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Saturday, June 16, 2012

Part 5: E.R. Trip #2 - How I earned my title of "Patient"

Part 5:  E.R. Trip # 2 - A Second Glimpse into the Abyss

"Personally, I am grateful for a crisis.  The crisis will give us the possibility to learn something if we are willing....if the heart opens up enough to tell the mind something", Gunther Hauk, Biodynamic Beekeeper featured in "Queen of the Sun: What are the Bees Telling Us".

"Crisis", from 'krisis':  turning point in a disease, as used by Hippocrates.

I had returned home (early Friday evening) and was reasonably comfortable, and VERY happy to be out of the hospital but still quite perplexed by my whole ordeal.  I was trying to get some food down, but was very tentative about putting anything down my esophagus as I could feel discomfort upon swallowing, although nothing like the massive chest pains I had had initially on Thursday.

Into the evening I noticed the worsening of my hives, with a huge swelling on the bottom of one of my feet, so large that I couldn't walk correctly.  Rashes, welts and lumps were erupting all over.

At my husband's urging (insistence), I called my doctor's office and had the good fortune of finding out that my own doctor was on call that evening.  She returned my call quickly and we discussed how much Benadryl (double doses) I could take and I followed her recommendations.  She noted she would be there for "Sick Bay" (early office hours) on Monday morning and I could slip in to see her then, that she might need to run me through a course of steroids.  Ok, all good.

Things seem to be ok into the next day and I am beginning to rest although I know I am stressing about the ordeal and still not knowing exactly what is wrong with me.  I am taking it very easy though and trying to eat a bit here and there.  My hives are nearly all gone.

In the evening, I decide to have a sweet potato (this would end up being really ironic), and put one in the microwave and go back to sit down.  As I get up to go and get it from the microwave, I start breathing rapidly and shallowly and am thinking....is this shortness of breath?  I catch myself on the kitchen counter as my ears start plugging and ringing, my head feels like it is swollen up and my hands start tingling.

I make it back to the couch and look at my husband and say 'I'm in trouble'.  I barely hit the couch before I am passing out, in and out of consciousness, and hear my husband yell for my son, as he is dialing 9-1-1.  He slaps me on the face (he told me he did, I have no memory of it) and tells me to stay with him and I remember looking at him and saying 'ok'....and then mouthing "I Love You".  (Once again I get this feeling that maybe, just maybe this is the end of this life-time for me.  I decide that is b.s. and feel my "Pennsylvania Dutch" stubborn streak kick in....thank you, Grandma).

My husband has the foresight to send my son down to the end of the driveway to flag the squad---we live out in the country and have a very long drive----and by now my hands are nearly completely numb and the tingling is moving up my arms, which I am trying to tell him saying "hands", "hands". 

The EMTs come into the house and I hear him telling them about our trip to the hospital already and bringing them up to speed.  They put a B.P. cuff on my right arm and just about then I completely lose the use of my arms and my hands cramp up tightly....like claws. (My husband tried to pry my right hand open a bit and could not even budge it).  I am saying 'oh my gawd, my hands, my hands, look at my hands!!'. 

The BP cuff is just killing my right arm and I beg them to take it off.  They switch it to the left arm and I am horrified as I read the monitor which notes my BP as 70 over 30!!!

I hear one of the EMTs say something about dehydration and I have water sitting there on the table and ask for it and can now use my left hand enough with his help to down the few ounces that are in there.  Almost immediately, my hands begin to uncramp and the tingling begins to subside.  They also took my blood sugar as my husband said I hadn't had much to eat for the last couple of days and we were all surprised to see it was over 130. 

They decide to transport me and bring the gurney into our family room.

Once I am loaded into the back of the ambulance, the EMT to my left starts an I.V. port as they are taking down my name and information.  I'll always remember this guy, 'Cunningham' read the name on his shirt, as when they were taking my age down, he said "you are, uh, forty-what?".  Now later on, I thought that maybe I had given them the year of my birth and that this was a reflection on his poor math skills, but I am choosing to remember it as his guess at my age....  :-)

Cunningham starts to hook up the saline solution and another EMT, the driver, comes into the vehicle from the side and behind me to cut through the center console.  Why he came in that way and not the driver's door, I do not know, but when he did, he tripped over the I.V. line which ripped the hub out of my arm and my blood was strafing the inside of the ambulance and Cunningham, straight out of a B-horror movie.  I turned to the general direction of my husband who was by now seated in the passenger side of the front and said 'Honey, I don't want to go'.

He was having none of it, and said quickly, 'we are going'.

When we arrived at the hospital, the EMTs had already had several printouts of my heart rate (all normal), and I was feeling weak, but ok.  No I.V. had been hooked up....they gave up on that. 

I was taken to a different room in the E.R this time...one with a view....a view of the central hub, or nurses'/doctors' station.  Kelly was not on this night (it's not a good thing when you start learning these folks' names), and we were assigned another nurse who instantly pissed off my husband when he asked the tech to have my family wait in the waiting room while they got a gown on me.  (I refrained from pointing out to him that really, my husband has seen me naked before, but that he ---the male nurse---has NOT, maybe HE should go wait in the waiting room).  I could see the look on my husband's face....one I strive not to elicit and I sent up a silent prayer that nobody else gets in his way between here and the waiting room.  (Later I found out from my son that my husband had been growling at the aide who offered to escort them to the waiting room, and that my son had worked to calm him down a bit.)

For way longer than it took to get a gown on me, they kept my husband and son out of the room and finally the nurse said they could come back in.  Basic info and vitals were taken.  I was glad to see a much higher B.P.

I asked them not to put any tape on me or even their sheets/blankets as I wasn't sure what my issue had been with the hives before.  Even as I said this, I looked down at my wrists and could see hives, literally, before my very eyes rising up on my inner arms.  I pointed it out to the nurse.

This nurse had the bed-side manner of a dried piece of cardboard, but we actually ended up doing ok with him, after a time; he did eventually lighten up a bit.

The E.R. doc came in to see me....the very same doc that had seen me less than 48 hours prior.  He proceeded to ask me the very same questions about my medical  history that he had asked me before....but hey, I do know they have their system. 

We explain what happened and proceed to go into detail about the symptoms and that one of the EMTs had said something about dehydration.  He steps out of the room (and see now I can see everything the nurses and aides and docs are doing when they leave the room as I have a straight view of the hub area) and goes to a computer, so I presume he is pulling up info about my stay in the hospital, which I have summarized for him.

A tech comes in to draw blood (my vampire friend from Africa); I call him by name and we chat and I realize as he is drawing blood that he isn't so happy about my veins.  I was all the rage with the vampires when I was in the hospital.....they kept saying how great my veins are and how they wished all their patients had such good veins....now he can hardly find one that is up enough to meet his standards.  Hmmm.....

After a time, a tech comes in and says she is here to take me for.........wait for it..... A CHEST X-RAY!!!!   I look over at my husband who has the 'huh?' look on his face too and I say, "uh, why am I getting a chest x-ray?"  She says, "oh, you don't want one?".  I said, "well, could I just find out why I need one?" 

So she goes to chat with the doc, remember I can watch all this, and I observe the dialog between them...she comes back with a sheet of paper and says, "here, sign off here that you refused the chest x-ray".  Okay at this point, I think I am tripping and in some crazy-ass movie with a playwright that needs to be fired.  You just canNOT make this sh*t up....medics tripping over I.V. lines and so on.

I say, "well, I DIDN'T refuse it; I just want to know WHY I need it".  She goes over and gets the doc who comes in and explains to me that he wants to run all the cardiac protocol again so they can rule out heart attack.  WHAT???  I said, ok, I just had a stress test, passed it per the cardiologist, all heart blood enzymes were good, EKG is good, right?  Yes, right.  Ok then, I don't think it's my heart, do you?  He refuses to answer no matter how many times I ask him for his professional opinion, merely repeated the 'party line' of, well, we have protocols.  I again saw, it isn't my heart and I don't wish to repeat the cardiac tests.

He comes back a bit later to say that the heart enzymes were slightly elevated on the blood test they just took, but he'll take another blood sample and retest.  He does also note that my potassium was very low, so orders a drink for me to correct that and says that could affect the original blood test.

Ok, so we are in a holding pattern here. 

Meanwhile, another patient has been brought in next to me....our room is just divided by a curtain and we can hear everything going on over there.  He has chest pains and our nurse would end up being pretty much completely focused on him for the remaining 5 hours that we would be there....as well he should have been.

Our nurse did come back in and check my vitals again and I showed him again, my hives, which were now all over the backs of my legs, my torso, erupting on my face, just about everywhere.  I asked him if he had ever seen anything like that before and he said, yes, that he has seen it on himself and that he is deadly allergic to aspirin and had had such a bad reaction to it that the E.R. staff was ready to intubate him and told him that if he ever has an aspirin product again, he likely would not survive that....Captain Cardboard shows a glimmer of personality at this point.

Okay, I am glad to know I have someone that understands I am having a reaction, but also now am a bit freaked out.  I work on my deep breathing and relaxation visualization as I peek at my b.p. numbers and see they are at stroke levels:  155/98.  (In my summary of all of my adventures, I'm going to get more into b.p. and the body's agenda.....I really became aware of some surprising things).

Captain Cardboard gets me on some antihistamines after checking with the doc and hurries back to attend to the chest pain patient.

My 2nd blood test ends up being ok, cardiac enzyme-wise, the doc comes back in (we've now been there over 4 hours), and says that it may well have been dehydration so decides to then start a saline drip, which they set up to go very, very slowly.  I ask if I can have some water, which they do give me and I'm getting that down, but it's ice water and I'm freezing as I don't want any of their blankets on my skin....my son takes off his hoodie and gallantly lets me cover my hive-ridden (and unshaven....see 2nd post in this series about personal hygiene/grooming) legs with it.  I have my tee-shirt draped over my arms (it's the nastiest shirt I own...stained with holes in it....see above mentioned post....it's since been turned into cleaning rags).

So, as we are waiting for the slowest drip I.V. in the world to get into my body, we can't help but hear what is happening next to us and to focus on it.  In my philosophical moments, I wonder if exposure to this patient is part of why I have gone through this ordeal, because it was quite sobering.

This man, complaining of chest pains, was scheduled to have a double-bypass at a major university teaching hospital in about two weeks---his medical record ran the gamut of so much that we fear:  high blood pressure, diabetes, a bout with prostate cancer, surgery on his testicles (so much for privacy laws....we heard it all), high cholesterol, he had been a smoker, but quit two weeks earlier.....it was a mess.

They could NOT manage his chest pain.  They would go in and have him rate his pain (most times between 5-8 on a scale of 10), give him pain meds and then check with him in a bit.  It would cycle down to a 2 or 3 and then in about 20 minutes we'd hear him tell his wife, 'chest pain is back'.  She'd call the nurse and it would start all over again.

They decided they would transport him to the hospital where he was going to receive the surgery (approximately an hour away), and presumably set about making those arrangements.

Except time just went on, and on, and on.

At one point, I heard the pain come back to him yet again and the call light was put on, which an aide answered.  I heard her tell him that she would go check and see what the doctor wanted him to have.

Not only could I SEE what was going on in the hub, I could also HEAR most of the conversations in there and I heard the aide talk to the nurse in the station who said "well do they know that he is going to be transported to another hospital?!?!".  Oh......My......God.    I wanted to scream "......" at them, well, I will spare you what I wanted to scream---where is Shirley MacClaine from Terms of Endearment when you need her!?... but I mostly just wanted them to take care of this poor guy and not kill him before they could get him to a more competent facility.

I thought happy thoughts about him.....intently.

I decided my situation was not bad.....not bad at all.  If I had to wait another 8 hours for the I.V. bag, I still would be going home.  If I had hives, they could be controlled with Benadryl or steroids.  If I had to do unnecessary testing and learn some lessons the hard way, well then still, I would live to fight another day.  The best case scenario for this guy was a trip to a cardiac surgical unit where a massively invasive procedure awaited him and a long, long road of recovery.

I had at least learned most of my lifestyle lessons before ending up at the mercy of painkillers on a gurney in a small town E.R.  I quit smoking & alcohol consumption over 20 years ago, remained active, had logged nearly two years on a plant-based diet, total cholesterol 140, average B.P. (when not faced with extreme stress) 112/78 and so on.  I was over-whelmed with gratitude for my good fortune and for my inquisitive mind that had sent me on my current path.

Since it became apparent that I was going to be there for awhile (the liquid in my I.V. bag had only decreased by about an inch), my husband opted to run my son home, so he could get some sleep.

Meanwhile, back at the ranch, patient 'Zero' has been admitted.  He ended up being taken to my old room....a lovely room, with a nice happy mural of a pastoral setting hand-painted on the walls and no view of the nurses' hub....I missed that room.  Anyway, I hear this guy being brought in and basic information taken.  He's so loud, I can hear the intimate details.  Our nurse has been assigned to him as well (guess they figured I'm just in for a drink of water, since I've 'refused' all the good tests, so he can handle it). 

This guy is very crass and LOUD, did I mention loud?,  and announces that he 'can't take a piss'.  Nothing comes out and it hurts and can they put a catheter in him or something and if they do will all the piss drain out of him.  I'm shaking my head thinking that my husband has left before the best part of the movie came on.  The nurse leaves his room briefly after telling him that yes, they are going to take care of it and he's going to get some meds ordered for him. 

About 20 seconds goes by and I hear this huge CRASH and banging and yelling and I know it is coming from Zero.  (Zero as in zero patience, zero tolerance for pain and zero class whatsoever).

A nurse goes scurrying down the hall and I hear her say, 'did you just kick something?'.  Zero says 'no'.  She says, 'are you sure because I heard some clanging in here?'.  "Nope, I didn't kick anything, I can't piss", Zero eloquently replies.

I can hear the nurse uprighting something in the room and she again says,  "are you certain you didn't throw something or kick something?".  Zero finally fesses up and says, "yeah, I kicked that table over there".  The nurse asks him to please not kick anything, this is their property and they don't want it damaged and tells him that medication is on the way.

About 10 or 15 minutes later after I finally flag a nurse's aide down (I realize after my husband has left that I don't have a call button in my room) to unhook my various leads so I can go accomplish on my own what Zero is unable to, I pass by his room and can't help myself and sneak a peak in Zero's room ....he is OUT COLD.  I'm thinking they gave him the upper end dosage of something....or maybe Captain Cardboard has nailed him with a tranquilizer dart to the neck....can't say I blame them.

Time slowly passes, husband returns, doc checks back in the room and is satisfied with something on his chart that he is reading and says that I can go home, I don't even need to finish the I.V. bag.  A nurse is with him to go over my after-care instructions and to sign off saying I've been instructed on several things that I am not being given including the management and use of an epi pen.  I have the deer-in-the-headlights look and she realizes about half way through that they have the wrong print-out for me....goes back and tells the doc, who prints out something else and we start again.

Seems there isn't really a dismissal sheet for:  Patient needs FOOD and WATER.  Which is about what all this boils down to. 

I was also advised upon leaving to be sure and think about anything different at home that I might have, like new soap or new shampoo, new detergent....told that I needed to go through everything at home that might be new and really think about that. Of course, color me crazy, but I'm thinking the fact that I didn't have any hives until AFTER I came into the hospital should go into that analysis.

I'll summarize in my next entry where I'm also going to attempt to delineate the many lessons learned, but we may never know exactly what caused my original pain.  My husband and I have a working theory though.....probably it was the acidic lemon juice in the bottom of my bottle that I had just chugged and immediately bent over to hook up the farm implement to the tractor.  Possibly there had been a tear or some damage in the esophagus from either bushhogging over rough terrain or maybe I had something already damaged, who knows.  We think the acid from the lemon may have simply eaten through some soft tissues there causing the excruciating pain I experienced.

My hesitation to ingest anything and the hospital not ensuring I had adequate fluid intact contributed to the event leading to my 2nd transport.  At this point, both my husband and I were on edge and not understanding what might be wrong, hit the panic switch.  Err on the side of safety I guess, although one could certainly make the argument that the hospital and the E.R. are not necessarily safe places to be.

Interestingly and ironically enough, as I researched a few things during my recovery period, I discovered that sweet potatoes (which I was craving and was the ONLY thing I wanted, followed by bananas, which both I and the hospital were out of), are some of the best sources of potassium!  My dangerously low levels of potassium can cause tingling and the cramping I experienced in my hands/arms.

As for the hives, I am still working on that mystery, which I do have some ideas about and will cover in more detail in the next post.  My father, an oral surgeon, mentioned angioedema which I wasn't familiar with and told me he has had that before and that there may be a genetic component; he never did figure out triggers for his.

It's all rather anti-climatic in the end, but frankly, I'm very thankful for a lack of drama at this point....boring and simple can be quite good.

To be Wrapped Up: Next:  Recovery, Follow-Up and Lessons....oh, the Lessons.
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Healthy Snack 

Scott Jurek, Ultramarathoner, vegan and now author "Eat and Run", can't wait to read it, has an interesting recipe for some snack bars.  He calls them "Chocolate and Adzuki Bean Bars" and you can read a great interview with Scott and find the recipe here:
 http://www.runnersworld.com/article/0,7120,s6-242-303--14320-F,00.html

I am dissecting nutrition and what it takes to be truly fueled and turning to what the successful vegan athletes do, seems to be a good idea.  I decided to give Scott's recipe a try.




I started low-tech with a potato masher to blend up the beans and banana  I used three different kinds of beans, not just the adzuki as that is what I happened to have handy.  I did move up to a mixer, but an immersion hand-held model did the job fine.





When I first tried these, I didn't think I liked them much, but they are really growing on me...I mean seriously growing on me.  I have some ideas on playing with Scott's recipe.  I would like to power them up even more by replacing some of the flour with hemp powder.  Raw sunflower seeds could be added as well and would give it a little crunch.  I think a 'blonde' version of them would be good too and instead of the cacao powder I will try some cinnamon and other spices and maybe add some apples for part of the beans.  The possibilities are endless.  I especially love that there are beans in the recipe as I am determined to get those into my diet daily.  It's a great snack and one that I will be making quite frequently. 

It would be nice to slice these bars up and have at the ready in the freezer.....in case you have to go to the hospital where they may or may not feed you.  ;-)

NOTE:  I didn't have the dried fruit that Scott uses in his recipe, but that would give it a bit more sweetness.  I also didn't use the maple syrup, but did use a bit of agave.  I'd like to replace that with dates.



Sue, feeling pretty damn good these days, in Ohio


6 comments:

  1. So you still have to guess what caused your pain in the first place...
    What a story!
    Do you intend to have a gastroscopy?
    I really hope, I never have to enter intensive wards.
    You write wonderfully. Waiting for the lessons learned! Thank you for sharing!
    Silvia

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    1. Yep....still have to guess. Crazy, eh? A scope is an option, but at this point, I'm not planning on having that done. My body seems to be healing very well and I figure the less involved I am with the traditional medical world the better!

      I am pursuing some 'alternatives' which I'll write about in the next post. It's been fascinating learning.

      I really, really, really hope you never have to go to an E.R. either!!!!

      Thanks for reading and thank you for the very kind words....I'm a 'writer wannabe', so this blog is partially ful-filling that dream for me.

      Take care!
      Sue

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  2. OMG Sue! So glad you are feeling better! How scary! You are right, you couldn't make this stuff up. Life is sometimes stranger than fiction!

    Take care and stop by Lowe's to see me at least!
    Gale

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    Replies
    1. Thanks, Gale. Will do. Gotta look for a scratch 'n dent frig for the garage anyway. My husband goes a little crazy when summer harvest starts and he opens the frig to find a 'sea of green'.

      Take care,
      Sue

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  3. Hope you are well and writing ...
    I am really curious to read about your learning experiences!
    Silvia

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    Replies
    1. Hey Silvia,
      Thanks...am doing very well. Have quite a bit written up...trying to organize it. Hope to get the first part up in the next day or so.
      Take care,
      Sue

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