I’m Afraid Mr. Shanholtz Is Going to Die
It’s All In Your Head
Yes! I was finally leaving Pittsburgh. It is said that a journey of a thousand miles starts with a single step. Mine started with a nurse removing my PICC line and the EMTs sliding me onto a gurney for the two hour trip. It was unusual though, that I was leaving on a Saturday evening, since Maybrook Hills Rehab didn't usually admit patients on the weekend. But people prayed!
I was on my first ride in the back of an ambulance with wheels instead of landing skids. The view was nothing exciting like my helicopter ride. All I could see were the tops of trees and telephone poles through dirty back door windows. I pretty much rode in silence while Julie rode up front in the passenger seat talking to the driver.
When we got to Maybrook, around 8 PM, I was wheeled down to the end of one hall and put in a room with a view of the parking lot. Many of the rooms had two occupants, but I was alone. The first person we met was nurse supervisor Dina. She was very welcoming and when she heard I hadn't had supper, she went and found a couple hamburgers for me. Dina also removed my catheter for me — definitely not a pleasant experience.
When I woke up in the morning it was November 6th, I thought about an event I was in that made worldwide news, and even changed some federal regulations. It even got me an interview on WTAJ. More about that in part 5.
After church on Sunday Julie came to be with me, as she would most Sundays during my two stays at Maybrook. She would tell me what went on at our church:who was there; interesting things that were said; and who asked about me. Also, I had some visitors — family and friends from church.
On Monday therapy came to evaluate me. By that I mean they assessed how weak I had become and what would be needed to get me back on my feet. Sitting up and hanging my feet over the edge of the bed took some effort and I felt unsteady. In fact, I couldn't even roll over in bed myself. They had their work cut out for them. At first a therapist named Linda came to my room three times a week to do some simple exercises to build up my strength. She had me do all the exercises on the bed.
During that first week, Maybrook’s nursing staff was concerned about my tunnel wound and sent me back to UPMC Presbyterian to have it checked. The doctors who had cared for me there during my long stay said that the tunnel wound looked like it should and that there was no reason for concern. So I ended up riding two hours each way and spending only 15 minutes at the hospital.
The next week therapy came and took me to the therapy room to do more kinds of exercises. Getting me there required the CNAs coming beforehand to place me in a wheelchair using a special type of hoist called a Hoyer Lift.
During these first two weeks I had a fair number of visitors, which was great since most of the visitors I was told I had at UPMC Presbyterian had come while I was unconscious. It was especially nice that our small group from church came and held that week’s meeting in my room.
So here I was in rehab and on the road to recovery. But something was wrong. I did not seem to be progressing. No one knew why yet. I had lost my appetite. I forced myself to drink a couple sips of milk or juice and eat a couple bites of food at each meal. I thought maybe I would like food from home more, so I had Julie bring in some food in the evening when she came to visit me. But I ate only a couple bites of that food, too.
Things got worse. I started having difficulty breathing. Julie and the nurses were starting to get concerned. On Saturday a technician came to my room and took a chest x-ray. The next day, only 15 days after arriving at Maybrook, I was taken by ambulance to UPMC Altoona.
During the next few days in the hospital, doctors ordered various tests, but they could not determine any conclusive cause for my breathing difficulties. My oxygen levels remained high, yet I felt like my lungs had a problem getting in enough air. The medical staff gave me a CPAP machine to wear at night. On Thanksgiving day, after a long day, and a Thanksgiving dinner, which the cafeteria provided free to everyone at the hospital, the doctors sent me back to Maybrook along with the CPAP machine. That evening my two sons came to visit at Maybrook. Their visit made the evening go better. This was the first Thanksgiving that Julie and I were not having together with extended family.
By that Sunday after Thanksgiving, I was having even more difficulty breathing. This caused great anxiety in me and Julia. Julia had slept all night next to my bed in a chair. When she woke up it was still dark, and being so stressed by my condition at that point, she went out to the parking lot at Maybrook and threw up. The lung doctor told me to wear the CPAP at night, but I wanted it on all day and night because I couldn't get enough air! To help me breathe better, the nurses prompted me to breathe in through my nose and out through my mouth. I had been a mouth breather all my life.
By the middle of the week, the doctor ordered Xanax for my anxiety over my inability to breathe right. In other words, they were thinking, “It’s all in your head.” To rule out the possibility that my problem actually was in my lungs, they made plans for me to be seen again by the lung doctor.
On Saturday, December 3, my breathing was so bad that one of the nurses who had checked my vitals went to the the shift nurse supervisor and said ”I am afraid Mr. Shanholtz is going to die.” Fortunately, Julie and I weren’t aware of this conversation until I was leaving Maybrook at the end of May.
Dina, the nurse supervisor, told me she needed to call an ambulance to take me back to UPMC Altoona, but I wanted to wait until Julie got back to Maybrook. She called my wife before calling the ambulance and by the time Julie got there the EMTs were wheeling me out of the room. Later, one of the EMTs who is a friend from church told me that, at the time, he thought I was going to die.
This time, back at UPMC Altoona, they put me in the cardiothoracic ICU. Over the next couple of days I had blood tests, a CT scan, and x-rays. Doctors discovered that I was drowning from the inside! When I was seven years old, I almost drowned after falling off an inner tube in a lake at a camp ground. But my mother quickly pulled me out of the water. This time there was no body of water for anyone to pull me out of. The water was already in my lungs.
On Tuesday a technician came to my room to do a thoracentisis to drain the fluid from my lungs. She had me roll onto my side while she first gave me a shot of Lidocaine, which felt like a hornet sting, in the one side of my back to numb it. Then she pushed a long plastic tube called a pigtail catheter into my back through my skin, my muscles, and between my ribs until it reached my pleural cavity. Using an ultrasound machine she was able to make sure it went where she needed the catheter to go. She repeated the same procedure on the other side of my back. After she drained the fluid from both sides she showed me how much came out--two and a half liters! No wonder I hadn’t been able to breathe.
Fluid was collecting in my lungs. Why? The doctors had their suspicions. They decided that on Friday they would do a transesophageal echocardiogram to see if bacteria was damaging my heart. Hospital staff wheeled me on a gurney to a room with several other people waiting to have the same type of procedure. Before the doctor arrived, a nurse explained to me what was going to happen: the doctor would run an ultrasound scope down my throat to look at my heart. Then she gave me a paste to swallow to numb my throat. What nasty tasting stuff! After the doctor arrived, the anesthesiologist gave me “Twilight,” which is a an anesthetic technique in which you are given just enough anesthesia to sedate you, but not enough to put you to sleep. The next thing I remember is waking up feeling like I just took a nap.
I thought I would be going back up to my room, but the doctor said I had to go get a heart catheterization. What? Why? From what the doctor saw, he wanted to check to see my heart up close. As it appeared in the ultrasound, the heart catheterization confirmed that bacteria had traveled to my aortic heart valve and eaten much of it away! No wonder I had trouble breathing.
I needed a heart valve replacement and the cardiologist considered me a high risk patient because of many factors. He decided one of the surgeons in Pittsburgh needed to do the surgery. But before I was sent to Pittsburgh, a nurse drew blood for the first of eight blood gas tests I would have over the next few weeks. My mother had had this test before her heart surgery and she had said it was one of the most painful things she had ever had done. I remember her saying it felt like someone was pushing a steak knife into her wrist. So I dreaded it when I heard they were going to do it to me. Mother was right. It was awful! The blood gas test involves pushing a needle into the middle of your wrist to draw blood from your artery so that they can test to see how much of your various blood gases are reaching the cells of your body. This cannot be done taking blood from a vein.
On the 10th of December, the hospital staff arranged for an ambulance to take me to to UPMC Shadyside, Pittsburgh, for my eighth surgery. That snowy evening the ambulance crew finally came for me at about 9:45. I remembered that my mother had only been in the hospital a few days after her open heart surgery. So I thought that surely I would be making the return trip in maybe a week.
Some of the music I was listening to while writing this part:
