Once the plane docked at the gate, we got up and started to gather our carry-on bags as usual. The captain then announced over the PA that we had to wait while the Australia Quarantine Inspection Service boarded and made an inspection of the plane, and we wouldn't be allowed to disembark until they were done. So we sat and waited. After ten minutes or so, they finally let us off.
Fortunately our flight was almost empty, so we got off the plane and through immigration pretty quickly. Better still, since we were virtually the last ones on to the plane thanks to our quick connection in Bangkok, our luggage was almost the first to appear on the baggage claim carousel. We hoisted it on to a trolley and went through to customs.
We had filled out our customs forms indicating we had soil on some shoes, wanting to do the right thing and help prevent foot and mouth disease from getting into Australia. Despite my obviously painful condition, the customs officer we saw insisted on inspecting the shoes we were carrying in our bags, so we had to get them out and show them. After a few minutes we got the all clear and proceeded out to the terminal. I was surprised that of all the airport officials we saw, none of them took a second look at my condition, let alone asking if I needed help or medical attention.
21:00. Michelle's parents were waiting for us in the arrivals terminal, not expecting the horror that awaited. They could see something was wrong with me and Michelle told them I wanted to be taken directly to a hospital. We chose Royal North Shore since it was the closest to home.
21:45. We arrived at the Royal North Shore Hospital emergency room. The nurse on triage duty got Michelle to fill out some forms, took a look at me, and declared it would be apprximately a 4-hour wait before a doctor could see me, indicating the waiting room full of other patients waiting for attention. We decided I needed to see a doctor quicker than that and Michelle's parents suggested taking me to a nearby 24-hour medical centre. If that didn't help we could always return within four hours.
20:00. Arrived at Neutral Bay Medical Centre, which turned out not to be open. The car trip had begun to affect my stomach and I ordered the car pulled over. As soon as it stopped I opened the door and retched, although nothing came out.
20:20. Arrived at Chatswood Medical Centre, which was open. Despite the cold, I'd had my window wound down for fresh air in my face during the drive. We went, filled out a form, and sat to wait for the doctor on duty. One woman was in the queue ahead of us. When the doctor came out after seeing his previous patient, he took one look at me and said to the woman waiting, "Do you mind if I see this patient first?" As soon as I was in the examination room, the doctor said, "Get to a hospital right away." We told him about the 4-hour wait at Royal North Shore. He suggested we go to the Seventh Day Adventist Hospital at Wahroonga, which is a private hospital with an emergency admissions section. I begged for something to relieve my condition and he gave me a shot of antihistamine in case what I was experiencing was an allergic reaction.
20:50. Arrived at the Seventh Day Adventist Hospital. I stepped out of the car and collapsed on the steps leading to the main entrance, throwing up violently. This time stuff did come out, making a mess of their front steps. Once inside, I was admitted immediately and placed in a bed. I don't remember much for the next few hours. I was placed on intravenous antibiotics since the doctor diagnosed some sort of infection.
I saw several doctors during the day: an ear, nose and throat specialist, an infectious diseases specialist, and a neurologist. The agreement was I had an infection. I was put on three different intravenous antibiotics. Since I was also in a lot of pain I was given morphine and another drug (maxalon) to prevent nausea, which I was definitely feeling. I don't remember, but Michelle says I refused to eat today, saying the smell of the food made me nauseous.
Late in the afternoon the doctors told me I would be transferred to Royal North Shore so they could do CT scans on my head. Two hours later an ambulance finally showed up to take me there. It was my first ever ride in an ambulance, but I don't recall much of it.
19:45. Arrived at Royal North Shore and was given a bed in the emergency room, where I'd been triaged less than 24 hours ago. I was taken for a CT scan. Soon afterwards, a gaggle of doctors came to see me. It did indeed look like I had an infection, and it had taken hold in the veins behind my eyes, very close to the brain. They increased the range of antibiotics I was on to ten different types, to make sure something worked since they still hadn't identified the microorganism responsible yet. As the doctors left I overheard some nurses discussing my CT results: "Have you seen his scans?" "Very interesting..." Nobody bothered to let me see them. I was also given a steroid to reduce the swelling in my eyes and nose.
22:00. I was transferred upstairs to ward 7B, the neurology ward. I was given a bed in the female room (presumably because the male room was full) next to a woman on a respirator who snored all night, sounding like a cross between a snarling werewolf, a couple making love, and a 110-year old man who has been chain-smoking 2 packs a day since age 9. A second IV line was placed into my other arm and the drug heparin was pumped in at a constant rate by a machine which kept beeping in the middle of the night. Heparin was to thin my blood and prevent clotting in the veins behind my eyes from the infection.
10:00. I was given a wheelchair ride to the optic clinic in the hospital, for a check on my vision. One of the eye doctors was off sick and there was a long wait to see the other. An hour and a half later I finally saw the doctor, who examined my eyes and declared that there was no damage to the eyes themselves or the optic nerves, but the muscles which align the pointing of the eyes had been affected by the swelling. I could see fine out of each eye, but together they didn't line up and I had double vision. The doctor said it should heal naturally as the infection is beaten.
12:30. After a rushed sandwich for lunch I was taken to the MRI room for a scan. MRI scans are not simple and painless things like CT scans. You are strapped to a table with your head restrained by straps, with a plastic mesh cage placed over it. Then you are slid into a narrow claustrophobic tunnel head first until you are fully inside the machine. Then each scan takes several minutes, and they do lots of them, and each one consists of a jackhammer noise inside the machine circling your head in various directions. I had scans of 3, 7, 10, 6, and 6 minutes length, followed by being pulled out of the machine, injected with dye, pushed back in, and scanned again for 6, 6, and another 6 minutes. With nothing to look at, nothing to hear except this circling hammering noise, and completely unable to move, it was a very odd sensory deprivation feeling. Not feeling too well to begin with, I drifted off into several dream-like hallucinations, including one about floating away in an underwater bubble, surfacing inside a luxury yacht full of beautiful female spies...
After returning from the MRI experience, I was moved to the male neurology ward. The other occupants were:
Scary Guy: I'm f***ing okay!After his mother left he thrashed around a lot and swore a lot more.
Scary Guy's Mother: The doctors will take care of you.
Scary Guy: They don't f***ing know a thing!
16:00. Michelle came to visit me. I had some dinner, which was the first real meal that I could enjoy for two days. It was just meat and three-veg with custard for dessert, but it was delicious.
20:00. At the insistence of a nurse I had a shower. A bit wobbly on my feet, but it felt good to be clean again after two days of lying in bed. When I got back there was another man in the ward, an old man who had apparently had a fall and developed a blood clot in his head somewhere.
20:30. I realised I should probably let my mother know I was in hospital, so I phoned her with the news. Later, as the rest of us tried to get some sleep, Scary Guy was moved to another room, still kicking and swearing.
Scary Guy is wheeled back into the ward. The story apparently is that he fell through a skylight and landed on his head while trying to rob a house. I'm thankful he is strapped into his bed with restraints.
10:00. My mum and Michelle come to visit. I am wheelchaired back to the eye clinic for another check on my eyes. This goes much quicker than last time and soon I am back. Unfortunately, my charts have been misplaced en route from the clinic to the ward. I am in serious pain but the nurses can do nothing without my charts. They are finally located at the hospital pharmacy and rushed back to my bed, whereupon I am dosed up with morphine and given half a dozen intravenous antibiotics in a row.
16:30. Loki and Rach come to visit, which is nice. Later, the microbiologist doctor comes to see me and tells me they have identified the infection. I have staphylococcus aureus (or "golden staph") in my blood. He says I will need to be on intravenous antibiotics for the next two weeks or so to get rid of it. I was hoping to get home quicker than that! The old man in the ward had his operation this afternoon and is wheeled back in for the night.
09:00. An ambulance comes to transfer me to Dalcross Hospital. When we arrive, the ambulance drives down the narrow driveway, turns around in the carpark at the end, and returns to the main entrance so it can stop on level ground and my gurney can be wheeled out. As the ambulance approaches the entrance area, another car enters the driveway and, despite seeing the ambulance there, drives right up to the entrance, blocking our path. As the car sits there, with no sign of moving, the ambulance driver leans out the window and yells at the other driver, "Get out of the way! We have a patient in here!" The car driver does a "Who, me? You want me to move my car?" before the ambulance driver yells at him again and he finally moves out of the way.
Dalcross seems nice, but I have severe head pain again and need to be given morphine in the evening.
I am taken for an ultrasound examination of my legs, to check for any blood clotting in the veins there. The results are good - despite a week in bed my legs are healthy enough.
Before dinner I get a dose of maxalon to combat nausea. With its help, I manage to eat my dinner and keep it down.
For the first time in several days I do not need morphine to eliminate head pain overnight.
In the afternoon I am wheeled out of my room on my bed for the angiogram. I am a bit apprehensive about this procedure, since I know it involves sticking a catheter in my femoral artery and threading it up into my head. I ask a lot of questions as they prepare me. Finally they begin with a local anaesthetic injection in my right groin area, which stings a lot. Then the doctor threads the catheter into my artery, which feels a little weird, but not painful. I feel nothing as it is threaded through my bloodstream all the way up into my head. Then the doctor injects a bit of iodine dye and takes detailed x-rays of the blood vessels there. The dye causes an intense hot flush over one side of my face and head, and my eye sees bright sparks of light despite being tightly closed. After a few of these on the right side, the catheter is rethreaded into the left side of my head - I can feel a vague sensation of something moving around inside but it is not unpleasant. The dye and x-rays are repeated on the left and then the catheter is removed and the doctor places a gauze on my groin and holds it tightly for the next 20 minutes. As he does so, he shows me the fluoroscope pictures of my bones on the screen next to me, which wriggle around as I move.
I am placed in a recovery ward for an hour after the angiogram, then moved back to my room once the puncture wound in my groin has stopped bleeding. I am told not to move my right leg for at least four hours to prevent opening the wound and blood spurting from the artery. While I wait, the good news comes through that the infection seems not to have affected most of the blood vessels in and around my brain. The main carotid arteries are a bit constricted however, but the doctor says that is most likely caused by pressure from the swollen tissue around them, which will get better as the swelling goes down. With the angiogram over, I am taken off heparin and put back on clexane injections.
Paul visits just before lunch and brings more chocolates - peanut brittle this time. In the afternoon I get some exercise, stratching my legs by walking around the hospital a bit. My legs are very weak after two weeks in bed, and I get tired after walking up and down a couple of short corridors.
With Michelle in the room a doctor tries to insert a new cannula into my left arm. Being almost used to this by now I sit on the edge of my bed as he does it. The cannula goes halfway in, then gets stuck on something in the vein. As the doctor wiggles it around trying to get it threaded into the vein, I feel serious pain and all the blood rushing out of my head. I say I'm about to pass out and lie down quickly. The doctor gives up, removes the cannula, and says we'll try it again later. At this point I notice Michelle has rushed out of the room.
At around 20:00 a different person comes in to replace my cannula. I grit my teeth but this time there is no drama and the whole procedure is relatively painless.
With my arms temporarily free of IV lines I go out to Lindfield with my mother for lunch at a Thai restaurant. We have red curry beef, which is delicious compared to the hospital food - not that the hospital food is bad, just that something different is luxury. After lunch we find a gourmet grocery store and buy some blackberry ice cream for straight away and a slice of lemon-lime cheesecake for a snack later tonight.
After the angiogram I am taken for another CT scan then wheeled back to the recovery ward for an hour or so. An old man is also there, groggy from anaesthetic after some surgery. He starts chatting up the nurse who is looking after us, in a semi-conscious and highly amusing way. The nurse can barely control her laughter. She tells the man that his wife will be in to see him later, and he begs her not to tell her anything about their illicit affair. The nurse laughs and and tells him that she told the man's wife after his previous surgery and she laughed about it.
Finally back in my room, I have the cannula in my arm removed for the last time! I eagerly look forward to my first night in three and a half weeks without an IV line in my arm. I am started on warfarin, which is a tablet form of blood-thinning agent. Since it takes a few days to build up to an effective level, I keep having clexane injections.
I am taken for another CT scan today, to get an image without iodine dye in my blood to contrast with yesterday's. I am able to walk to the scanning room, and do a fair bit of walking around the hospital for exercise.
Michelle takes me home for lunch. When I return for my clexane and warfarin in the evening, I ask if I can go home overnight, returning in the morning for clexane and my INR blood test. The answer is yes!
At 18:30 I get a phone call from the hospital. The nurse tells me they will be able to discharge me tonight after I get my final clexane injection! We arrive there at 19:30 and are given bunches of instructions, prescriptions, notes for my GP, and ongoing blood test appointments. I get my final clexane injection and a dose of warfarin, and we are away! Yay!
So I am out of hospital, but I am still on oral medication for another three months or so. My right eye is now more badly misaligned than my left, meaning I still have double vision which is distracting and annoying, but that should clear up over the next few weeks. But I'm home, and that can only mean I'll feel better.
My dose of warfarin is reduced and he prescribes 300mg of aspirin a day to go with it to continue to decoagulate any remaining clots in my veins.
I am feeling much stronger, since I have been able to exercise my legs by walking around and get into the sunshine a bit.
I go to my GP, who examines the lump. Knowing my recent medical history, she calls the doctor at Dalcross and discusses it with him, using big medical words. He recommends I go straight to Royal North Shore Hospital and get someone from the neurology department there to examine it.
I call Michelle at work and she meets me at North Sydney station so we can go to the hospital together. We go to the emergency department and tell them what's wrong, and that I was in the hospital recently and I needed someone in neurology to look at me. The triage nurse advised us there would be a wait of about an hour. The time was 17:00.
As we were waiting, other patients drifted in and were assigned places in the waiting queue. Unfotunately, we'd apparently been assigned the lowest priority, because everyone who was waiting when we arrived was seen to, as well as half a dozen or more other peoiple who arrived after us. Thankfully there was a football game on the TV in the waiting room, which I managed to watch all of before we had to move. We hadn't eaten any dinner though, and were beginning to get very hungry.
Eventually, after 22:00, we were called in to the examination room. A doctor examined me, and I told him my story. He said he would call someone in neurology and left us for a few minutes. When he came back he said everyone there had gone home for the evening! He said he would take a blood sample and that we should return first thing in the morning. He gave us a letter to give to the triage nurse and told us to insist that the triage nurse call neurology straight away, and one of the neurologists would come down, rather than having to wait for hours again.
We went home and had a very late dinner.
We waited just over an hour and a neurologist appeared. He took us into a room and examined the lump on my head. He said it looked like an infection, but I was on such a high dose of antibiotics he was surprised I could have picked one up. He phoned the neurologist who had overseen my entire hospital stay and he suggested changing me to a different antibiotic. The subordinate neurologist gave me the prescription and told me to check in with my GP in a few days to make sure it was dealing with the lump.
The lump on my head has subsided. There is still a lump there, but it is small and doesn't seem to be doing anything. I don't think it will ever go away fully.
My right eye is still not pointing properly. It has improved noticeably over the past two weeks though, and I can sort of see things within about 20 centimetres with proper stereo vision again, but beyond that I still have two overlapping fields of view. I'm hopeful that the rate of improvement will continue and I should have normal vision again within another couple of weeks or so.
So I did a short test drive from our place to the local shopping centre - about a kilometre or even less. It was not really good. I didn't hit anything, but I was rather nervous, and the lack of stereo vision on the left side of the car was extremely disconcerting. I had trouble judging distances between obstacles when parking, and reversing was difficult.
I'm the first to admit I'm not the world's greatest driver to start with. I'm competent enough, but not a really skilful driver. With half my field of vision impaired, I didn't feel too good at all. So I just rang the garage and arranged for the inspection to be changed to a time when Michelle can drive there.
He expressed surprise and said if they haven't recovered by now they probably won't ever do so. He suggested I see an ophthalmic surgeon, who could assess me and discuss the possibility of surgery to tweak the eye muscles so that the eyes can line up properly again.
I'm not exactly keen to spend time in hospital again. Although the alternative is living forever with eyes that can't line up whenever I look to the left. I've driven a few more times and am getting a little more comfortable driving short distances, but I haven't driven any further than a couple of suburbs, and am not keen to. Bleah.
He said this sort of thing can still heal by itself after a year or more, and that we shouldn't be hasty about rushing into surgery, which was fine by me. He suggested I see him again in 3-6 months and he could measure my eye response again to see if it had improved any. And even then, if I can cope okay it's probably not worth having surgery.
I actually think I have noticed some improvement since early March. I can look a bit to the left without the eyes misaligning. So hopefully it will continue to improve.
My eyesight is still improving noticeably, though very slowly, some 16 months after I first got sick. It's now only really noticeable on rare occasions, like looking hard over the left shoulder when reversing the car or something. So, with this good news, I declare myself basically recovered!