I CAN'T SPEAK

'How am I going to communicate with this trache in my throat?' This question had been high on the list after first being put on the respirator. 'Does anyone read lips?' To my surprise and my delight, my first wife could read my lips almost perfectly. As long as she was in the room, there was no problem, but she was only there half a day.

My parents, in-laws, and I developed a method whereby if there was a word I was trying to say that they couldn't understand, they would ask what letter it began with. They would recite A-B-C-D-E... and I wouldn't make an expression until they reached the correct letter. I would then widen my eyes or make a tiny sound with air I could get into my cheeks. If the first letter wasn't enough to guess the word, it was on to the second and the third. After a few days of this, it became a slow but reliable method of communication.

If no one was in the room with me, I could make a duck-like sound by squeezing air between my cheek and gum that would get the attention of whomever was outside the door at the nurses station. I used this most often if I detected a leak in the hoses that carried the oxygen from the respirator. The system had an alarm that would sound if a tube became disconnected. But because of my stillness and sensitivity to that much needed air, if I was deprived the even least little bit, I became acutely aware and would sound my own alarm. (When you hold your breath, you can still puff your cheeks in and out without air escaping from your lungs. That was enough air for me to make my sounds.)

'So when is my surgery?' I knew I wasn't going anywhere until my broken neck was mended.

In the first week that had passed, while concentrating on my ability to breathe and trying just to get me stable and comfortable, there were other things going on in my body. I had been catheterized to regulate my bladder and what often comes with prolonged catheterization is the Urinary Tract Infection. One of the symptoms of the UTI is a high fever. They will not operate on a patient with a high fever. The combination of the trauma of being paralyzed, the recurring infections and pneumonia kept my temperature constantly elevated. Consequently, it would be weeks before they would perform the operation to realign my spinal cord.

'What do we do in the meantime?'

A day or two after the trache was put in, Dr. Bregman came in the room for his rounds and asked me how I was feeling. He then told me the following day they would begin weaning me from the respirator.

'How long do you think it will take?' I asked.

"That's entirely up to you," he answered knowingly. "See you tomorrow," and with that he left the room.

The nurse came in next and informed me it was time for suctioning. This was quickly becoming one of my least favorite routines. In this process they remove the respirator tubes -- my source of oxygen -- from my trache, take a long skinny sterile catheter with one end attached to a vacuum and stick the open end into my trache hole down into my lungs to suck out secretions that accumulate there. This is common with all people who are on a respirator.

The problem is, the entire time she is sucking out the secretions, there is no oxygen in my starving lungs. With my inability to inhale without the respirator, I am breathless, helpless, and in fear of passing out. Suctioning only takes seconds but it was an eternity as far as I was concerned. Then she has to do it again. Twice every time. This is ultimately good because, by clearing the lungs out, I am better able to breathe. But early on, while my lungs are so weak, it's like the fear of drowning all over again.

When she is finished, she quickly reattaches the respirator tubes and gives me a few "sighs", otherwise known as oxygenating me. These are puffs of air that can be given in addition to the regular breaths provided by the respirator. Little did I know a time would come when I would look forward to the horror of being suctioned just so I could receive the delicious 
"sighs" at the end that refill my lungs and give me a wonderful -- however brief -- sense of calm.

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