The stabbing begins early evening on June 20, 2011, just one day after starting the antiviral medication. Soon after dinner the knife thrusts rip up the right side of my rib cage. Laboring for breath, I decide to try a walk around the neighborhood. I hobble a few panting steps before I must retreat inside, seeking comfort on the sofa in the TV room.
The cats do their best as always, but their gentle rubs and purrs are no match for the moment. It is odd that this pain should have occurred within 24 hours of beginning the antiviral medication. Last Wednesday and Thursday, while working the church festival, I had noticed a burning irritation in the lower right side of my back. No rash or blistering was observable until Sunday morning when I telephoned my physician. Even after the marks had appeared, the discomfort was a more tolerable burning and drilling sensation—until now.
I try to watch a Pirate baseball game, but not even my favorite spectator sport can distract me from the knife that rips up my right side. I can concentrate only on trying to inhale as little as possible to make it hurt less. As the evening gives way to full darkness, I wonder how I will be able to sleep. I also wonder about the cause of this unusual pain. Perhaps I am having an allergic reaction to the medication. Or is it something else?
By 11 0’clock, I decide to telephone my doctor. I leave a message on his voicemail and consider other options. I don’t feel able to drive to the local ER; even if I could, I doubt that I could survive a two-hour wait in the waiting room chairs with God knows how many other miserable people surrounding me. To call for an ambulance strikes me as a bit dramatic, but it may be my best option. Thinking clearly has become more difficult with each stabbing minute. So unclear is my thinking by now that I make three unsuccessful attempts to call for an ambulance by dialing 9-9-1. While 9-9-1 will get me a clearance TV at Sears, it is certainly no way to procure the ambulance I need now.
In desperation I telephone a friend and labor to blurt out that I could not get through to emergency responders when dialing 9-9-1. Mark gently reminds me that the number I want to call is 9-1-1. I wince through a weak chuckle. Now I dial the correct code and connect to a dispatcher. The dispatcher knows the pertinent questions to ask and instructs me to have a list of my medications ready for the EMT’s who should arrive in about 20 minutes. Unfortunately, that will require more thinking. The good news is that except for the antiviral I am currently taking, I take only one other daily medication. The bad news is that I take 13 different doctor-prescribed supplements every day, and I need to make note of them. The thoughts of what items to take, wondering about the cats, and if I should call anyone else at this late hour are close to overwhelming as I continue the struggle for breaths.
I fumble through the bottles of supplements in the kitchen cupboard, listing each, then trudge upstairs to secure my wallet so I will have ID, medical cards, and some money. Barely through those chores, the doorbell rings and red lights swirl and flash through the lace curtains on the front windows. The cats back up to a safe elevation on the stairway. The two EMT’s introduce themselves as they enter, and I shuffle-step to the kitchen to show them my list of meds and supplements. Shawn, the younger of the two, recognizes me as his ninth grade speech-media communications teacher. Thank God he was a good student and not one of the tormentors in my homeroom whom I wanted to strangle by the end of my last year of teaching. They ask a few questions to ascertain my condition; then they go back to the wagon to bring in the gurney.
They re-enter the house in a minute or so, and I labor through near-breathless answers to their questions. They position the gurney as best they can in tight quarters and allow me to finesse my way onto it, helping just enough. The gurney is over-sized for my townhouse foyer. EMT Joe moves a stereo speaker so they can make a turn to exit the front door. It feels weird to be hoisted out my front door like a Turkish sultan. Somehow, in our grand exit, a cut glass candle holder is knocked off the oriental shelf and crashes into tiny bits all over the foyer floor. The cats have raced for their lives up the steps and are in hiding under the big bed. I hope my neighbors don’t surmise that I have had a heart attack or, worse yet, tried to kill myself.
The ride down Route 30 toward the hospital looks altogether different looking out the back windows of the bouncy ambulance. It appears that we are riding uphill, even though I know that we are humming along a downhill stretch. In almost no time we arrive at the hospital. It must be somewhere around 12:30 AM when I am wheeled into curtained cubicle 29 inside the ER. A nurse comes in to begin her interrogation; I am ready to turn over my exhaustive supplement list and respond to her questions. They fit me with an oxygen mask and decorate my upper torso with stickies to monitor the heartbeat.
The next two hours are challenging as I am unable to achieve any degree of comfort on the cold ER gurney, covered only with a white hospital sheet. The stabbing persists. A close second in annoyance is the soft, but penetrating bell gongs that resound every minute for the entire wait. Finally, when the young ER doc enters smiling, he quips, “You must be pretty healthy, judging from that list of supplements you’re taking.”
“Not so healthy tonight,” I manage.
Nestling on the side of my gurney, this thirty-something ER doc proceeds to give me the lowdown on shingles symptomology. As a motorcycling whiz-bang in medical school in Arizona, he had contracted shingles a decade ago and tells me about some of the residual discomfort, called post herpetic neuralgia (PHN) that can linger for months in some cases. He assures me that the acute pain I am experiencing is caused by the virus attacking the nerves in the diaphragm, which expands and contracts with normal respiration. He maintains that while the antiviral medication will ultimately stop the viral encroachment, it does nothing to relieve pain in the meantime. He surprises me more when he offers, “Shingles gets more severe as we age. Shingles pain is the leading cause of suicide among the elderly.”
I wonder if he thinks of me as elderly, or is this just a cautionary note? Two nurses enter the cubicle to consult with wonder doc.
Summer playwriting workshop, 1999. Remember that one-act play you managed to work up – not really a play – no real conflict, just a few scenes with dialogue between your elderly protagonist resident, Charlie, and his caregiver, Louise. Perhaps Wonder Doc has given you the conflict you need for your Charlie character – unbearable shingles pain.
Back to my service, he offers me a fix for the pain I have been experiencing this long night—a 14-day, descending dose of the steroid prednisone—if I will agree to it.
What’s not to agree to? The ER will administer the first mega-dose. Then I will be discharged with a script to take to my local pharmacy in the morning.
After downing the first dose of the precious drug, I am directed to remove the hospital gown, dress back into street clothes and see the receptionist in the waiting room. Then they ask whom I will call to take me home. I refuse to disturb my friends at 3 AM, so they call for a wheel-chair van. The knife still rips through my rib cage, so the waiting room vigil is interminable. After the better part of an hour an ambulance shows up because there is no available wheel chair van at 4 AM. I must fork over $36 in cash, exact change only, in order to get the ride home; debit or credit cards are not acceptable. Fortunately, I am able to retrieve the exact change from my wallet.
The pain less severe, I ride shotgun in the ambulance for another bouncy ride. At about 4:30 AM we pull up to my house, and the attendants walk me to the front door. After closing the door and crunching shards of glass under my feet, I catch sight of Patches and Cokie, wide-eyed on the stairs, peeping at me through the spindles. I gather up the largest pieces of broken glass and then wipe up the tiny shards with a large wad of moistened paper towels. Patting the cats, I tell them how good it is to be home. I follow the cats, ascending the steps like a thief in the dark, to reclaim the night.
© Dave Knoepfle