An important part of anyone’s anatomy . . .
It’s been a week now, and I’m monitoring my nostrils very closely.
Last Saturday, a week ago, I had a spontaneous nosebleed, the first in my life. One that I’ll remember for the rest of my life. My left nostril gushed blood over the front of my sweater and spattered the immediate area.
What had I done wrong? Fortunately, I was in one of those cubicles that provide free toilet paper, so I kept stuffing wads up my nostril. When each wad was thoroughly soaked, I extracted it and stuffed another one up.
When I examined myself in the mirror, I had blood smeared on my chin and hands. Cold water removed most of the stains from my sweater. I walked back to my book table in the Coliseum with no toilet paper trailing from my nose.
There’s a lot going on up there . . .
An hour or so later, I felt the blood flowing again. I pushed a handful of tissues against my nostril and fled to the washroom. Another bout with the wad stuffing and everything was normal again.
Soon it was time to leave for the day, and return in the morning. Sister Sue and I headed for Laura’s for supper. On High Street my nose gushed again. I pulled over, got out, and let my nose drain into a puddle on the ground. Holding tissues to my nostril, I drove to the closest pharmacy, Shoppers Drug Mart, corner of John and Memorial. More puddling on the ground. The pharmacist on duty responded immediately, escorted me to the staff washroom, let me do the wadding thing until the flow stopped.
The pharmacist offered no other solution than cotton balls. He asked me if I was on a blood thinner. I said no. He was concerned but out of his element. He found a bag of cotton balls for me. I picked up two large boxes of tissues, returned to the car, made more puddling on the ground, stuffed my nostril with cotton balls, and made a decision.
I had to go to emerge.
TBRHSC emerge in daylight . . .
It was full dark. I dropped Susanne off at Laura’s and drove to the Regional Health Sciences Centre emergency department. Coming off Oliver Road, I had a general idea where emerge was, but saw no sign. Drove past it. Turned around, found a prominent sign, drove up the ramp. Every parking space filled. Making a three-point turn and cramping the steering wheel with one hand, I abandoned the car where other arrivals could still maneuvre. More puddling on the ground.
TBRHSC emerge at night . . .
With bloody tissues pressed against my nose, I waited for somebody behind the glass wall in the reception area to notice me. Finally someone responded. Scrutinized my health card. Directed me around the corner to a seat in a tiny waiting area. Blood gushing. I asked someone where the washroom was and rushed there, washed myself up a bit, left splashes everywhere, got wads of paper towels, returned to my seat. Immediately called into the inner sanctum.
Someone behind a reinforced glass barrier asked me something, I forget what. I christened the counter liberally, tried to wipe it up. Was sent to the general waiting room.
Within minutes the triage nurse called me. I gave her the particulars of my case. Asked me if I was on blood thinners. I said no. Meanwhile, I’m swallowing blood. Was sent back to the waiting room. Barely got settled when I heard someone calling “Ed – GAR”. “Ed – GAR”. Finally dawned on me that she was calling me, “ED -gar”.
She ushered me through the double doors to the examination area. Room 3. Across from the desk where a nurse and the doctors hang out. I looked around for a hard chair that I wouldn’t mess up too much. A woman in green scrubs directed me to sit on the clean sheet of the bed. Later learned that this woman was a resident, Dr. P.
She left the examination room door open.
What the doctor sees . . .
I could see everybody walking by, they could see me. During the course of an hour I managed to smear blood everywhere ̶ counter, floor, sink. Interview with Dr. P. She said my nasal passages looked dried out. Looked at my list of meds. Asked me if I was on a blood thinner. I said no. Asked me if I took a daily aspirin, 81 mg. I said yes, my doctor’s orders. Then it twigged. Aspirin is a blood thinner. Meanwhile, I was holding a deep-sided tray under my chin to catch drips. I was swallowing blood. I coughed up a big clot of blood. Then Dr. L came in, introduced Dr. P. as “his” resident, which I took to mean his student/apprentice. He wore a white lab coat over a black shirt and trousers.
How you see yourself . . .
Dr. L. gave me two options.
Once the flow had stopped, I could go home, and if the flow started up, I could try squeezing my nostrils for fifteen minutes, and if that didn’t work, I could return to emerge.
Option Two: Let the doctors pack my nostril to apply pressure to the ruptured vessel and hopefully allow it to heal.
I chose Option Three: Since I still had blood flow, I suggested I do the nostril squeezing right then and there, and if that didn’t work, then pack my nostril.
It was agreed.
At some point, my cell rang. It was Laura. Wanted to know what was happening. I updated her.
The doctors left me leaning over the sink, bracing myself with the left hand. With my right thumb and forefinger, I squeezed my nostrils just below the nose bone . . . hard. Hard. Hard. For fifteen minutes. I was sure I would leave permanent indentations there.
After fifteen minutes, I stopped squeezing. And the blood recommenced flowing.
The doctors moved to Option Two. Dr. L. was instructing his resident, Dr. P. She sprayed something wet up my nostril. Then she took a tongue depressor out of its package. Up close it had the same shape and size as a surf board. Farther away, it may have measured four inches long and five-eighths of an inch wide. It was relatively flat.
“Push it up,” said Dr. L.,”until you meet resistance. Be gentle but firm.” She told me to lean back on the raised segment of the bed. She pushed the board in, millimetre by millimetre. I felt it.
She stopped. “I hit resistance,” she said.
Dr. L. took over. He pushed it in, inch by inch. I felt it. When it hit the back of my skull, he stopped. “It’s your first one,” he said to Dr. P. “You’ll soon get used to it.”
The doctors left. I could feel nothing happening. Through the open door I could see the activity in the hall around the nurse’s desk. The doctors returned.
Apparently the board had transformed into a self-inflating cotton nose pack. At some point I mentioned that I had recently recovered from a marathon bout with a cold virus. “Ah,” said Dr. L. “That explains it.” He meant that the decongestants I was using had dried out my nasal passages. I had mentioned that the bleed started in the Coliseum where the air was extremely dry.
There were two strings dangling from the nose pack. Dr. P. taped them to my cheek. Dr. L. said I should keep the nose pack in for two days. He said I could remove the pack by pulling on the strings, but advised me to let a doctor do it. Advised me to stay off aspirin for two days. I asked the doctors for their names, and thanked them.
Whereupon I was discharged.
I kept some tissues hovering near my nose just in case. I pushed through the double doors into the reception area. I headed out. As soon as I stepped outside, there was a gush of blood.
From my RIGHT nostril!
More puddling on the ground. I stumbled back into reception. Pushed on the double doors. Locked. Staggered over to the glass wall. One triage nurse was busy, the other, gone. I loitered where someone in the back room could see me. Finally a lady came out. “I just came out of there,” I said, gesturing to the examination area. “I have fresh bleeding.”
“Uh,” she said, “you’ve been discharged. Can’t let you in.” She left.
I hung around. I appeared to be the only one in the entire unit who was distressed. After five or ten minutes, the lady came out again. “Okay,” she said, “you can go in.” She pressed a button somewhere. The double doors opened.
I found my way to the desk. “Hello, again,” I said, to Dr. P. and Dr. L. “It’s the right nostril now.”
Ushered into my former examination room. Room still liberally sprinkled with blood. My blood. Leaned back on the bed. Dr. P. stuck a flashlight up my nose. “I don’t see a clot,” she said.
Dr. L. entered. “It appears,” she said, “to be overflow from the other side.”
It was. The flow stopped. I thanked them again.
No one had towed my car. Back behind the wheel, I drove to son Rob’s place, where I was staying. Stemmed leakage with tissues. Phoned Laura and Susanne to update them. Laura had phoned wife Olga but left it to me to mention my trauma. I phoned Olga. She took it very well. I was more worried than she was.
When you feel you’re just vegetating . . .
I had no appetite. I could not lie down because my packed nostril was leaking clear mucus stained with blood. The right nostril dripped constantly. I was swallowing blood. I commandeered Rob’s La-Z-Boy chair, tucked a towel under my chin, covered myself with a blanket, positioned a box of tissues within reach, and slept fitfully all night (both Rob and Carmen were away). Periodically I had to stem the flow of mucus and blood and clear my throat.
Morning . . . I picked up Susanne. We went for breakfast. I managed to swallow two Finnish pancakes. Made a quick shopping stop. Arrived at the Coliseum, waited with other vendors until the doors opened at 10:30. Informed the management that I had to pack up and leave, but my table partners were carrying on. I explained things to Elle and Harold when they arrived. Got everything squared away in the car.
Made another quick shopping stop. Dropped Sue off at her apartment block. Hit the highway north. Pulled over a couple of times to sop up fluids and have a quick nap. Gassed up in Nipigon.
Arrived home at Wildgoose Lake. Unloaded the car. Commandeered my old La-Z-Boy chair from our mutt, Miko, who quickly adjusted to the reality that the chair was mine for the next while. I rarely left that chair. Slept most of the time, kept myself hydrated with green tea, and had an occasional nibble.
My main problem now was mucus congestion. When my right nostril plugged up completely with green mucus, I tried squeezing the sopping nose pack and blowing out the right nostril. Resorted to an old Ukrainian remedy: a generous dollop of table salt in a mixing bowl, a litre of hot water, and a towel draped around the bowl and my head, for up to twenty minutes. It worked.
Sunday . . . Monday . . . Tuesday morning, the
When you’re feeling more than you can express . . .
first good sign. No blood spotting, just clear mucus in both nostrils. Had a shower and shave. Drove myself to emerge in Geraldton (Olga doesn’t drive anymore).
Registered in Outpatients at 1:45 p.m. By 2:15 I was in an examination room with Dr. D. She had treated me about two weeks before when I was wrestling with a cold virus. Advised lots of green tea, and chewing lemons as I would chew gum. Good old Ukrainian remedies, I believe. I gave up after two days ̶̶ the chewing, I mean. I switched to oranges ̶ for the Vitamin C, you know. (Dr. D. doesn’t believe in vitamin supplements.)
The doctor interviewed me as thoroughly as the triage nurse did. Made me sit on the clean sheet of a bed. She smiled when I mentioned I was off aspirin for two days. “Aspirin remains in your system for seven days,” she said. Left me for a long time. My back ached, so I slipped back into the hardback chair. The doctor returned and explained what the procedure would be.
She would try to pack as much vaseline as possible between the nose pack and the nasal passage. Made me sit on the bed again. Said something about applying the vaseline daily. She left. The nurse entered, told me to lie back on the clean sheet, boots and all. She proceeded to pack in vaseline. Left the room. Returned a quarter hour later and packed in some more. Left again. Finally, satisfied, she called the doctor in.
Dr. D. approved her work. Dr. D. seized the double strings (which I had numerous times re-taped to my cheeks, but now they were dangling loose). She pulled firmly. Again. And again.
What we both feared, of course, was that the pack had bonded with whatever scab had formed on the ruptured vessel. She pulled. And pulled. Little by little the pack detached itself from its cozy burrow. With a final jerk, it came out.
No gush of blood.
Dr. D. instructed me to lie quietly back for a while. When she returned, she was happy with her work. She had been cautious and meticulous. I recalled that Dr. L. at TBay hospital had suggested I could even remove the pack myself. Bad idea.
I asked her how long she meant me to paint the forward portion of my nasal passages with vaseline. She said every day. Which I took to mean every day for the rest of the winter, when heated rooms promote dry air.
Discharged at 4:30, I went out and purchased a humidifier, our old one no long functioning.
I went home. No leakage. Had a good supper.
Since then, I have green mucus clogging both nostrils from time to time. But I simply blow each passage one at a time, gently.
What a relief.
I reflect on how some little thing, such as a butterfly flapping its wings in Brazil, or an imperceptible decline in humidity, can trigger something as devastating as an unstoppable nosebleed.
How complicated the world is.
How wonderful to breathe through both nostrils.
What a gift.
A nose is a man’s best friend . . .