How I Ended up in the ER on my Summer Vacation - Coffeeshop Writer's Group

Parts of this are published in my Upper Moreland Patch.com blog.

"There it is on the left,” said my boyfriend Scott, pointing at the Lobster House in Cape May. I looked up from my book – “Swimming to Antarctica” by cold-water swim champ Lynne Cox.


After a scrumptious dinner we walked around the perimeter.

This is where the ice comes from to keep the fish on ice.

I liked this fisherman's gear, similar to when I wrote the book The Old Woman and the Sea.

I was excited for our dinner, but at the same time was nursing a terrible problem.

If you’re a woman, chances are that some day you’ll have a "UTI," a urinary tract infection. These annoyances are quickly fixed by antibiotics.

If you’re me, however, the situation is much more complicated.

In 2011, I had a kidney transplant, due to taking the drug lithium for nearly 17 years, to manage my bipolar disorder.

My daughter Sarah gave me one of her kidneys, which allowed me a second chance in life.

What we didn’t plan on was that the life of my kidney would be jeopardized by frequent urinary tract infections.

The symptoms are unmistakable: fever and chills, exhaustion and the indescribably horrible feeling that you have to pee every 5 minutes.

Once these symptoms begin, they don’t let up until I’m on the eighth floor of The Tower Building, Einstein Medical Center on Broad Street, lying in a hospital bed, designed by a master torturer.

Transplant patients get their own room since we have lowered immune systems due to our immunosuppressant drugs.

As nurse Katy rolled me onto the Transplant and Oncology Unit from the ER, the nurses greeted me as if we were old friends: Funso from Nigeria; Crystal, whose daughter will enter kindergarten this fall; Andrea, Mary and Bob.

I also met a patient named “Jack,” who was having trouble with his transplanted liver.

“Oh my goodness!” I said when I learned he’d been on the unit for eight whole months.

I often saw him on his laptop when I passed his room on my endless loops around the unit, pushing my intravenous drip bag, treading carefully in my little blue booties.

HER LAPTOP BREAKS

Like Jack, I brought my laptop for what I thought would be meaningful hours reading the online Times - to bomb or not bomb Syria (today, the Times is chiding Obama on his indecision; he's turning the decision over the Congress, yeah, let them take the blame for our third war) and dig this headline "Mary Cheney chides her sister for same-sex marriage."

When I clicked on the laptop on the bed table at the hospital, the screen turned white as snow. Something had broken.

Hopefully Medicare will pick up the $310 tab from Classic Computer.

What made my four-day stay halfway tolerable was the staff. Whether it was the nurses, the food service people, cleaners, doctors in training, each was a gem of kindness and compassion.

 Here's Vanity, fair, who brought in the food. I loved her blond hair beneath the hair net.

“Anything I can do for you before I leave?” each one would ask.

Doctors would arrive early in the morning, around 6 am.

 Stalin Campos, MD, and doc-in-training David Estrada. Both are from El Salvador.

The wildly popular transplant surgeon Stalin Campos, MD, originally from El Salvador, knocked on the door with his students in tow – I call them “ducklings” – hugged me and said, “Ruth I really really like you, but I don’t want to see you this much.”

This was my fourth visit.

The genesis of the UTI is that the enemy bacteria takes up residence in the bladder.

“The bacteria travels up from the skin and up through the urethra. It can go into the bladder or the kidney itself,” said Sarah A Perloff, DO, FACP, program director for the Infectious Diseases Fellowship and associate program director of the Internal Residential Program.

Like Campos, she is always followed by her own ducklings, mostly female.

Dr. Perloff and I go way back to my first urinary tract infection.

 I was relieved to see her. She and my transplant team would put me on the right antibiotics to chase out the evil invaders that were making my life miserable.

She told me they had a series of antibacterial IV’s (intravenous drips) for me since they wouldn’t know the name of my particular bacterial infection for several days.

Meantime, they would infuse me with a few medicines that should help. Welcome  Invanz, Citrobacter and all. Do your dastardly work!

In fact, within one day, my symptoms ceased and I was ready to do the impossible – go home.

“You know what I like about you?” I said to Dr. Perloff, whose hobbies include bike-riding, gardening and knitting. “You spend time with me. You listen to me and answer all my questions in an unhurried manner.”

“I make a point of it,” she said smiling. “I know people like it.”

After she left, there was another knock on the door.

It was two men in white lab coats – of course! – and I couldn’t fathom who they might be.

Pharmacist John Knorr is on the right. He's training Doil Kim, from the University of the Sciences. Don't you love Kim's rocker hair?

John introduced himself:  John Knorr, PharmD, BCPS, Transplant Clinical Pharmacist. Student Clerkship Coordinator.

Quite a nice-sounding title, don’t you think?

He told me he was the pharmacist for the transplant unit. At his side was his student. He took a list of my medications and then I brought up a question that would determine the rest of my life.

HOPES OF DIABETES-FREE LIFE DASHED FOR GOOD, HAMMETT!

After my kidney transplant, I acquired insulin-dependent diabetes from the antirejection meds, which were now Prograf and prednisone. I was on a campaign to get off the prednisone, in the hope that the diabetes would go away.

“Not a good idea,” said John. “Your Prograf also heightens your sugar level.”

Though I hated hearing it, at least I knew once and for all: stay on your meds and accept the gift of life with all its Faustian complications.

I confess I’m a terrible patient. Boredom is my enemy. And that dreadful bed I lay in while the medicine coursed through my body was tying me up in knots. Every time I got in bed I went into despair.

“Look!” said Maxine, one of the women who changed the sheets. “Your bed has a sinkhole from where you lie down.”Also known as "The Rack."

Ah, validation.  I’m a psychotherapist so I know how important it is to hear one’s subjective feelings upheld by a third party.

After the doctors would leave – the highlight of the day – I’d wonder how will I get through the day. 
After all, I now felt fine, but the invisible enemy within had not yet been conquered.

Visits by Scott helped immensely. Since we live next door to each other he gave me reports on our garden: zucchini aplenty and tomatoes swaying on the vine. He brought me two crunchy fresh salads to snack on.

I read the Phila Tribune, a black newspaper, that I really enjoyed. It featured a fascinating article about the USSR, under Josef Stalin, invited black Americans to live there in the so-called classless egalitarian society.

The blacks had no idea of the massive genocide or killing of political prisoners going on the the country. Read more. 

Thanks, Ruthie, I certainly will.

SHE LOSES HER CONTACT LENS

The mini-tragedy of the broken laptop was rivaled by another one. Blind as a bat, I wear contact lenses. I lost one of them.

In a gallant effort to find the blue-tinted lens, I got down on my hands and knees and scrubbed the entire floor with wet paper towels. Not easy when you're 67 yrs old.

“It’s got to be here somewhere,” I told myself but never did find the damn thing.

Friday, the day I got there, they wheeled me in for an ultrasound to my kidney to show if the blood vessels were working properly. Which technician would I get? Gensi, the Albanian? Jeff the bearded one? Or Wendy? 

The test showed my kidney was in fine fettle. My daughter Sarah would be proud of me. She and I both know I exercise and eat right to preserve her precious gift. Diabetes kills kidneys. I lost mine once and don't plan to again.

I told myself to stop complaining and commanded myself to finish the latest New Yorker before the next one arrived at my door. I’ve never finished a single issue.

On Monday morning, the transplant team said I could go home. Nurse Bob gave me the news before he stuck me in the belly with my insulin before lunch.

They never give you enough insulin in the hospital, fearing, I spose, you'll go low. I had my own stash inside my backpack and made up the difference.

When you're told you can go home, prepare for a humongous wait, perhaps 4 hours. Massive amounts of paperwork are filled in. I reverted to my usual M.O. and marched around the floor again in my blue booties.

I learned from Mark, one of the cleaners, that when a patient leaves, the furniture in the room is moved to the side and the whole room is scrubbed clean. I’d witnessed it a couple of times and wished I could help. I wanted to do something to feel useful.

Last time I was there I put myself in charge of the plants along the window sill. I must've done such an impressive job, they were all gone.

Could it be that when I left, my missing contact lens would be swept away into the sudsy water?

Dr. Radi Zaki, head of the transplant unit, came up with a plan which we hope will permanently oust the infections.

I’ll take a low dose of Bactrim every day. I asked my Giant pharmacist Erich Dietz what he thought of this plan. Fine, he said. The main side effect of Bactrim is kidneystones.

Well, here I am, Saturday evening, sipping on a cup of Red Raspberry Tea with a jigger of plain cranberry juice inside, Dr Sarah Perloff's idea.

COFFEESHOP

We had a short stack..... Marf, Linda, Carly and me.

Scott stopped in to show me his new glasses, which he'll wear full-time, instead of reading glasses.

Scott and the Crepe Myrtle Tree. The flowers absorbed so much water, the boughs bent down. Scott staked em up.

COFFEESHOP GROUP

Like all of us, Carly has intense feelings about her poetry and short stories. The four of us there - Marf, Linda, Carly and I - are rabid in our desire to do outstanding work.

So, she was shocked when I said I didn't like the ending of her short story NAILS.

You can't just end it there, I said. There's no resolution.

Martha agreed.

Carly's face registered shock and near-despair.

Not to worry, we reassured her.

We worked on the story nearly 45 minutes, coming up with a resolution - and the exhortation, For godssakes, don't put the moral at the end - lem em figger it out!

It should be quite good when next she brings it in.

Marf brought in two excellent poems she dashed off in milliseconds, perfectly formed from her pen.

Linda revised Chapter Four of her novel - AGAIN! - and brought in a new poem, asking, "Have I lost my magic?"

Marf reassured her that once you've got the magic, it never goes away.

I brought in a 7-page short story, whose characters live off Roosevelt Boulevard in Philly and are named
Sue Ann, Gramps, Mama, among others.

Since I only met them last nite, I am still getting to know them as I infuse them with life and personality. I remember how the newly deceased Elmore Leonard wrote about the importance of character names.

When Scott and I were eating our weekly pizza an hour ago and watching To Kill a Thief with Robert Wagner, he finished the dishes, came and sat catty-corner on Gramma Yetta's plastic-coveed love seat and said, "I really like your short story. I think it's one of your best."