Sunday, November 13, 2011

Huff, Puff, and down we go

It's been a rough couple of months for Ol' Abner. When his surgically improved toes healed, he felt ready to push his feet into walking shoes and enjoy a stroll around the neighborhood. Brown dog was incredibly happy to adopt this old habit quickly. I walked with him and was surprised as he trudged up the slight incline leaving our house slowly. He could barely talk and was gasping for breath. We concluded that he was really out of shape from recent inactivity. A few days and we thought he would be fit and able to regain his past level of walking.

After a few days with no improvement, I urged him to call his local primary care provider. After a few more days of delay, he finally gave up and called. When he explained his problem by telephone, the instruction was to proceed to the emergency room. Feeling as though that was an overreaction he continued trying to push through the huffing and puffing. After his follow up with the podiatrist, I urged him to go ahead and have this problem evaluated. It wasn't getting better and I hoped it might be something easily remedied.

Emergency rooms are seldom pleasant places to spend the afternoon. We felt a little silly as we shared the waiting area with a man denied entrance to an airplane with his red swollen leg, an elderly couple accompanied by a loud daughter thinking she should take charge of the system, and a young man seeking pain medication for his swollen gums. The triage nurse called us in for evaluation and one glance at the intake sheet caused her to immediately call for a technician to come from the inner-sanctum of the treatment area. A snippy young man sitting at a previously empty desk chastised me for not stopping there as we arrived. Ol' Abner's complaint was supposed to be treated as a life threatening emergency. I didn't bother to explain that he had been missing at the time and we had proceeded to the "check in" cubicle. Abner was escorted back and I was instructed to return to the waiting area to enjoy the stares of those knowing their arrival had preceded ours. Meanwhile snippy young man sat at his desk showing the apps on his smart phone to a security policeman as my husband's escort came to the door and said something to him, then pointed to me. Snippy young man nodded and continued his conversation. Another twenty minutes passed and a nurse came through the sliding door and called my name. Snippy barely glanced up as I entered the portal beside him. The nurse thought I had left since the technician had come out earlier to have Snippy young man to send me back to join Ol' Abner.

Ol' Abner was perched on a cot with oxygen on his face, a blood pressure cuff on his arm, leads on his chest, and a pulse oximeter on his finger. The physician had advised him that his EKG looked good, his blood work raised no concern and we awaited the chest Xray. The contraptions attached to his person had indicated that he was not absorbing enough oxygen, thus the oxygen flowing up his nose. We had been there about two hours by this time, and Ol' Abner was lamenting that it would be very late when we arrived home, a rather prophetic observation.

His exit from the emergency room followed a path to an inpatient room for observation and further testing. The chest xray had shown fluid in his lungs and the doctor calmly suggested that he remain for a day or two flush the fluids, determine the cause and plot a course of treatment. He was there for four nights and on the fifth day he was released by a reluctant physician when he promised to return for additional outpatient tests.

Our home in Dogpatch is a little over a three hour drive down the mountain and over a couple of rivers and around another mountain or two from the city. Following his admission to the hospital I drove home over the winding roads frequently shared by deer in the dark of night.
Brother had come by to feed the dog and allow her a minute of outside time, but she was a bit confused when I arrived alone. I packed some clothes and the next morning delivered the pup to her favorite canine bed and breakfast before repeating the previous morning's journey down the mountain.

Congestive heart failure was the final diagnosis. Additional tests indicated that he needs oxygen when exerting himself. A therapist came to the house last week and brought small tanks of the stuff and tubing to attach it from a backpack he can carry as he walks. Today he walked with his pack of oxygen and the dog is happy again.



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