Surreal but very real

by Nelson Roth

Surreal would be a word to describe my experience following Pam’s brain hemorrhage. Although very real - what was happening to Pam was like we were in a dream.  At the same time, I knew Pam’s condition was very real and something was critically wrong.

The big concern was - “What’s happening?” And, “Where do we go for help?”  

I had no idea what the answers were to the questions coming to mind. And, as I reflect back on it now, it’s like we were in a distorted dream - a big blur.

Being in this dreamlike state actually made me feel numb in a way; which in the long run probably helped me stay focused. I don’t remember panicking or overreacting. I was very concerned; yet I remained calm.

A description of what those days were like is summed up best in our trip to the hospital. It was in the middle of the night and very dark when a stranger drove us to the emergency room. And though the heaviness of the darkness was how I felt, we were literally being taken by the hand of God and guided to where we needed to go.

So, here we were in an unfamiliar place having no idea where to go for the help we desperately needed. And yet, my experience was that everything we needed came our way and every question we had was answered at the time we needed an answer. And it happened over and over again in the course of the next days and weeks.

God knew exactly where we were!  He knew we needed a miracle. He provided for everything we needed throughout this unreal time; and, we experienced the truth of this passage - “The peace of God ... surpasses all understanding,” Philippians 4:7.

Out of a heart of gratitude, I say, “Thank you, Lord, for hearing our prayers and the prayers of our family and friends. Pam and I are so grateful to still be journeying through this life together. Our desire is to live life to the fullest and share our story of God meeting us where we were and with exactly what we needed.”

Hanging in the balances

It wasn’t until later, actually much later, that I came to realize I had been admitted to the hospital in serious condition. Being in such a weakened condition caused me to be compliant with any and every recommendation by the medical staff; except one, which I’ll explain later.

Surrounded by the events of the day, the Emergency Room staff was convinced I was suffering from what they termed, “acute seasickness.”  So prior to being admitted to the hospital, they performed a nasogastric intubation on me, hoping to stop the vomiting and nausea. If you have ever had to endure this process you know what I mean when I say, “I hope I never have to go through that again.”  

From the gurney in the Emergency Room, I was lifted onto a gurney which would transport me to my hospital room.  It was Sunday morning by now and the halls of the hospital were uncanningly quiet. The sound of the wheels on the gurney against the cold marble floors seemed determined and calculated. In minutes, I was in my room followed by a team of nurses. No one spoke English, so in solitude, they attended to my immediate needs.

Balancing rocks along the  Malecón ~ Puerto Vallarta, Mexico

And then came a parade of doctors followed by the poking and prodding of needles...blood tests...an IV line and so on.  First in line was an Ear, Nose and Throat specialist, accompanied by two student doctors.  Gratefully, all of them were proficient in English.  One by one, they began carrying out a battery of tests. The longer they lingered in my room; the more hopeful I became.  While they were conversing back and forth in Spanish after every test or exam, Nelson and I would look at each other hoping they were going to say, “It won’t be long now...the sickness will end and you can go and enjoy the rest of your vacation.”   Unfortunately, that was not the way the conversation ended.  Instead, they seemed confused as to why nothing was working and felt the best diagnoses was an extreme case of vertigo.  

By now, it was late into the day and we were well over 24 hours since the incident on the boat. With no sign of progress after hours of medication, a multitude of exams and tests, and the intubation tube removed, an internist was called in. After consulting with the ENT, the internist felt the next step would be to rule out anything neurological.  So, their big challenge was to schedule the one and only neurologist in Puerto Vallarta. In the meantime, we waited.

The next thing I remember...I was awakened at 3:00 am by the internist. He came into the room, stood by my bed and told me the neurologist had ordered a CT to be done immediately; and that the two of them would be in later in the morning to share the results with us.

At 10:35 am on Monday, March 21, 2016, I heard the words that no one ever hopes to hear.  “We’re sorry to have to tell you this, but your brain is bleeding. The brain hemorrhage has caused a significant amount of blood on the brain.  We need to do a MRI to see how much damage has been done over the past couple of days and what our next steps need to be.”

To say the least, we were stunned as we listened to the results of the CT. Resolved to do the only thing we knew - TRUST IN GOD - we began to pray and to rally others to join us.  Here’s a Facebook post that Nelson sent out early Monday afternoon.

"Monday, March 21, 2016 - While in Puerto Vallarta, Pam got seasick on a boat trip Saturday afternoon. She has been in the hospital since then. After working through a number of symptoms, dizziness, nausea, double vision, weakness and slurred speech; they've discovered the issue is not stomach related, but brain related. The neurologist showed us this morning the CT results which revealed a hemorrhage between the cerebellum and brain. They believe the hemorrhage is the outcome of the motion sickness and all the vomiting. There was also a tumor found in the CT; which is a non issue and could have been there a long time. An MRI is necessary to know the extent of the bleeding. They advise that she cannot travel til they know all that the bleeding may be doing. Pray for Pam, she's claustrophobic and the MRI will be a little over an hour. They will use a lite anesthesia to keep her calm. The neurologist will then come to see us. We will definitely not be leaving tomorrow as planned. PRAY, that the bleeding stops."

For those of you that have been on this journey with us since that prayer request know that God did hear all of our prayers; and between the CT and the time of the MRI,  the bleeding miraculously stopped. And as you remember at the beginning of this article, I said there was one time I would not be able to comply with the doctor’s recommendation.  Well, that recommendation came as a result of the MRI.  Not only had the MRI revealed the bleeding had stopped, the MRI had also revealed an AVM (arteriovenous malformation) which required surgery to stop the bleeding permanently.  So, the doctors recommended surgery at a hospital in Mexico which was a six hour trip from where we were; however, after prayer and a lot of consideration, we decided to wait to see a neurosurgeon in the States.

With the decision not to have the surgery performed in Mexico, I was left hanging in the balances of uncertainty for what each new day might bring. And so, the journey of healing both physically and emotionally from the trauma would begin.

Attended by an angel

Literally, we arrived at the hospital in minutes.  The doctor pulled into a front row parking space in the hospital parking lot, directly next to the Emergency Room entrance.  He no sooner turned the key to shut off the car; and an attending ER staff member appeared with a wheelchair for me.  

With Nelson by my side, the doctor and hospital staff member quickly escorted me into the Emergency Room where I was immediately surrounded by a team of doctors and nurses.  The questioning began about the incident and the ordering of tests quickly followed.  There was a whirlwind of activity.  It was so surreal.  The whole event seemed like a scene from some hospital drama on television.

Somehow, in the midst of all of the scurrying around, Nelson and I got separated for a brief amount of time. One of the nurses said, the doctors have asked your husband to step out of the ER into the lobby..

Alone now and uncertain of my condition, I began to search for a familiar face...some sense of security.  So, in a weakened state and through blurred vision, I tried desperately to focus on finding the doctor who had brought me to the Emergency Room.  From a distance, I could see doctors huddled together in a corner of the room discussing the next steps to take.  Was that him?  I thought I could see him; but, it was as if no one else was acknowledging his presence.  And then,  he was gone.

Later, I would learn the doctor, was beside Nelson...navigating him to the front desk of the hospital to register me as patient.  And then, Nelson said, once he got to his destination, he turned around to thank him, but the doctor was gone.  

In the meantime, while Nelson was filling out paperwork for the hospital, that same doctor was standing next to me holding my hand….assuring me that I was going to be fine.  Even as I write this, I am brought to tears when I think how I pleaded with the doctor to stay with me.  Gently he leaned down and said, “I know you want me to stay, but I must go now.  I’m leaving you in good hands.”  And then, he turned and quietly walked away saying nothing to the Emergency Room staff.

As soon as he left, Nelson returned.  At the same time, a specialist was approaching me to deliver the news they were going to attempt one final procedure to stop the nausea and vomiting; and if that failed, they would have to admit me to the hospital.  Unfortunately, the intervention did not produce the results we had all hoped for; so the attending doctor in the ER decided it was best for me to stay overnight.

And so, a parade of specialists and a list of tests was about to begin in the hours and days to follow.  However, before, we jump too far ahead….I really want to finish telling you about the doctor who attended to me the night of the incident.

After days of inquiring with the hotel, ER, and hospital staff about the doctor who came to our room in the middle of the night, drove us to the hospital, assisted Nelson to patient registration, and stood by my bedside, we never did find out who he was. The hotel staff didn’t have any record of calling a doctor the night of incident and we never received a bill from the hotel for the doctor’s services.  Likewise, we couldn’t find anyone in the Emergency Room who remembered the doctor or knew where he might have come from; nor anyone on the hospital staff knew of this mystery doctor. And, again, when we checked out of the hospital there was no charge for his services.

There are many questions that remain unanswered for us; but this one thing we do know, he saved my life.  We may not know who the doctor was or where he came from; but we do have confidence in whom sent him.  We truly believe this was an assignment from the Absolutely Spectacular One.

In the still of the night

We arrived back to our hotel room around six o'clock Saturday evening. Hoping to rest and then to wake up out of this nightmare, I went straight to bed. Instead, after sleeping for five hours, I woke up in a worsened condition. Weak, dizzy, and vomiting, I attempted to make my way across our hotel room to the bathroom. Crying and barely able to communicate, I said to Nelson, “Something is terribly wrong.  I’m concerned I may have had a stroke.”  Immediately, Nelson responded, “Honey, we have to do something. I’m going to call a doctor.”

As soon as Nelson got me back into bed, I heard him talking to someone with the hotel.  He was requesting a doctor to be sent to our room.  By now, it is eleven o’clock at night and I’m feeling weaker and fading in and out of a state consciousness.  With the room spinning and everything  in the room appearing to be double, I felt like I was slipping away.  And then, I heard Nelson announcing from across the room, “It’s the doctor!”  How was that possible?  It had only been ten minutes since he made the phone call.

The doctor came in, introduced himself; and then, Nelson proceeded to share with him the series of events and what people on the boat speculated to be the problem - major seasickness.  Quietly and gently, the doctor walked over to my bedside and began speaking to me…”Mrs. Roth, Mrs. Roth, I am here to take a look at you. May I exam you?”  Honestly, at this point, I was too weak to interact. I needed an answer.  I needed a miracle.  

Then I heard the doctor say, “Mrs. Roth, you are very ill and I believe it would be best for you to go to the hospital.  I’m going to call the ambulance.”  Immediately, tears began to flow.  Just thinking about being moved and transported in an ambulance made me feel sick; and then the thought of going to a Mexican hospital brought with it all kinds of uncertainty and anxiety.

Although, I was submitted to the doctor’s suggestion, in my weakened state, I grabbed Nelson’s hand and whispered, “No. Please, not an ambulance.”  My mind had flashed back to the car ride to the hotel on the cobblestone streets and I couldn’t imagine lying down flat on a gurney in an ambulance to the hospital.  The doctor overheard our conversation and without hesitation, he said, “Well then, I’ll take you in my car.  You really must get to a hospital as soon as possible.”

Wait a minute!  What just happened?  Did this doctor say, “I’ll take you in my car to the hospital.” ?  Isn’t this unheard of?  Am I in Mexico?  These and the thought that I might be dying were some of the many thoughts going on in my head at the time of his announcement.  Now, transporting me from the hotel room to the hospital by car was the next great challenge.

With help from hotel staff, the doctor and Nelson, I was carefully transported a little after midnight from our room to the doctor’s car.  As I think back on this moment, I distinctly remember the silence, the cool air, and the star-filled sky as we solemnly proceeded on the winding sidewalk to the car. Getting into the car, I looked back at the open lobby of our hotel, wondering as we pulled away, will I ever be back here again?  

More than a paramedic

Every nautical mile closer to the harbour, brought a break in the weather and by time we docked, you would have never known we had experienced an intense storm.  

After such an emotion-filled ride, passengers extended their well wishes as they scattered to go about the rest of their day; and the captain and his crew began their routine process of shutting down the boat.  And there I sat.  Unable to move, because any movement created an avalanche of feelings - nausea, dizziness, slurred speech, double vision and overall weakness.  Finally, after much persuasion, I took steps to get off of the boat. None were successful. Every step was filled with anguish as it became more of a reality something was genuinely wrong.  

Slowly and methodically, we walked a few steps and then stopped for me to sit down as I was so weak and relentlessly vomiting.  Eventually, we got to where the captain and his wife had an office for her real estate business and his deep sea excursions.  She encouraged us to come in out of the heat and rest until I felt stronger.  

Nelson got me as far as the first chair at a desk positioned in front of large glass doors. I continued to be sick and it became more apparent my speech was impaired as well as my vision. Of course, all along believing I was just dehydrated from the continual vomiting caused by the seasickness.

And then, someone passing by saw how sick I was.  He turned around. Opened the door and said, “I’m a paramedic and I was wondering how I could help.”  Immediately, he began asking us questions and then, I heard him say, “Give me a minute.  I’m going to run to the pharmacy.”  

Everything inside me wanted to scream .... “Don’t leave me.”  For a moment, I thought, he is more than just a paramedic, he is the answer.  He’s going to figure out what exactly is wrong with me and I’ll make it through this unbelievable nightmare.  

Well, as fast as he left, he returned carrying with him an arsenal of medications for nausea and vomiting.  Declaring, “this medication should bring you relief in minutes,” I took it; and yet, there was no change.  Convinced he had done all he could, he said, “I hope you get better and if you don’t see some relief soon, you really should consider going to the hospital.”  And without hesitation, I mumbled to Nelson, “Please, please don’t take me to the hospital.”  

By now, hours had passed and there was no sign of relief. The muscles in my body had become fatigued and it was next to impossible for me to walk; however, the captain and his wife offered us a ride back to our hotel.  So, slowly and gradually - with the help of my husband, we made it to the car.  And with every bump on those nostalgic cobblestone roads of Puerto Vallarta, I was reminded of how much pain I was in.  

In route to our hotel, we passed two hospitals and again, we were encouraged to go to one of them, if I didn’t feel better in a few hours.  Softly, I whispered to Nelson, “Please, don’t take me to a hospital.”