I’m really glad they did, because I took 40mg of prednisone at 6:30 this morning. It is now 1:10pm and I am ZOOM! ZOOOM!! ZOOOOOOOM!!!!
Lucky you, I’m going to sit down to blog. Because I go downstairs to obtain object A, then I notice object B is out of place, clean countertop S, put Q away, fold N, pick up cat fuzz, pour myself a glass of water, look to see if I have T, U, and V to cook D later this weekend, notice R is out of place and take it back upstairs….and then realize I didn’t get A. Rinse. Repeat.
I think they sent me home because the cough sounds so bad, but ….there may have been other factors in the wary looks at me today.
I left my water downstairs.
Okay. I am sick. Again. I came home from Phoenix and promptly came down with a cold. A plain, vanilla, corona virus. I am a nurse in a pulmonary clinic, and every year we have patients that call and say they have the flu. Most of them do not. They have a cold, and they forgot that colds are not fun, either. If you drive a Prius, say so. Don’t tell me that your Prius is actually Ford V8 Expedition Alaska Singularity-Creator. I am not impressed. (And you thought nurses were nice people.) (silly.)
Granted, these are pulmonary and renal patients. Some of them actually are having COPD exacerbations. A cold on top of COPD may well feel like a Ford V8 Etc, etc. A handful are having CHF exacerbations. Some of them get dry because it's winter, or that corona virus causes a little damage and a little dehydration, and that little bit of AKI on top of CKD means their lungs are full of fluid, not flu.
Further, chances are EXCELLENT that the average person with said cold-not-flu (and not one of the other possibilities) does not need antibiotics. If it goes on awhile, maybe a Zpack is needed. That’s it. Just because you sneezed, you do not get a Zpack. You get soup. When you call my clinic and you genuinely have the flu, you sound like you’re driving around in a Singularity-Creator. And guess what? Possibly, I’m going to tell you that you get soup, too. But I’ll be more sympathetic in my delivery of this news. When you need the ER, don’t worry…I’ll tell you, and yes, I'm going to tell your doc you called.
I did what I was supposed to do for a plain old cold. I made soup. Rest, fluids, added more vitamin C and ibuprofen because I am happy to pay for expensive urine for a few days so that I can honestly tell my mother, the not-a-nurse, that I’m doing what she tells me to do. It faded to my usual cough. I’ve had a cough for so long I can’t really tell what was lingering-viral-thing and usual-cough-that-hasn’t-been-fixed-for-a-year.
And honestly, I’m so used to coughing all the time, I get sick of thinking about it and I don’t care anymore. In my head, I’m hoping that once I get the rebar placed, something akin to magic happens.
Possibly the lungs will be free to expand…and if there is schmag buried in the warm, smushed up left lower lobe that never opens that the CT scan does not show. Because it does NOT, in fact, show that…which does not quiet my irrational fear of this happening.
Possibly, whatever fluid is or isn’t building up because my right ventricle is twisted and smushed and fluid is backing up into my lungs….something I have NO rational reason to suspect is happening given my beautiful 110/70 vessels. And the echo cannot show the RV enough to prove or disprove this, and yet this even-less-rational fear also won’t shut up.
Irrational fears take energy. Thinking about things over which you have no control takes energy. The Buddha said these things are dumb, and you shouldn’t do them. Occasionally, I take that advice. If I were succeeding with this today, I would not be writing right now. I blame prednisone.
The cold faded to my normal life of mild cough/typical chest tightness/wow-did-we-drop-down-in-elevation-by-50-feet-because-I-actually-noticed-I-breathe-better-honey-when-can-we-move-to-lower-altitude?...
Then we rented an RV and went to Roswell, New Mexico. Because that is something people should do.
It’s January. It got down to negative 22 degrees the first night. We had a great time….drank a bottle of five year old Prisoner (mmmmmmmm), we three played a card game (Chase: 2, Mark: 1, Michelle: 0), cats started to shake off some of the terror of being inside a moving house, lot of stars the brief amount of time we forced us all (humans, not cats) out in said negative 22 to see constellaions….was a good time.
Coughing more the next morning. Blamed cats. Because husband asked about it in that tone of his that says My Wife Needs To See A Doctor, Goddamit Why Don’t You Listen To Me On This. Made posole, because that's what you eat New Year's in New Mexico. Been making it for ten years, deeply happy comfort food posole. Went to alien museum with family. Forced teenager to stand in front of aliens while I took pictures, which made me very happy. Photos of pained self-conscious teenager in front of styrofoam aliens are perfect. (He does not actually hate me, although I realize he has grounds to do so.) Ate green chile with every meal that wasn't my posole. Noodled around in Santa Fe, looking at arty things, and mineral-y things (well, they did. Minerals are rocks, and rocks are boring.) Debated alien existence over chile rellenos. Had seven year old port that evening (mmmmmmmm). Read books. That night was only down to 20 degrees above zero. Slept like shit regardless. Coughing even more the next day. Blamed faint smell of propane, in addition to cats, because husband asked with aforementioned tone again.
By Sunday, I was doing the driving and at dinner, I decided to pull the whole way home. I waited until coming out of Trinidad to tell them so, because by then I was sure I could make it. I felt bad. Really bad. Chills with cough, no fever. So I got us home by 11:45 pm. And the next day I felt post-death. The cough was spasm-y, clear/white sputum, congested, chest super-tight, sinus pain, blah blah. I called in to work at 5pm because I knew it would be bad. And I was right on this. But it was not flu. Nobody else was sick.
So what was it? I don't care. More damn coughing.
Wednesday I came to work because I felt a little human, and because there is still one task with renal referrals I routinely do that the other nurses don't know how to do yet. (And I began teaching Kate how to do that thing this morning.). I did fine most of the day, but by the afternoon, the cough was worsening. I felt better, but I sounded bad. One of the docs made an aside about “Michelle’s pneumonia.” Twice. When I thought everyone had left, I had Denise, one of my nurses, listen. I knew it wasn't pneumonia. But I asked her to do it. I asked her to percuss me, too, which is incredibly helpful. (Was something I used to do a lot working nights at Porter...as often as was possible, and when clinically stable enough, my intubated patients always got a bath, a hair-washing and often percussed if it helped on my watch.) (I was kind of a fuss-budget.) (When I was hit by that car, I had blood in my hair for two days. If someone has blood in their hair, get it out, for gods' sake.) (I blame all parentheticals on the prednisone racing through my bloodstream. So should you.)
I’d forgotten Dr. E was still in clinic. He came in and told me I needed Tussionex. “But I don’t want narcotics,” which sounded way more whiny-12-year-old-girl than I’d intended. He offered "see me unofficially", and he wrote the prednisone, the cough medicine, and a Zpack. He is a very kind, deeply wonderful person. I know why his patients love him the way they do, and I understand it. I forgive the comment that my pectus doesn't affect me. That still isn't true, but he engenders trust for good reason. I have always respected him. I was very grateful and all funny-feeling and hate imposing. (I am my own worst enemy when it comes to people helping me.) He thought it odd I considered it imposing. But being a nurse with a chronic cough who happens to work in a pulmonary clinic is not actually like being a person who is hungry and happens to work in a restaurant. It just isn't. And that's a whole other barrel of monkeys. Anyway. He wanted me to stay home today.
I didn’t. And I sounded worse today. By a lot. Even though I feel better. (Prednisone! For people who do not have access or interest in illegal stimulants!!) Why did I fucking go to work? Because of aforementioned enemy-self-person, and by noon I thought they might tie me up in a sack if I didn’t leave. I wasn’t there because I want to be all a martyr and come to work. Nor do I do this because I want to be indispensable. Beneath this nurse is an ex-database administrator whose purpose in life was to write clean, flawless code complete with comment code so that nobody would page her at three in the morning to go fix shit. And anyway, an ICU nurse goes home when report is done.
I do this because I want to deny I’m sick with anything ever. And there’s this whole thing with reality not cooperating with me at ALL and this whole thing about I have NO CLINICAL FUCKING REASON FOR HAVING A COUGH FOR A YEAR. So this additional cough on top of it should be no different. And yet. Here it is. And. Maybe if I act like everything's fine it will be. Because that works well.
You get tired, you know. You just get tired.
So. I came home today. And I’m not going tomorrow. Even though the prednisone is making me think about all this work I could be doing and buzz buzz buzz having the energy to do it….
Here I am. Annoyed. Hating my nebulous non-excuse of an ICD-10 code. Talking to myself.
I’m gonna go make soup.