The Rule of Three

Yesterday-Thursday-did NOT begin well. 
Because of taking four different drugs Wednesday night, I woke up twenty minutes late from the most lovely dead sleep ever.  Why the drugs? I'll get to that.
No time to make my own breakfast.  No cup of French press coffee.
Instead I flew around the apartment like a maniac trying to find a piece of paper I needed, kissed Bob in a hurry while apologizing for my language and launched out the door.  A few more four-letter words might have slipped out.  Apologies to the neighbors.  I had to get to the bank, drop off prescriptions, go to physical therapy, to work.  No time to take the late bus when you have errands.  As I broke into a run I realized that running still hurt my, uh, recent surgical site.  A few people may have wondered why the young woman up the street was jogging down the road at 7am cursing while clutching her left boob.  Not a great moment for me.
What a hell of an exciting few weeks these have been.
Last Wednesday I had minor surgery to extract an abnormal fragment of breast.  I had every reason to believe that abnormality was benign.  But until you know, you don't KNOW.  And removal seemed the efficient and effective option.
Surgery went well enough.  I spent the following weekend in NJ with Bob, the kids, his sister and brother-in-law and their son (thanks for the hospitality, Laura and Frank-I'm sorry if I said or did anything weird but blame it on the Vicodin).
I got back on the bike.  Again.  Tuesday night I rolled along happy to start feeling good again. So what if I had two inches of stitches under my sports bra?  I felt better with every mile.  A couple of guys in a sports car slowed down and beeped.  They waved.  Did I know them?  I waved back then felt a sharp pain in my right thigh and saw a black wasp departing.
I said a bad word.  Maybe repeated it a few times.
I pulled over.  Yanked up the leg of my shorts.
I thought to wait a minute or two.  I've had three allergy injections per week for a year and a half now to desensitize me to bee and wasp stings.  This process has gone excruciatingly slowly (I've reacted three times to my shots) but it promises to work long-term.  The decision to start the treatment came after three anaphylactic episodes and a fourth sting that resolved safely without too much of a near miss (when honeybees get me, the reaction is slower).   Wasps are nasty-the reaction is faster, it's more dangerous.  BUT maybe I wouldn't need the EpiPen this time.
This could be dealt with.  But I would only wait two minutes to make a decision.  I checked my watch. I was on Route 327, not far from downtown Ithaca.
I watched the swelling develop fast.  Then the itching started on my neck.
And I began to have a bad feeling.  When you read about the symptoms of anaphylaxis, one is described as "a sense of impending doom."  Basically you have a very strong instinct that you are about to die.  And unless you DO something, you will.  That feeling came and I recognized it.  It isn't panic.  It's a deep knowledge of truth and a recognition of urgency.  Suddenly THERE IS NO TIME.  THERE IS NO TIME.
Decision made.  The EpiPen doesn't hurt going in.  It's FAST.  It starts to hurt the second after it injects, while you hold it to your quad and count to ten.  I called 911 and explained my location:  on Rt 327 south of Ithaca two miles off Rt 13, near the intersection of Gray Road and 327.   I took out my Ziploc bag, took 25 mg of Benadryl, a dose of Pepcid (has an antihistamine effect).   I called Bob, got voicemail, called back and got him in person, told him what happened.  He said to take my bike to the hospital with me.  Good call, Bob.  Hung up, sat down and waited.  The Enfield fire chief showed up first and started the paperwork.  The ambulance pulled up soon. With paramedics on site I feel fairly safe.  EMTs can only give you oxygen, take your pulse, and watch you.  Paramedics can use drugs and can intubate you if that has to happen.  Two young guys this time.  I joked with them, told them not to scratch the paint on my bike while they put it in the ambulance.  I gave them my used EpiPen to chuck in their sharps container.
They started the IV and I started feeling like I had something heavy sitting on my chest.  The backseat paramedic got radio permission from an ER doc to start the drugs.  I got IV Pepcid and 50 mg of IV Benadryl in addition to my prior 25, and they have to push it slowly because it makes you instantly feel sick.  But IV Benadryl is nothing compared to IV epinephrine.  I experienced that once and hope I never do again as long as I live.  No reason to think I'd need that this time.
Off to hospital.  Bob showed up very soon.  Then we waited.
No doctor showed up.  After almost two hours Bob and I were frustrated.  I just wanted the IV yanked out so I could leave and go to bed.  Forget seeing a doctor.  I could see the allergist the next day.  Finally I saw Sara Foster-one of our Corning teammates and a physician assistant who was on shift til midnight. She saved us by tugging on someone's sleeve.  In about five minutes a doctor came in.  Unfortunately he was a pompous ass and seemed to think that since he saw no hives and I had no other symptoms just then (hello?  The paramedics drugged me up?)  I must have unnecessarily used my EpiPen.  So with no knowledge of my prior medical history he launched into a lecture about allergic reactions and how you shouldn't use EpiPens if you don't really need them.  He ignored everything I said.  He prescribed a small dose of prednisone for two days which he said I didn't have to take if I didn't want to, and threw some Pepcid in on the side.
The swelling on my leg was baseball-sized when I got home.  I started the prednisone and Pepcid.  Wednesday morning I had a softball growing-hot, itchy, painful to touch, ugly.  I took more drugs.
First thing Wednesday I went to the surgeon for a post-op appointment.  First things first-she had my biopsy results.  My tumor was BENIGN, a hyalinized fibroadenoma, although it's normally in seen in older women.  GOOD.  RELIEF.
The surgeon observed me scratching my leg and other multiple itchy spots and asked if I was all right.  I filled her in on Tuesday night's events.  She asked the name of the ER doctor.  I couldn't remember.  She recommended "having at it" when I received my "post-visit patient satisfaction survey."  Cayuga Medical Center likes to send those out.  She took out my stitches quickly so I could get to the allergist, asked if there was anything else she could do, wished me good luck.

The allergy office got me in to see a doctor fast.  The swelling on my leg had reached football dimensions and I'd begun breaking out in small patches of hives in other places.   The doctor reacted in outrage to what the ER doc said.  She stomped out of the room, came back and immediately dosed me with prednisone, Benadryl, Pepcid, and cetirizine.  She tripled my prednisone dose, extended it to three days and gave instructions for taking the three other drugs simultaneously.  She made me stay in the office for an hour to make sure I began improving.  "You did EXACTLY the right thing," she said.  "You know yourself and your medical history.  Your records here show everything and I remember your chart (she saw me the last time I reacted to my shots).  You are on the extreme end of the scale when it comes to reactiveness.  Don't ever let ANY doctor talk you into disregarding your own history."  She refused to say anything unprofessional about that other doctor but seemed pretty mad.

She also told me that given my history and the way my immunotherapy is progressing, not only will it take approximately five years or more for me to build up significant immunity to stings, but that the leading allergy experts in the world recently found that for people with my type of history and sensitivity, the most effective treatment requires a different approach.  Once I have enough immunity to tolerate the equivalent of four stings of all three types of venom at a time without reacting, I will probably be safest if I continue those three injections every six to eight weeks for the rest of my life, rather than stopping.
I said, "I could live with that."  She said, "Well, that's the point.  The point is that you LIVE."

So to sum it all up, Thursday just piled up on me like a ton of bricks.  You don't move too efficiently when you're on four different allergy drugs.  Thinking is slow.  But I got it done.  I ran all of the errands, paid the bills, filled out the paperwork, dropped off the mail, and got to physical therapy.   There I had to fill in one more person on uh, recent medical history-the physical therapy department likes to know all medications you're taking.
I found that while my shoulder is completely back to total range of motion and better strength, the rotator cuff is still being pulled partly out of alignment by the pectoral muscle.  No hand weights for me yet.  But I graduated to a green rubber band.
I spent the rest of the day at work, where alternately time slowed and raced as I tried to function productively while fighting drug-induced drowsiness and apathy.  Beats all that itching, though.

I woke up at 3:45 am with more itching and took more drugs.  I decided to do some laundry and type this.  Going back to sleep just wasn't an option.  Wide awake here.

As of last weekend I thought of jumping into a cross race as early as the 8th of September but I'm just not there yet.  Soon.  All of the medical stuff is resolving.  And the rule of threes has been satisfied.  I separated my shoulder.  I had a biopsy.  I had an allergic incident with a wasp.  That's three separate things.  Three.  NO MORE.  PLEASE.

Soon I hope to write race reports and stories of good times again.  No more medical stuff or doctors.  Can't wait to race again.

Thanks for reading.