You can’t leave, you have Pneumonia!

That is what they told me at the hospital… You can’t leave, you have pneumonia. What kind of travel adventure is that? Well, I can tell you it isn’t a typical travel story. But since we travel full-time, we take the good adventures with the bad ones, and if there is a story, and assuming it isn’t too embarrassing, then I will tell it. If for no other reason, than to keep the blog on the up-an-up. Maybe a story about some adversity will balance some of the stories about how everything is great.

Not about Alaska

When I left off with the Alaska series, we were departing Skagway and heading back to the ALCAN highway. We lived it last September and I haven’t yet told all the Alaska stories. Next, I write about our trip down the wildest part of British Columbia. If you missed the story about Stewart and the Klondike Gold Rush, here is a link. Skagway and the Klondike Gold Rush

Pneumonia

The story about being admitted to the hospital for pneumonia starts with a headache and overall the experience was a headache. I had bacterial pneumonia which means that I picked up the Streptococcus pneumonia bacteria somewhere along the way. Typically it is because someone I encountered left a cloud of airborne bacteria after coughing. If you see someone coughing go the other way.

Perhaps I have harbored the bacteria for a long time. I don’t actually know if I had the Streptococcus pneumonia bacteria, sometimes pneumonia is caused by the Mycoplasma pneumonia bacteria. What I know is that the pneumonia is responding to the antibiotics and this indicates that the pneumonia is bacterial rather than based on a virus.

What is Pneumonia?

Pneumonia is an irritation inside the lungs caused by a bacteria or virus. The inside of your lungs, the place where the oxygen enters your bloodstream, quits working properly. Usually, this causes shortness of breath, coughing, fever, and other pain. I had a headache and a fever.

Not just a headache

I had a headache when I went to bed on Wednesday night (January 3rd). I am typically tired enough that I could go to sleep at nearly any time. Wanting to go to bed early isn’t atypical. Having a headache is common. Most of my headaches are sinus-based. This headache seemed to fit the general characteristics of a sinus headache. Coffee, Tylenol, and a nap are my usual medicines of choice.

In this case, the headache was painful enough and close enough to bedtime to call for an early bedtime. When I go to bed this early it usually means I am done sleeping at about four in the morning. I don’t like getting up that early, but sacrifices need to be made. I like going to bed early and don’t mind getting up early.

A fever

Did I have a fever on Wednesday? I don’t know. You have to measure such things and I didn’t measure on Wednesday or Thursday. I likely had a fever on Thursday. Since Tami insisted that I needed to take my temperature on Friday and Saturday, we know for sure that I had a fever on Saturday. Since I was sleeping sometimes hot and sometimes cold, I assumed that I had a fever well before Saturday.

Departure from reality

Since I had at least an occasional fever, I may be telling a story that may not match reality. A fever has ways to confuse you and Tami said that she was quite interested in my version of what happened over the next few days. Anyway, it should be interesting. Maybe she will correct all my mistakes by adding a paragraph at the end of the story.

Coffee isn’t negotiable

On Thursday morning, I still had a headache. (Sometimes I have a headache from the lack of coffee.) It didn’t seem likely to be a lack of coffee because I only drink coffee in the morning (without exception) and Wednesday’s coffee consumption was average.

So, on Thursday I still had my morning coffee, some more Tylenol, and went back to bed. The only reason I got out of bed for the next two days was to drink plenty of liquids (including coffee), take more Tylenol, and go to the bathroom. I didn’t miss having coffee each day. Some things are not negotiable; coffee is mandatory. If someday there is a global coffee shortage I am in big trouble.

Not COVID

Over three days, I thought that perhaps I merely had a slight flu although I didn’t have the typical stomach distress. It wasn’t until Friday that Tami decided that I needed a COVID test. Two negative COVID tests pretty much eliminated COVID as a cause. Besides I didn’t have any problem breathing. I had always assumed that if I had COVID (or pneumonia) I would have problems breathing. Not so, I never had any problem breathing.

Not a stoke

Besides a headache, a stroke usually produces other symptoms like numbness and confusion. I only had a headache so it seemed that a stroke wasn’t the cause. Perhaps however I was confused. How would you know if you were confused? Can you be confused about being confused? Perhaps I am confused all the time with only a few lucid moments. Can you self-diagnose confusion? I wonder.

Saturday at the ER

I still had a pretty bad headache on Saturday afternoon and Tami told me to pick my emergency room. I get nearly all my medical care from the Veterans Administration, so the San Diego VA Medical Center (hospital) seemed to be the right place. Perhaps I could have been seen at the Balboa Naval Hospital, but I chose the VA to avoid the crowds. If nothing else, I avoided lots of paperwork by going to the VA.

Saturday, in the military, is a day to play sports. During (sometimes only after) these sporting contests include beer and maybe even some food. I figured that the Balboa Naval Hospital ER wouldn’t have a bunch of busted-up sailors seeking post-rugby medical care.

I don’t know how busy Balboa was, but at the VA emergency room care started the moment I walked in the door. Not having lots of emergency room experience, I would have assumed that this was the standard. Every other visit to an emergency room was chaos, not this time.

The first step in my medical care was that they wanted me to lie down. That sounded great to me. My trip to the VA was the longest time that I was awake for three days. A nap would have been very nice.

Gurney rides

I seemed to get a gurney right away. As predicted the emergency room wasn’t crowded. It was the least occupied emergency room I have ever encountered. Perhaps I don’t remember correctly but I think I was the only customer. One thing that shocked me about the emergency room was that, unlike TV shows, this emergency room was calm. Perhaps being the only customer had something to do with it, or maybe I departed reality and didn’t know it. (Tami-he was not the only customer!)

The real reason they wanted me to lie down

As soon as I lay down it was then that the nurses decided what they needed to do was stick me with a needle and give me an I.V. The gurney was a trap. They put me on the gurney just so they could practice on a pincushion. Shoot if one I.V. was good, wouldn’t two be better? So I got an I.V. in each arm and they weren’t just any old single tube I.V. Each I.V. had two ports.

My incorrect assumption was that they could deliver with one and remove blood with the other. I only learned later that every time they took blood they wanted to drill a new hole hoping for a gusher.

We want you to stay

The biggest surprise was when they told me they didn’t know what was wrong and that I would be staying in the hospital. (Tami-they retested for COVID and tested for flu and RSV; all were negative) They were admitting me. I have never been admitted to the hospital before. I assumed that I would be leaving within an hour or two after my arrival with some stronger pain reliever. I was very surprised that they wanted me to stay. I always assumed that if you walked into an ER then you would be walking out. I never thought that you would stay in a hospital for a headache.

I was happy to have my gurney. Even though it was an uncomfortable device, it was better than a wheelchair or walking. It seemed like I was on the gurney as soon as I walked in the door. I thought that they gave me a gurney to allow me to rest. Instead, they let me take a nap only for a minute or two before waking me. It was almost as if to make sure that I wasn’t going to get any effective rest. Usually, they only wanted to talk. They seemed to have a list of questions and were comparing the answers to the previous time they asked the questions. Sometimes the questions seemed tricky.

Did I have a COVID booster? (yes). Did I have a flu vaccine? (yes). Did I have a pneumonia vaccine? (yes). I found out later that the pneumonia vaccine only works against viral pneumonia and therefore had no effect on my case. Still, protection from viral pneumonia was a good thing.

Before going up to the hospital room it seemed like Tami (she was doing a great job answering the questions) had to run through the same list of questions at least three times. Did they lose the first set of answers? Strange

I was on board with staying at the hospital, especially after they mentioned that they might want to take out some spinal fluid to check for meningitis. You don’t want pneumonia, but you really don’t want meningitis.

Time warp

It was still early when the ER staff told me that they wanted me to stay in the hospital and that I would get a visit from the admissions doctor. I was trying to optimize the nap time even though the gurney was killing me. The admissions doctor showed up well before I got a hospital room, I thought it took a couple of hours. I found out later that I didn’t go to the ward until after four am. I would have sworn that I was in a normal (hospital) bed before midnight. Somehow my brain compressed twelve hours into four hours. Very strange.

I also remember that the admissions doctor was very nice. I think that at one time I may have opened one eye to see her. I remember that Tami got the thirty-question list again. Or maybe it didn’t happen; I am not sure. I am sure that the admissions doctor was there, but did Tami get the thirty questions again? I think so. One of the surprising questions was about an advanced directive. Did I want them to resuscitate if my heart stopped? (yes) It sure would have sucked to die from a headache.

The brick

The brick is a little computer that can collect several sensors and then transmit the information to the charge nurse station. For me, it was used during my first EKG and after that, it was hooked to a pulse oximeter. The intention was that I would be able to carry the brick everywhere I went (where was I going to go?) and that it would report back to the charge nurse if I was in trouble. A couple of times the brick ran out of power requiring a battery change. At other times it sent in false reports to the charge nurse. Nurses would quickly check on me when the brick made a false report.

I am sure the brick was designed to make my care better. I hated it. Once I got verbal discharge approval from the doctor, I took the pulse oximeter off my finger and gave the brick back to my nurse. No way was I going to let the brick get in the way of my discharge. Carrying the brick around and trying to sleep with the brick was one of the most painful things about my stay. I was glad to get rid of it.

X-rays, CAT scans, and an MRI

I had both an x-ray and CAT scan before I made it to a real bed. They took me to the CAT scan, which was located somewhere in the basement and only could be accessed from the outside of the building. As for the X-ray, they brought the X-ray machine to me. That was a surprise.

The first emphasis of the CAT scan was my head. That was a surprise. I later learned that they weren’t just looking for evidence of a brain, but were worried about a stroke. The CAT scan would have detected bleeding or a blood clot in my brain. When they got to the chest, they wanted me to breathe out and hold my breath on empty lungs. That was a challenge.

The next day they did the MRI. I’m not sure how I got there but I remember a pretty fancy wheelchair. At the MRI they were worried about a pacemaker and other metal in my body. The only metal I had was the remaining I.V. needle.

My right arm I.V. needle fell out hours before because it was not well taped. My left arm’s I.V. needle fell out during the MRI. They were trying to put some dye in my blood as they tried to put it in it spilled all over my arm. They were surprised when I told them that it failed and said that it was merely the sensation of being wet. I told them no, all the liquid was on the outside of my arm. It was wet; not just a sensation.

No veins

While at the MRI, they tried to re-establish the I.V.; after all the I.V. worked only minutes before my trip through the machine. They didn’t seem worried about the metal in the I.V. before the MRI but I guess that they felt it necessary to fix it before sending me back to the ward. They failed. I left with the MRI only halfway done and the useless I.V. needle hanging from my arm.

Back at the ward, they were unable to get the I.V. into a vein and at one time even remarked “Where are your veins?” I told them that they were buried under the fat layer. By this time I had been poked so many times it was getting very old.

Making jokes seemed better than passing out during the drilling. Eventually, they gave up and suggested that they would have to use an ultrasound machine to guide the needle into the vein. The ultrasound pin cushion nurse never showed up and eventually, they found someone that could hit a vein. This time they taped it down so that it wasn’t going to move.

Finally a real bed

I knew I didn’t get a private room, or even a semi-private room but the first night I couldn’t have told you whether the room had six or eight patients (really it was four patients). As an evaluation, the room was crowded and tattered. The staff however was superb. I didn’t meet anyone who I thought wasn’t supplying me with the very best care.

The food improved during my stay

The first meal was horrible. I had never seen a yellow hockey puck before, but eggs on Sunday morning were unedible, unforgettable, and unforgivable. Monday morning’s breakfast was much better. The food improved until I got my walking card.

By Monday morning, I was plenty ready to leave but the doctors (who were pretty rare on the weekend) wanted another day to evaluate whether or not the treatment was working. I didn’t have most of the typical pneumonia symptoms and they were worried about my lack of cough. Mostly they were going on the chest X-ray and the tiny sounds they heard when listening on their stethoscopes. Were the antibiotics working? They only had the X-rays to conclude that they were working. I had no idea what they learned from the multiple blood tests. Overall I got jabbed at least fifteen times.

Was I getting better or just anxious to leave? My desire to depart was not hidden. On Tuesday I offered to spell the word discharge for the doctors and they let me go.

Addendum

Addendum by Tami: This was our first real health emergency since being full-time RVers. Luckily, everything seemed to be working in our favor: we were in our home territory of San Diego, we were in a military RV park that allowed us to extend our stay, and Scott’s medical records and primary care physician were all within the San Diego VA system, and we had friends nearby that would help if necessary. It was also a wake-up call that we need to work on some things in case of emergency.

I would like to thank the VA staff for their care of Scott. Everyone we dealt with at the San Diego VA Hospital was kind and professional. They deal with a lot there and probably deserve more than they receive.

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