"Every Breath I Take" chapter 6

Cathy just sent me chapter 6 of "Every Breath I Take" and she assured me that chapter 7 is already well underway. If her plans (or lack of plans, really) for tomorrow happens she's hoping she'll have it ready for posting tomorrow evening. No promises though!

She told me to tell EJ and the anonymous person that commented on chapter 5: THANK YOU!! :-)

As usual: I take no responsibility for medical accuracy in the story.

Chapter 6

When Josh woke up Monday morning he was a little disoriented at first; it took him a moment to remember were he was.  His parents had sold his childhood home and moved into their current house a couple of years earlier and Josh had only visited a few times after they’d moved.  It was a nice house, but it didn’t have the familiar, homey feel of his childhood home. 

As he sat up in bed, after scooting back so he was leaning against the headboard, he realized he was hung-over. He probably should have skipped the last rounds of beers and shots with the Chris and Terrence, but after the ice had been broken and they’d managed to get past the initial awkwardness caused by his ventilator the three old friends had enjoyed the party and each other’s company and were meeting for a late lunch today.

Josh grabbed his iPhone from the nightstand and checked his email; he remained sitting in bed with back against the headboard with his ventilator attached to his tracheostomy tube. He’d sent his boss an email before he left his house Sunday morning, explaining he’d be out of town for a few days.  Josh had finished a big project the previous week and he still hadn’t gotten a new assignment, so he figured it wouldn’t be a problem to take a few days off. He was pleased when the reply from his boss confirmed that; he simply told Josh to enjoy his time with his family and get in touch when he was back in town.

After a few minutes he put the phone back on the nightstand and reached for a syringe to deflate his tracheostomy cuff. It was time to get moving; even if he had a bit of a hangover he couldn’t stay in bed all day and it was already almost nine in the morning already.  Josh didn’t take long to deflate his tracheostomy cuff, detach the ventilator tubes from his tracheostomy tube and plug his tracheostomy tube. He switched off the ventilator and headed into the bathroom to take his morning meds and go through his tracheostomy care routine.  He was breathing pretty well unaided, which was a good thing.

After he’d relieved himself Josh thoroughly washed his ands and then poured a glass of water and downed his morning doses of his medications. “I take more meds than most 90-year olds,” he thought, but he quickly pushed the thoughts away. The meds were important to keep him functioning.  After he’d taken his medications and brushed his hair and teeth Josh put on a pair of sterile gloves and started to his tracheostomy care routine. It was a multi-step process that included replacing the disposable inner cannula of the trach tube with a new one, cleaning the area around the tracheostomy and replacing the gauze dressing under the outer cannula and neck plate. He finished by the routine with replacing the tracheostomy tube tie that went around his neck with a clean one.

When he was done in the bathroom he headed back to the bedroom where he got dressed in his favorite pair of old, worn jeans and a grey V-necked t-shirt.  As he sat on the side of the bed and pulled on a pair of socks he realized he was still breathing pretty well and decided to go without his ventilator for a little while longer. It would be nice to be able to taste his breakfast – especially since he could smell that his mother was baking cinnamon rolls. His favorite.

“Morning, Josh,” his mother greeted him when he walked into the kitchen. “How are you this morning?”

Josh walked over to his mother and hugged her briefly. “Good morning, Mom. Apart from a little hangover I’m good. I had a little too much fun last night.”

“Shouldn’t you be using your ventilator?” his mother asked, concern lacing her voice.

“I’m breathing pretty well unaided this morning and I want to be able to actually taste my favorite breakfast. I’ll need it later, but I can go for a few hours without the ventilator helping me breathe.”

“That’s good,” she said, patting Josh’s shoulder. “There’s coffee in the pot and the cinnamon rolls are almost ready. As soon as Darryl and Jeremy gets here I’ll scramble some eggs for us; I’ve already fried some bacon ”

Josh poured himself a mug of coffee and sat down by the kitchen table where he grabbed the LA Times and started browsing trough it. After a few minutes his father joined them and soon after Jeremy showed up in the kitchen too.  After they’d eaten generous portions of scrambled eggs and bacon Carolyn topped off their coffee mugs and placed a basket of warm cinnamon rolls on the table. Josh wolfed down two and washed them down with coffee.

“Looks like you enjoyed that,” Carolyn commented as Josh drained his coffee mug.

“Yeah, I did. It’s been a long time since I had your cinnamon rolls, Mom. It was great. Thanks.”

As Carolyn started to clean up after breakfast Josh realized he was starting to struggle with his breathing and after he’d put his plate and mug in the dishwasher he excused himself and headed to the bedroom.  He sat down on the side of the bed and unplugged the ventilator from the outlet it had been plugged into overnight. Then he turned it on and zipped the bag closed before he uncapped his tracheostomy tube and attached the ventilator tube to it. As usual it felt good to have the ventilator help him breathe. 

# - # - #

As Josh and Jeremy followed the hostess through the busy restaurant Josh cursed himself agreeing to join him, Chris and Terrence for lunch in a public place. As usual people were either shamelessly staring or averting their glances as he walked past. Josh wondered if he’d ever get used to it, even if it was bothering him less now than when he’d first started using a his ventilator during the day.

When they reached their table Chris and Terrence were already there and to Josh’s relief they greeted him like nothing was out of the ordinary. His little ‘speech’ at Jeremy’s graduation party the previous evening seemed to have done the trick.

“What do you work with, Josh? You mentioned something about having to be back at work on Thursday last night, but I never caught what your actual job is,” Chris asked after a waitress had taken their orders.

“I’m a software engineer. My employer specializes in POS software for the hospitality business; hotels, restaurants… I’ve been working a lot on integration of hand held devices, such as iPad and iPod touch, into our existing systems lately. Like the handheld terminals the waitresses here have.”

“That sounds pretty interesting actually. You always were a bit of a nerd,” Terrence said. “I remember we always knew where to find you in high school; the computer lab.”

“Working on a computer was, and still is, one of the few activities I could do without being limited by my shitty lungs. When it was time to chose my major in college something computer related was a no brainer. I like my job, but I’m considering cutting my hours back and going to grad school part time.”

“Really? That’s great, bro,” Jeremy exclaimed.

“It’s not a done deal, but I’ve been looking into it and the local university actually has a pretty decent Master’s program. If I can get my employer to work with me on it I think I’ll go for it.”

“I don’t see why they wouldn’t? You getting more knowledge should be a good thing, right? Win for both you and them.”

“I really hope my boss sees it that way,” Josh said. The arrival of their food paused the conversation and they ate in a comfortable silence for a few minutes. When everyone started raving about how good their food was Josh remained silent.

“Is there something wrong with your food, Josh?” Chris asked, noticing Josh hadn’t made any comments about what was on his plate.

“No, it’s fine. It’s just I can’t really taste or smell much when I’m on a ventilator,” Josh explained. “It’s kinda hard to get excited about something that tastes nothing.”

“Oh, I didn’t know,” Terrence said, clearly a little embarrassed. “That must suck.”

“Sure does. I usually stay off the ventilator for at least one meal a day. I’m actually breathing pretty well today, so I could’ve unhooked my ventilator while we eat, but I think that would’ve freaked most of the other people here out. I save that for private settings.”

“I guess you have a point there,” Terrence agreed. “So, that tube in your neck, does it go all the way down to your lungs?”

“No, the cannula is only a few inches long,” Josh said, using the thumb and first finger on his right hand to indicate the length of the cannula on his tracheostomy tube.

“Really?”

“Yeah. I have what’s called a cuffed tracheostomy tube. There’s a balloon around the bottom end of the cannula, which can be inflated to completely seal off my trachea. I inflate the cuff at night, but during the day I keep it deflated.”

“So how do you inflate that balloon?” Chris asked with genuine curiosity.

Josh grabbed the inflation line with the pilot balloon that was hanging from his tracheostomy tube; as usual he’d made sure it was tucked inside the collar of his shirt and not visible. “I attach a syringe to this valve here, and push air into it. This part is called the pilot balloon; when the cuff is inflated so is the pilot balloon,” Josh explained before he tucked it back inside his shirt. He was glad his buddies were comfortable enough to ask questions and he didn’t mind answering their questions.

“Um...there’s a guy in my office that has a tracheostomy, or at least I think that’s what it is, it looks nothing like what you have coming out of the base of your throat,” Chris said, then he paused for a moment before he carried on. “What he has basically looks a hole in his throat with a metal circle around it and he doesn’t have the fabric square behind it like you have.”

“There are some people that prefer metal tubes, but plastic and silicone are the most common kinds or tracheostomy tubes these days. He probably had his trach put in while metal was the norm and prefers that. And not everyone uses the gauze dressings behind their neck plate, even with the kind of tube I have.”

“So why do you have the gauze thing there?” Terrence asked with genuine curiosity lacing his voice.

“I prefer to have the gauze dressing behind my neck plate because I think it’s more comfortable than having the plate in direct contact with my skin. It’s just how I prefer it,” Josh shrugged. “I have a few years of experience with having a tube in my throat and I know what’s comfortable for me. Some things are doctor’s orders, like having a cuffed trach tube. The dressing and the kind of trach ties I use are a matter of my preference.”

“Trach ties?” Terrence exclaimed, with genuine curiosity lacing his voice.

“The padded strap around my neck that keeps the tracheostomy tube in place. The ones I use now are very comfortable, because of the extra strap that keeps my ventilator tube in place and puts the weight of it on the strap around my neck instead of on my tracheostomy tube.”

“I had no idea there were so many things to consider,” Terrence said. “Sorry of we’re asking stupid questions.”

“These aren’t things most people know much about,” Josh said with a smile. “And I prefer that you’re asking questions instead of being awkward.”

The guys nodded and turned their attention back to their meals and conversation shifted to other subjects. By the time the meal was coming to an end Chris, Terrence and Jeremy felt confident they had convinced Josh to go to grad school and pursue a Masters degree. Josh was feeling more confident about the prospect of going back to school too and he even allowed himself to get a little excited about it.

# - # - #

After breakfast on Wednesday Josh packed his bags and bid his parents and Jeremy goodbye. As much as he’d enjoyed spending  some time with his family he was ready to head back home. His mother tried to persuade him to stay for the rest of the week, but Josh firmly declined, using running short of tracheostomy supplies as an excuse. It was a lame excuse and he knew it – if he’d wanted to stay longer he could’ve gone to a medical supply store and gotten more.

The truth was that he was getting tired from the constant stream of visitors at his parents’ house. They had a large circle of friends and lots of social commitments. After two days of pitying looks and prying questions he’d had enough and he was craving the solitude and quiet of his house.

To be continued.