I haven’t felt well this past week. In fact, I haven’t felt great these past couple of weeks, but the symptoms that I’ve experienced have worsened and culminated in a visit to the Emergency Room.
I think it all has to do with my C-PAP machine—the device that has prevented my fat neck from collapsing in on itself these past seven years, thereby avoiding a catastrophic end from Obstructive Sleep Apnea that has taken from us the likes of Jerry Garcia and Reggie White far too soon.
While the C-PAP saved my neck when I was fatter, I have continued to lose the weight collaring my face, but have been negligent in following up with my sleep doctor (In my defense, the sleep clinic I went to folded-up overnight, with no one I talked to in the medical community knowing what happened to it. When my doctor did resurfaced, now as a Mercy Health Physician, the inquiring Mr. Wright isn’t received as a loyal returning patient, put on the short rotation of scheduling, but is treated as a new patient and penciled in two and a half months from now. Alas, thus is life!). As the weight has dropped, the pressure of my C-PAP has stayed the same while my quality of sleep has gradually become poorer.
About three weeks ago I started feeling a tickle in my throat. Suspecting a summer cold, I carried on and didn’t miss a scheduled workout day. The tickle became a full feeling right around where I swallow. I’ve had full-blown strep throat and I could tell this wasn’t it: I didn’t have a cough that tendered up the throat; there wasn’t the excruciating feeling that I was forcing down bits of glass with every gulp. My sister had just recovered from bronchitis, but I couldn’t have that: one doesn’t break one’s mile record with such a lung ailment.
If what ails me wasn’t in my lungs, wasn’t a type of sore throat, and wasn’t affecting my head, then it was something new to me, and I’d try to suffer through it if I could carry on with my physical activities—if I didn’t miss my times with Laurie. But this past week it got worse when rising in the mornings. Upon waking, my throat was so tight, so full feeling that I couldn’t tip my head back without trigger an instinctual cough in hopes of clearing the passageway. It got better as the day progressed, but there’d be times in the day that my throat would seize up and I’d struggle to get in a breath.
Then shortly before five, Friday morning, I shot straight out of slumber, in full panic and seemingly completely unable to breath. I’ve had anxiety attacks, from time to time, that have caused me to bolt up out of bed in the middle of the night, smacking my chest with the feeling that my heart had stopped. In such events, you are reduced to the instinct to survive, and Friday morning I stumbled across the hall to the bathroom, able to get only a tiny bit of air in, in what must have almost resemble the reverse sneezing of a dog. I was unable to even cough out, let alone communicate. My panicked tumult so early in the morning aroused my grandmother from bed and she witnessed my struggle for breathe.
After what was about a minute, yet seemed like eternity, my throat opened up and I could breathe easier, and make grunts for yes or nos. As my Nana relayed her observations to my mother, a pharmacist and our household medical authority, I gradually regained the ability to speak. No Mom, it’s not in my lungs, I’m not asthmatic; it’s not strep throat; not a sinus infection, either. No, I haven’t been established with my new PCP on my new insurance; no, I can’t afford to pay out of pocket to see my old doctor.
Damned if she knew of any condition that would cause a spell like I had, which would allow me to workout virtually normally, and if I—her child, aye, but a 27-year old man—decided that he wasn’t going to lay down sick for the day, she couldn’t stop me. Unless I was experiencing attacks outside of morning, when my throat always felt at its worst, I wasn’t going to miss the day that was planned for me.
Friday, Laurie met me in Loveland for a day of bike riding on the Little Miami Scenic Trail. Laurie, the tri-athlete, owns a great road bike. I hired a comfort bike from Montgomery Cyclery—a fabulously run business that has a hassle-free rental process. As Laurie made final preparations, at her car, for the ride—watering up, apply sunscreen, checking tire pressure—I rolled and wobbled around the parking lot, remembering how to do what they say you never forget.
The humidity was blessedly low for a late July afternoon; the trail, a tunnel of tree cover over most of the stretch, had a nice breeze that kept us pedal-pushers comfortable. Laurie kept a challenging pace as she taught me the unwritten rules of the trail—where on the path to ride, how to pass others, how to cross roads against potentially cyclist-killing automobiles, to look out for fellow riders needing assistance; all this to keep me safe and an asset on the trail. We rode all the way to South Lebanon, ten miles out before matching the distance in the return. It was a wonderful day, and beautiful change of pace from the gym.
The rest of the day I was fine, only having teeny bit of fullness in my neck. Then, after sleeping without my C-PAP to see if that’d make a difference, I awoke at 7:30am, my normal time. I had just enough time to put on my glasses before my throat closed off again. Panic set in as I again stumble into the bathroom. My stridor, my coughing and wheezing, this time brought the women in my family—my mom, sister, and grandma— out of their bedrooms and they were horrified. Sister Sarah, the recently recovered bronchitis case, viewed a similar sufferer and encouraged me to “cough it up.” As I hadn’t had any mucus-y sputum hitherto, I could tell there was no “it” to cough up. My mom suggested that she’d stick a pin in my trachea. My Nana, the matronly supervisor, observed and issued emphatic encouragements.
In front of the bathroom mirror, in the morning light, with my glasses on, I could see that my face wasn’t simply without color—it was completely green. I had once seen a guy being treated in a college hallway after having passed out in front of a public speaking class. I had the same skin tone as him, and I feared I was going to lose consciousness. Fighting the dying of the light, I watched myself impotently coughing, choking without effective resistance. Then it subsided. No more than two minutes, it easily equaled the most scared I have ever been.
What could I do but seek medical treatment? When battling for my life’s breath for the second morning in a row, I was still completely baffled as to what it could be. Who’s to say it wouldn’t be worse tomorrow morning? In such a condition it was time to see the expert diagnosticians at the Bethesda North ER. My mom drove us recklessly, and it felt slightly surreal as I, the patient, with a feigned level-headedness, chastised her—better harsh words than a rebuke from the law or even further injuries to another.
Once in the ER, my mom told the admitting attendant that I was having trouble breathing and I was almost immediately taken back. Doctors inquired about my symptoms and took in my medical history. One doctor said it sounded like the attack of vocal cord dysfunction, and while waiting between tests, I looked up VCD on my smart phone: spasms of the vocal cords that blocks the airway, relegated to the throat, often misdiagnosed solely as asthma, terrifying but rarely life threatening. I felt that the doctor nailed it, but they must have to rule out everything to make a diagnosis official. As the X-Rays came back showing no collapsed lungs or physio-abnormalities of the throat, and throat cultures came back negative, I was more convinced that VCD episodes were what I was experiencing. They gave me a breathing treatment, and sent me home with prescriptions for an antihistamine and an inhaler, and instructions as to how to proceed.
As I sit composing and reliving this, I still have a tickle in my throat and an urge to cough that I fear might cause my throat to cinch up. I’m to make a follow-up with my PCP tomorrow, and call my sleep apnea doctor to plea for a sooner appointment. In the meantime, I’m hoping it was the C-PAP and a bug that is causing it; and hope that I won’t long require the wheezing machine and, as my body vanquishes the bug, the episodes will go away as quickly as they came. I’m smiling as I realize that, in thinking that out of this awfulness the best outcome will occur, I’m probably deluding myself but, hey, I’m an Optimist! We’ll see how it goes…