Glenn takes a nap Oct. 29 with Ariel on his lap. He had been sick for nearly two weeks with what we thought was pneumonia. Bed rest was high on his list of activities. Photo by Roni.
Our menacing porch guardian wasn't enough to convince trick-or-treaters that it isn't cool to take more than one piece of candy from the self-serve bowl. This bowl was full at the start of Halloween evening, but empty a couple of hours later. Photo by Roni.
Glenn's condition was considered serious enough that he was admitted to the hospital Halloween afternoon. He's looking a bit tired in this shot taken Nov. 1, but said he was already feeling much better, thanks to fluids, food and an oxygen boost. Photo by Roni.
Kaiser Permanente's Antioch hospital has a spectacular view of Mount Diablo. Here's how it looked around dusk on Monday, Nov. 2. Photo by Roni.
The daily trips to visit Glenn at the hospital are draining on poor Ben, who after a week of school was already feeling fatigued. He avails himself of the room sofa Nov. 6 for a nap. Photo by Roni.
Glenn sports his hospital-issued anti-skid brown socks and a pedometer given to him by the nursing staff to encourage him to take more walks so his lung capacity would increase. Photo by Roni.
A growing collection of get-well cards, flowers and artwork occupies a shelf in Room 205 on Nov. 6. Photo by Roni.
One of the hospital nutritionists puts her personal touch on a foam cup. Dreams are hard to come by in the hospital, where people are poking or prodding at you around the clock. Photo by Roni.
Heart rate 64 beats per minute, blood oxygen saturation at 96 percent. Those are the numbers we like to see. Keeping his oxygen level above 95 percent was a key to Glenn's getting to go home. Photo by Roni.
Looking up at the second through fourth floors of the north-facing hospital rooms. Glenn's final room, 329, was somewhere near the middle of the second row of windows. It had a great view of the staff parking lot and a cattle grazing field. Photo by Glenn.
Glenn dons his street clothes on Nov. 20 for a walk around the hospital. It was the first time he had been out of his hospital gown in three weeks. Photo by Roni.
Inside the hospital the temperature never changes. But outside, the seaons slowly shift as we head deeper into fall. Mount Diablo is shrouded in clouds during a storm Nov. 20 that left the ground rainslicked. Photo by Glenn.
Roni takes a break in the third-floor family lounge with a portable oxygen tank close by in case Glenn feels short of breath. We didn't need it on this walk. Photo by Glenn.
Dawn breaks over the Delta the morning of Sunday, Nov. 22, bringing with it hope that Glenn will soon be coming home. Photo by Glenn.
Discharged and free to go home, we take one last glimpse at the great gray walls of Kaiser Hospital on Nov. 24. We are all glad we won't have to be here for Thanksgiving. Photo by Glenn.
After weeks of hospital food, Glenn was in the mood to celebrate being home. We ordered a feast of pizza and pasta from Melo's in Brentwood. Good eats. Photo by Glenn.
Roni displays one of the more unusual items in our box of Thanksgiving morning bagels a bagel with jalapenos baked on top. Sounds weird, but it was mighty tasty. Photo by Glenn.
Roni dishes up fresh cooked asparagus while the turkey cools atop the oven prior to Thanksgiving dinner. Photo by Glenn.
It's already time to think about Christmas. Roni puts the finishing touches on the tree decorations Nov. 28. Because Glenn is still not up to full strength, Roni for the first time strung the lights herself. We decided to keep the tree on the floor rather than place it up on the display table as we usually do, because nobody thought they had enough strength to lift it up there fully decorated. That's usually Glenn's chore. Photo by Roni.
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Giving thanks... for health insurance
November 28, 2009
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.
The following day, Friday the 13th (and no, we’re generally not that superstitious), we got a visit from the infectious diseases specialist who asked Glenn if he had traveled recently to the Southwest or the Central Valley. Had he been hanging around areas with a lot of fresh dirt? Had he ever been homeless or shared needles? Very unusual questions. After building the suspense, the doctor told us that one of Glenn’s pathology tests had come back positive for something called Coccidioidomycosis, more commonly known as Valley Fever. A fungal infection, the spores are common in certain areas of the country and tend to more often afflict people of particular ethnic groups. Most people who are exposed to the spores develop immunity or may have a mild case of Valley Fever and never show symptoms. But for others, the disease can be life-threatening. Pneumonia is one of the symptoms.
The doctor put Glenn on a toxic antifungal drug called Amphotericin B Lipsomme that looked a little like frozen orange juice concentrate when it was administered through his IV. He would have to stay on the IV for at least 10 to 14 days, after which time he would be switched to pills he could take at home. We began to worry that he might have to spend Thanksgiving in the hospital.
Glenn’s breathing was showing signs of improvement. He was able to take walks around the hospital on lower oxygen settings without desaturating. Eventually the walks got longer and he didn’t need the oxygen bottle at all. He was able to spend long periods sitting in his room without being hooked up to the oxygen. His doctor moved him once again from the second floor back to the third floor.
We were nearing the end of Glenn’s third week in the hospital when one of the doctors burst into the room one morning and joyfully proclaimed, “Have you heard the good news? You have an infection!” The pathology report had come back negative for cancer, so all that was left was to confirm the Valley Fever diagnosis, which the microbiologists were working on doing by growing a mold culture on Glenn’s lung tissue sample. The results are still weeks away.
After 10 days on the Amphotericin B, the doctor switched Glenn to the pill-based Fluconazole on Monday, Nov. 23. That night, Glenn was told he’d be going home the next day.
On Tuesday, Nov. 24, following 24 days that included five rooms, scores of nurses and doctors, about 100 respiratory therapy treatments, and countless needle pokes, Glenn got to come home. He was tired from the ordeal, but grateful his ailment had been diagnosed and that he would be home in time for Thanksgiving dinner with the family.
If there was anything to be thankful about, besides Glenn’s homecoming, it was for the fact that our Kaiser insurance plan covered most of his hospital expenses. Although we have yet to hear a final tally and may never, the cost of Glenn’s treatment less than two weeks in was already $164,000. Our portion will be around $3,000 plus some incidental expenses for outpatient visits and medications. We figure that more than covers every health insurance premium we’ve ever paid or likely ever will pay. Little things you never think about at open enrollment time when you are griping about the rising cost of health insurance.
Glenn’s illness has been a shock to our household in many ways. He was forced to go on disability, which has put a bit of a dent in the budget, although a manageable one. Roni was finding little opportunity to rest, splitting her time between being with Ben at home and going to the hospital to be with Glenn and dealing with issues related to his disability insurance. Ben was stressed out that Dad was hooked up to a bunch of tubes and wires and had to stay in a hospital room instead of coming home.
The first day Glenn was home we celebrated by ordering a big pizza and pasta meal from Melo’s Pizza in Brentwood. He was craving “real” food after more than three weeks of eating boxed meals served up by the hospital nutritionist. He also needs to fatten up; he lost about 8 pounds during his stay. We tried to take care of that Thursday with one of Roni’s delicious Thanksgiving feasts of turkey, stuffing, mashed potatoes and gravy, candied yams, rolls, asparagus, cranberry sauce, and pumpkin pie. If it didn’t work the first time, we still have a couple days of leftovers to consume.
‘TIS THE SEASON
We feel like we lost a month, with all the goings on. Now we turn our attention to Christmas. Glenn will be recuperating for a while, but that hasn’t stopped Roni from hauling out the boxes of Christmas decorations and going it alone. The day after Thanksgiving she eagerly set up the wood display table where we usually stand our tree and covered the whole 3x6-foot area with her collection of ceramic houses and figurines. We decided that it would be better to place the Christmas tree on the floor this year rather than have Glenn try to lift the fully decorated tree up to the layout table.
Not that Glenn won’t get to help out in the decorating process. As soon as he gets over his bouts of fatigue and dizziness brought on by his medicines, he will attempt to string some Christmas lights. We’re all hoping he’s feeling well enough before Christmas to truly enjoy them.
Here’s hoping you have a happy and healthy holiday season.
Glenn, Roni and Ben