Giving thanks... for health insurance

It started out like the flu. The fever. The little cough. The body aches. That was all Glenn thought it was when he started not feeling well at work the evening of Friday, Oct. 16. Fortunately it was the end of the work week, and if he was going to have to endure his first sickness in nearly two years, best to do it at home. That’s what he thought Saturday when the symptoms kept him in bed much of the day. Then, mysteriously, they vanished by evening. Perhaps this was just some 24-hour bug. Maybe the daily vitamin supplements he’d been taking all along had helped his immune system ward off a more serious illness.

He still felt fine most of Sunday. But as the late afternoon rolled around, the fever and cough returned with a vengeance. The illness had obviously not run its course. That night, his right side hurt as he tried to sleep, and his hacking cough kept us up for hours. He called in sick to work Monday and Tuesday, then wound up having to beg off Wednesday, as well, convinced that the worst symptoms would pass and he’d be well enough to return to the newspaper Thursday. He made a brave attempt to work Oct. 22, but by the end of the night his fever was so bad he knew he wouldn’t be in the next day.

Roni had seen her man ill long enough and encouraged him to go to the doctor. Reluctantly, Glenn made a clinic appointment with his regular physician Friday morning. Turned out it wasn’t the flu at all; it was pneumonia. The doctor ordered a chest X-ray, prescribed an antibiotic called Avelox, told him to rest a few days, and sent him home.

On Saturday morning, Glenn came out of the shower and discovered that his skin was covered in hives, a reaction to the Avelox. He called an advice nurse at Kaiser Permanente and was switched to another drug called Cephalexin. It wasn’t quite as good as the Avelox, he was told, but take it for 10 days and it should knock out the pneumonia.

But rather than get better, over the next week Glenn’s health deteriorated. He lost his appetite and was becoming dehydrated. The cough hadn’t improved a bit; he could hear a sound like crackling cellophane every time he took a breath while lying in bed. His fever continued in the triple digits. He felt groggy, tired and disoriented.

By Halloween morning, he’d hit a low. Desperate for help and again at Roni’s urging, he called Kaiser and got a Saturday afternoon clinic visit at their Deer Valley medical offices in Antioch. Surely if the Cephalexin wasn’t doing the job, there was some drug at the pharmacy that would. Glenn was first subjected to another chest X-ray, then went for his doctor appointment. The doctor checked his lung capacity and oxygen saturation levels, which were both low. He pulled up the new chest X-ray and compared it with the one taken Oct. 23. The image showed a large mass of infection in the right lung, and it had grown worse in the past week. The new prescription: a stay at the hospital.

* * *

You always think that bad things happen to “the other guy.” Until they happen to you. We never thought that Glenn would be hospitalized, yet there we were on Halloween afternoon registering in the ER, waiting for more than an hour until they had readied a bed for him. There were forms to fill out and tests to be run. Ben was at home with his friend Nick preparing to go trick-or-treating and celebrate the festivities. Roni had to call him and tell him she’d be a little late because Dad was in the hospital.

They admitted Glenn to an isolation room on the third floor. They put him in isolation initially because doctors were concerned he might have contracted H1N1 or swine flu. All his nurses and other visitors had to enter the room wearing masks. They hooked him up to an IV and pumped him full of a myriad of drugs designed to combat whatever it was that might be causing his symptoms. Swine flu was ruled out quickly. But the doctor still wanted to run some more tests to find out why an otherwise healthy 44-year-old man was unable to ward off pneumonia with traditional antibiotics. They took another set of chest X-rays and a CT scan.

One of the specialists, a pulmonologist, saw something in the CT scan that didn’t look right. A dark mass. He asked permission to perform a bronchoscopy, which is essentially sticking a camera through the patient’s nose and into the lung, where a small biopsy is taken. The mass might just be an aggressive form of pneumonia, or… No one said it in so many words, but the expectation was lung cancer.

The bronchoscopy was only moderately successful. The doctor got a sample for the pathology lab, but he was concerned it might be too small to be conclusive. The results would take about a week. Even though Glenn was now fully hydrated and eating better since being admitted to the hospital, his doctor didn’t want to send him home until the test results came back. She figured that if they showed positive for cancer, chemotherapy could begin immediately by IV. Also, Glenn’s breathing hadn’t improved much. He required 6-8 liters of oxygen to sustain his blood oxygen saturation levels above 90 percent, the minimum safe threshold. He couldn’t be discharged until the breathing was better under control.

It was a nervous week for us as we awaited the results of Glenn’s tests. Roni and Ben came to visit almost every day. Family and coworkers sent cards and flowers that Glenn displayed on a shelf in his hospital room, the encouragement helping to bolster his flagging spirits. He was moved from the third floor to the second floor, then back to the third floor in less than a week. Meanwhile, he underwent an exhaustive schedule of respiratory therapy every four hours, a regimen that included Albuterol inhalers and a machine designed to shake the chest to loosen mucous that might be trapped in the lungs. He was placed on steroid pills that caused his blood sugar levels to rise to hazardous levels, so he was placed under diabetic diet restriction and subjected to blood glucose checks and insulin shots several times a day.

Glenn had been in the hospital nearly 10 days and had been moved yet again to the second floor when the doctor came in one afternoon to tell us that the bronchoscopy had proved inconclusive. They needed a larger sample to work with, and the only way to get it was an invasive open lung biopsy, which involved cutting three incisions into Glenn’s right side. He would have a chest tube connected to his side for a day to drain fluid and need stitches for a week or so. He had the procedure done the morning of Nov. 12. Right away there was some encouraging news: the surgeon, who is an expert at recognizing cancerous growths, didn’t immediately see something he could identify. We’d cling to that while we waited for another week for this batch of pathology reports.