Training Log Archive: Swampfox

Skied, conditions improved again with some new snow overnight, and trails with even better coverage. Still uneven where the underlying ground has bigger dips and bumps, but quite good considering! Aimed to keep the intensity very easy in light of just being sick, and I could feel my arms some from yesterday. Still, out for 2+ hours again, and I tacked on a half hour of snow trails running at the end, which took me to, and into, darkness. Parking lot was pretty full again when I showed up.

Air was amazingly still.

First ski of the season, and December 1st, so timely! Skied 2+ hours with Tyler. Conditions were nothing to complain about and much better than I had expected or even hope. Not mid-winter conditions, and the trails had been only rolled, but I can only imagine that large swaths of ski country in the midwest or northeast would be overjoyed to have it this good in early December.

I'm sure it helped that I hadn't done anything in nearly a week, but even so, I had no idea that I might stay out as long as I did, and I didn't feel near as clumsy and as weak (arms) as I usually do starting out the season.

It was great, such a nice day to be out, and the parking lot was nearly full with skiers and snow bikers. I know some people get annoyed when it's "crowed" but it's never bothered me, and, for that matter, to me, the more the merrier. The more people outside, exercising, having fun,and enjoying the outdoors, the better. And, if nobody was showing up, there wouldn't be any groomed ski trails or reason to have them.

C • Northeast 12

Everything went as planned at this morning. Got up, had some breakfast, the Hospitalist zoomed in, gave me a thumbs up, cleared me for discharge, and--surprisingly to me when I asked about it--said I could do anything I felt like doing with regards to exercise, starting tomorrow. I just have to finish off a course of antibiotics and a steroid, which I will do.

I will certainly take it easy for several days, but that was great to hear all the same.

I was back home by 2 this afternoon, and already the whole thing feels like an unplanned mini-vacation. Just an odd experience in many ways with a happy ending.

But I'll tell you, I really hope I don't have to go to another hospital for a long, long time, no matter how friendly the staff is.

C • Glad you are back home... 1

In the spirit of sharing some things--in the hope that it could be in some way useful to someone else down the line who might experience something simliar and/or who might benefit from it in some way--I offer the following below, and also acknowledge the example Peter Gagarin has set in sharing things that not all of us would or do find easy to talk about. That said, there's nothing here that seems overly personal or difficult to write about or that I consider TMI.

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Believe it or not, I am writing from the hospital. I had the beginnings of a sore throat on Saturday night, and it was a "regular" sore throat on Sunday and Monday. Yesterday, however, when I woke up, something was more wrong, and it felt like my throat was very dry, so dry that I had difficulty swallowing, so I tried to moisten things up, which would have worked better if I could get more of it (a sip of coffee) through. I checked and saw the my family doctor's office had just opened, and it's only 5 minutes away, and it seemed to me like maybe it would be a good idea to pay a visit.

The response at the reception desk was not positive: "We're all booked up and there are no openings today. Would you like to make an appointment for later in the week?" I was able to convince them that if a doctor couldn't see me, maybe a nurse could take a real quick look. A nurse led to a PA led to a doctor led my next stop being the ER. Before I left, they had done a rapid strep throat test, and it was positive.

I will pause at this point to pose the question: what is the point of having a regular doctor to see, if you can't see them on short notice for some more urgent condition? Of course they have their appointment schedule, but even with an appointment, it's not at all unusual to have to wait for 30 minutes or more--so obviously things must come up. If you're wondering why not just switch to another doctor or group, consider that in a smaller town, there may be no other alternatives.

At the ER, they did some blood work (always, without fail) and did a CT scan with contrast (so much fun), and stuck some antibiotics in me for the strep. Once the results in, the ER doc said I had a serious problem, because your throat is really, really swollen, and everyone needs to breath. The next step was to see an ENT specialist. The local guy was apparently not in town and nobody knew where he was. The next closest place was Cheyenne, and apparently the situation there was similar. Maybe the skiing was really good over at Steamboat and it was vacation time. Maybe the ENTs were skiing together!

So more calls and decision was to send me down to Fort Collins. Via ambulance. Not how I had expected to be spending my day, but, you know, there are worse ways to travel. By conestoga wagon comes to mind. Or dog sleigh. They said I could drive down myself as long as nothing went wrong, but that if something went wrong, it would be very bad. Therefore, ambulance. So ambulance it was.

I expect to learn there are cheaper ways to travel than by ambulance, but so it goes. We do what we must.

The ambulance came with 3 personnel. A driver who was being trained, a co-driver, and a medical guy who would attend to me as needed. They looked to all be in a vaguely late 20s to mid-30s type age, and all of a mold that you would recognize. Since the main risk and the reason I was going down by ambulance was that if the swelling continued to increase my breathing was going to be compromised, I wondered if the medical dude was up to the task. How much actual experience did he have with the emergency procedures that would need to be performed very, very rapidly, and very, very correctly? I decided not to ask. There was no point. The answer quite possibly would only lead to worry. This was the ambulance, these were the guys, and this was the way it was going to happen, so there was no point in worrying.

I learned that as a patient in an ambulance, you ride facing backwards. It's a different view, with the landscape constantly receding from you, instead of the other way around. You are also looking right into the faces of drivers in other vehicles as you are passing them Sometimes they are looking at you. I decided to ignore them all and didn't wave. I spent most of the time reading anyway.

I don't know how fast we drove. There were no sirens and no blinkers (so far as I know blinkers weren't turned on), but we did travel in the left lane the whole time, and as far as I know no vehicles passed us on the trip. It was quite different from how I usually drive. When I drive, I stay in the right lane almost all of the time, and almost all of the other vehicles pass me. I like not having to be in a rush.

At the Fort Collins hospital (there are several, but they only sent me to one of them) a security guard at the ER frisked me (no joke!) and confiscated a pocket knife that was in my backpack, nurses checked me in, an ER doc looked me over and said: "Your throat is very swollen."

We waited for the ENT specialist to arrive. The strong belief was that I had developed one or more abscesses in a tonsil and surrounding tissue and that it would need to be drained. The procedure was described as "unpleasant." Oh, well, once again, we do what we must. I wondered if I could be brave. All you can do is try when the time arrives, but in advance I did not feel confidant, and here, too, you can never really know until the time is at hand--brave words in advance are only words.

Then I was taken to a procedure room where the ENT dude was to do his stuff. Now I had a new nurse. She mentioned the possibility of sedation. I became very enthused about that possibility. She said she would advocate for me. I became very enthused about my new nurse and told her so. I felt like we had forged a bond and several times while we talked and strengthened our bond, I emphasized how good a patient I would be with sedation. Maybe the best patient ever!

As time passed, the nurse left the room, and when she came back, I reminded her that she was going to advocate for me and how much easier everything would go with sedation. I felt our bond was getting stronger.

The ENT doc arrived. He bounced into the room with energy. He was on the short side, 40-ish, personable, and very direct. He spoke in plain language and looked me directly in the eyes the whole time he was speaking. In my experience, many other doctors could learn from him, in terms of how to interact with a patient. But maybe that is just me. Maybe plenty other people prefer not to know, and prefer to see everything as rosy.

His name was Dr. Roberts and I could not help but remark on the fact I had always loved the song by the same name (but a miss: it turned out that I hadn't heard correctly and he was actually Dr. Robertson.) He wasted no time, and picked up a scope and proceeded to insert the tube end through a nostril, telling me it would tickle a little bit. Tickle would not be how I would describe it, but I don't how better to describe it: the sensation wasn't pleasant, but it wasn't any worse than mildly uncomfortable. Halfway down, he told me the worst part was over ("worst part" would be another clue it wasn't a tickle.) The probe reached the right area, and he looked around for a half minute or so, the whole time still talking to me and telling me what was going on. What was going on was that I had a large area of much inflamed tissues. There were no abscesses, there was nothing to be drained. I was very relieved to hear that. I still liked my nurse a lot though, even though I would no longer need her advocacy.

What happened next surprised me. I thought he would withdraw the probe. Instead, he called in the ER doc and a couple of other people to take a look. Apparently what I had was unusual enough that it was likely they had never seen it before, and he wanted to offer them a look to further their medical knowledge. I was okay with that and it was a little bit funny to me to have these folks eagerly rushing in to take a look at my inflamed larynx. I hardly ever get any attention like this. Star power! After all these years, I was finally in my element.

So, he considered the course of action, talking aloud to me the whole time. My condition would generally mean being put in the ICU, but it was really only for observation and not for intense treatment, so he thought I could go in the cardio ward with a heightened level of observation.

If things got worse, what would happen next would require very urgent action, and he told me very matter of factly that: "I will slash your throat, do I have your permission to slash your throat? You're not a Jehova's Witness or anything, are you?" I told him if he needed to do it, he had my permission, but could he make it extra gory and take pictures? People would want pictures. Personally I think it's gotten to the point where it's hackneyed but people still say "pictures or it didn't happen."

I would be given antibiotics and steroids via IV; the steroids (3 different) were to get the swelling down. I would be observed carefully.

It sounded good to me. It went very quickly--maybe not even 10 minutes--and yet at no point did it ever feel rushed. The good doctor answered all my questions. " Day or night he'll be there any time at all Doctor Robert,"--from the song.

And then he left. He had been in the middle of a busy schedule of appointments at his office when he got the call to come over, and had broken that off to see me.

Next a very friendly Hospitalist--Jay Dennihy--came in to see me to go over what we would be doing next. He was also great. So then it was up and off to my room, and people started taking care of me.

Now it is a little over 24 hours later, and I am vastly better. I could actually already started to feel a bit better somewhere around 8:30 last night--I know because I checked my watch when I noticed. If on Tuesday morning I had felt like I feel now, it would never have occurred to me that I needed to go try to see my doctor.

But when I write about feeling better, I should also add that a funny thing about this entire incident is that aside from the sore throat and throat swelling, I have felt 100% perfect the whole time. Were it not for the throat, I would feel fine about the prospect of going outside and doing a hard workout. So it's not the least like it's been horrible or super painful or anything like that. Nor did anything ever feel scary. And I will stress again it has nothing to do with me being brave. I think rather it's an attitudinal thing or maybe a decision you can take when you step through the doors of an ER, at which point you're probably better off just accepting that it's out of your hands, whatever follows will happen, and worrying will accomplish nothing positive. That is not bravery; it's rationality.

The care has been excellent (I'm at Poudre Valley), and everyone has been exceptionally friendly with me. I've seen enough and know enough to know it's not like this at every hospital, so I feel lucky about this.

I was impressed by how well they tolerated me especially yesterday, when I was trying to talk. I think what was coming out was largely unintelligible because of the throat swelling, and it had to have been hard to make out what I was saying.

For the same reason (being barely able to speak), I decided not to call anyone to let them know what had happened because I was afraid they wouldn't be able to understand me over the phone and would only get very worried. I did send email to update my neighbors next door who are good friends. It was garbage day, and I knew they might get worried if a day passed and they still saw my garbage bin on the street, and then they might get really worried when they tried to check on me.

Dr. Robertson came in the morning to check on me, and said that I was so much better that he would reluctantly allow me to go home today, but that he really thought it would be better for me to stay one more day. I agreed to that without hesitation, but did ask that blood work be discontinued. I hate being stuck with needles. He said that actually it wasn't up to him but up to the Hospitalist. When Dr. Dennihy stopped by not long after, I told him that I had agreed to stay for another day, but asked that the blood work stop. He went along with that. I also asked him if I could stop the all liquid diet (all I had to eat yesterday was one cup of creamed potato soup--good, but it wasn't much!) and he agreed that would also be okay. I was already happy about Dr. Dennihy, but this left me feeling even happier. In the hospital, the default is always to do more labwork, and if you don't question it, they might even stop you on your way out to draw one last vial or two of blood.

So unless something unforeseen happens, I will go home tomorrow, I will take some penicillin and steroids for a few more days (please no doping tests for me!), and I will be good to go. All I can add to that is: so fine!

Things I did well:

1) Tuesday morning, when I realized it was a struggle to get even a sip of coffee down my throat, and saw that my doctor's office was open, I took prompt action: I took several minutes to gather a few items (contacts, glasses, a book and newspapers) knowing there was a chance I might not be returning home, and put away 2 things that might have spoiled. Then I was off.

2) At the doctor's office, when the receptionist said there weren't any open slots and they wouldn't be able to see me, I was very polite but firm that I really needed to be seen by *someone*.

3) I have made good decisions about the medical recommendations and options presented to me.

Things I did not do well:

On Sunday, even with a sore throat, I went running. I knew it had some risk of making things worse, and also knew it would be good for me mentally. The sore throat wasn't bad, I felt completely fine otherwise, and I really wanted to get out on what was such a nice day and do something. I told myself I would go at a very, very light tempo (which I did) and that I would stop immediately if I started feeling even the tiniest bit worse. There's no way to know if this was a factor in things going so much worse by Tuesday morning, and maybe what happened would have happened anyway. Knowing how things played out, I can't be objective about the decision. The best I can say was that it was a calculated decision. It was not a smart decision, however.

C • Get well 16