Kevin
People with spinal cord injuries make the most progress in the first six months of their recovery, or so I had been told. But, five months and five days after my accident, I found myself right back where I had started: in a hospital bed.
I lay there miserably while the ER doctor, a balding middle-aged man, examined me. “Your lungs sound clear,” he said as he finished listening to my chest and replaced the stethoscope around his neck. “Your heart rate’s on the low side, but I see your blood pressure is a little high.” He frowned over the top of his bifocals as he looked at the notes on my chart.
I nodded. The nurse at the triage desk had said the same thing after taking my vital signs. It wasn’t until she’d told me the number that I felt the first flicker of fear. “That’s really high for me,” I had responded. “Ever since my injury, my normal blood pressure rarely goes above one hundred unless I have AD.”
The triage nurse had never even heard of autonomic dysreflexia. Thankfully, I carried a medical alert card from the rehab center that explained it in case I was ever hospitalized. “You have to be an advocate for yourself,” I remembered Bob telling us in quad class. “Even among medical professionals, you’ll encounter many people who have no experience treating patients with spinal cord injuries and won’t understand some of the problems we deal with on a daily basis. But you know your body better than anyone, so don’t be afraid to speak up.” I had Nick dig the card out of my wallet to give to the nurse. Once she read the description on the back, which stated that AD should be treated as a medical emergency, she made sure I was taken to an exam room right away.
I was thankful not to have to sit in a crowded waiting room, but I wished I could just go back home and sleep in my own bed. My head was pounding, and I kept alternating between hot flashes and cold chills as the doctor poked and prodded. He asked me all kinds of questions about my symptoms and medical history as a nurse hovered nearby, monitoring my pulse, blood pressure, and temperature.
“How long have you had this Foley catheter in?” the doctor asked at one point, lifting the bottom of my hospital gown to look between my legs.
I thought back to the last time Sam had changed it, just after Greg left. “About three weeks. My caregiver puts in a new one every month.”
He nodded. “We’ll need to take it out now and insert a clean catheter so we can collect a urine sample,” he said apologetically. “We can’t use the old one in case it’s been contaminated with bacteria.”
I felt too sick and tired to care what anyone did down there. “Sure. Whatever you have to do.”
He had his nurse collect the sample, then draw some blood from my arm. “I’m going to get these to the lab,” she said once she finished labeling the last of the little tubes and containers. “I’ll be back to check on you in a few minutes.”
After she left the room, I looked over at Nick, who had been sitting quietly in the corner, texting on his phone the whole time I talked with the nurse. He was hunched over with his head down and his elbows propped on his knees, both thumbs tapping away at the screen. I watched him for a few seconds, taking in his disheveled appearance. We had left the house in such a hurry, he hadn’t had a chance to change out of his wrinkled t-shirt and sweatpants or comb his hair, which was sticking up in all different directions. Sometimes he styled it that way on purpose, but I could tell he hadn’t put any product in it that morning. Under the harsh fluorescent lights, his face was pale. I frowned as I studied it, noticing the deep worry lines on his forehead and the dark circles under his eyes. How long had those been there? I wondered. He looked almost as bad as I felt. I was the one in the hospital bed, but he had a distinctly unhealthy aura about him that concerned me. “You okay, Nick?” I asked.
His head shot up in surprise. “Yeah, I’m fine,” he replied quickly. “How you feeling?”
I shrugged. “Eh… I’ve been better. But then, I’ve also been worse.” Despite my deja vu, it wasn’t like my last trip to the ER. At least, this time, I could move my head and arms. I didn’t need a neck brace or oxygen tubes to help me breathe. And hopefully, I would be able to roll out of there that afternoon without having to stay in the hospital overnight.
My hopes were dashed when the doctor came back with my test results. “Well, Mr. Richardson, it looks like you have a urinary tract infection,” he said. “Your white blood cell count is elevated. When accompanied by a fever, that usually means your body’s fighting some kind of bug.” He pushed his glasses up higher on the bridge of his nose. “Your urinalysis was positive for the presence of bacteria, which confirms the diagnosis.”
At first, I felt relieved. A UTI was no big deal; my urologist had warned me that they were pretty common in people who used catheters to pee. I assumed the ER doctor would prescribe some antibiotics and send me on my way.
But then he went on, “After consulting with your urologist, I ordered a urine culture to find out what kind of bacteria we’re dealing with, but that can take a day or two to come back. In the meantime, we’re going to admit you for observation and IV antibiotics.”
“You mean I have to stay in the hospital?” My heart sank. “For how long?”
“At least a couple of days,” the doctor replied, reaching up to adjust his glasses again.
“A couple of days?” I repeated in dismay. So much for hoping I’d be heading home in a couple of hours. “Is that really necessary?”
He looked down his long nose at me, blinking seriously behind the thick lenses of his bifocals. “Unfortunately, it is. Besides treating the infection, we need to monitor you to make sure the AD resolves. Until it does, you may require medication to stabilize your blood pressure.”
I sighed. “All right,” I said grudgingly, resigning myself to spending the next two days in a hospital bed. If that was what it took to feel better and get back home to my son, I would do it.
“Sorry, Kev,” said Nick after the doctor left. He looked at me, nervously licking his lips. “I hope I didn’t do something wrong that caused this…”
I shook my head. “Nah, Nick, it’s not your fault. Apparently, infections like this are pretty common in people like me. Just comes with the territory when you need a tube to take a piss, I guess.” I tried to downplay how bitter I was about the situation, not wanting him to feel worse. I didn’t blame him or Sam for the fact that I’d contracted an infection; they were both careful, but some aspects of my disability were out of anyone’s control. Why did everything have to be so damn complicated? I missed the days when I didn’t have to worry so much about what was happening inside my body, when it just worked the way it was supposed to.
Adding to my annoyance, the two orderlies who arrived to take me to my new room refused to let me transfer to my wheelchair for the ride there. They insisted on using a hospital gurney instead, sliding me onto it with as much care as they would a random piece of cargo.
“Hey, watch out for his feet!” Nick cried, frowning. “He needs some padding under his heels so he doesn’t get pressure sores.”
I saw the orderlies roll their eyes at each other. “Relax, man; it’s a five-minute ride up to his room,” one of them said.
I flashed Nick a quick smile, grateful to him for trying to look out for me. “I’ll be fine,” I told him. “Will you bring up my chair?” I was more worried about my brand new wheelchair being left behind, lost, or damaged. Without it, I would be bedridden.
Nick nodded, gripping the head rest. “Don’t worry, bro; I got it.” He followed us down the hall to the elevator, pushing the heavy power chair the whole way up to my hospital room. He parked it in the corner as the orderlies transferred me over to the bed, then waited in the hall while my new nurse came in to help me get settled.
“I called AJ,” Nick said when he came back in. “He’s gonna bring Mason by for a visit when he wakes up from his nap.”
“Thanks, Nick. That’ll be nice.” A lump rose in my throat as I realized I wouldn’t be home to read Mason a bedtime story that night. I knew it would probably bother me more than it would him – like me, he’d already had to adjust to having other people take care of him since the accident. I just hoped he would understand I hadn’t abandoned him.
I was feeling a little better by the time AJ arrived later that afternoon. “How you doing, bro?” he asked as he sat down next to my bed, holding Mason in his lap.
“Not too bad. The drugs are helping,” I replied, glancing down at the IV in my arm. The medications they’d given me had worked to lower my blood pressure and bring down my fever. I still felt tired and weak, but at least the headache, hot flashes, and chills were gone.
“Good,” said AJ, grinning with relief. “You gave us a scare.”
I saw him glance at Nick, who was slumped in a chair on the other side of the room with his phone in his hand again. I wondered what he had texted AJ earlier. Nick had handled everything so calmly and maturely, it hadn’t occurred to me that he might be taking this harder than he’d let on to me. But now, remembering how exhausted he had looked in the ER, I realized the responsibility of becoming my caregiver had taken its toll on him.
“You can go home now, Nick,” I said, turning my head toward him. “AJ will stay with me awhile, and when he and Mason leave, I’ll be ready for a nap.”
“Oh, no, I’m okay,” Nick started to insist, but I cut him off.
“Dude, you’ve been hanging out here all day. You look like hell. Go home.” My voice was firm. “Come back tomorrow after you’ve had some food and rest.”
He looked like he wanted to protest, but he finally nodded. “Alright, fine. I’ll see you in the morning.” He leaned in to give me a hug. “Love you, man.”
“Love you too, brother,” I replied, patting his back. “Thanks for being here for me.”
AJ stayed for another two hours after Nick left, but when Mason started getting fussy, he, too, headed home. It was the first time I had been “alone” since leaving the rehab center.
Of course, I wasn’t really alone. But the nurses who came in like clockwork to take my vitals or turn me over in bed were too busy to talk beyond the basic questions they asked me each time: “How are you feeling? Are you comfortable?” It wasn’t the same as having someone there to keep me company.
I watched TV for a while, then tried to fall asleep. But, despite feeling tired, I lay awake in the dark, listening to the sounds of the hospital: The click of the infusion pump as each drop of medication dripped down the chamber and into my IV line. The low hum of the blood pressure cuff as it automatically inflated around my arm every fifteen minutes. The squeak of the nurses’ shoes on the shiny tile floor. The rattle of carts and gurneys rolling past my room. The murmur of voices in the hallway outside my door.
All of it triggered my deja vu again, bringing back more bad memories of my last hospital stay – those dark days and endless nights I had spent in the ICU, unable to move, unable to breathe, unable to sleep, so doped up on drugs that I’d hallucinated death omens as I mourned the loss of my wife and my life as I’d known it. I remembered the raven hovering over me as I lay in my hospital bed, helpless and vulnerable… but I also thought of the blackbird that had given me hope. I had come so far in my recovery since then. Yet here I was, right back at square one.
That’s not true, I told myself as tears of frustration filled my eyes. This is just a temporary setback. In a few days, you’ll get out of here and start moving forward again. You’re going to be fine.
But as the minutes ticked by, the tears began to trickle down my cheeks. Try as I might to have a positive attitude, sometimes it was hard not to feel sorry for myself.
***