Holding Down the Fo(u)rt(h)

I spent a chunk of the last Fourth of July in the emergency room, having created a little fireworks display inside my head that morning.

I really, really do not want to turn that into an annual event.

I’m not worried about another seizure.  I’m confident in the diagnosis: a serotonin storm, brought on by the combination of Zoloft and Ultram.  An antidepressant specifically designed to increase the level of free-floating serotonin in my bloodstream, and painkiller with a side effect of heightened serontonin, adding up to an overload.  In retrospect, I can recognize other symptoms in the days and weeks leading up to the seizure, which all evaporated as soon as the culprits were apprehended.

Great, wonderful: a happy ending.

Now here it is, another Fourth of July, and I should be in the hospital.  I know I should.  I was told, quite clearly, to go to the ER – and not the local ER, but down to Mass General because that’s where my surgeons are and it’s where this latest procedure will happen – if I developed a fever or had a noticeable increase in pain.  And I have both: the fever is low-grade, 99.1-99.4 (though normal, for me, is down around 97.5, so the readings are misleadingly low), and the pain is steadily climbing.  But I’m able to blame the fever on a New England summer day that brings us temperatures in the 90s by 10:00 a.m. and humidity in the 105-110% range, give or take.  It’s hot out, and so I’m hot in.  And the pain is still manageable with the medications I have on-hand.  Barely, and I can’t manage the anxiety and insomnia, but still.

I’m holding down the fort here, resisting the hospital for all I’m worth.  Just for today, I want to be with my kids.  I want to make a special dessert (Oreo cheesecake) with Emily, and watch Willem and Jacob man the grill.  I want to coax smiles and the occasional giggle out of Isaac.  I just want to be here, home, on the Fourth.

I’m terrified of the hospital.  Terrified of just how wrong things can go.  Terrified of another round of “rest and recovery.”

There’s an awful irony, in the timing: as of Friday, my VNA caregivers and insurance company decided that I no longer needed to receive in-home nursing care.  I was officially declared to be healed from the March surgeries, ready to abandon all bandages and wound dressings.  Six hours after that final nurse visit, I was on the phone with my new gynecologist, listening to her explain that I had this mass, and would be having another surgery, and starting all over again.

So, I’m home.  Just today, because if things continue to advance as they have been, I won’t be able to manage my own pain tomorrow, and the fever might become more consistent (because, truly, it measures in the normal range every other time I check it).  I’m not being reckless, I’m just indulging in a little bit of conscious denial and avoidance today.  One more day home, and I’ll get up early tomorrow and head in to Boston to get back on this roller coaster ride again.

I just need to hold down the fort, for myself and for my kids.  Sometimes the mental health needs come before the physical ones, by a day.

(And, yes, I hear just how defensive I sound.  I know that means I should grab the already-packed hospital bag and go, because I’m clearly receiving signals from my body and brain which I am choosing to ignore.  I’ll behave better tomorrow, I promise.)