Ummmmm, Okay.

I need to call my family.  A call at 3am might worry them.  But I think about what I'm going to say once they pick up and decide that worry is kind of inevitable at this point.

Ring Ring 

Jamie:  Hi Dad!  It's Jamie.

Pause.

Dad:  Jamie, it's three in the morning.

Jamie:  Oh, you are going to feel so bad you just said that.  This is really good.

***

My sister is 7 months pregnant with my niece.  If things don't go well for me I wonder if she'll call the baby Jamie.   If I asked, she would kind of have to, right?  I keep this thought to myself.  It entertains me but it would upset my sister.

I'm really trying not to think that way.  Yes, this is brain surgery.  There are risks.  But, I voluntarily do risky things all the time, like rock climbing.  Is this any different?  The stuff of life is risky.

And, there's really nothing I can do about all this anyway.  That's really what's keeping me extraordinarily (and somewhat surprisingly) calm.  This is all just kind of happening and I'm like "Ummmm, okay."

The changing of the guard.

I'm wheeled to another part of the ER to get my enhanced CAT scan.

Diane has arrived.  

Earlier that evening, before anyone thought it was serious, Diane wrote the following e-mail:

"Okay.  Page me.  I'll be around.  I have to work tomorrow, unfortunately, 8-6, and can't get out of it unless you're actually dying.  But otherwise I am there for ya."

So the first thing Diane says is "I'm not here because I think you're dying."

Then she puts a headband with reindeer antlers on my head.  I'm plugged in and tied down to all sorts of wires and stuff so I guess I'm wearing it.   I'm not sure I can look any weirder than I already do.

Diane is going to stay with me overnight and help me find out what the deal is with needing surgery.  This doesn't jive with what we heard four years ago.

Dr. A shows up with the consent form.  "Not yet" I tell her. 

Dana has my cell phone and I see that Barb has tried to call back.  I've been waiting around for a while so I decide call Barb.

Jamie:  Hi Barb.  Ummmmm.  My brain is bleeding again and I'm in the hospital.

And before I can say anything someone starts to wheels me away to get the special CAT scan. 

Jamie:  I have to go.  

I can't even imagine how confused Barb is.
And my antlers are missing.

Are you drawing on my face with a Sharpie?

The Duke ER has valet parking.  Fancy.

The Duke ER also has a metal detector.  Not so fancy.

"I'm here!" I announce to nobody in particular realizing I don't totally know why I'm here.  

 They give me a hospital bracelet with a bar code and QR code.  Fancy.

***

I get my own cubicle in the ER.  And yellow hospital socks.  Dana and I are entertained by the bits and pieces of conversation we overhear in the ER.

Random people stop by to take my vitals and my blood and my money (the ER visit isn't free).  Most insurance policies don't charge you for your ER visit if you're admitted so I wonder if this means they'll be sending me home soon.

***

Dr. H, the emergency care physician arrives and I explain what I can.  He asks if I have the MRI scans from four years ago.

I proudly present him with a giant folder I diligently put together after my hospital stay.  I have to admit I'm a little disappointed when he just takes the CD with my scan.

Dr. H also asks for a sample of my flora.  Or something like that.  I realize he just needs me to pee in a cup and wonder why he didn't just say so in the first place.

Flora?  Pfffft.  

***

Still waiting.  Dana notes that you don't want to be the priority in the ER.  

Good point. 

***

I'm thinking about possible outcomes.  Let's say my brain is bleeding.  My understanding based on what the doctors said in 2009 was that if my brain bled again I would just have to manage the symptoms.  They wouldn't consider anything like surgery unless I was drooling and pooping myself.  The symptoms are not so bad.  I kind of feel like I'm just a little bit drunk all the time.

***

Dr. H returns.  My brain is bleeding.  OK.  Now what?  

Dr. H isn't really sure what they're going to do about it.  He mentions surgery and I assure him that's not an option.

***

Dana is eating a sandwich. 

"Can I have that?" I ask her.  I know, quite brazen especially considering she can't really say no.

Dana hands me her sandwich.  I tell her that she's going to feel really good about giving it to me because it's possible it's the last thing I will be able to eat for a few days.

***

The ER has gone silent.  Dana and I briefly consider the possibility that the rest of the world has been taken out by a deadly disease and somehow our ER cubicle was spared.  We take our picture.

***

Dr. H returns with Dr. A  
(So much for the end of the world).

Dr A:  We've taken a look at your scans.  Your cavernoma has grown significantly in size.  We're very worried about pressure that's creating on your brain. 

Jamie:  My brain is too big for my head?  I knew it.

Dr A:  Somebody from neurosurgery is looking at your scans right now.

Dr H:  In order to alleviate the pressure they might have to put in a shunt for the cerebrospinal fluids.

Jamie:  Like a blow-hole? 

***

Jamie:  I need to use the restroom.

Jamie thinks:  Time to make a run for it.

When I come back to the ER cubicle the floor is wet.  During my voyage to the bathroom an IV bag inadvertently exploded.  

Dana:  Like champagne on New Years!

***

Dr H:  You're not going to like this.

Jamie:  There's a problem with my flora?

Dr H:  They need to do surgery.

Jamie:

Jamie:  

Jamie:

Jamie:  Hang on.  I'll wake up in a just a second because this can't be happening and must be a bad dream.

Awkward Pause.

Jamie:  I don't understand.  Is having surgery a decision I need to make?

They don't need to say anything for me to know this probably isn't a decision.  

Jamie:  Well, what now?

Dr H:  We've ordered a contrast enhanced CAT scan and then we'll admit you to the hospital and get you up to ICU.

Jamie:  Okay.

And with that a swarm of people enter the cubicle and are on my like vultures.  

Dr. H is making a mess of my left arm with two IV's and an arterial line.  Not sure what they're doing to my right arm.  There's a lot of blood and Dana, thinking she might faint, steps out.

Dr A has a razor in hand.

Jamie:  You're kidding me.

Dr A:  I just need to shave off five small patches of hair to attach these nodes to your head that you need for the CAT.

She's already stuck one of these nodes on my head and then I think she's drawing on my face with a Sharpie.

Jamie:  Are you drawing on my face with a Sharpie?

Dr A:  Yes.  I'm outlining where I've placed the nodes in case they fall off.

And then I hear the scrape of the hand razor on the back of my head

Scrape, scrape. 

Dr A:  We need you to sign this consent form.  

She has a pen ready to place in my right hand.  My left hand is indisposed.

Jamie:  I'm left handed.

Dr. H:  Really?

Jamie: Diane.  I need Diane.  

And I guess I'm not going to trivia

I'm going to trivia tonight.
It's 6pm and I'm dressed and ready.

A postdoc from the lab has been staying with me for the past three weeks and he arrives home as I'm about to leave.

He asks "How did your thingy go today?"

I reply "I don't know.  They said they would call me."

And then I look down at my phone and see that my Dr's office is calling.  How about that?

Me:  This is Jamie.

My PA:  Hi Jamie.  I happen to be at the office late and your MRI came in and we took a look at it and your MRI is different.  You need someone to drive you to the ER.

Me:  Now?

PA:  Right now.

Me:  Um.  Okay.

My PA:  Is there someone there we can talk to?

Me: Why yes, he just walked in.  

I hand the phone to my pal.  He assures the doctor that I won't drive myself to the ER.

My PA:  What ER is nearby?

Me: Duke 

PA:  Big Duke?

Me: Yes, Big Duke.

And I guess I'm not going to trivia.

***

Before I go to the ER I take a shower and eat cookies.  I know what I'm doing.  Twenty minutes isn't going to make a difference.

I don't want my lab friend to get roped into what could be an ordeal.  There are tons of friends I could call who would be there in a heartbeat.  I take pause because now I have to sound an alarm that feels unnecessarily dire.
I start making calls.

Ring!  Ring!  Ring!

Dana:  Hello!

Jamie:  Do you want to have an adventure tonight?

Dana (enthusiastically): Yes!  What time?  Where?

Needless to say, I delivered on adventure.

Pop Up MRI

On the drive down to the MRI I wonder if this is just a big waste of time and money.  I've really tried not to live under the threat that something might happen with my brain again.  That would be alarmist and unpleasant.  And furthermore, very very unlikely.

I take pause at the set-up where my MRI will be done.  It's like a pop-up MRI shop.

I've had enough MRI's to know that they can play music in there.  So I bring a CD (I still have some of those) and the technicians remark "This is a first" but play it.

During an MRI you just kind of lay there and it's noisy clanking sounds like someone emptying the dishwasher drunk.  Except there are barbells in the dishwasher.

Part of me thinks about what's happening with the imaging and it's kind of amazing.  Another part of me thinks "This takes 15 minutes and it's clanky.  This feels kind of primitive for 2013."

When it's done I ask "So, anything good?"

"We're technicians, not doctors."

I wait for a copy of my CD.  Based on last time I learned to keep your own records.  I'm told that they'll get the images over to my doctor and I'll hear back in a day or so.

Kind of anticlimactic.  I'm not sure what outcome I want or what outcomes are possible.  On one hand it would be nice to know that there's a legitimate reason I've been feeling woozy.  But, that legitimate reason might not be so nice.  

Kind of like when you gain weight and think "Well, maybe it's just because I'm pregnant."  And you're sort of happy to have an explanation for the poundage but then you remember that you think you might be pregnant.

Scheduled

Some insurance confusion but MRI is scheduled for tomorrow.  This was one of many points in the process when I might have thought  "This is just too annoying and I don't really feel that bad.  F it."

And that settles it.

Still feel lousy.  Call PA’s office to schedule an MRI. 

Jamie:  I think I should get an MRI, right?

Nurse:  I would.

And that settles it.

Cookie Party.

I rested all day to be able to attend.  I love Diane's cookies.

This happens like three times

I get out of bed and I vomit on a towel. 

And then again in the bathroom. 

I go back to bed.  

This happens like three times.

I had one glass of wine.  This is ridiculous.  Is this what drinking is going to be in my 30’s? 

Getting out of bed was repeatedly unpleasant so the remainder of the day is spent in bed.

I had three invites for holiday parties this night.  I cancel them all. 

And it’s Girl’s Night with some climbing gals

I have one glass of wine over the course of five hours. 

PA

Never heard back from the neurologist but I got an appointment with my PA today.  She gives me the sobriety test neuro exam and I do a fantastic job.  In heels, no less (I’m in heels.  My PA is wearing clogs).

The plan is for me to take anti-vertigo medication for a few days and get a blood test.   They will issue an order for an MRI for next week and cancel it if need be.

I leave the office feeling woozy which I attribute to the taking of the blood.  I sit outside the elevator bank for a solid 15 minutes until I feel OK driving.  I wonder if I’m just a bit depressed.  Or hungry.

Hold

I call one of the neurologists who I met with in 2009.  I’m on hold for quite some time.  I finally speak to someone who informs me that because my appointment was over three years ago I’m considered a new patient.  They will forward my phone number to the doctor’s schedulers.  I don’t have a good feeling about this.

At the shopping center across the street from the climbing gym.

Pizza.  Yum.  I’m not ready to be at home alone on a crappy day so head to a movie.  During the movie I get a voice-mail from my doctor.   He’s done some research and shares it with me.  He doesn’t say it but I think he’s a touch more concerned than he was before that this has something to do with my brain.  But he's not telling me to go to the ER.  

Vertigo

12.7.23 TRC Morrisville, mid afternoon

I decide to bury my brain thoughts and just climb.  Just relax, just climb, just follow, just breath.  

My second climb includes an under-hang.  As I place my hands on the holds things start to feel a bit surreal.  And when I get to the under-hang I experience something that might have been Vertigo. 

“Down.  Down.  Down”  These are not climbing terms.  This is Jamie.  Scared.

My tone is such that my belayer lowers me immediately and I bury my head in my shoulders to untie myself and hide the impending tears. 

My belayer gets me a Gatorade and I explain my concerns.  Then I say  ‘I’m done climbing for today.   And I think I’m going to stop running and working out for a bit too.  And, I want to go to Ruckus and order a pizza with pepperoni and pineapple and eat as much of it as I want.”  I had been trying to cut down on mindless eating this month but I wanted to rule out all factors that could contribute to dizziness.  So, I don’t care if Barb already made me lunch.  I’m having it again.

I send a text to my psychiatrist (yeah, I have one of those) because I need the judgment of someone with more medical background than me and I have this guy’s cell phone.   We talk and he advises me to take it easy for the rest of the weekend and to see a neurologist on Monday.  He also speculates on possible non-brain causes for dizziness including ear infection.  I feel much calmer having spoken with him.   And I’m excited about pizza.

Fake Starbucks in Target

12.7.13 Target, early afternoon

I have plans to climb mid-afternoon.  In between climbing and running I go to Target to get some supplies for a work project.  I feel a bit overwhelmed in the store but it’s a rainy Saturday during the holidays so of course the store makes me weary.  I sit in the fake Target Starbucks and read a book.  Then I just drive to the climbing gym and sleep in the backseat for a half hour.

Now that the brain question has been planted I’m feeling a bit anxious.   I feel funny but I’m not sure if it’s the anxiety or what.

Tasty Shake for Lunch

12.7.13 Saturday Morning

Run with Barb in the morning.  I’m still feeling a bit dizzy and I say so. 

Barb:  “Do you think it has anything to do with your brain?”

My thoughts stop in their tracks (my feet do not - I keep running).  I think Barb just brought to surface something I must have been thinking about on some level.

After our run, Barb makes me a really tasty shake.  Apparently this shake has the nutritional and caloric content to constitute a meal.  So, I call it lunch.

Out of Alignment

Barb and I run again.  I find that I'm wanting to veer off the path like a car out of alignment.  I'm pulling.

It’s been a long time since I’ve gone running.  I'm breaking my body back into it.  

I guess.

Wobble Gobble

I run 8K on Thanksgiving and feel wobbly afterwards.  

That’s reasonable, right? 

I mean, it's an 8K.

I wrote a blog post for work.

World fame, here I come.
http://advanced-hindsight.com/2013/11/25/how-we-trained-for-the-color-run/