Thursday, March 03, 2016

Flat On My Back

I started a new immunotherapy on February 4th. I didn’t start experiencing side effects for a couple of days, but then my heart went out of rhythm and my shortness of breath got quite a bit worse. I’ve had heart rhythm problems for a long time, so I didn’t get too worried about it. The spells usually last only a few hours and then I go back into rhythm. Being a “tough guy” I decided to ride it out and not get too excited about the whole thing. I was a little concerned about the shortness of breath, it got to the point I couldn’t take more than ten or fifteen steps without stopping to rest for a minute or two. But I’m a pretty sedentary fellow, I don’t do a lot of walking anyway, so I just sat around at my desk or in my power recliner and took it easy.

The spell didn’t last a few hours, it lasted three days. Finally, as I sat waiting for the irregular heartbeat to go away, I noticed a change slowly creeping up on me. It seemed to be getting worse. My breathing became even more difficult and I became a bit disoriented. My wife had gone to the bedroom to take a nap and my grandson was plugged into a video game in the next room. If I stood up, I knew I would collapse. I realized I was ALONE, flat on my back, and rapidly going downhill. I wasn’t sure what to do, if I called would somebody actually hear me? After a few moments I did call and my wife was there in a flash. By this time I could feel myself getting ready to faint and incoherently told my wife to call an ambulance.  Of course she has low vision and can’t see the numbers on the telephone to call 911. She handed me the phone. I can remember thinking…how do you dial 911? After a couple of tries, I hit the right number combination and handed the phone back to her to get an ambulance on the way.

While waiting on the squad, I reached up and touched my forehead and it finally dawned on me what was happening. My forehead was wet and clammy. I was disoriented and ready to faint. My blood sugar was going low! I needed sugar and had my wife go get one of my grandson’s juice pouches. One of those tough mylar things with a tiny little straw that you have to poke in just the right place. After a half dozen tries, I finally tore open the pouch with my teeth and chugged the whole syrupy thing. Within a couple of minutes I could feel my body starting to crawl up out of the pit of despair. 

By the time the ambulance arrived, my sugar was back up to 95. For normal folks, that isn’t too bad, but for me 95 is still pretty low. So I was still a little shaky when the EMT’s started working with me. It was decided that I needed to take a trip to the ER, particularly since I was having some afib also. They dragged me out to the ambulance on a cot and loaded me in the back. As they prepared to leave, they grabbed an oxygen tank and stuck a cannula under my nose. The tank was empty. They grabbed the spare tank…also empty. One of the EMT’s astutely observed “That should never happen.”  Due to some unusual circumstances, two ambulances had shown up, so it was decided to unload me from the first one and reload me into the second. Why they couldn’t just trade oxygen tanks was never considered for some reason.

While on the way to the ER, it was determined that I needed an IV line. This decision was made just as the vehicle started down Pothole Avenue. A three or four mile stretch of road that has so many craters in it you’d swear it was a war zone. I’m a hard stick anyway and the thought of an EMT trying to start an IV in the back of a moving vehicle running over potholes is close to my worst nightmare. I was amazed that he got it started on the first try. I doff my hat to you sir, you were amazing.

By the time I arrived at the ER, the super-sugar juice had kicked in and I was back among the living. I ended up sitting around for about four hours and then was sent home. Nothing was done regarding my irregular heartbeat which finally cleared up the next day. The shortness of breath remained however.

My next immunotherapy treatment came a few days later and the afib came back along with it.  I seriously believe that the treatment is causing the problem although the list of side-effects lists it as an extremely rare occurrence. Several more days of irregular heart rhythm and I went to my regular appointment with my cardiologist. By this time I was resigned to the fact that something was seriously wrong and agreed to be admitted to the hospital when he suggested it. CT scans, X-rays, blood tests, pulmonary function tests, etc. proceeded from that point.  Finally I was given an infusion of steroids and antibiotics and I snapped out of my funk almost immediately. Like night and day. One minute I was barely able to drag myself out of a chair and the next I was up walking around fairly well. They insisted on a full five day course of the steroids, but I felt amazingly better. It was sort of like a mini-vacation except that it included getting stuck with needles and such. I was released a couple of days ago with a final diagnosis of pneumonia.

My next round of immunotherapy is tomorrow morning, I’ll be curious to see if the irregular heartbeat comes back for a third time.

Update: The third round of immunotherapy has been postponed until my oncologist can obtain the doctors notes and test results from my recent stay in the hospital. Preliminary review of the CT scan interpretation indicates the lung cancer is continuing to grow. The steroids have been put on a maintenance level tor the time being. An MRI brain scan spotted a possible malignant skin cancer on my head, having a biopsy done on it in April. I should know something by late next week on where things proceed from here.

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