Always Take Extra Underwear

If you’re anything like me (and I know I am), you grew up with a mother or two who were seemingly obsessed with the daily freshness of your lower undergarments.  How many times have you heard this admonition?

“Make sure you put on clean underwear!  You’ll be embarrassed if the paramedics have to cut you out of something dirty and stinky!”

Because, for some reason, this hypothetical scenario always involved your horrendous, disfiguring injury, requiring an ambulance crew to destroy your pelvic clothing in order to save your life.

Well, I can happily tell you that I wore clean underwear three Tuesdays ago when I walked into the emergency room at Hillsdale Hospital. I just wasn’t counting on the transfer to Beacon Kalamazoo (formerly Ascension Borgess), or the transfer to Beacon Lee Hospital in Dowagiac for physical therapy, or the total three weeks spent in a hospital room.

This all started back in 2012.  A cold virus began attacking my heart and killing it off.  At first I treated it like pneumonia — that’s what it felt like — but put off going to the doctor about it for far too long.  Finally, when I couldn’t take two steps without gasping for air like a fish out of water, I went to the ER for the first time in this series of events.

Hillsdale did what they could for me, then sent me to Borgess (everyone still calls it that; the buyout just happened recently) for a heart catheter to make sure there were no blockages. Which there weren’t, but my heart would never pump at full capacity again. Suddenly, at three years of age shy of 30, I was living with heart failure.

In 2022, almost exactly ten years later to the day, I ran into a situation in which I was on a work trip, had not realized that my heart meds were going to run out in the middle of this trip, and was two states away from a pharmacy that could fill them. I was able to fill them when I got home, obviously, but by then, I looked like a Macy’s Thanksgiving Day Parade balloon.  This time, I went straight to Borgess, knowing my heart was being affected.  They did another catheter exam, found no blockages, got the bloating down, and had me follow up with my cardiologist here in Hillsdale.

Now we come to the first weekend of this month.  Saturday night and even moreso Sunday, I simply could not get to sleep because my heart was racing and pounding so hard that I could hear it any time I put my head on my pillow.  I thought maybe something I had eaten was causing the issue, so I waited to see if it would resolve itself, though I couldn’t recall eating anything out of the ordinary for my diabetic, heart-healthy diet.  But by Sunday night, I knew I needed to get to the emergency room.  I wasn’t able to get there without an ambulance until Tuesday the 5th, and I didn’t feel like it was such an emergency that required an ambulance, so in case you’re asking, that’s why I didn’t just call 911.  I probably should have, but that was my line of thought at the time.

When I got to the hospital, they did some blood work and found signs that it had been a heart attack.  Which is something that has always worried me since my first diagnosis.  I’ve never felt any chest pain.  My heart does not cause pain when it’s in distress, and that’s been a major concern of mine: I could very well have a heart attack and simply not know it was a heart attack.  That has now happened.  My worst fear has been realized.

In case you’re wondering, my heart rate was 143 BPM when I was admitted — which is great for a fast EDM song, but not so much for one’s heart.  In fact, there’s a design I made many years ago to show love for the common tempo of most danceable music, consisting of a 128 BPM time signature with a heart replacing the bulb of the quarter note.  I distinctly remember my mother responding, “if your heart is beating that fast, something is very wrong!”

But it didn’t stop there.  The drugs that are typically used to bring down a racing heart rate are also known to have the potential side effect of screwing with one’s kidneys and liver, and they did that to me.  On top of that, one is a blood thinner.

As best the doctors can tell from my two MRI scans, that caused a pre-existing clot in my brain to come loose and give me a stroke that damaged the portion that processes the left side of my vision; meaning that from just left of center to my far-left periphery, my vision now fades quickly to a gray nothingness.  If you’re standing right in front of me, I can see you just fine, but if you start moving to my left, I very quickly won’t be able to see you at all.  And because the damage is in my brain and not my eyes or optical nerve, it’s a problem in both eyes.  At first I thought it was just the left eye, but the right eye has the same problem.

Thankfully, unlike the heart attack, I recognized almost immediately that I was having a stroke, and I was already in the hospital.  In fact, it happened the morning after I was admitted.  I was eating breakfast and I simply looked over to another part of my plate when I noticed that I couldn’t see anything to the left.  I immediately hit the call button and told the staff, and a doctor quickly came to find out what was going on.  The MRI was scheduled for that afternoon.

The good news was that we caught it, it was relatively minor (I haven’t lost any other functions whatsoever), and it’s a condition that may still resolve itself.  I’m told that it’s usually about six months later that we can say whether or not it’s permanent.  Personally, I’m already accepting of the fact that it probably is permanent.  I wouldn’t say I’m “resigned” to the idea, because I’m still able to see well enough to do just about anything except drive, and I don’t drive to begin with.  My acceptance of this is a positive thing.  I have to adjust in some ways; get used to looking to the left at times when I didn’t have to before, and that’s about it.  I got very, very lucky.  I could well be dead right now from the stroke alone.

The bad news, at least in the short term, was that because of the stroke, we couldn’t continue with the drugs to bring my heart rate down.  At least not until enough time had passed that the doctors were relatively certain it would be safe to continue.  By that evening, we already knew I would be transferring to Borgess the next day (Thursday the 7th), because while Hillsdale Hospital is an effective emergency and general healthcare facility, my case was already well into specialized territory, and we’re just too small a town to have much in the way of specialists.

So the team at Borgess — and I mean a team, because not only did I have multiple specialists looking after my care, but Borgess is also partnered with Western Michigan University as a teaching hospital, so I was a bit of a case study for a group of students from various practices — did everything they could to bring my heart rate down with different medicines that weren’t quite as effective, but at least brought me down to the 120’s until they could determine with another MRI that there were no more clots, or at least nothing that would cause damage if it came loose.  There was still one small spot that they noticed, but it wasn’t a cause for concern.

Once that determination was made, it was back on the standard meds, and my heart responded quite well.  In fact, by that evening, they had determined that an ICD (internal cardiac defibrillator) would be the best path forward.  That was something my cardiologist and I had been talking about for a while — in fact, I’ve even worn a “life vest” external defibrillator for a while a couple years ago in preparation, just to see if it was going to be necessary.  Various factors prevented it back then, but considering I’ve now had a heart attack and was completely unaware of it when it happened, now was the time to get it done.

So on Friday the 8th, I went into an operating room and had a hockey puck-sized battery pack placed in my shoulder and wired to my heart.  It’s actually a combination ICD and pacemaker, so if my heart goes wonky without having an outright attack, it’ll deliver a light shock just to get me back in rhythm.  Why do one or the other when you can do both, right? 

It’s good to have some peace of mind, knowing that I don’t have to worry anymore about whether or not I’ll feel an attack if another one happens.  In fact, these things are designed to warn me before anything gets too severe.  It’ll beep at me when it detects signs of an attack, which is my prompt to call 911 immediately, then it’ll shock me if my heart stops.  Hopefully it never activates, but if it does, my chances of surviving are much higher now.

And I can tell you from experience that it’s very weird to hear something beeping from inside your body, because that night, every time I started to lose consciousness, it started warning me.  Not even the nurses were sure it was my ICD until it happened three times in the middle of the night.  They took an X-ray in the morning (Saturday the 9th) and spotted that the lead to my lower chamber had disconnected at some point after the implantation, which was causing the device to think that my heart rate dipping during sleep was an attack coming on.

So that afternoon, I went back into the O.R. and had the lead reconnected.  That did the trick, and I haven’t had any issues since.

At least not with that. We did discover, after the surgical site had healed enough to remove the bandage over it, that I’m apparently allergic to the adhesive that was used in that bandage, as there are scabs along the edges of where it sat.  I’ve never had a surgery that required such a bandage before, so I had no way of knowing.  Those areas have caused more irritation than the actual incision has, with some sharp itching pains that continue today, but they’re already healing enough that some of the less-affected portions are already cleared up.

The incision itself hasn’t been painful since the swelling dissipated.  Astonishingly, the body isn’t used to having a big plastic bauble put under one’s skin, so it took a few days for that to happen.  But by the time I left Kalamazoo, the swelling was gone.  My skin is still adjusting to the new addition, and I have limited range of motion in my left shoulder until the incision fully heals.  Plus, I already know that I can’t reach as far to the right across my body anymore, the ICD simply prevents the motion to a certain degree.

But it was still a while before I could get out of Borgess.  We still had the bloating to resolve.  Lots of trips to the bathroom — which I was thankfully able to do on my own the entire time — and lots of keeping track of how much I was eliminating.  You might be surprised at how much the bladder fills up and how quickly when a drug is forcing all the excess water out of your body.  It was a very careful balance to not drink too much and keep myself from getting dehydrated.  I found that sucking on ice helps slow me down, otherwise I’m liable to just guzzle water like a high-pressure pump.

In the last few days in Kalamazoo, I started some physical therapy, because I had practically been bedridden even before I got to the hospital in Hillsdale.  The hip injury I got while riding the Blue Streak at Cedar Point back in October didn’t help.  After a couple of sessions doing basic exercises in my hospital room, they took me to a stairwell to attempt a climb.  I took one half step up and darn near collapsed.  My muscles were not ready for that, and they wouldn’t be able to send me directly home if I couldn’t climb the stairs up to my apartment.

Medically, everything else had been dealt with except the bloating, and that continued to diminish (and continues to diminish today thanks to some new prescriptions), so that wasn’t really a concern anymore.  New prescriptions were sent to my pharmacy here in Hillsdale, a follow-up appointment was confirmed with my primary care provider, and I was otherwise prepared to go home.  It was just rebuilding those atrophied muscles that still needed to be done, and Borgess only has a high-intensity P.T. program that would not have been good for my heart.  So we decided to get me some therapy while staying at an assisted care facility.

After failing to find a place for me at either of the facilities in Hillsdale and two others near home (one in Spring Arbor and another in Coldwater), we found out that a message I had received out of the blue prior to all of this — only on the State of Michigan’s web site, and only through that one message — was, in fact, correct: the state had terminated the Medicaid coverage that I had just received all of my approval documentation and insurance card for two weeks prior.  This was confusing, because I’d been in the process of figuring out what was going on with my local Department of Health and Human Services caseworker when this whole incident began, and when I had informed the folks at Hillsdale Hospital about it, they told me their system showed I still had coverage, no issues whatsoever.

But because of this insurance snafu, I was stuck in a bed that was medically unnecessary for me to be in while the Borgess business office worked things out.  This isn’t the first time they’ve come across situations like these, so they know how to respond to them.  They told me the best way forward at that point was to re-apply for Medicaid.  Since I’m currently without income, it was anticipated that the system would approve me automatically the next day.  It took two days, but I got another approval from D.H.H.S., so the team was ready to move forward with a transfer.

This past Sunday, the 17th, I went into a swing bed program at their in-system Lee Memorial Hospital in Dowagiac — now simply known as Beacon Dowagiac, even though all of the signage inside and out still says Ascension Borgess Lee Hospital.  I was technically there on an outpatient basis to receive physical therapy, but the swing bed program is a bit of a middle ground that made me more of an inpatient case, so I was able to stay for as long as the therapists determined was necessary.  It was anticipated that could be up to two weeks, given how badly the stairs had gone in Kalamazoo. 

Thankfully, it didn’t take that long!  Just a day after doing some in-room exercises, walking around the hallways (with a walker), and some brief stair practice on a wooden training rig, I was able the next day to do more than a standard single flight of stairs four times in two sessions!  My therapist was rather impressed, and so was I!  It was a very quick recovery!

So by yesterday morning — Tuesday the 19th — we knew I would finally be sent home that evening.  I did some walking around the halls with a cane very briefly in the morning before we realized the walker is better for me, and they’ve ordered a walker for me which will be covered by Medicaid due to what is now an officially documented back injury.

I arrived home last night and slept the best I have in nearly a whole month.

So what does this have to do with underwear?

Well, like I said, I had a clean pair on when I went to the E.R. in Hillsdale, but that was all that I had with me.  I didn’t anticipate a transfer, let alone being in any given hospital for three whole weeks, otherwise I would have brought more with me.  By the time I left Borgess, I had already made up my mind to buy some from whatever Meijer is nearest to Dowagiac (they’re all over Michigan; it couldn’t be that far, he thought without realizing that Hillsdale didn’t even have one until just this year) and having them delivered to the hospital.

Because the only way I could have gotten some from home would be for my mother, who had a spare key to my apartment throughout this ordeal, to bring some all the way to Kalamazoo earlier, which she couldn’t do because her truck is falling apart and can’t reliably make the trip.  Dowagiac is even further away from Hillsdale than Kalamazoo is, so there was no way the truck could be relied upon for that journey.  Plus, by the time I got to Dowagiac, she had already left for a vacation out of state, so even if the truck were perfectly functional, she wasn’t here to drive it.

Turns out the closest Meijer to Dowagiac, Michigan — which is about halfway between Kalamazoo and South Bend — is about the same distance from either of those cities.  It’s over in Benton Harbor, on the shore of Lake Michigan.  It’s about 17 miles as the crow flies, but Google Maps clocks the fastest route at 21 miles, entirely on surface streets, for a 30-minute drive.  Not terrible, but a bit of a haul for an Instacart driver.

I placed the order anyway, hoping someone would pick it up.  I added the incentive of a $10 tip, on top of the $10 delivery fee and $20 cost of the product itself.  These four pair of boxer briefs are easily the most expensive underwear I have ever bought.

But someone did pick up the order, and by Monday morning, I had clean underwear on.  That alone was a small victory.  I’ve never been more thankful for clean underwear in my life.  To be clear, I hadn’t soiled myself or anything like that, but… I mean, we all know that grody feeling that comes on after merely a day.  Imagine that, times 14.

So if you’re at risk of a medical emergency of some sort, here’s my advice: have a go bag ready with everything you’re going to need for a longer hospital stay than you expect.

Extra underwear is a must.