal. I'll wait.

Except that on Monday, while I was at the supermarket, I got a call from a hospital clerk who wanted to discuss my 0800 appointment for Tuesday. For a bronchoscopy.

Fuckin' what?

Apparently a gap opened in their list, and they forgot to tell me. I got slotted in because other than the cough problem, I'm in good order. The lung doc figured I'd probably need a bronchoscopy, and he knew he could safely slide me into the gap because I'm not in my seventies, and on five different kinds of medications.

The clerk was surprised I hadn't been informed. Not as surprised as me, I told her. Fortunately, I'm not stupid: I actually asked about pre-procedural prep ("Don't eat after midnight." "Why? Will I turn into a gremlin?")

I also asked about driving. And there began the problems.

With the total lack of warning, there was no way Natalie could go in with me. And what with the sedation, I wasn't supposed to drive for twelve hours afterwards. Hmmm.

Well, okay. I figured I could just stay in Launceston, shoot on out to Bruce's place in the evening, catch a movie with him as usual, and then drive home roundabout midnight, as I often do of a Tuesday. There. Plan made.

I got out of bed obnoxiously early and drove into Launceston like a chiropteran making a rapid exit from Sheol. That ensured I found a parking place near the hospital - one that would actually let my car sit for near-enough twelve hours. Yay!

They signed me in pretty quickly. And then they gave me the dreaded backless gown. These days, you also get nifty paper underpants and booties. Add to that a nice little lap blankie to keep the breeze away from your 'nads (those paper underpants are about as useful as... paper underpants, really) and you're all set for a forty-minute wait in the TV room of lung-victim hell.

Happily, it was a slow day at the hospital. There were only two people before me, and neither of them seemed particularly tuberculoid. We nodded and smiled and carefully avoided looking at each other's paper underpants, and eventually, I got called into The Room. With The Chair.

The nurse was nice, but she made a hash of sticking a drip in my hand. Natalie told me later that it's probably because of my more-than-usually tough skin. The nurse did ask about that - wanted to know if I did a lot of outdoors work. I do work outdoors, but no more so than any gardening type... it's just my skin. Anyway, she missed the vein in the left hand, switched to the right, and caused a truly remarkable amount of pain by missing the vein there too, whereupon she just gave up.

Fuck it hurts when they miss the vein.

I lay there on the chair, waiting. I had the blood pressure cuff round my left arm, the pulse monitor on the index finger of my right hand. Lacking anything more interesting to do (I did smuggle in a book, but it was kind of hard to read with all that crap hanging off me) I played around with biofeedback. I discovered that simply by concentrating hard, I could move my heartrate down to sixty-five (it generally hung at about seventy-five, which is higher than I like, but I haven't been able to exercise well lately) and up as high as ninety or so. I also discovered that my blood pressure is about 123/77, which is pretty reasonable for a forty-five-year-old man coming out of a bout of bronchitis. It's even better when you recognise that hospital stress tends to raise everybody's blood pressure. (Natalie's jumped twenty points when she had it done in a hospital. Which is weird, since she works in the things.)

So all up, aside from this stupid cough, I'm doing okay.

The nurse finally noticed my fluctuating heart-rate. She stared. Asked me what I was doing. I said "Biofeedback. It's fun."

She stared some more. Then switched the machine off. Well, okay.

The doc arrived. He was good value. They stuck a needle into the crook of my arm, and then put a mask on my face. I had to inhale nebulised lignocaine for a while, to numb the airways. Apparently, jamming a camera up one's nose, then all the way down to the lungs can be traumatic. Who knew?

Finally, they got around to loading me up with a mix of Fentanyl and Midazolam.... yippee. Happily, whoever mixed the dose had a light hand. According to the doc, most people come out of it without realising anything has happened. I, on the other hand, recall... well, a little more than I want, really. The bit where the tube wouldn't go up my left nostril, so they tried my right, then went back to the left -- there's a thing I could do without. But on the other hand, the bit where the doc tilted the vidscreen and said: "There's your vocal chords. Say 'hello'..." was very cool. Especially because I did indeed say 'hello', and my vocal chords moved in the most amazing way. Keen!

Anyway, they had a good old probe around down there. I don't recall that they found anything too exotic, and they wound up splashing in a bit of saline so they could get some sputum samples, which provoked a certain amount of coughing. And at this point, I'd like to report that it's fucking difficult and painful to cough with a camera in your goddam lung...

... then they wheeled me to the recovery ward. I got a little oxygen while we waited for the various drugs to clear, and then they shifted me and my bed to a second ward. Shortly thereafter, they brought me my clothes and my bag, and shifted me to yet another ward - this one all about chair. (I abandoned my paper underpants with alacrity, and returned to the comforting cotton of my regular Rios.)

And the waiting began.

Apparently, I shouldn't have told them I planned to (eventually) drive home. I had been quite clear with them that I wasn't driving for twelve hours. But they didn't like the sound of that, and so instead of letting me go by 1330, as they'd intimated, they 'asked' me to stay 'a while longer'.

By 1500, I was over the whole funking experience. Sitting around in a hospital is dull. I'd read a lot. I'd even composed about a thousand words of fresh fiction on the Netbook 'puter I brought. But I was bored, and I was feeling rocky from the afterFX, and I wanted to GTFO.

So I called up a nurse, and very politely explained that she needed to remove the needle still hanging out of my arm, or I was going to do it for myself. We had a short, friendly conversation, and then they brought me some self-discharge forms. And I left.

I can understand that the hospital needs to cover itself, sure. But enough is enough.

I did have a bit of aftermath. For some reason, I started running a low fever at about five o'clock. But by eight o'clock, I was in Bruce's kitchen, cooking asparagus and mushroom crepes with cheese sauce for him and Tiarne, and by eight-thirty, the fever was broken, and gone. We watched a French crime/thriller thing which was, by and large, not too bad, and I hopped in the car and went home almost exactly twelve hours after the bronchoscopy was complete. The drive home was very normal indeed.

Kudos to the doc: he had a good sense of humour, and he really did handle the machinery - the hospital's and mine - well. I have no soreness at all today, and though the cough did flare up, he warned me of that, and it really hasn't been a big deal. The nurses were nice, the hospital was organised... but no matter how you paint it, the whole thing was still a tube up the nose and down the chest, followed by several hours of post-drug hangover and waiting.

Ah well. We shall see what the results show, eh ?


  1. "my more-than-usually tough skin"

    thats one way of describing it

  2. Hey Mate, next time you get a bad case of phlegm in the lungs, find a decent acupuncturist and try cupping. They loosen all that crap out and for the next week you'll spit out a huge amount of the stuff, but it really quickens the recovery time.