Monday, December 18. 2006Saga of the NosebleedBy Jim Poyser It began innocently enough, in the shower. I felt a warm wetness in my nose and when I touched the edge of the nostril with my forefinger, there was blood. It began innocently enough, in the shower. I felt a warm wetness in my nose and when I touched the edge of the nostril with my forefinger, there was blood. I finished my shower, dried off, got dressed, all while holding my head back and dabbing the blood away as it trickled out my nose. I sat in a chair for twenty minutes until the bleeding stopped. The next morning, the same sequence. By the third morning, a little spooked by the association of the shower with the bloody nose, I washed my hair in the kitchen sink, thinking it would make a difference. It didn't. My nose began to bleed again. I went to work that day, more bemused than concerned, but when my nose erupted once again, mid-morning, I knew I was in some kind of terrible trouble. My nose hadn't bled for years, maybe a decade, who knows. It's not something that gets on your radar of concerns, like a disturbing mole or a persistent cough. Only a nosebleed. As a child I'd witnessed some dramatic nosebleeds courtesy of my dad. His nose would gush blood. I remember one day in particular, him driving and bleeding, both my brother and I too young to take the wheel. All we could do was hand him tissue paper that was quickly turned red and sopping wet. I was convinced that my dad would bleed to death from the nose. My second nosebleed of the day was problematic, of course, but I had an important meeting downtown with a man who was visiting from LA with a potential freelance job for me. He had arranged to meet me at the restaurant at the Conrad Hotel, fancy environs indeed. We enjoyed our conversation and just when I was getting to some ideas designed to impress him, my nose abruptly began bleeding again. I looked around to see if any of the other diners had noticed. My lunch companion extended his handkerchief, and we quickly left the restaurant. Fortunately, he was a doctor and we went to his room where he gave me advice on stopping the flow of blood. At the same time he helped me hunt down some phone numbers and strategize a plan. He stressed the importance of getting an appointment now instead of waiting until mid-afternoon — which could prove too late to see a doctor. Convinced I was okay enough, I left him and headed for my car. I have a stick shift, and if you've ever wondered if it's possible to hold a bloody handkerchief to your face, wield a cell phone and drive a stick, simultaneously, I'm here to report I didn't crash my car. I drove north on Illinois Street headed for the ENT my family physician had recommended. But I was having trouble getting connected to the ENT. Its phone labyrinth was, well, labyrinthine, and when I finally got a human being on the phone to discuss my predicament, I was immediately put on hold. It was at this point that I glanced up into the rearview mirror to see that my other nostril was now emitting blood. Fear washed through my body. Never in all my experiences of nosebleeds had I ever seen both nostrils pouring forth. I hung up the phone. I could die on hold at this rate. The immediate care, doc-in-the-box was not too far away, and it was in the direction of the unresponsive ENT group, as well as my own family physician's office, so I decided to go there. My nose had stopped bleeding by then, but the doctors at the immediate care facility had a measure of concern after I told my bloody tale and I was sent to St. Vincent's Hospital to the emergency room. I called my wife en route and she agreed to meet me. The ER was surprisingly calm; perhaps it's only TV shows where ERs are teeming with blood and turmoil. I was soon attended to by a doctor whose manner was to place a reassuring hand on my shoulder from time to time. Simple, but effective. He found the offending spot in my right nostril and pronounced it an anterior bleed. This was good news to me, though prior to this experience I had never even considered terms like "anterior bleed" vs. "posterior bleed." But it's easy to imagine the difference. A posterior bleed means it's way up there, perhaps out of the reach of normal means of investigation and treating nosebleeds. I imagined having being admitted to the hospital and having my nose and sinuses probed arthroscopically. Instead, a cauterization would do the trick. The good doctor took care of the procedure quickly, wherein silver nitrate obliterated the area of the bleed. It didn't even hurt, really. After a few minutes rest, it was time to go home. I was fine, and since we'd brought cars separately, we drove separately, me home, my wife to purchase a humidifier. The evening was normal, save for the fun of being able to tell my story. Yeah, I spent part of the day in the ER. Oh my god, I bled in the freakin' Conrad. Blood coming out both nostrils is surely one of the seven signs of the Apocalypse. Still cautious the next morning, I avoided a shower or the sink. I went to work and all seemed calm. Then, mid-morning, it happened again. This time, I was afraid to drive so a co-worker drove me home. My wife left her work, then picked me up and away we went for a return visit to St. Vincent's. "Back again?" one of the nurses said. I know I looked miserable and scared. What was going on with my nose? Was it a different, second spot that was now bleeding? Was the interior of my nose deteriorating? The same doctor was on duty and it took only a few minutes for him to note with irritation that in fact blood was coming from the same spot. For some reason, the cauterization had not been successful. He performed the procedure again, but to make sure it held, he inserted a balloon up my nose. I was not prepared for the shock of my nostril being abruptly penetrated by an object. Both eyes burst tears. I cried out. He inserted a syringe into the tube of the balloon contraption and pumped air into it. I could see the right side of my nose grow to enormous proportions. "That should do it," he said. "How long do I have to keep this in?" I managed to ask. "Three days. Make an appointment with an ENT doctor for Monday." Three days with this bratwurst stuck up my nose? In a daze I left. When we got home, my wife made an appointment for Monday afternoon. The reality sunk in. Seventy-two hours of this misery. It wasn't the discomfort of the balloon that fueled the misery. That was a tangible phenomenon, something I could understand. The real problem was I was terrified the nose was going to bleed again. After all, if it did, the ER doc had failed twice, so why try again? What would happen if I began to bleed? What choices did I have? None of them looked good. It was an impossible expanse of time to imagine; three days of fear. And so I settled into it. Lots of movies, lots of worry, lots of checking my throat for fresh blood. Lots of friends calling, food arriving, periods of feeling better. Then, I would feel a trickle of fluid in my ballooned nostril. I could imagine the hole opening up again, pouring down around the balloon and down my lip, or trickling down the back of my throat, or exiting out the other nostril. Or all the above. Those three days passed as somehow they always do when you're waiting for something to come to fruition. The Monday afternoon trip to the ENT was anti-climactic, really. This doctor removed the balloon from my nose and pronounced the septum of my nostril fine, and I was free to go. I couldn't believe it. Part of me just knew there was more pain and suffering to come; could it end so simply, after all? It's been three days since then, and every day I feel a little better, a bit more sure that the roller coaster actually stopped on that second visit to St. Vincent's ER, the Day of the Balloon. If I'd only known then that the fluid-y feeling in my nostril those three days was snot, mucous and very little blood, I wouldn't have taken that periodic bath in fear. Trackbacks
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