Back to the beginning... Saturday the 15th

Caris, here. Many folks have asked for a slightly more detailed accounting of how we ended up where we are now. This is the story of Saturday, August 15th, 2015.

Things might be a tiny bit jumbled, but I wanted to write it all out before I started mixing the order of events up in my head even further. Bill remembers some but not all pieces of the day, so it's also for his edification.

6am to 8:20am

Saturday morning, Bill awoke rather early with a sort of gasp and a start. He said he was feeling weird and that he had some nausea. He went downstairs to "walk it off" and started walking around the downstairs of our house. Eventually he came back upstairs and told me that he was having some strange sensations and sounds in his right ear. The sound of a rush of blood to your ears, but involuntarily happening every few seconds, and the nausea wasn't much better. I asked if we needed to go see a doctor before embarking on twenty-someodd hours of travel to Rio. Bill shrugged it off and said, "I'll probably feel better with some breakfast."

He took a shower and started packing up the remainder of his things for the trip. I took a shower and started getting dressed. After his packing was complete, he went downstairs to start breakfast. 

A couple minutes later, I heard a crash. I called his name and got no response, so I ran downstairs to find him having a very stiff-bodied seizure on the floor. The crash had been one of our barstools getting knocked over.

I got him on his side and managed to reach for his phone (plugged in a few feet away) to dial 911. The 911 operator called an ambulance and talked me through what to do. I had already done the right thing, and she had me start counting his inhales into the phone as his seizure subsided and he was in the postdromal phase of the seizure and actually breathing again. Still unconscious, now drooling, but breathing, thank goodness. He had bitten his tongue.

The paramedics arrived. They were happy (or surprised) that I'd known how to handle a seizure. They took over and started asking me questions, getting his insurance info, trying to wake him, checking his blood sugar, etc. They end up calling the fire department to help get Bill onto a stretcher and into the ambulance as there were only two of them. As they do this and take good care of Bill, I went upstairs to put a shirt on, put the dogs up, and call my dad to meet me at the hospital. I was only half-dressed when this started.

The fire department arrived rather quickly and they loaded Bill up and were out the door. They told me which hospital they were headed to and that I'm welcome to go with them in the ambulance, but I might want my car later. I opted for car. I got explicit instructions to take a minute to calm down a bit and to NOT follow them through red lights, but drive safely, obey the rules, etc.

8:45am to 1pm

The ER at Seton. Room 13. Why the hell does an ER have a room 13?

I arrived and Bill is still mostly unconscious, but starting to come around. They had oxygen on him and he was starting to respond to his name and open his eyes. At some point as he's becoming more conscious, my dad arrived.

My dad, for those who don't know, was a practicing internal medicine doc for awhile. He's been out of the medical world for some decades, but he's a fantastic resource when crazy health things happen and an all around wonderful human being. I don't know what people do in these situations without someone like him.

Bill was finally conscious. They gave Bill Ativan to prevent further seizures. It made him sleepy and woozy. He started complaining that he was super duper hungry because he didn't get breakfast, but they can't let him eat until they're sure he's not being whisked into surgery. At that point I was thinking that I was glad he didn't yet make or eat his usual large breakfast smoothie, because that would have been horrible coming up or worse, being aspirated during the seizure.

I called Bill's folks and they started driving to Austin. I contacted our friends in Brazil and the airlines to cancel trips. 

The ER folks got him in for a head CT and had an MRI on order, but that was a longer and slower line and was going to be a couple hours. 

We waited for the MRI to become available. Bill was still complaining about being hungry, and he was upset at the Ativan side effects. He is not good at being on drugs.

They come back with CT results. The results are not great, but CTs don't give us much detail as they are low-res. "A 5-7cm mass of some kind -- it could be a lot of different things," says the on-call internist. We needed the MRI to know more.

1pm to 4pm

They took Bill away for 40 minutes or so for the MRI around 1. My dad and I tried to stomach some hospital food since I hadn't eaten anything at all. I cried for the first time.

They brought Bill back to the room after his MRI. They said he was a great patient and very still. He even slept through part of it. He said it was cool to have an MRI and that he enjoyed it.

Bill started feeling more nauseated and having heartburn. They gave him some anti-nausea meds via IV and some maalox orally to try to settle his heartburn. It went okay for a little while, but he's also still hungry. The Ativan started wearing off and they gave him Keppra, which is a more focused anti-seizure drug that shouldn't have the same loopy side effects.

They came back with a tiny summary of MRI results. "There's definitely something there, but I can't say exactly what. It seems likely that it's a tumor." 

They said we aren't having surgery today, because it wasn't actively bleeding. Hooray? It did mean Bill could eat, so we get him a powerade and some fruit.

They promise us a room on the 6th floor and change the room number at least once. Then we wait.

Bill was extremely excited about the idea of calories at this point. He had two sips of powerade and started feeling badly again. They gave him more maalox since he thought it was heartburn. Maybe 30 seconds after the maalox went down the hatch, he reached for the barf bag that I handed to him... and then I had to leave the room to call the nurse, as I'm a sympathy-puker. I kept it down, Bill did not.

The nurse gave him more anti-nausea meds.

Even more time went by. We actually moved upstairs to a room around 4pm. Number 643. Better than 13, at least.

4pm on

Bill ate a few bites of food, but it was gross and he still felt sick. We started having a small stream of family and close friends, which kept his spirits high, even as he felt bad. The poor nurse needed to replace his ambulance-inserted IV with a regular one and missed on the first (and second and third) try. Bill was unimpressed. A better nurse came in and did the IV and it was fine. 

A neurology resident visited and spent a bit more time explaining the MRI results. There's a necrotic spot in the center of the tumor that might be what's wreaking all of the havoc and caused the seizure. The tumor is not metabolically active and didn't take up much contrast, which is good. He will be on anti-seizure meds and isn't allowed to drive for 3 months after the most recent seizure. She asks me about personality changes over the last few months. I hadn't noticed anything unusual (for Bill!)

I ran home at some point around 8 or 9pm to grab extra clothes and toiletries and electronics for both of us. Fortunately we had both already packed for a trip, so finding these items was easy. 

Back at the hospital, I acquired a cot and maneuvered his bed over in the tiny room. I can't speak for Bill's experience, but I proceeded to have the worst night's sleep I can remember, between trying to contain my sobs all night and the interruptions from nurses checking in on Bill every 2 hours. Lucky Bill got a medication to help him sleep.