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In the Hospital Again

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UCLA Santa Monica Medical Center

Ye gods, not again! On Sunday during the hour of the wolf (around 4 AM), my digestive system spewed waste with great force. While still in bed, I projectile vomited with such velocity that nothing within an eight foot radius was left unmarred by my effluvia. This was followed up what the doctors at UCLA Santa Monica Medical Center referred to in my discharge papers as “acute weakness.” It was more than weakness: I was too lethargic to get out of bed.

Unaffected was my brain function. Martine wanted to call an ambulance to take me to the hospital. I demurred. Then she called my brother in Palm Desert and got him into the act. At that point, I finally agreed. Martine cleaned me up as best she could. In no time at all, the Los Angeles Fire Department was there hoisting me up and strapping me in a device that took me down the apartment steps to the waiting ambulance that stood there with its lights flashing.

I asked to go to the UCLA Ronald Reagan Medical Center. Apparently, their emergency room was filled to capacity with the usual weekend accidents. Fortunately, there was an opening at the UCLA-owned Santa Monica Medical Center. If I were to go to a non-UCLA-affiliated emergency room, I would be poked, prodded, and tested for days for the simple reason that few if any hospitals could afford to keep an endocrinologist on hand at all hours. Probably not even Bellevue in New York or the Mayo Clinic in Rochester, Minnesota!

So, what happened? I am no longer possessed of a working pituitary gland in the center of my head (due to a benign tumor I had roughly between 1956 and 1966). No pituitary gland means no signal to my glands to produce hormones. So, no hormones at all—zilch. That means no thyroid, no testosterone, and—most important—no adrenaline.

Sometime in the early morning hours of Sunday, my body made a request for adrenaline due to something I ate. When it did not respond to that request, my body basically shut down. Fortunately, I was conscious the times I wasn’t snoozing.

And so what did they do at the hospital to make me better? Not a damned thing. Before the paramedics came, I asked Martine for a glass of water and five 10mg tabs of Hydrocortisone, which I was able to ingest. I was still weak for several hours, but that’s what made me feel able to get up and walk.

What the hospital staff did do was X-Ray me, start an IV, and take my vital signs. Fortunately, the hospital had access to previous hospital admissions which gave my medical history. When they finished poking and prodding me, they discharged me. Scram, Buddy, we need your space for other patients. So they called Martine, who was having back pains from having to clean the mess I made; and she grabbed my car keys and picked me up.

In the end, I wonder whether I should have gone to the hospital at all. I decided to mainly because Martine and my brother were bummed out by my condition. I’ll have to talk to my doctor about this when I see her.

I Dodge a Bullet

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Wednesday, November 1, 6:00 AM

Life is strange when you don’t have a pituitary gland. Mine was removed by surgery in September 1966. On Wednesday I woke up early to go to the bathroom. After I did by business, I got up and … and … and …

B L A C K O U T

When consciousness returned, I was bleeding from a large bump on the left of my forehead and I felt as if one of my ribs was broken. Imagine Martine’s surprise when she woke up to go to the john about an hour later! There I lay, covered in blood and unable to raise myself due to (1) pain from my broken rib and (2) general weakness due to adrenal insufficiency.

Without a functioning pituitary, one has no thyroid function, no sex hormones, and—oh, yes—no adrenaline. All those have to be supplied from outside the body. Those early morning hours can be killers. Ingmar Bergman had a good reason to call it “The Hour of the Wolf.” At my request, Martine got me a glass of water and five 10mg tabs of Hydrocortisone.

Eventually Martine has to call 9-1-1 to get an ambulance. I couldn’t just lie on the bathroom floor forever. The emergency medical technicians took one look at me, hoisted me up, and trundled me of to the UCLA Medical Center, where I spent a couple of days in the intensive care unit and an observation ward.

I strongly suspect that this is how I will leave this world. At some point, the adrenal debt will be too high; and there will be a general system shutdown. Not a particularly painful exit.

For the time being, I’ll still be here. I hope.

Ach! Not Again!

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UCLA’s Ronald Reagan Medical Center

Yesterday morning, I found myself being admitted to UCLA Hospital’s emergency room. That morning, I awoke around six in the morning to go to the bathroom. Coming back I found myself bumping into things. When I tried to get back into bed, I slipped and fell on the floor pinning my left shoulder between the bed and my nightstand. I was too weak to make a serious attempt to get up.

Martine heard my fall and frantically tried to help me. But how could she, with her right wrist in a cast from when she broke it the week before. For hours she tried to make me comfortable and gave me water to sip through a straw. Fortunately, she had the presence of mind to give me 30mg of Hydrocortisone, which, as it happened, is the cure for the symptoms I was experiencing.

Time and time again, she asked if I wanted an ambulance. My consciousness was improving from the Hydrocortisone Martine gave me, so I finally said yes. It seemed that the bedroom was crawling with Emergency Medical Technicians from the Fire Department within minutes. They hauled me out of my wedged position and dumped me on the bed. Their strongly recommended I be admitted to the hospital. I tried to resist their suggestion until I had the feeling that it was pretty much de rigeur in their profession.

So, as when I had my last serious Addisonian Crisis on December 30, 2017, I was trundled down the apartment steps, plunked into the ambulance, and driven to the UCLA Hospital emergency room (but without the sirens).

What was wrong with me? The scientific term is panhyopituitarism, which means I no longer have a pituitary gland. It all happened many years ago. To read the gory story of my near-death experience in 1966, click on this post from April 2015.

By the time I got to UCLA, I was feeling pretty good as the Hydrocortisone was doing its job; but I knew I would have to go through the medical profession’s equivalent of the death of a thousand cuts. I was wheeled from one clerk to another and asked for details which were entered into their system. Fortunately, In December 2017, I had roughly the same situation.

Still, it seems that emergency wards assume you have some internal organ problem such as a heart attack or cancer, so I was hooked up with little stickies all over my upper body and probed with needles until the doctors determined that, yes, I would not be likely to die on the spot. My problem was not a disease of an internal organ, but the fact that I was missing the body’s master gland and occasionally needed to have extra amounts of ACTH (adrenocorticotropic hormone) in lieu of natural adrenaline.

On at least two dozen times, I made the point that the problem was that I had no pituitary. I had to talk with an endocrinologist because my ailment was not a common one, certainly not one that a typical emergency room physician would grasp. Not only that, but the cure had been applied hours before when Martine gave me my medications. Back in 2017, the same hospital held me for three days until the resident endocrinologist strolled in with her hands in her pockets and, immediately understanding my situation, had me released.

Fortunately, I was released late that afternoon. Maybe it was the record of my 2017 experience that convinced them to let me go. Maybe it was because they had me walk to the bathroom and saw that I was fully mobile. And apparently, the doctors did talk to the endocrinologist who told them to let me go. I felt bad to be around all those persons who were really suffering. I kept telling the nurses I felt I was occupying space in their emergency room under false pretenses.

So I took a taxi home, and Martine was at the front of the apartment to give me my wallet so I could pay the driver.

The funny thing is, there is little advanced warning when one is about to suffer an Addisonian Crisis. In this case, I didn’t suspect something was wrong until I returned from the bathroom to go to bed. That was approximately a half-minute warning.