It’s an eerie morning in Southern California as I wake up to an auburn glow filtering in through the blinds of my bedroom window. At times, the evening light will affect a warm luster with a blending of yellows and reds and pinks. This morning is not that kind of color. This is bright orange at 10 am. Parting the blinds, I examine the sky to determine the cause. Outside, it looks like the kind of day you can be excused for opting out of. That thought tempts me but a glance across the bedroom to the orange warning light of my oxygen concentrator dissuades the notion. The orange warning light means it’s slowly wearing out. If the concentrator dies, I’m going to be between several rocks and a multitude of hard places. I take the ominous sky as the lesser of two apocalypses.
This morning I’m on the last step of an epic journey, an odyssey, to replace the dying oxygen concentrator with a new one. After what I’ve been through to get to this point, no amount of orange glow outside is going to stop me now.
Unbeknownst to me at the time, several miles away a wildfire was spreading through what I considered to be the wealthier suburbs. That’s where the orange glow was coming from. When I stepped outside, in the fall season, I decided it just looked festive. Autumn’s pumpkin sky. But we’re getting ahead of ourselves.
From the onset of this odyssey, I knew it probably wasn’t going to be as simple as exchanging the malfunctioning oxygen concentrator for a new model, like one might a car or the middle child. What the gods had in store for me, I never expected.
It begins the day their oracle, my pulmonologist (a lung specialist doctor), prescribes to me a series of tests to prove I need the medical machines I’ve been using since the 8th grade. Like all mythical heroes, I’m not pleased by this because it delays me from getting what I want. My doctor wishes it was that simple but when it comes to the gods, his hands are tied.
Sorry, have I been saying gods? I mean health insurance. #blessed
Accomplish these tasks and the health insurance deities will grant me a new oxygen concentrator so I can live. He doesn’t say it quite like that, but that’s how it feels. Years of playing video games have taught me to recognize a quest when I see one and so when I’m handed a sheaf of prescriptions, I understand what to do.
Immediately google the cheat codes.
Except this is real life and there are no shortcuts available to me. If I want to save my universe, I’ve got to get a new oxygen concentrator. And if, in order to do that, I’ve got to spend a month questing my way forward, so be it. I’ve slain internet dragons and saved the world (of Warcraft). How tough can a few medical tests be?
Wrestle The Dream Kraken
The first test is a sleep study conducted overnight at a lab next door to the doctor’s office. My appointment time is 9:30 pm and the Uber gets me there a little before. It’s odd seeing the entire strip mall that both the doctor’s office and the lab are part of at night because everything is closed. There’s no reason for anyone to be here, except for the lit windows of the sleep lab.
I’d like you to know I want to call them “happy lit windows” but happy is an emotion and everything about the sleep lab seems designed to make all emotions fade away.
When you walk in, you should notice the duality of the colors used in the decor. From the floor to about four feet up, the walls are a dark grey. Above this, a dull white. This stylization permeates every room of the building, from what I can see. To me, it feels like standing in the shallow end of a pool, visually-speaking. My head wants to tilt up to avoid water capsizing over my face (when you’re under 5′ the shallow end is neck-deep). I feel this fear despite the fact I’m standing on land and there’s no water anywhere.
Such is the power of interior decorating.
By the time I’m sitting in the room where I’ll spend the night, all the fight has been sapped out of me. Shivering slightly in my underpants, I let the technician attach more than a dozen wires to my chest, my head, my neck, and my legs. The adhesive glue bonds well with my leg hair (they’re invited to each other’s birthday parties). Looking more like a trainee astronaut from the 60’s than a guy about to get a good night’s rest, I shimmy into the large bed (gray sheets). The technician, his hands washed clean of the adhesive glue, gives me a nose cannula for the oxygen (which I won’t get at the start). Normally I sleep with an apnea mask, but tonight they need to test if I can sleep without the BiPAP (a fancier CPAP) machine, so I’m not getting any of my regular, necessary help.
What I’m in for tonight is anything but restful slumber.
Hooked up and tucked in (giggle), I’m told to await further instructions. Laying in the darkness broken only by the red glow of the infrared camera, I try to sleep. From the intercom, a voice.
WIGGLE YOUR TOES.
I wiggle my toes. The voice asks for other gestures and actions that I can only assume are intended to remind the patient of just how much that infrared camera can see, which is everything. And they are always watching. The voice concludes its demands with the suggestion that if I need anything, just wave. Silence follows this last instruction. Not yet struggling to breathe, but significantly uncomfortable, I attempt to sleep.
My attempt is unsuccessful. The technician returns. It seems I need oxygen.
These little visits during my night at the lab continue to happen as they slowly add back in all of the components of what usually makes for my version of a good night’s sleep. In the morning, around 5 AM, I’m told the test is over and I can get up. My hair is a mad scientist mess. The sticky pads are ripped from my skin with a sympathetic jerk. Looking like what the cat dragged in and threw up, I leave the sleep lab vowing never to let insurance do this to me again.
Naturally, I’m back two weeks later for another round of tests.
Apparently, the first night was just to determine if I actually had sleep apnea. You know, that sleep disorder I’ve only been dealing with since the 8th grade. Have I made this point enough? Probably. There are times in my life when I savor being right. But this vindication feels hollow as the adhesive glue and the wires are applied for a second time. When the voice demands toe wiggles, my little piggies are already jiving. Unlike the last time, this overnight study is going to test what air pressure my lungs require pumped in to prevent me from having sleep apnea. This process is called titration and even though it rhymes with hydration, the two are not related.
While I attempt to sleep in the lab, a technician remotely controls the pressure of air pumped in and out of my lungs. They slowly increase the pressure to find the optimal combination of both in and out. This may seem familiar to some of you. On one end of the scale, there’s a mere blowing of air. On the other end, there’s AVAPS which is an acronym for a really intense amount of pressure. Over the course of the night, I experience the entire spectrum. Not restful slumber.
The test concludes at 6 am. I walk out with wild hair. The first part of my quest complete.
Blow the Ancient’s Horn
The next step in the quest is to have my breathing data collected by conducting a series of relatively brief tests with fancy medical devices. It’ll take up a morning at worst. But when I arrive at where my GPS told me to go, I discover this place is a large, open-air building with several parking lots and numerous points of entry. It’s still a little bit strange for me when I encounter these structures here in California because from my East coast perspective they look like motels. When I go to visit a doctor’s “office” at a motel, my reverence for their medical authority decreases somewhat. This is mentioned both to point out that these buildings often make it harder for me to find the right office and to condescend on Southern Californian architecture which foolishly doesn’t believe the great blizzard is coming.
Hallways need roofs and walls, this is civilization, let’s act like it.
After wandering the multi-tiered, dimly lit parking garage of an office structure, I find the correct door. Inside, I delight in seeing that it looks much like a normal doctor’s establishment. There’s no open windows or livestock but plenty of dated magazines. I’m shown to the back room, the testing room, for a short wait. Sitting inside the windowless space, it looks more like a storage closet than a facility for conducting what I’m told are very specialized tests.
Of most notable interest is the long, PVC pipe-looking tube with a mouthpiece and the glass cage that looks like a telephone booth or human aquarium. Both of these testing devices will be used today.
The technician conducting my tests is an older man with a bushy grey beard. He discusses what we’ll be doing today in a calm, helpful manner until somehow we sidetrack the conversation into all the people who never show up for their appointments. This fact greatly disappoints him. I concur in an attempt to move on but we circle this wounded moose like wolves for another five minutes. Then he remembers what we’re here for. Moving the long tubular device over to my face, the technician instructs me to put my mouth on it, to wrap my lips tightly around the rubber end that looks like it comes from a SCUBA mask. It’s firm but chewy.
You’re not supposed to chew on it. Here’s how this test goes.
With your mouth securely around the long tube’s end, the technician, his bushy mustache rustling in your ear, counts down from three. Then, you blow. You blow as hard and as long as you can into the tube so that the machine can measure how much you blow. And while you do this, with a chewy rubbery thing in your mouth, the mustachioed technician barks words of encouragement.
YES THAT’S RIGHT, GOOD JOB, CHRIS, OOO YOU’RE DOING SO WELL, KEEP IT UP, THAT’S GOOD, CHRIS, YES!
Suffice to say, it’s difficult to keep one’s focus on blowing a steady stream of air when you’re trying not to laugh at John Bolton’s doppelganger cheering you on to completion. He runs me through the test five times until the machine gets an accurate reading and Mr. Bolton approves of my blowing technique. The things one does for healthcare in this country.
After he finishes, we move on to the human aquarium portion of the data collection. I sit in the clear box on a small stool while putting my lips to another tube and attempting to blow. I make it about three seconds before I cannot catch my breath and have to exit the chamber swiftly. We abandon this test and I’m on my way out the door.
Two down. One to go… so I’ll just wait until the last possible minute. I mean, what could possibly happen to stop me from getting a no-appointment, walk-in X-Ray?
Witness the Pumpkin Sky
The third item on my medical shopping list is to obtain x-rays of my lungs. Not the first time I’ve had this done. It’s a pretty simple process involving another windowless room, a large medical device, and following instructions over an intercom. Sometimes they make you wear a hospital gown but other times you’re good to go in street clothes. I guess different x-ray machines have various opinions on protocol. Machines can be so moody.
Occasionally the walls are painted with dinosaurs.
I mention these details to make it plain my reluctance to get the X-ray taken care of earlier than say five days before the next appointment with the lung doctor stems from a place of nonchalant laziness and not fear. Although as always, there’s the question of parking.
Driving in the early afternoon, there’s smoke from burning wood in the air. My mind wanders to camping trips and cabin cookouts of vacations past. It’s a comforting scent, there’s a resourcefulness to it, but it’s followed by the terror that fire stirs in our ancestral hearts. When I arrive at the medium-sized office, the parking lot is full, save for one space. Inside, the waiting room has actual magazines and closed-circuit TV advertising different forms of healthcare adventures.
Putting my name in, I’m told there’s a short wait. How familiar. I suppose that’s what the room is for, I remark to the receptionist. She smiles back. I take a seat. When you have a soft voice, any jokes that fall flat can be chalked up to the other party not hearing you. Convenient, that.
From my firmly-cushioned chair, the outside doesn’t look too bad, the glass is tinted so the orange glow is gone. Across the room, I see another couple sit down. A younger male and an older female, except she doesn’t look that much older, a senior versus a freshman. They both wear clothes I associate with being in college and having opinions. Deciding to people watch, I try to figure them out.
She seems to be way more into him than he is into her. With her phone out, she forces him to smile in a selfie. He does but then goes back to playing a game on his phone. Not unusual behavior. But then, she sees a smudge on his face. In full view of the rest of the room who are paying absolutely no attention except me, she wipes the corner of his mouth with her thumb. He allows this without much protest. If I were him, I think, I wouldn’t put up with being treated like I was my girlfriend’s good little boy, not in public.
At this point, I’m suspecting she must be really good at medical tests.
The receptionist calls out the next name. The younger man stands up and the slightly older-looking woman follows, a Rolling Stones emblazoned mini-backpack slung over her shoulder. Just as they move out of earshot, I hear the receptionist remark, “And you must be his mother.”
Before I could process the error in my assumptions, the pumpkin sky makes itself known.
From a central station somewhere in the world, an alert is issued to all cell phones in the region informing us about the existence of a wildfire nearby. Every phone in the room cries out in angry, vibrating tones. In quiet unison, we clutch our vital devices to read the news. The wildfire is still on the outskirts of town. Discussions spring forth as to whether this fire is spreading, the location of the evacuation zone, and will we need to leave now? The battery on my phone dips to the shallow end and I contemplate leaving the X-ray facility to get home, charge my phone, and prepare for evacuation. Only the reassurance of the receptionist that the fire is a good ways off from where I live keeps me from bailing. There’s urgency in the air now, mixed with the smoke.
I get the x-ray taken after a short wait.
Driving home is weird. The orange, pumpkin sky feels only three-stories tall. There’s a low, thick smoke ceiling to the world. It looks uncannily like the footage one sees from conflict zones. If an armored vehicle leads a convoy through this next intersection, things would make more sense.
For days after, I monitor the fire through the twitter feeds of various emergency departments. The blaze thankfully never gets close enough for me to need to evacuate but that doesn’t stop concerned friends and family from texting me asking me if I’m evacuating. For future reference, “Are you evacuating” is not a smart thing to text someone who might be near an evacuation zone. No matter how many times one has checked to see if one needs to evacuate, getting a text like that is distressing and makes one need to check again. It’s okay though, I’ve probably done something like that too.
The local wildfire gets contained and eventually extinquished without any loss of life, as far as I’m aware. Other regions aren’t so lucky and I cannot imagine the struggle nor the bravery of those involved in stopping fires like these.
Time to turn in the quest.
Having completed the objectives three, I show up at my next doctor’s appointment ready to go home with a new oxygen machine, or at least the insurance’s approval for a vendor to supply me with a new one. But if you’ve made it this far, I think you know what I’m about to say next. Do I get it?
The health insurance gods demand a final test. Willing supplicant that I pretend to be for medical reasons, I do it. Remember when I woke up to the sound of my bathroom flooding and had a PulsOx monitor hooked to my finger? We’ve finally made it back to that soggy morning. After I give the testing device with the results back to the vendor, I wait to get it processed and my oxygen concentrator issued. I believe it will only take a matter of days.
Forty-six days later, I’m scheduling the delivery of the machine.
They show up at 4:30 pm with my oxygen concentrator. My brand new machine. When the deliveryman puts it in the bedroom, I ask if he brought new tubing too. He looks apologetically at me. Nope. Just the oxygen concentrator. He asks if I still want the machine or if he should take it back. I calmly inform him it’s mine and I’m keeping it. When he leaves, I lock the door. So close to the finish line, I’m not taking any chances.
Mission truly accomplished.
Skip ahead one month, I’m back in the lung doctor’s office where I learn the new sleeping regime isn’t working. It’s not the oxygen’s fault, it’s the BiPap and my sleep apnea not cooperating. The experiment that is my life remains ongoing but what happens (and is still happening) next is a story for another time.
Returning to the first night with my new machine, I fall asleep listening to the hissing, buzzing, churning sounds of oxygen. Lit by the glow of the machine’s green “you’re good, bro” light, all is correct with the world.
And for that night, it was.
Our Odysseys may never be over, yet there are moments where it feels like we’ve finished. It’s done. We can rest. At least until the next obstacle shatters our illusions of triumph. When that happens, a voice in my head urges me to forget believing in a journey’s end. Can’t get hurt if you have no hope, the logic persuades. But the moments of victory, no matter how fleeting, those are the moments that keep me going. I hold fast to them when the wind has died. Like oars, I pull on them with all my strength.
The sea is deep. The monsters are scary. And on the horizon, home.