Saturday, March 12, 2011

Hi-Ho, E.R. here I go!

I went to the ER because I have heart, lots of heart. In fact the problem was the imminent eruption with bits of my heart over here, and some over there, and a bit on the monitor. The high blood pressure wasn’t helping.

One ER male doctor, Dr. GungHo, was a combat action junkie and charged everywhere. He was shouting out stuff: central lines into me, IV’s, blood draws, more blood work and an in and out (you don’t want to know that unless you like catheters so much you want to have straw stuck into your bladder).

I had waited a bit, you know how things are, so much to do before dying. But after three and a half days and all the heart pills I could take without flatlining, it was time. E.R. we go! The downside of delay is that I had this red haze in the brain and eyes, I couldn’t speak clearly. This made a comedy of ‘Who’s on first’ with Linda giving me ‘break pack’ of emergency ice in the wait room as I tried to explain having a “HEART attack!”. Which must have come out like “‘eak ‘ack”, another time, falling OFF the ER bed they transferred me to, I asked her to ‘Raise the bed arm.’ As I was about to fall over.

“You have a bad arm?” Linda asked, as I leaned closer toward a 4 foot drop and face plant.

“Hospital bed, raise arm of hospital bed!” I tried to speak slow and clearly.

“Raise your arm above your head?” Linda asked with a puzzled look, but started doing that, and eventually raised my arm above my head, while I finally fell over and indicated what I wanted by knocking the side of my head against the lowered hospital bed arm.

‘RAISE, please!”

“Freeze? You need a blanket?”

I groaned in agony and tried other words, “LIFT!” “UP!” and she got it and got me into the bed. Just in time for Dr. Gungo to get his adrenaline fix for the day by charging my bed with two RN and someone who just ran off to do what he shouted.

I tried to let the person in front of me in the lounge in first. I mean, he had a bag hanging out of him with blood coming down the tube. Which is a bad sign in my book. I tried to say, ‘take him’ except I could only see out of one eye and couldn’t spot him. Plus my speech was interrupted by groans as y heart was at 70% erratic by this time, and I wasn’t breathing but coughing and choking, sometimes not breathing at all.

Dr. GungHo was at the end of the bed yelling, “When’s the last time you coughed up blood?” I was showing the blood that came from my nose and ears, but he was obsessed and then when I got him to understand it was just food and phlegm as I aspirate, he started yelling for chest x-rays. I tried to explain about the needle phobia, but with four people in the curtain and Dr. GungHom who was trying to hold me down, thusting his face forward almost into mine and telling me he didn’t give a damn out my needle phobia. I kept thinking, “Uppercut or choke the trach?”
But the RN female, RN Busy, was on my left distracting me from levelling Dr. Gungho, as she was saying, “No, I don’t have a needle” while she had the rubber arm wrap and a LONG, THICK main line needle in a sterile holder in her hand. I kept pointing to the one good vein (right arm elbow) but Dr. GungHo was shouting, ‘Put it straight into the hand!” with that 'no time, no time!' tone.

Oh God! A little too much drama.

I tried to say how, I bleed out, the hand veins spontaneously bleed, and are not strong enough to hold a main line. But that was too much so I said, “Needle phobia, PHOBIA: Needle here, Beth go away, I scared hit you.”

This must have got through as she told me she would hit me too as she took kick boxing.

“Y?” I asked, meaning the woman who taught kickboxing for women there. She was surprised but said yes, we bonded, almost decided to bout a little then she decided that my right elbow was the only vein strong enough. Dr. Gungo kept shouting orders and swept out of the curtain area to go get a x-ray machine or something. I asked RN Busy what was up with him. She did an eye roll with "Men. Hurry, Hurry."

Dr. Gungho rushed back, to find out why I wasn't already with an IV in me, and a main line and some blood work and 'push'. He was up in my face and trying to hold me down, while RN Busy kept saying, "I'm not doing anything" while getting the area prepped for a needle. Since they were on either side, I kept doing wrist turns to free my hands and arms from Dr. GungHo, trying not to punch his head several times in a second, as he wouldn’t let me finish a single sentence. The RN was deflected by Linda and during all this the monitor kept making these ‘look at me!’ loud beeps. It did this when I stopped breathing, or flatlined for more than 10 seconds, and I looked over to see waves of erratics with my heart rate over 150 bpm resting (well, not restful), both the lower and upper chambers were erratic.

Linda looked over and saw what we call ‘the jackpot’ when they all come up the same and was saying to herself, "Oh shit, oh shit". Heartrate 145, systolic 145 and diastolic 141. They will say you can’t have the systolic and diastolic that close, but it happens with autonomic failure. My systolic was up at 190’s for a while, which is nose bleed, brain bleed time. I guess it was good to be at the ER after all.

RN Busy was about ready and I said, "Butterfly insert, we have a protocol." And she just gave me 'the gaze'. I said, "At least tell me it will be a small needle." in a pleading, 'just lie to me' voice.

"Well, it won't be as large a needle as it COULD be." She said with an odd glee.

Oh vey, trauma ahead.

When I was brought in, they wheeled me to the wheelchair transfer bed but once I was fully transfered someone realized the heart monitor there was broken. There was much swearing. I was at the edge of the ER room and the intake room, where I sat/lay with my top off, and six main heart monitor 1 inch square leads, along with a dozen thin leads, all leading off to a monitor they hurriedly rolled in. Dr. Gung Ho’s assistant grabbed my oxygen concentrator, and ripped our air canula off in order to reach the intake in the next bay (Geez, are cut backs so bad they steal medical supplies from patients?)

By this time, due to the heat, I looked all over like I was a goth let out in the sun for the first time, bright red burn looking on my arms, my face, and my upper chest. The couldn’t seem to get the ‘can’t sweat’ so Linda broke another break pack and whapped it into my groin. Uh….thanks?

The pain in my chest was crabs with razor claws, demon machine crabs hacking me up from the inside. Bad Demon crabs! And it hurt to breathe. Oh, maybe if they killed the demon crabs, the needle wouldn't be that bad. No, it would be bad, both were bad.

Suddenly Dr. Gungho and most people got yanked as Dr. Cool came in, with my chart. Dr. Cool was not in a panic, nor was he yelling out everything for the ER to hear. He had been going over the notes on my disease and realized that it was not a structure problem, but an electrical problem. He gave me morphine and ativan and the RN Busy, who was yanked was telling the other RN on the other side of the curtain that I was a word that meant both agitated and mentally out there. This pissed off Linda, who was right there. Dr. Gungho later read the chart and apologized to her (or rather he apologized about the way he had treated me, but not saying sorry to me, but Linda).

Dr. Cool had three hopes: 1) medical intervention with drugs (he gave me the morphine to take the edge off the pain so I could talk) 2) IV, and being admitted to figure out later or 3) a chest charge and then start again. A chest charge is when they use the things they zap people with who have died, or flatlined, only I get it while awake. Personally, with the erratic and flattening I was presenting, and the exhaustion, I didn’t think I could hold the charge. Which means the charge would make my heart stop entirely. So this was not a first option for me but a last.

I could, now with the morphine, speak and be understood. Dr. Cool said he would try a non-invasive approach and gave me a different type of beta blockers, not the maximum but combined with what I had taken about triple my dose. He told me that these beta blockers were the ones preferred by pro golfers. I checked and he is right, golfers use them to stop the shaking from adrenaline while putting, as do expert musicians to calm the nerves that might affect performance.

He gave them, not much happened, Nurse Busy came back and I was now able to talk to her and explain how my hands spontaneously bleed, so that was a bad choice for and IV. She kinda freaked about that, which surprised me as it is common in seniors toward the end of life. She kept saying, “Yes,” and “oh right” when I talked about not sweating but put me down as ‘agitated and flushed, with skin dry’ on the chart. I asked her later and she said, “Oh, I just kept saying ‘Yes’ to talking while I do my assessment of patients, it lets me do my job in peace.” - great. She is the kind of RN I hate, as they don’t listen, don’t care, and don’t value any info the person might have.

Dr. Gungho was the same, and treated the patients like they were junk information compared to his all knowing eye. As I was leaving indicated it was the not the beta blockers that fixed me, but the anti-anxiety aspects of them (Linda declared him: asshat!)

Dr. Cool was not only professional, but also, patient as my heart finally, after two hours accepted the new drugs, and stopped the erratics.

“What happens in six hours?” I wanted to know. Or what happens when I don’t have these drugs.

He thought the heart erratics were a flare up, but I should see my GP. Or maybe he couldn't do anything else now they were gone, and either be admitted full time to the hospital or hope for the best. Problem was they ‘flared’ for three days and a half, and since then, I have had over 25% erratics on all of my heart monitor readings (taken several times a day). And my GP is gone until May 5th, Linda says. "But did you want to stay in the hospital?" She asked.

"Hell no."

She says the GP appointment is a long time away, but next week, she will get a boost of medication from the locum.

Dr. Cool was happy that he did it without needles, though I knew coming down that an insulin test and bloodwork was likely. I was happy too. And what was best, was Dr. Cool did it all from the first with all the shouting and background noise with a high tech hearing aid in both ears. Yes, he was hearing impaired, and a better doctor. Maybe it was the lip reading that helped him understand me better, that and the morphine allowing me whole words without groaning.

Nurse Easy came in and was there to give me my ‘in and out’ to get a ‘pure sample’ of urine from my bladder. I asked her if she had gotten one (the 'in and out' catheter). She said she had ‘many times’.


I asked why exactly, if she didn’t mind telling me (was this a medical or sex thing?). She didn’t understand why it was strange. I said, that anyone who can feel down there and puts that in a lot must have SOME reason, with a raised eyebrow look.

Oh, no she had DONE it to OTHERS many times. Oh, not so great.

After leaving I told Linda, ‘If I had know my vaga was going to be on display for most of the ER staff and walk-by’s, I definitely would have done a clean before leaving the house.” She nodded in agreement. This was not the time any woman would want to have a few bits of wet cheap TP stuck here and there. Due to our Toilet paper scrounging, I had been using the ‘touch wet and half dissolve’ horrid stuff they seem to stock in public restrooms – the ‘half ply’ TP.

I was wheeled out by Linda, covered in medical litter. Linda who falls in the ‘loves to rip band-aids off of others’ camp of the world (sadism my dear, a touch?), got to play ‘strip, hunt and rip’ with the 18 different pieces of bonding leads they had on me once we got home.

At home Linda helped me change into a sports bra then it was up at boxing. There I explained my exercise strategy to the new coach filling in while Ian is gone. It is based on the old Willie Wonka and the Chocolate Factory. There is that girl who gets purple in the face and blows up because she eats the ‘not quite perfected’ everlasting gobstopper. The Coach knew exactly what I meant, he remembered the film well. I said, “I have double mats, and get rolled from push ups to sit up, until my face looks like that level of red/purple” – I did 85 pushups and 135 sit-up, including an additional 20 push ups with my knees above me, on the wheelchair and 30 sit ups with my legs to my knees in the chair, while I lay on the mats. I was trying to sit up, kiss my knees and hold it.

As the coach said, “You get the most extreme core workout of anyone.” Then onto the heavy bags where I did six punch combos at speed, after warming up with 100 jab/cross combos as a southpaw, and 100 as a righty. Then working with my partner, speed and heavy combos until the sweat dripped off, and my hospital tag was whizzing round my wrist.

As strange as this may be to understand, I do what I need to in order to survive, so I can ‘live’ and reach a place where I can dream again, hope again – which isn’t now.
I had waited three days because I hoped the erratics were temporary, but the pain kept getting worse. Then, each day, I needed to go to ER but wanted to get 'just this meeting' done, or 'just that' done. Once I decided it HAD to be, I still waited until Linda woke so that I could get a ride to the ER, with her assistance, in a cab using transport saver coupons I bought two years ago. That way she could stay at home and do the job application. She took me to the E.R. instead, and I had my emergency ER coins for either the cab tip or the parking meters (we used them all on this trip). A ride in the Ambulance would have saved me 40 minutes in filling forms and transport but we would have been billed $60-85. And we didn’t have $60-85.

I wheeled up to boxing because if I don’t sweat and push the blood around I go downhill quickly. The high blood pressure and heart beat of exercising draws the blood from the edema in my legs, and pushing it into the capillaries. After a month without it, my arms and hands are pale to transparent, I am unable to be in any temperature change without passing out (like the ER for example, I was able to stand the warm because I go boxing), and I start bleeding from sores opening up from the Edema.

My tripling my heart meds shows a recorded degeneration of the central autonomic system. I hope they can use that to get me a pace maker or some permanent electrical solution. Yes, exercising after the ER is a risk, waiting to go to the ER is a risk, but without the security of funds, and now, at the tail end of this disease there is nothing left but risks. And I try to make the smart ones that will keep me going as many weeks or months as I can. (oh, and Linda submitted her applications on time that day, as well as the applications due the next day as well)

I hope this weekend to be able to get out to the French Food Festival, but also do a few postcards to all the friends who have been helping me feel not completely alone. It really helps. And I hope you have a great time. Let me know what you are up to, or share some ER story, and I will try to reply to every person. I do all I can, and when I don’t, that happens when I am physically unable to get to the computer. You’re my friends, why wouldn’t I want to share this with y’all.

Pssst!: We took several rolls of the heart monitors showing the erratics with us so we can show the doctor and heart specialist. And I took pictures post boxing of Edema gone bye-bye and later this week, pictures of ‘bloated goat foot’ as a compare contrast, just like show and tell in first grade!


Kita said...

Jesus, Beth - i don't know how you do it. To have had that ER experience and then go boxing - you have more strength in you than you know! You are an amazing person, I hope you know that. I look up to you in awe because you show how it is done. Honestly, I love you just because you are you. Amazing.

Neil said...

Don't you just love doctors who don't understand or listen to their patients?

You are amazing, Beth. Crazy-in-a-good-way amazing. That's why I love you so much, O Internet Niece.

Going boxing after that ER visit sounds almost peaceful. And I'm glad you're still here to blog about it.

Love and zen hugs,

Kate J said...

Only you could recount that whole ER episode and put such humour into it. Dr Gungho, Dr Cool and Nurse Easy! It must have been horrific, for you and for Linda too. I have never had to go to (or as we call it here A&E) for myself, and though I've taken people there it has never been anything really serious. Amazed you were able to box after that... but really glad you did.

Just now watching TV news of the awful scenes from Japan, people's smashed homes, whole towns swept away... unbelievable.

Love & peace

Lorna, Bob and Liam said...

Fun and games at the ER... NOT. Glad Dr. Cool came along, he sounds like an island of sanity in the whole experience. Yeesh.

Boxing sounds... amazing. Glad you managed it, although after the ER... well, actually, maybe it was a bit cathartic? Given you restrained yourself from justifiably punching out Dr. Gungho.

Hang in there...

wendryn said...

Oh my dear. Sounds like a seriously harrowing experience. I wish you could find doctors who listened better.

I'm glad you went boxing and glad you got some circulation moving again. I hope it helps keep you on the right side of the dirt for a while longer. *hugs*

tinarussell said...

Yeah, freaking doctors and their messiah complexes. They need to chill out. Some doctors seem like they must feel the need to PROVE all those years in med school and such make them gods on earth or something. I’d like to slap them all.

Hooray for us difficult patients, the ones who stand up for what we want and what we need. We need to stick together :)

Bonnie said...

Wow. Just, wow. Most of that post left me speechless.

But I do have to say I like the first picture. It took me a minute to get it: she's taking her gloves off, right?

Elizabeth McClung said...

Kita: I don't know how I do it either, I try not to think but just do, as it helps lower the pain. I think most people could do maybe not this as they are more sane than I, but amazing things. Thanks for your love, it helps me.

Neil: Yeah, the doctors should try listening instead of assuming, though looking at the tape later, I would have been freaking too.

Kate J: I tried to write it, Linda said that is how it was, but she wanted to read on to find out what happened next. I am glad I got the boxing done and now can recover - photo's from hospital and my heart tape from the hospital soon!

Lorna, Bob, Liam: I am SO glad Dr. Cool came, or I was hooped, as that was one BIG needle.

Wendryn: Exactly, just trying to keep on the top side of the dirt.

Tina: yes, I was glad that this time no one died next to me, and I didn't die - and Dr. Cool came and got the job done.

Bonnie: Yes, she taken her lace glove off with her teeth, which is how I take things off now, and I think is ready to unleash some hurting. I was speechless too - still recovering from all the erratics, flatlining and the rest.

Baba Yaga said...

Save us from that medical view that the patient is not only an idiot, but an idiot and a hysteric.

And thank goodness for Dr. Cool. I have a soft spot for medics who share bits of information such as that about the golfers.

You have a genius for retaining your humour and your sharpness where most of us would just be gibbering. It sounds truly ghastly.

Boxing afterwards - somehow, I am not surprised. I even see the logic, but it's a logic few would ever manage to have worked out, or to apply.

Raccoon said...

Boxing right after the ER? That kind of makes for tight timing, doesn't it?

When I was in ICU, ever so long ago, before they gave me a tracheotomy, I had two tubes tucked down my throat, so I couldn't speak. Instead, while trying to chew through the tubes, I was doing the whole "blink-spelling" thing.

Do you have any idea how hard it is to blink-spell the word "doozy?"

Elizabeth McClung said...

Baba Yaga: The best medical and quality of life return possible. Thanks for the comment, I try to keep my head, even in pain when all about me are losing theirs. But then, I am used to the feeling. After it had calmed down, RN Busy ran back to ask, "How would you have rated that pain out of 10?"

Seriously! Then went on to ask, "Would you call it stabbing or aching?"

Please, someone get that outdated model canned!

Raccoon: Actually yes, as I had a prolonged case of locked-in where I could not move my one eye that was open, it was at a fixed point. I could blink S.O.S., but no one ever got the blink system for over an hour. After that, they prefered to 'guess' after one letter than let me spell it. I didn't spell 'doozy' though - I did find I was choosing shorter words after the first sentence.

Waking up with a trach is a fear, is it a realisitic 'bad' fear, or just another thing to get used to?

Vanessa and Gang said...

1. LOL @ Asshat!

2. Thank God for Dr.Cool!

3. Only you could come out of the ER and still kick ass and take names!

P.S. The Bandaid Brigaid might do better if they use mineral oil to unstick the leads and bandaids instead of ripping. I use a Qtip to roll the edge up and do the entire underside with mineral oil. A lot less painful that way.