Hey Everyone, I Almost Died … Again

Posted by – October 15, 2008

Wow. Last Thursday was my first CODE BLUE since February 1992.

Human error + clogged lung = over 10 min hypoxic and unconscious. And it led to a not-so-happy jaunt to Bellevue ER which was ultimately pointless aside from the observations gleaned, and my first sight of the Empire State Building from the back of the ambulance.

What triggered all this? My airway became totally occluded by mucous. Suctioning didn’t fix it. The vent was unable to get air to me. At home, we know to BAG BAG BAG if the vent’s normal operations are being blocked. I TYPED AMBU. The nurse said “ambu?”
then, DIDN’T AMBU!

Shortly after that, everything went black. Then I felt oddly disconnected from corporealNick; not like sleep–this was a near death experience. Then a split second later, I open my eyes, and the RT with the big Goliath beard is bagging me. As soon as someone AMBUed and oxygen started reaching my brain again, I woke up. It felt like a split second later, but the clock was indicating 10+ min later!

It was around 4:15am. Mohammad is bagging me, Tony the RT is also there, the on-call doctor is there, the nurse is there and also several people I’ve never met are there. I realize a code blue had been called (your patient is blue? CODE BLUE!!) though they canceled it once they realized my pulse had never stopped and I was pretty easy to revive (just bag me, dammit!)

Tony dumps a bullet of albuterol solution direct to my trach. The young on-call doctor is calling an ambulance and calling the number on the “next of kin” form (my mom) and telling her it could be a pulmonary embolism or heart attack or stroke. He didn’t think someone could be that blue, and that unconscious for so long, from just a mucous plug, and wanted people in acute care to rule out serious problems, so off I went to the ER at Bellevue Hospital in Manhattan. The ambulance left Roosevelt Island and all types of tall buildings, complete and incomplete, blurred past.

Going to Bellevue ER was rather pointless. The ER doctor said “he’s not hypoxic,” which was true, and after that they pretty much ignored me (to focus on patients who are actual in crisis). . Bellevue is better than USA hospital in Creighton in Mobile, where gangsters with gunshot wounds bleed beside you in the waiting room or occasionally wander in and shoot their friends, but not by much. It is the same genre of place, a “last resort”-type hospital for the city’s uninsured, though it seemed a lot better funded than USA (most everywhere is). But it’s definitely not as bad as NYPD Blue depicted Bellevue on TV, putting violent people in cages, etc. (maybe that’s upstairs). Some staff were friendly, others, as my girlfriend put it, had “a false veneer of helpfulness,” and lots of others just ignored me because they were too busy dealing with the city’s drunks, criminals and psychos. The dude across from me drank a brewery and ran afoul of the law and the NYPD brought him in and brought him out.

Aside from observing interesting things like that, spending my day in the Bellevue ER was a total waste of time. My girlfriend (thank G-d she was there to help me communicate) and I sat there for eight hours while they did nothing they couldn’t have done here at Coler (an EKG and an x-ray). They can do this here, and did!

As I returned to Coler via ambulance, I got a great view of the Empire State Building from the back window, right before we turned into a tunnel. That was cool.

I was so glad to get back to my room and the nurses who are familiar with what I need, and very happy to be alive after all that.

But later that night, I did break down psychologically some. It was so scary, so close to death, so close to losing everything I want so much. It was too much.

But I am okay now, physically and mentally intact.

Monday, one of the Filipino RNs (insights often come from unexpected places) mentioned I almost died on The Day Of Atonement. “On that day, The Powerful One decides who goes,” she said. “You stayed. This is a good omen for the New Year.”

I hope that’s true.

This is like my hundredth second chance. I feel the pressure. I can’t waste this chance, not even for a day.

Nick

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  • R Belasco

    Most people probably can’t visualize what you mean by bagging or ambu-ing someone. A manual resuscitator is often called an “ambu bag” because of a company named Ambu that produces the self-inflating manual resuscitator. It is also called a “big valve mask” or “BVM”. Look at the following for a description and an animated visual:

    http://en.wikipedia.org/wiki/Bag_valve_mask

    http://vam.anest.ufl.edu/checkout/check-sirb.html

  • R Belasco

    Jamie has had the experience of having a mucus plug clog his trachea so completely that bagging didn’t work and we had to pull out his trach tube and replace it very quickly. That’s why we keep spar trach tubes close at hand. Once, did this in the van pulled over on the side of the road. It was scary, but thank goodness changing the trach worked! Jamie had this experience at least one more time; he was with a nurse, and the rest of use were at school.

    These near-death experiences that you and Jamie have each had multiple times have each worked on me somehow. Each experience is carved or tattooed on me, you know? It’s like living in a war, maybe, and you’re being bombed every now and then. You tend to huddle under a table when you hear anything that reminds you of the bombing. Maybe we have PTSD?

  • aleja

    Ruth, that’s a good explanation, and I like the animated visual you found.

    Also it doesn’t surprise me to know or hear that dealing with these kinds of events can cause PTSD-like feelings, and I’ve only been around a short time. You learn quick, I know that much now.

  • aleja

    “I know that much”, even.

  • Sharon Cobb

    i JUST got your message. For some reason you were in my Spam folder!
    Thank G-d I checked it.

    I don’t know what to say! It seems,though, you have a purpose for being here, so get busy doing whatever it is you’re suppose to be doing!

    How frightening that experience must have been.

    Please call me or have your mom call me if G-d forbid that happens again.
    I’ll try to get to NYC to take care of you myself!

  • Robert Smith

    Hey Nick,
    This the first time I have commented on one of your posts, I do read quite often though.

    First I’d like to say I am glad you are ok. I too have a trach and am on a vent 24/7 and have been for the past three years. I do know what you are talking about and the feeling of having the inner cannula plugging up, not a fun experience to say the least. Luckily it has not come to using the ambu bag.

    Robert

  • Benjie

    What are you doing in New York without me? (see ur e-mail)

  • Michelle

    Yes, most people wouldn’t have understood “AMBU”, but a nurse who works with patients on vents sure as hell should have.

    (Hi Nick, been to your site before but just alerted to the fact that you’re now in New York City. I’m also a vent user, living at home.)

  • Tammy

    I go to Code Blues every day at work. My hospital calls in therapists/social workers automatically on all codes; we're part of the Rapid Response Team. Thank you for this, Nick…what it's like the be the person in the bed with so much chaos going on around. And that everyone has moms, Alejas, not to mention thoughts and feelings many times while this is going on. PTSD would absolutely fit for some people. Again, many thanks for sharing.

    Tammy

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