Friday, April 27, 2018

Recalled to life: or, where did my last six months go?

On August 26 of last year, I was just sitting down to appetizers with my wife at a local restaurant when I passed out. Six months and two hospital stays later I am not only recovered but have what in essence is a second opportunity to live fully. Was it a stroke? A nervous breakdown? Adrenal insufficiency? A road-to-Damascus moment? What happened?

I had just returned from a long trip, driving home alone for 1,200 miles after dropping our son off at college for his sophomore year. I was sleeping rough in the car, eating catch as catch can . . . overdoing it. I was tired, more profoundly sleep-deprived than I could imagine.

Still, it was quite a surprise to pass out for the very first time in my life, especially in a public place. Though I was only out for 30 seconds or so, my thoughtful wife summoned an ambulance immediately. I found myself being loaded onto a gurney, cannulated, and shipped off to the nearest hospital. (Here's how awesome the restaurant was -- they boxed up our dinner to go!)

I was floundering. I shook with tremors, and numbness and tingling plagued my hands and feet. I was dizzy, but not in the classic sense of the room turning about me. Instead, I felt as though I were tumbling forward, end over end, uncontrollably. I was flushed and sweating, alternating with bouts of chills. My heart raced and my breath caught in my throat. My ears rang, and my throat was swollen and painful. I couldn’t bear light or noise. I was curled in on myself like a fetus.

I was drifting in and out of consciousness, and unconsciousness would have been my first choice. Above all, I was in an absolute and helpless panic. It felt like the floor had opened beneath me and I was plunging hopelessly into a never-ending nothing. You know how you miss a step in the darkness and suddenly stumble, grasping helplessly for something to steady you? This was my state, lying stock-still and wired up to all the diagnostic machines.

After two days and no diagnosis, they sent me home. I hung on for a month, hoping the problem would cure itself. Finally, in early October, I was seized with another spell so severe that I packed myself off to a second institution. Once again, they examined me — nothing. Fortunately, my wife had made an appointment at the adjacent cardiologist’s office. He took one listen to my thuddering chest and ordered a coronary angiogram (this is when they slip a tube up your vein and take a gander at your ticker with the help of x-rays and dye).

That test proved negative — as did many others. In fact, they tested every part of me over six days, through MRIs, CT scans, bloodwork, you name it. The doctors examined everything but my taint (look it up). No abnormalities were found. They were very apologetic. (One thing I did note is that many medical specialists simply cannot think, can’t extrapolate outside the bowling-lane boundaries of their unique disciplines. This clinical modesty results in the reduction of errors — and liability — but it doesn’t go far in solving a complex problem.)

An inevitable round of visits to specialists turned up nothing. Meanwhile, I was still living a very provisional existence. I was trapped at home, still victimized by the same symptoms, unable to sit up for very long periods, much less travel, and exercise, do the chores and run the errands. I couldn’t go to shul or to school functions. Initially, I was largely unable to talk for a couple of weeks, and the ability to write a coherent sentence took about a month. I was sleeping 12 to 14 hours a day, with naps of 2 to 4 hours in between. I was vanishing.

Finally, somewhere between the endocrinologist and the neurotologist, I got help. The diagnostic prize goes to ENT-otolaryngologist Carol Foster at the University of Colorado Hospital. “It’s SLEEP APNEA,” she pronounced with confident finality.

????

It still astonishes me that such a prosaic problem should be life-threatening. However, with me the problem was far worse than imagined. I went to a sleep clinic and had a study done — the kind where they wire you up and monitor you all night. (Again, my prescient wife noticed a problem years before, and I had been tested no fewer than three times by three different clinics, with inconclusive results.) It turns out I was experiencing an AHI (Apnea-hypopnea index) of 52 — meaning I was coming out of a sleep state nearly once a minute, all night long.

Not only had this produced the symptoms outlined above, but I learned that perhaps for as long as a decade, I had been sleep-deprived like this. My neural and cardiac functions, my cognitive skills, my focus, my immune system, even my glandular output and the amount of gray matter in my head, had atrophied to the point that my life was in danger.

By this point, I was sweating through three T-shirts a night, and beginning to feel uncontrollable hallucinations creeping in at the corners of my consciousness. I hunkered down and hung on. Thanks to the efficacy of my health insurance, I waited FOUR MONTHS for the CPAP machine that saved my life.

Finally, I started healing. I craved and drank cup after cup of green tea. It felt as though within me, stark against a field of deep red, was a small system of black branches, growing outward, with painful slowness. It was my nerves regenerating, my senses widening.

Now, I know that for many sleep apnea is the flavor of the month and that hordes are clamoring for the little bedside “breathing machines” that regulate one’s airflow during sleep. However, mine is a link back to health and sanity. After five months flat on my back, vegetating, I finally felt alive again. Gradually, I could do more — drive to the store, the library, my daughter’s school. Hit the gym. Take out the trash.

I started to read again. Trapped at home, I finally finished Don Quixote, Nicholas Nickleby, Tristram Shandy, The Odyssey. I read over a book I had finished writing — and discovered that it wasn’t finished. My mental deterioration was obvious over the latter half of the manuscript’s pages. I set to making the book over again.

And to making my life over again. I could now tell that the incremental damages to my body had severely circumscribed my ability to deal with people, stress, and various professional and personal challenges. I was noted for not being able to go out at night, to attend social functions, to even pass the time of day with someone without falling into an irrevocable panic. Now I find myself capable of all these things, social again, able and eager to travel, not consumed with anxiety. I am becoming a new and different person, hopefully a better and more authentic version of myself.

This carries anxieties as well. My wife is getting used to someone who is now much more capable, centered, and present than the old curmudgeonly me. Is this a good thing? To me it seems equivalent to getting used to a spouse who’s been overseas, or in a coma, or both, for years. My alert exuberance can be quite irritating. And what about the return of a vanished libido? We are working on it.

Of course, all this illness led me, as the least thing usually does, to bouts of pretentious and self-pitying thinking. Not knowing if you are going to have a life is sobering enough. Now I thought: well, here I am now. What am I doing here? What am I good for?

The short answer is, just what I was before. These mental belches come and go. However, I did stubbornly pull a few precepts out of the experience. 
  1. The body has primacy. I’ve never had a comfortable existence inside of mine, being the kind of person who lives for and within the confines of his head by and large. However, I am manifested in my body, must greet the world with it, and now I must nurse it along. It told me in no uncertain terms that I can do, say, think nothing without its consent. I am finally listening to my body. The payoff is, in taking it seriously, I now find myself at the gym every day, eating better, and losing weight. It’s a miracle to regain years of dimmed vitality, especially when I am still capable of using them.
  2. I don’t have time, or rather it’s all I have. My children are almost all grown, I’ve had two or three careers, a couple of marriages. Due to age, my demographic value is now nil. Biologically speaking, I’ve done my part and am no longer needed. Whatever else is true, I have no time to waste. I get to live my life, love my loved ones, and have a few more laughs. So if you were about to ask me to get involved with something stupid, I can’t. I have to hurry.
  3. I need to be here now. My recovery means that I have not only better health and function, but that I have a broader bandwidth — emotionally, and dare I say spiritually (ssh don’t tell). My senses grow sharper and more comprehensive, my boundaries widen, and it can all be a little overwhelming as I am used to being shut up in the closet of my limitations, walled off even from perceptions, new sensory input. But I hang in there. We owe the world the gift of our attention.
  4. As usual, I am not in charge. My AA experiences continue to teach me humility. I keep Victor Frankl’s Man’s Search for Meaning next to my religious texts and consult it often. “Everything can be taken from a man,” he writes, “but one thing: the last of human freedoms — to choose one’s attitude in any given circumstances, to choose one’s own way.” At my worst, the absolute nadir of despair, the deity was still there and the architecture of the cosmos hung together. I almost lost it all, and came through with a second chance at a better, fuller life. None of it is my doing. I am grateful.

For me there is just today, and the older I get the more I am at peace with that approach. One of my favorite prayers states that “We have come into being to praise, to labor, and to love.” That is precisely what I intend to do.



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